Hope everyone is staying cool so far! I brought back my buddy Thorough Jim (I’m pretty sure the lol he used in his email reply was approval for that nickname?) for our final SUMMER SAFETY SERIES topic: PLAYGROUND SAFETY!  We’re talking both private backyard safety and public park best practices today.

Maybe you’re well versed in Boo-Boo’s and Owwies because your kid’s a Tazmanian Devil or maybe you’re a park first timer who is freaking out about the impending doom that the playground brings … don’t worry, me and Thorough Jim (nee: James DeCarli) have all the info you need to keep everyone safe. As a reminder, Jim has the following letters behind his name, so you know he’s legit: PhD, MPH, MPA, MCHES and he runs a company ALL about safety called Pro Consumer Safety.

Anyways, I reached out to my boy and asked him the important stuff for us and this what he had to say:

As owners of a backyard playground, what are common pitfalls and dangers in a private home and what can the homeowner do to keep everyone safe?

  1. What steps should homeowners take to keep their child-guests safe when they have a swing-set/ginormous climbing apparatus in the yard?

For any backyard playground, homeowners need to follow the age-appropriate recommendations before allowing children to use the playset. Most playsets have recommendations for specific age groups such as “not recommended for younger than 2-years”, to “2-5 years” or “6-12 years”. So always follow recommendations before allowing use. Further, before allowing a child on the playground, make sure the child removes loose clothing, drawstrings, clothing with hoods, jewelry, scarves, opened-toed shoes, long or loose shoe laces, and no bicycle helmets. These items can easily catch on equipment causing strangulation or severe falls.

The National Program for Playground Safety recommends using S.A.F.E. to assess the safety of playgrounds. Keep in mind that once a new playset is properly installed, meeting local and state safety codes (check with your local city or county building department for safety requirements), will deteriorate overtime, so regular assessment before use is always recommended. Using S.A.F.E. can help. Whereas:

  • “S” is for supervision. Adults need to be actively watching, listening and viewing all children on the playground and this includes watching those in crawl spaces as well.
  • “A” is for age-appropriate. The adults need to make sure only children using the playground are at the appropriate age for use. Age categories include 2-5 and 6-12. Playgrounds are designed differently to accommodate the average size and developmental ability of the child applied to slides, platforms, guardrails, etc.
  • “F” is for fall surface.  The appropriate surface under the playground and to at least 6-feet surrounding it should be of loose fill such as 12-inches of sand, engineered wood fiber, or gravel. Surfaces NOT recommended include grass, dirt, asphalt, and concrete.
  • “E” is for equipment maintenance. As mentioned, playground equipment when new, and installed properly, will deteriorate overtime with use and among both hot and cold weather conditions. Make the playset is free of rust, broken parts, splinters in wood, cracks, holes, protruding bolts, etc. In addition is the condition of the surface which can change with time among both with use and weather conditions.

Homeowners can download the Playground Safety Report Card to assess their own playground. If a homeowner is having a new playground built it is recommended to always check with the city or county building department for specific building requirements.

  1. What is the number one most preventable (excluding pool related) injury on the backyard play set?

The number one most preventable injury on any playgrounds is falls. In general, most injuries happen at public and school playgrounds because there are more children at these locations. However, injuries from home playgrounds are found to be more severe, resulting in concussion to broken bones. Falls are most common from swings and slides, followed by climbers. Fall related playground injuries at home playground are usually from lack of proper playground surfacing and maintenance (not checking surface conditions, rusty, loose equipment and bolts), followed by lack of proper installation and supervision.  To help prevent such injuries home playgrounds must have appropriate landing surfaces under and up to 6-feet around the playground, recommended at least 12-inches thick (sand, engineered wood fiber, or gravel). In addition, when shopping for surfacing, be aware of the types of surfaces, what they are made of and are free of environmental hazards. The Health Schools Network, Inc. provides recommendations that include playgrounds and toxic threats for surfaces.

