Summertime, and the Falling is Frequent
by Robert Latkany, MD, Sarah Varney, and Barbara Lock, MDMay 31, 2009
For kids, summer is a time for climbing, swinging and exploring. We encourage these adventures! But we also encourage parents to take precautions to prevent their children from suffering serious injury from falls. There are a surprisingly high number of injuries related to tree-house falls every year, injuries from rope swing falls, and from falls out of unsecured windows.
A study of all hospital admissions at a single institution due to falls from 10 feet or more by Lallier et al revealed that patients mainly fell from balconies, windows, trees, roofs, stairs, and diving boards. Of the 1,410 patients admitted as a result of a fall, 64 children—45 boys and 19 girls ranging in age from 1-18 years old, were included in the study. While this is a small sample, and the results cannot be taken as gospel, the findings are still useful:
• Most falls occurred in private houses and during the summer months.
• Most of the children hospitalized due to fall had fallen from 20 feet or less (two stories)
• Head trauma was the most common type of injury
• About half of patients with serious injuries required surgery.
Since falls from less than two stories high can result in serious injury in children, and even death, it's worthwhile to take a closer look at this summer risk.
Windows
Falling out of windows has been called a silent epidemic. Pressley and colleague analyzed data from The Kids Inpatient Database (KID-HCUP), and found that kids age 4 and under tend to fall out of windows at a much higher rate in the warm weather months than in the cool weather months. Teenagers did not show a seasonal trend towards accidental falls out of windows. Mayer et al identified most falls occurring in children age 5 and under, at home, on summer evenings, frequently after having climbed up on a piece of furniture. Window guards are now mandatory in many cities. Put up the window guards, even if they look ugly. They could save your child's life.
Tree Houses
More than 47,300 children were treated in the U.S. for emergency injuries related to tree-houses, according to a retrospective analysis of a 17-year data set from the National Electronic Injury Surveillance System conducted by Randazzo et al. That's nearly 2800 patients per year, mostly in the summer. Fractures were the most common diagnosis,and the upper extremities were the most commonly injured body part. The odds of sustaining a head injury were increased for children younger than five. Older children and boys were much more likely than younger children and girls to fall from a height of 10 feet or more. But that old Bob Marley lyric “the higher they reach, the harder they fall” does turn out to be true. The risk of hospitalization tripled if the patient fell or jumped from 10 feet or more.
There are no national or regional safety standards for tree houses, so make sure you scope out the tree house before the kids play in it. Is it secure? Is the railing high enough? Is it too high off of the ground?
Rope Swings
Accidents down at the ol’ swimming hole or the lake front at the cottage are also worth your attention. Sorey et al looked at falls from river tree rope swings in a retrospective analysis of injury reports from a variety of sources from 2002-2006. They found 73 injuries directly related to falls from river tree rope swings in patients from age 5 to 25 years old. While finger fractures were the most commonly reported injury, serious injuries such as broken legs, concussions, and also spinal cord injuries were reported. These kinds of accidents are also bad news because they often happen in out of the way places where there may not be roads for ambulances or emergency response personnel to get through. Young children and non-swimmers should stay off any type of rope swing, whether it’s over a river, stream or lake. The rest of us should stay off of high, thin rope swings over shallow water.
Summer falls is Medpie.com's #5 Hidden Summer Health Hazard for Kids.
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