What E.R. Doctors Wish You Knew

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Scary Stat: Drowning is the second leading cause of injury-related deaths in children, claiming more than 1,000 young lives per year. More than half of these accidents occur in the child's backyard pool, and one third happen at the home of a friend or relative.

Listen to the Doctor: "Drowning is a quiet killer. Your child will not start flailing--he'll just go under. A common scenario is that a bunch of adults get together, and no one's really watching the kids. The need for constant supervision cannot be overemphasized. If you have to turn away even for a second, another adult should watch the child. And all parents should know CPR. If you have a pool, surround it with a tall fence with self-closing and self-latching gates. But fences are not foolproof. Another fact: Small children can drown in an inch of water, so wading pools, bathtubs, buckets, diaper pails, toilets, spas, and hot tubs all pose a risk. Think supervision, supervision, supervision."--Alan Nager, M.D., director of the Division of Emergency and Transport Medicine at the Children's Hospital of Los Angeles

Find Out More: For excellent tips on how to prevent drowning among kids of all ages, consult the National Center for Injury Prevention and Control at www.cdc.gov/ncipc.


Scary Stat: Some 1 million children a year are victims of child abuse and neglect in the United States--and most experts agree that the problem is underreported. Head trauma, including shaken baby syndrome, is the leading cause of child-abuse death among children.

Listen to the Doctor: "If your gut feeling about a caretaker tells you that something isn't quite right ... well, something probably isn't. There can be abuse with no external signs. If you pick up your baby from day care and he seems unresponsive--or he has a weak or high-pitched cry--that could be a sign of shaken baby syndrome. Your caretaker may also tell you that she put the baby down to sleep and just couldn't wake him up, yet there's no history of an accident. With external marks, look for pattern burns or bruises in places where toddlers wouldn't normally bump. The middle of the back, the abdomen, and the buttocks rarely get bruised unless there's abuse." --Kathryn Emery, M.D., emergency-room physician at the Children's Hospital in Denver

Find Out More: For detailed information about how to detect child abuse, log on to www.kidshealth.org.


Scary Stat: Each year, 4,700 American children are taken to the emergency room after falling from a window, mostly at their own home.

Listen to the Doctor: "Parents should know that a screen is not sufficient to keep a child from falling out of a window. And they should also be aware that even a fall from a first-floor window can kill a child. Here's how to cut the risk: Do not put furniture by windows, since small children can climb onto a windowside chair or table and tumble out. If you have double-hung windows, open them from the top rather than the bottom. Open a window from the bottom no more than four inches. And install child-safety window guards, which are the best prevention of all."--Karen Sheehan, M.D., medical director of the Injury Free Coalition for Kids of Chicago, at Children's Memorial Hospital

Find Out More: Log on to the National Safety Council's Website at www.nsc.org.


Scary Stat: According to the National Burn Information Exchange, scalds are the leading cause of accidental death in the home for children under 4, and scalding accounts for 40 percent of the burn injuries for children up to age 14.

Listen to the Doctor: "We see a lot of second-degree burns caused by boiling-hot liquids in the kitchen. Typically, a child will hit a pot handle on the stove and the contents will splatter her. And sometimes parents will misjudge the heat of bathwater. Pots should be on the back burner with handles turned away, and you should never put a child into a bath while the tub is still filling, or without checking the water temperature first. (Keep your hot-water heater set no higher than 120°F.) Any burn that blisters, has destroyed the top portion of the skin, or involves the face, hands, feet, or genitals should be examined by a doctor. Such burns are prone to scarring and carry a huge risk of infection. To ease the pain before you get help, run cool water over the burn for 10 to 20 minutes. Then cover the burn with sterile, nonadhesive gauze. Don't use ice, butter, or ointment. If there's a blister, don't pop it; it helps protect against infection."--David Bank, M.D., medical director of the Pediatric Emergency Department at Phoenix Children's Hospital

Find Out More: For a complete rundown on second-degree burns, log on to the University of Iowa's Virtual Hospital at www.vh.org.


Scary Stat: Children under 3 are at greatest risk for choking, suffocation, and strangulation. Airway obstruction is the leading cause of death in children younger than a year.

Listen to the Doctor: "Babies and toddlers put everything into their mouth. Certain activities pose an even higher risk for choking, including eating while walking, running, or laughing. Don't feed a small child hot dogs, whole grapes, hard candy, popcorn, nuts, raw carrots, or apple chunks, and make sure all food is cut into small-enough pieces. Older siblings can be careless about leaving dangerous toys or small objects (coins, marbles, balloons, pen caps) lying around. If the object gets stuck in the trachea, the child can lose consciousness. By the time paramedics arrive or the child gets to the E.R., it could be too late. So parents need to know basic life support for both infants and toddlers." --Barbara Peña, M.D., attending physician at Miami Children's Hospital

Find Out More: Most hospitals offer classes in CPR. You can also check out the American Heart Association's course by calling 800-242-8721 or logging on to www.americanheart.org.


Scary Stat: Since 1996, more than 150 children have died from hyperthermia as a result of being locked or trapped in a hot car. According to a 2002 Safe Kids?GM survey, one in five parents rarely or never locks his car at home, which means kids can climb in to play--and that spells danger.

Listen to the Doctor: "Parents must lock their cars at all times--even in the driveway or garage--and hide the key, because kids could sneak off and play in the car. In hot weather, a car can heat up to 160 degrees in minutes. This can also happen in cooler weather--when it's as low as 60 degrees--though it takes a little longer then. Another important caution: Parents will sometimes leave a child in a locked car in a supermarket parking lot, run in, do the shopping, and come out to find the child suffering from heat exhaustion or heatstroke. Please, take your child with you!"--Bob Wiebe, M.D., medical director of the Emergency Center at the Children's Medical Center in Dallas

Find Out More: Log on to www.safekids.org or www.gm.cm.


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