  1. Do you see parents making a recurring mistake when it comes to backyard safety?

One of the most common mistakes that parents make over and over regarding backyard safety is lack of appropriate supervision, followed by not having proper layers of protection or use safety equipment.

SUPERVISION & CHILD DEVELOPMENTAL GROWTH: As the child grows, parents often miss developmental markers of the child and how the backyard environment can influence risk. For example, as an infant who is learning to crawl and walk, carriers a different risk. Whereas supervision by the caregiver is generally “within-arms-reach” at all times. Equally as risky are toddlers. As they become mobile, walking and running, they easily trip and become distracted easier thus easier at injury risk from exploration and being inquisitive. A typical backyard has many risk factors including pools, ponds, fountains, barbecue grills, tree houses, trees to climb, poisons to multi-levels with hard surfaces, to cactus that has sharp points or stickers, etc. Once children are out of the toddler age, between 5-12, parents often forget and assume this age group is safe now. But they still need supervision. Even at age 13 and over when they are old enough to watch younger siblings for short times, they still can be at risk and often more at more severe risk. Parents often underestimate the risk this age group can get into, especially by not paying attention to their environment, such as a patio roof that is close to a pool, for example. This is just too attractive and easy for an adolescent to think “hey let’s jump from it”. While supervision might not always be constant, parents should assess their backyard and identify environmental conditions that can influence behaviors that can put children at risk of injury. In addition to supervision and layers of protection, parents need to explain to children about the importance of following rules and boundaries. 

PROPER — USE OF SAFETY EQUIPMENT: Another common mistake is not using safety equipment or not using it properly. One of the most common is helmet use. California law requires children 17 and younger to wear a helmet properly while riding a bicycle, scooter, skateboard, or roller blades/skates. It is all too often I see children, as well as adults, not wearing their helmet properly. They wear it incorrectly by wearing it like a hate, far back on their head, exposing the front of their head. This is dangerous while riding a bicycle because with most bicycle crashes, the rider goes forward, over the handlebars where the front of their head hits the ground first. If wearing a helmet like a hat or having it too loose or not buckled snugly will push the helmet off and the front of the rider’s head hits the ground. Often a loose helmet strap can cause the helmet to catch on the bicycle or another fixed item like a car mirror, etc. causing the rider’s neck to twist or be torn, causing neck injury. While California law requires helmets in public locations, in the backyard children can still be injured from not wearing the helmet or not wearing it properly. The proper way to wear a bicycle helmet is flat on the head just above the child’s eye brows and fasted snugly.

People visiting public playgrounds

  1. What’s the leading playground injury?

The leading playground injury is falls. This includes both at home and at public playgrounds. Most falls at public playgrounds are from swings and slides. Fall-related injury are often due to poor quality surfacing or not maintaining surfaces under slides and swings. These fall-related injuries have resulted in concussion, neck injury to broken bones.

While adult supervision can help prevent these injuries, what is equally as important is for the parent assess the playground before use. Some school and city playgrounds have safety inspectors to make sure it is up to standard and meet regulations. However some playgrounds do not or they might not be inspected often. This will put children at risk of injury hospitalization and death. The National Program for Playground Safety provides State Report Cards on the conditions of playgrounds at schools, child care and parks, by state and U.S. nationwide. California overall was provided a “B-“.  Therefore, it is recommended that parents always check the condition of the public playground before use. While parents can also use S.A.F.E. by using the Playground Safety Report Card to assess its safety before use, the U.S. Consumer Product Safety Commission (CPSC) recommends always check the following before each use:

