By Rachel Hoeing and Tracy Beatty, Emergency Medicine RN

Summer is in full swing! As we enjoy the outdoors, the sun, the beach, and the pool, we also tend to get a little lazier at this halfway point. This tends to be the time of year that unfortunately many families make trips to the Emergency Room as a result of outdoor accidents. One of my good friends and fellow mommy confidantes, Tracy Beatty, has worked as an RN in the Emergency Room for more years than she can count. Her husband, Mike, is an ED physician. Between the two of them I knew they had seen more children come in and out of the Emergency Room than they had ever wanted to witness. I asked them to share with us some of the most common reasons they see children in the summer months. They also gave us advice on how to hopefully prevent these accidents!

Bicycle/Skateboard/Scooter Accidents

The weather is warm and the kids are ready to enjoy the outdoors. In all of the excitement it is very easy for parents and children to forget the most important thing they need while biking, skateboarding or scooter-riding, a helmet. Did you know that wearing a helmet can decrease a child’s risk of head trauma by 85%? It is the most important preventative measure you can take to keep your child safe when participating in these types of activities. And remember, children learn best by observing you. Whenever you ride, PUT ON YOUR HELMET.

• Never ride a bike, skateboard or scooter near traffic.

• Use your helmet on every ride. No matter how short or close to home. Accidents happen in driveways, on sidewalks and on bike paths, not just on streets.

• Buy a bike that is the right size for your child. “Oversized” that you feel they may grow into are especially dangerous.

• When purchasing a helmet look for the sticker that says the helmet meets the CPSC safety standard.

• A helmet should be worn so that it is level with the head, not tipped forward or backwards. The strap should be securely fastened, and you should be able to move the helmet in any direction.

•All skateboarders and scooter-riders should wear not only a helmet but other protective gear. Wrist guards are particularly important while participating in these activities. When a child falls it is natural to reach out to brace themselves resulting in wrist injury.

Playground Injury/Accidents

During the summer we all spend a great deal of time on the playground with our children. Falls account for 60% of playground injuries. Whether they are in our backyards or at a public park we as parents need to be very cautious of the equipment and surfaces we are allowing them to play on. We want them to run like mad and have a great time, but we do want to keep them safe and injury free.

• Parental supervision can decrease our child’s chance of injury significantly. PLEASE always know where your child is on the playground so you can redirect any activity that may result in injury.

• Always make sure the equipment is age appropriate.

• Since falls are the biggest threat on playgrounds the protective surface is very important in injury prevention. There should be loose- fill materials (shredded rubber, sand, wood chips or bark) maintained to a depth of at least 9 inches. The protective surface should be installed at least 6 feet in all directions of the equipment.

• Make sure to always check metal slides are cool to prevent children’s legs from getting burned.

• I know this statement will get a great deal of fuss from lots of parents out there but here goes. Never let your child play on a trampoline. Concussion, spinal cord injury and death have occurred in children on trampolines. If you are going to allow your child to use a trampoline, make sure it has a high surrounding net, springs and bars are properly padded and most importantly never leave them unattended.

Lawn Mower Safety

I know this is an odd one, but I can’t tell you how many kids we see in the ED that have been hit by a lawn mower. A majority of these cases were unintentionally inflicted by a parent or grandparent. The most common lawn mower injury we see is amputation of the toes or foot. These injuries are pretty simple to avoid by using two simple rules.

• KEEP KIDS OFF THE RIDING MOWER. I know it is tempting to give the kids a fun ride on the mower but it is very, very dangerous. If the child looses balance and begins to fall the driver instinctively will bend down to catch them. Whether this is from the left or right your hand that is left on the steering wheel will unconsciously turn the mower in the exact direction the child has fallen hence running them over.

• KEEP KIDS OUT OF THE YARD while mowing. As we all know, kids are fast and can approach the mower quickly not realizing the dangers and accidentally be hit.


We all love being around the water in the summer, and no one loves it more than children. Whether you are on the lake, at the beach, or at the pool parental supervision is a must when children are present. Some children may simply be reaching into the water to retrieve a toy. Some children may be good swimmers but simply get overwhelmed or tired in the water. Enjoy the water this summer with your family just remember to never leave your children alone, even for a moment.

Overexposure to the Sun/ Heat Exhaustion

Enjoy the summer sun, but do so knowing the risks and signs of sunburn and overexposure. Did you know most kids rack up between 50% and 80% of their sun exposure before age 18? It is very important for parents to teach their children how to enjoy the sun safely. Sun safety includes protection from burns, dehydration and heat exhaustion.

• Babies under 6 months old should not be in the sun for long periods of time. If going out in the sun is a must dress the baby in lightweight long pants, long-sleeved shirts, and a brimmed hat that shade the neck.

• For young children use at least a SPF 15 and apply 30 minutes before going outside, even on cloudy days. You want to look on the sunscreen bottle to make sure it will protect against UVA and UVB rays. Don’t forget to reapply every two hours, after swimming or sweating.

• Same rules apply for older children regarding sunscreen use. You do need to remember to apply enough sunscreen for it to be effective. A young adult typically need at least one ounce of sunscreen applied to all exposed areas.

• Don’t forget sunglasses! Yes, your eyes can get sunburned. In just one day out in the sun without protection can result in a burned cornea. Make sure to purchase sunglasses that have a label stating they block 99-100% of ultraviolet rays.

• When children are participating in any intense activities, games or sports, you must keep them well hydrated. Light clothing should be worn and frequent water/hydration breaks should be mandatory. Avoid juice or sodas for hydration, stick with water, Gatorade or any flavored sports drink.

• Signs of heat exhaustion include nausea, vomiting, fainting, confusion, diarrhea, unexplained fever higher than 102 degrees. Seek immediate medical attention if your child exhibits any of these signs during or after sun exposure.

Other less common injuries but important none-the-less…

1. Keep fireworks away from children. They can cause significant burns and injury.

2. We all love to open our windows and let the fresh air in during the warm months. Those parents, who have two story homes, please open windows from the top not the bottom. Children can fall through the screen with very little force. Also keep windows clear of furniture that a child may climb onto and fall out the window.

3. Allergies/asthma visits definitely go up in the ED during the summer time. Please keep your child’s medicine updated and a supply readily available if your child needs it.

We hope this is some helpful advice as you unleash the kids to go crazy outdoors this season! A huge thanks to Tracy and Mike for their words of expertise and their wealth of information!

  • Some information provided by “Guidelines for Summer Safety,” by the American Academy of Pediatrics.