About 150,000 individuals visit American emergency rooms each year for injuries caused by closing car doors, says the National Highway Traffic Safety Administration. Many more such injuries are treated elsewhere. More than half of the victims are children less than 14 years of age. Severity of injuries ranges from minor to those requiring surgery, including (rarely) amputation of parts of one or more fingers. Other non-traffic injuries involving children include: falls while entering or exiting cars; falls from the exterior of vehicles (the result of climbing on cars or adults momentarily placing infants in car seats on the hood, top, or back of cars); lacerations from sharp edges on bumpers or license plates; and being struck by someone opening a door or tailgate.
Parental common sense, awareness, and supervision are the only antidotes to such injuries. However, there are recommendations for preventing accidents related to taking infants in car seats in and out of cars – an act which injure thousands of adults each year. That is the subject of our next posting.
Crying infants and unruly children may be a greater distraction for a driver who is the only adult in a car than are texting or using a cell phone. Undisciplined and unrestrained pets also present problems.
1. Distraction of all kinds cause 80% of crashes and 65% of near-crashes. Distractions contribute to 16% of all fatal crashes, leading to around 5,000 deaths every year. Children are four times as distracting to drivers as are adult passengers, and infants are eight times more. The more kids in the car, the greater the likelihood problems occurring. In Australia, one in five parents report that actions by their children led to an accident or a “near miss,” with men reporting being distracted more than women.
2. Routine driving distractions are compounded by misbehaving children. Before setting out, check your fuel supply. Are you going on a route you are unfamiliar with? Frequently having to look at a GPS or stopping to check maps are major distractions. Do you know where you are going to park? What is your next step after you take the kid(s) out of the car? Honking at friends causes mishaps; don’t do it even if children ask you to.
3. There are three main types of accident-causing distractions. Tending to children figure in all three – often simultaneously:
● manual – moving your hands from the steering wheels.
● visual – focusing your eyes away from the road.
● cognitive – letting your mind wander away from concentrating on driving.
4. Be aware of your own distractions. Being angry or upset, having a headache, or being sleep deprived adversely affects driving skills – and probably lowers your threshold for kids getting under your skin. Being aware of how you feel may help alleviate the negative effects of the kids’ behavior. Adverse effects from medications you take for your symptoms may further impede your ability to drive safely.
5. Prepare yourself mentally to ignore crying and tantrums. Do not reach into the backseat to tend to children while driving. Reaching requires you to take one hand off the steering wheel, shift your position in your seat, stretch your body, and move your feet from their optimum reaction location. Let children cry until you can safely park the car. Accepting a used candy wrapper from a child in the backseat requires you taking a hand off the steering wheel, takes about three seconds. It that time your car travels 130 feet (40 meters) at 30 miles (48 kilometers) an hour. Apps are available that block incoming messages and send automated responses saying you are driving and will answer when you can.
6. Prepare children for the trip. Do they have to use the toilet or need their diapers changed? (Do you have to use the toilet?) Plan to keep kids occupied with age-appropriate snacks and toys, ones that they are unlikely to drop. Bring their favorite DVD. Point out places that will interest them.
7. Place children so that they are visible in the rearview mirror. Inexpensive mirror systems are available so that you can see rear-facing infants in the back seat. Some systems provide wide angle views and extra lighting. However, viewing them requires taking your eyes off the road. Some safety officials question whether these systems improve safety.
8. Be firm with discipline. Explain the importance of safety for older children. Tell them that excessive whining, tantrums, and roughhousing is unacceptable. If they do misbehave on the way to a movie or to their favorite fast food restaurant, for example, turn the car around and go back home. No negotiations.
9. Evaluate other drivers before letting them drive your kids. A person’s greatest lifetime risk of crashing occurs in the first 6 to 12 months after receiving a license. Many teenagers are addicted to cell phones. One in four admits to texting while driving and 40% say they have witnessed other teen driver use cell phones unsafely. The use of cell phones, even hands-free ones, quadruples the risk of crashes. Evaluate nannies and grandparents, for example, for their driving skills with crying infants and unruly children. In Britain, a school for nannies teaches proper driving with children. (Or let them read this article.)
10. Dogs in cars can be as distracting as children. Thousands of car accidents each year are caused by unrestrained dogs. Freely roaming pets nudge drivers, sit on drivers’ laps, and, rarely, place their paws on the steering wheel. In crashes, unrestrained dogs become projectiles, seriously injuring others or themselves. Moreover, most children enjoy riling up their pets, creating all kinds of disturbances. One problem is getting both pets and kid(s) out of the car safely. Pets have been killed in traffic or gotten lost while drivers are busy getting a child out of the car.
If you’re weary of hassling your kids to wash their hands – alas, look forward to more weariness: getting them to dry their hands properly.