  • Ensure that surfaces under and around the playground have at least 12-inches thick, and at least 6-feet surrounding the playground equipment, of wood chips, sand, mulch, gravel or mats that are safety tested. For swings this surface must extend back and front that is two times the height of the suspending bar. Make playground surface is in good condition each time before use
  • Make sure playground structures that are more than 30-inches high are spaced at least 9 feet apart from each other
  • Check for dangerous hardware conditions such as protruding bolts or opened “S” hooks, especially those that are rusted
  • Check for spaces that can trap children, such as openings in guardrails or between ladder rungs (this space should measure less than 3.5 inches or more than 9 inches
  • Check for sharp points, edges, wood splinters in equipment
  • Check for tripping hazards such as concrete footings, rocks, tree stumps, etc.
  • Make sure elevated surfaces, ramps and platforms have guardrailsh)Make sure children have no loose clothing, drawstrings, jewelry, scares, bike helmets, or opened-toe shoes.
  1. What should a responsible parent carry with them for first aid when taking the kids to the playground?

Trips to the local playground with your children is a great way for them to exercise, socialize as well as to learn and explore, all while having fun. A responsible and informed parent knows that an injury can happen and must be prepared. Prevention is always first by following S.A.F.E, and specifically active supervision, including making sure the playground is clear of any hazards and while age-appropriate. Most playground injuries are minor. But it is good for a parent to know how to assess the difference and know what to do. This is where basic first aid and cardio pulmonary resuscitation (CPR) is helpful. The American Red Cross (ARC)has local classes for parents and other caregivers, such as babysitters, available which is highly recommended.

Injuries at the playground are usually minor scrapes and bruises. Remember anytime a child is hurt, as you are aware as a parent, the first action is to help calm them, then get them to a safe location and administering the form of first aid they need. Anytime you feel an injury might be more serious, such as a severe fall, do not move the child and call 911. For minor cuts and scrapes a first aid kit, again knowing how to use it properly by taking a basic first aid class from ARC is recommended. Your basic first aid kit at a playground should include:

For Minor Cuts & Scrapes:

  • Gauze
  • Small scissors for cutting gauze
  • Tweezers (in case of wood splinter-NEVER use for Bee Stinger removal)
  • Rubbing alcohol or antiseptic wash
  • Anti-bacterial cream, gel or spray
  • Adhesive bandages (a variety including triangular and tubular (for fingers, toes, elbows, knees, etc.)

For burns, bites, stings and allergies:

  • Topical burn ointment or spray
  • Sunscreen
  • Anti-itch topical cream (bug bites, bee stings, etc.)
  • If child or caregiver is allergic to Bee stings or not known include an EpiPen (epinephrine injection to prevent anaphylaxis)
  • Any type of poison plant consumption or other poison concern call Poison Control 1-800-222-1222
  1. What are the proper steps for treating a bee sting? 

As a Master of Certified Health Education Specialist (MCHES), the following information on steps for treating a bee sting is not intended nor implied to be a substitute for medical advice. It is provided for educational and awareness purposes only. It is not to be used as a substitute for the care and knowledge that your physician or child’s pediatrician can provide you. The following information was obtained from WebMD on first aid for insect sting allergy treatment.

 If history or symptoms of anaphylaxis:

ð      If the child has a history of anaphylaxis, do not wait for signs of a severe reaction, immediately use EpiPin to inject epinephrine. Then immediately call 911.

ð      If the child is experiencing symptoms such as trouble breathing, feeling faintness or dizziness, hives, swollen tongue, immediately use EpiPin to inject epinephrine. Even if you are unsure if the symptoms are related epinephrine will not cause harm, but by not giving the injection could be fatal. If no improvement in symptoms, call 911. Sometimes another injection is necessary if symptoms continue. For children specifically, can be injected again after 5 to 30-minutes. Anytime epinephrine is used, immediately call 911.

