Doc Talk: Why There Are No Accidents

By Alan L. Nager, M.D., MHA

Child safety - no accidentsThe other day, a 9-year-old came in to the emergency department with an elbow fractured in a way that required a surgical repair with metal pins, and a cut across the middle of his forehead that required plastic surgery. He had tried to skateboard down six stairs.

In emergency medicine, we don’t call these “accidents,” because the injuries that happen by accident are almost always preventable. And the key to preventing these injuries in kids is proper supervision by parents.

You shouldn’t let your kids treat your home and furniture like playground equipment. Easily 80 percent of the injuries we see happen when kids are doing things like jumping on furniture or climbing on counters. We see skull fractures, concussions, broken bones and lots of cuts (50 percent of them on the face) because kids were playing rough indoors.

Outdoors, where there is playground equipment, parents sometimes have the naïve idea that kids will play in an appropriate way. But children will go down the slide standing up and jump off the swing. A large number of elbow fractures that require pinning are due to falls from jungle gyms.

Kids don’t think about the repercussions and the consequences of their behavior, which means parents need to set rules to help children stay safe. Rarely do I see a child in the emergency department who wore a helmet when riding her or his wheeled vehicle. Scooters and skateboards require wrist and elbow pads as well. We see many elbow fractures in kids who ride unprotected. We also see head injuries that involve bleeding in the brain.

health - Nager

Alan L. Nager, M.D., MHA

But just setting the rules isn’t enough. Kids, by nature, tend to be rule breakers and risk takers, and they require attentive supervision. Be there, and pay attention. Don’t be in the other room. Don’t be on the park bench checking Facebook on your phone. Don’t walk away to chat with a friend or get an ice cream. It is always easier to think these things happen to other kids, but I’ve seen a lot of parents whose children are injured beat themselves up, saying they lost sight of their child for a minute.

Risk-taking and its consequences are part of childhood. But by watching over your children, you can limit the number and seriousness of their injuries.

Don’t be a parent who says, “If only I had ….”

Alan L. Nager, M.D., MHA, has been Director of Emergency and Transport Medicine at Children’s Hospital Los Angeles for the past 18 years, and is a professor of Pediatrics at the Keck School of Medicine of the University of Southern California.

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