While frequent and thorough hand washing is the most important measure to reduce transmission of disease-causing microorganisms among children (and adults), proper hand drying is almost as important, says the Centers for Disease Control. Most children do not dry their hands well. Transmission of organisms is more likely to occur from moist skin than dry skin. When hands are only shaken dry after washing, as many children do, some organisms may remain on the hands. The friction of drying removes organisms that washing loosened. Single-use, disposable paper towels is the preferred drying method. Reusable, cloth towels, especially when slightly moist from previous users, (sometimes many users) abets the spread of disease. Dry between fingers and around nails. Dry until no moisture remains on the hands.
For kids, Halloween means trick-or-treating, wearing costumes, carving pumpkins, and listening to scary stories. For pediatricians, Halloween means informing parents that pirate-type baggy costumes can catch fire if children come too close to jack-o’-lanterns lit with candles, that carving pumpkins is not child’s play, and that face paints may cause rashes.
1. Halloween is a scary holiday. About 4,000 individuals, a majority of them children, visit ERs each year with Halloween-related injuries. Many more injuries are treated elsewhere. About half of ER visits are pumpkin carving-related. Other visits result from adults falling while putting up or taking down decorations, children tripping on their costumes or falling while running over lawns in darkness, or traffic incidents.
2. Buy/make safe Halloween outfits. Costumes should be made from material marked “flame resistant.” Such material is unlikely to catch fire, and if it does the fire can usually be extinguished before serious burns occur. Accessories – masks, beards, and wigs – should also be fire resistant. Avoid costumes with big, baggy sleeves or billowing skirts. Costumes should be short enough to prevent children from tripping and falling. High heels cause accidents.
3. Other safety considerations. Make sure that hats, scarves and masks are tied securely lest they slip over children’s eyes, that eyeholes are sufficiently large to allow full vision, and that swords, knives, and other accessories consist of soft material.
4. Daylight is the safest time for trick-or-treating. However, traditionally, children prefer darkness. Dress children in bright colored items and trim costumes and bags with reflective tape. Supply children with flashlights. Wear a reflective vest yourself when accompanying trick or treaters.
5. Child proof your property. Consider using glow sticks to light pumpkins. Place candlelit pumpkins on sturdy tables, away from stoops where children walk, and away from curtains and other flammable objects. Keep outdoor lights on. Remove garden hoses, toys, bikes and lawn decorations from porches and front yards. Clear wet leaves or snow from sidewalks and steps. Lock up dogs. In apartment buildings, make sure that all trick-or-treaters get into the elevator together and insist that kids walk stairs in an orderly fashion.
6. Rarely, face paints cause skin reactions. Buy face paints in reputable stores; there are strict government rules about ingredients. Use only items meant for the face; nail polish is not. Test a dab of face paint on your child’s arm a day before Halloween. Check results. Avoid applying near eyes. However, a small amount of an approved face paint getting into a child’s eye or mouth is generally safe. Wash eyes with water to relieve discomfort. If necessary, call the poison control center or seek medical attention. Remove face paints when no longer needed to reduce the risk of allergies. Follow directions on labels for removing face paint.
7. Children should not eat candy until they get home. This allows you to inspect the candy. For young children, look for choking hazards – gum, peanuts, hard candies or small toys, for example.Inspect commercially wrapped treats for signs of tampering, such as an unusual appearance, discoloration, pinholes, or tears in wrappers. Discard items that are homemade or not wrapped. (Deliberate tampering of Halloween candy is an extremely rare occurrence. News stories about it occurring are often hoaxes.)
8. Carving pumpkins is not child’s play. Serious hand injuries occur. Allow young children to draw faces with markers. Pumpkin carving kits and knives specifically designed for carving are available for children and adults. Those for children need parental supervision. Before carving, dry your hands and the pumpkin; pumpkins are slippery when wet. Place pumpkins on solid surfaces. Never cut towards the hand that holds the pumpkin.
9. The risk of a child being involved in a serious pedestrian/car accident on Halloween night is twice the average of all nights. This statistic may be due merely to more children being out after dark. However, the excitement of trick-or-treating makes children forget street safety. And there may be increased drinking among drivers. Half of drivers involved in Halloween-related accidents are drunk. Help older children plan safe routes.
10. Miscellaneous. Decorative contact lenses are not recommended for children. Skip houses where entryways or stoops are not clearly visible or where there is a dog barking on the grounds or on the other side of the door. Barking dogs can frighten young children and cause them to react inappropriately.
Editor’s note: a Google search shows many articles on Halloween-related stomachaches. However, these articles are based on assumptions, not facts. If you know of any evidence-based articles on the subject, please let me know – for next year. KN
Last month I told you how to download TravWell, a mobile app from the Centers for Disease Control (CDC), to help you keep your family healthy while visiting over 200 countries. (Yes, 200+) Authoritative, timely, easy to use, fun, free, tailored to your itinerary… This app is almost like having your own travel medicine expert traveling with you. And what can be better than that?
Download it below:
Well, possibly you could ask for another app from CDC. And here it is. Can I Eat This? is an interactive app that tells you – using pictures – what and what not is likely safe to eat and drink in each of the 200+ countries found in TravWell, (described above.) This app is also free – and well worth checking out even even if you aren’t going anywhere.
You can download it below:
Drinking adequate amounts of liquids is essential to staying healthy when traveling. Liquids help counteract fatigue, jet lag, altitude, hot and cold environments and other vagaries of travel. A common misconception is that one has to be lost in the Sahara to become dehydrated. In fact, dehydration comes in all degrees of severity and occurs before thirst occurs, gradually affecting mental and physical abilities. Young children are more susceptible to dehydration and some beverages are counterproductive in this age group.
1. Kids should drink bottled water. Children are especially susceptible to waterborne intestinal illness. Tap water everywhere contains some micro-organisms. While our bodies are accustomed to the organisms in tap water at home, those in water elsewhere – even where sanitation is reasonably good – may be sufficiently different to cause mild discomfort for a few days. Such discomforts are often blamed on travel – with the remedy drinking more water. If it is tap water, it worsens discomfort.
2. For children, plain bottled water suffices. Encourage children to drink. Never force them. Sports and energy drinks and electrolyte solutions are rarely necessary for healthy children. Many of these beverages contain caffeine and large amounts of sugar and salt, and are intended for adults. On planes, many parents aggressively push fluids on young children to prevent dehydration. Not necessary. Dehydration in flight is a myth.
Bottled water is merely subterranean spring water or treated tap water, and, unless optimally processed, is no better than tap water. Where sanitation is poor, opt for well-known international brands of bottled water. Local brands may contain organisms and sometimes chemicals (arsenic in southern Asia, for example).
3. Water intoxication, drinking too much water virtually, never affects children. It occurs in competitive athletes who perspire profusely, losing large amounts of water and electrolytes (sodium, potassium, and chloride, for example) and subsequently drink large quantities of water without replacing the electrolytes.
4. Temperature of liquids is not important. Drinking hot drinks in cold weather or cold drinks in hot weather does not affect body temperature. Hot chocolate may give children (and adults) psychological lifts – if they like hot chocolate. Ice cold beverages do not cause illness. For children, when more fluids are indicated, cold beverages are generally more palatable than warm ones.
5. Check ingredients in bottled beverages. Especially overseas. Carbonation acidifies beverages, killing organisms, adding a degree of safety. Carbonated drinks are known as “with gas,” even by waiters who speak no English. There are no known adverse effects from carbonation. Overseas, some bottled water is mineral water, with very high concentrations of calcium, sodium and other minerals which, rarely, may cause problems in children, and best avoided. European spas tout their waters as therapeutic for whatever ails you, claims largely unproven.
6. Ice is OK where sanitation is reasonably good. A cube or two is unlikely to contain sufficient organisms to cause illness. Elsewhere, ice is usually made from tap water, often in difficult-to-clean equipment. However, “No ice, please” does not necessarily mean that you’ll get no ice. Waiters, from habit, add ice. Ask for a fresh drink in a clean glass.
7. Tap water too hot to touch is generally safe. It is “pasteurized,” having remained heated in the heater and pipes sufficiently long to kill virtually all disease-causing organisms. Boiled water is always safe. Boiling for one minute suffices. For overseas travel, carry an electrical coil, a current converter and a socket adapter, available in travelers’ supply catalogues. Note that heat does not remove chemicals and other impurities. Freezing does not kill organisms.
8. There is no foolproof method to recognize safe water. Crystal clear water in lakes, rivers and streams occasionally contains organisms from birds, animals and humans. Water marked for drinking (taps, fountains) in rural national parks and forests is generally safe; it is monitored by authorities. Elsewhere in rural areas, drinking water may contain disease causing organisms and pollutant chemicals. Contamination increases after heavy rains. Children’s habit to place their mouths on public fountains is unlikely to make them ill.
9. Know how to purify water. Convenient easy-to-use filters and chemical drops and tablets are available for travel and camping. Some filters remove most chemical pollutants. See websites and camping supply stores. Follow directions carefully. Know the amount of chemical to use, how long the chemical needs to be in contact with the water, and how long filters are safe to use before they become clogged, for example.
10. Miscellaneous. Avoid fresh fruit drinks from street vendors. Such drinks are usually squeezed in impossible-to-clean equipment and may be diluted with tap water and contain ice. Avoid water in canisters in hotel rooms, even when labeled “safe to drink. ” Such water is refilled from tanks wheeled down the hall, a process subject to lapses in sanitation. A brightly colored ribbon on water taps is a reminder to use bottled water.