If no history or symptoms of anaphylaxis:

Remove the stinger

Scrape the area with the edge of a credit card or straight edge object to remove it

Do not pinch the stinger or use tweezers because this can inject more venom

Control swelling

Ice the area

If stung on arm or leg, keep it elevated above the child’s heart

Remove any tight-fitting jewelry from the sting area. As it swells rings or bracelets might be difficult to remove

If pain continues, call 911 or if not severe ask a pharmacist what over-the-counter medications are recommended for the child’s age. Remember do not give aspirin to anyone under the age of 19

To reduce itching, use anti-itch cream. There are products for children. If unsure check with a pharmacist

Follow-up

Healing can take 2-5 days. Keep the wound clean to prevent infection

  1. What does dehydration look like in kids?

Dehydration happens when the body does not have enough fluid (water and electrolytes-sodium [salts]) to function properly. While the body loses fluid throughout the day from sweating, crying, urinating and bowel movements, and evaporation through the skin and when breathing, this fluid loss is generally balanced by the body’s natural thermoregulatory system and through replacement of regular dietary intake from food and liquid. However, dehydration can occur when this balance is offset. This can happen by having additional fluid loss from having a fever, diarrhea or vomiting, or through excessive exposure to hot temperatures or physical activity. Anytime this fluid loss is unable to be replaced will result in dehydration.

Remember while dehydration can happen at any age, infants and young children are at greater risk of dehydration than older children and adults, because they can lose fluid much more quickly. Further, dehydration among infants and children is not just limited to hot weather during summer months, but year around. One of the most common causes of dehydration in children is acute gastroenteritis (stomach flu) causing fluid loss through vomiting and diarrhea. Parents must recognize the signs and symptoms of dehydration and know when to seek medical attention to avoid severe complications or death. The signs of dehydration can range from mild to moderate, and severe.

SIGNS & SYMPTOMS OF DEHYDRATION

Mild to moderate dehydration:

  • Playing less than usual
  • Urinating less frequently (for infants less than 6-wet diapers per day)
  • Parched, dry mouth
  • Fewer tears when crying
  • Sunken soft spot of the head in an infant or toddler
  • Stools will be loose if dehydration is caused by diarrhea; if dehydration is due to other fluid loss (vomiting, lack of fluid intake), there is be decreased bowel movements

Severe dehydration (In addition to the “Mild to Moderate” signs)

  • Very fussy
  • Excessively sleepy
  • Sunken eyes
  • Cool, discolored hands and feet
  • Winkled skin
  • Urinates only one to two times per day

PREVENTION

Be aware of the signs and symptoms especially during illness such as fever, vomiting or diarrhea for any age. For older children, specifically during exposure to hot weather or physical activity, ensure proper hydration through fluid intake and food energy to replace fluid losses. For any age during extreme heat advisory or strenuous physical outdoor activity keep well hydrated. The American Academy of Pediatrics provides the following links on the causes of dehydration. Each link also explains when to seek medical assistance and preventive recommendations for each cause.

  • Heat Exposure and Reactions from exposure to hot weather, and outdoor and sports activities can result in severe dehydration if not properly hydrated, leading to heat cramps, heat exhaustion and heatstroke.
  • Vomiting (with diarrhea), when vomiting and diarrhea happens at the same time, caused by viral infections, food poisoning, traveler’s diarrhea, bacterial infections, can cause severe dehydration.
  • Vomiting (without diarrhea), the forceful emptying of what is in the stomach, from stomach infections, food poisoning, ibuprofen overdose, food allergy, coughing, motion sickness, headaches, and serious causes and cyclical vomiting, can cause severe dehydration.
  • Diarrhea, from viruses, bacterial infections, food poisoning, giardia, traveler’s diarrhea, to serious causes and complications can quickly result in severe dehydration.

What’s the big one point takeaway you want the non-reader, readers to know?

“Adult supervision” means watching, listening, seeing the child and being within reach.

OK DEFINITELY re-packing my diaper bag after posting this because I have about nothing useful in it for any disaster outside of hunger and poop.  Will be including MANY of his safety items for sure.  Ok people, as I always say when I interview Jim, print this article and post it where you and your caretakers will see it because the information really can make a difference in a time of need.  STAY SAFE!  Smooches.

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SUMMER SAFETY SERIES: PLAYGROUND SAFETY

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