4 Common Trauma Concerns for Children

by Jennifer Jordan

As parents, we attempt to keep our children safe as soon as they are born — nestling infants in rear-facing car seats, putting them to sleep on their backs in approved cribs, and child-proofing our houses. These behaviors seem natural; yet, they are only a prelude to maintaining safety and minimizing accidents throughout childhood.

The Center for Disease Control (CDC)’s Injury and Prevention Control reports that non-intentional injuries are the leading cause of death among children. Every four seconds, an emergency department treats a child for injuries, and every hour, a child dies from an injury.

According to Leigh Ann Scates, Trauma Coordinator at Wadley Regional Medical Center (Wadley RMC) in Texarkana, Texas, the most common childhood injuries result from suffocation, drowning, poisoning, falls, and motor vehicle accidents, which are the leading cause of death among children aged 5-19 and the number one cause of death at Wadley RMC. The CDC shows similar national statistics. Head trauma from bicycle accidents is the second most common injury after car crashes.

All of these statistics are alarming and can feel overwhelming, especially if you have adventurous children who like to scale kitchen cabinets and leap from the top of the monkey bars. Learning how to avoid injuries is essential. The key is to be aware of risks and to take recommended precautions.

1. Motor Vehicle Safety

Nearly 73 percent of child safety seats are improperly installed or used. Almost one-half of children aged 14 and under who died in a car accident were not restrained at all, according to Scates. Correctly installed and operated child safety seats reduce the risk of injury up to 71%.

Review your safety seat manufacturer’s instructions to ensure that your child’s seat is installed properly. If you are buying a used car seat, check the expiration date of the seat.

The American Academy of Pediatrics recommends that most children ride in rear-facing car seats until the age of 2, forward-facing car seats until the age of 4, belt-positioning booster seats until the age of 8, and that children wear shoulder and lap belts when they have outgrown booster seats. Children under the age of 13 should ride in a vehicle’s rear seats. Parents should heed these guidelines and also follow the laws of their state.

Texas requires a federally approved passenger safety seat for every child who is under the age of 8 and whose height is 4 feet, 9 inches or less. If a child is over age 8, or is taller than 4 feet, 9 inches (even if he is not yet 8), he does not have to be restrained in a child safety seat, according to the Texas Department of Public Safety. However, Texas law requires lap and shoulder belts for anyone driving or riding in a vehicle, regardless of age.

Under Arkansas law, a child must ride in a federally approved safety seat until he is at least 60 pounds and 6 years old. Anyone under the age of 15 needs to wear a seat belt in Arkansas.

2. Preventing and Curbing Injury from Falls

Wadley RMC’s most commonly seen injuries are those from falls, whether due to sports, use of ATV equipment, or recreational activities such as bicycles, scooters, and playground equipment, explains Scates. Wearing proper gear while playing sports is important. Children should always wear well-fitted helmets, knee and elbow pads while riding any type of wheels. Scates emphasizes that children should wear brightly colored clothing, ride as far right as possible to the flow of traffic, and obey all traffic signals, making sure to look at both sides of the street before crossing an intersection.

Parents should check playground equipment for safe conditions and properly working parts. Soft bedding such as sand, rubber, or mulch is the best groundcover for playgrounds. Parents and caregivers should ensure that children play only on age-appropriate equipment and that they are consistently supervised during play.

Dangerous falls can also occur inside. Children can easily use drawers and knobs to pull themselves up onto furniture, which can fall on top of them. Secure to the wall any dressers or other furniture suitable for climbing. Use a bed rail as children transition out of their cribs and toddler beds. If children’s rooms are on an upper level, lock all windows in their rooms and keep away any objects that can be used to access windows. Screens alone are not enough to prevent a child from falling through. The Kids Can’t Fly Campaign recommends installing child safety window guards and always supervising children around windows.

3. Water Safety

The hot months are also ripe for childhood accidents, especially around water. Wadley RMC sees an increase in near-drowning and drowning accidents during the summer. Children should always be supervised around any body of water. It is customary to hear much noise as children play in water; a too quiet child in water usually signals trouble. Parents and caregivers should be aware that drowning victims often suffocate silently, unable to splash, wave or yell for help — also know as the Instinctive Drowning Response, coined by Francesco A. Pia, Ph.D.

Children who cannot swim or are not strong swimmers should wear U.S. Coast Guard-approved life jackets at all times, whether they are at the beach or pool, or on a boat, or near a lake, river, or stream.

The American Academy of Pediatrics recommends that children younger than 6 never be left alone in a bathtub, or in a bathroom if there is water in the tub. Drowning can occur in as little as two inches of water. Always drain tubs immediately after use, and keep a non-skid mat on the bottom surface of the tub or shower to minimize falls. To avoid burns, spout covers should be used to prevent little ones from turning on hot water, and water heaters should be set below 120 degrees Fahrenheit. Toilet locks should also be used to prevent curious infants and toddlers from drowning.

4. Household Safety Tips

Keep these items locked in a cabinet:

All medicine, including over-the-counter medicine
All cleaning products, including any product containing chemicals such as laundry detergent, paint and fertilizer
All alcohol

Keep these items out of reach of little hands: