Category Archives: Injury Prevention

How to prevent and treat bug bites and stings

By Erin Dobie, CNP

Minnesota summers bring warm weather and opportunities for our kids to go outside exploring and playing in nature. Pesky insects often irritate or interrupt summer fun. Learn how to prevent insect bites, treat bites when they do occur, remove ticks and how to know when you should seek medical attention for your child.

How to treat bites

Insect bites and bee stings react because of venom injected into the skin. The severity of reaction depends on your child’s sensitivity to the venom. Most reactions are mild, causing redness, local swelling and irritation or itching. These usually will go away in two to three days. Calamine lotion or any anti-itch gel or cream may help soothe the itching.

Bee stings cause immediate pain and a red bump, but usually the discomfort lessens within 15 minutes. More than 10 bee stings at once (extremely rare) may cause a more-severe reaction with vomiting, diarrhea and headache. Allergic reactions to bee stings can be severe and quickly get worse. These reactions include difficulty breathing, swelling of the lips, tongue or throat, or confusion. Children who have a severe reaction need immediate medical attention, and you should call 911. If the child has a known bee allergy and an Epi-pen is available, the Epi-pen should be administered in addition to calling 911. If a stinger is present, try to rub it off with something flat such as the edge of a credit card. Do not try to squeeze the stinger out or try to dig it out. If it does not come out easily, soak the area in water and leave it alone to come out on its own.

Tick bites don’t often cause much of a local reaction. They’re primarily concerning because they can transmit infectious diseases. Ticks are prevalent in Minnesota. They’re generally found on the ground in wooded or heavily bushy areas. Ticks can’t jump or fly. Generally they climb grass and climb onto someone to attach as we brush up against them. Ticks are most active during the spring and summer months.

There are a few different infectious diseases that can be transmitted by ticks, but the most common one found in the Minnesota-Wisconsin area is Lyme disease (Borrelia burgdorferi). To infect a person, a tick typically must be attached to the skin for at least 36 hours. The incubation period, the time from infection to being symptomatic, is anytime between three and 30 days.

Lyme disease can present in many different stages. Early localized stage often includes a red ring-like rash (or may resemble a “bull’s eye” target) that slowly expands. Other symptoms include headache, fever, joint or muscle aches and overall not feeling well or excessively tired. If your child develops these symptoms within a few days to weeks after tick exposure you should seek medical attention to evaluate for Lyme disease. Lyme disease is evaluated by medical history, physical examination and sometimes a blood test. It may take the body several weeks to develop antibodies and the blood test may not show up positive early in the disease. Most cases of Lyme disease are easily and successfully treated with a few weeks of antibiotics.

How to prevent a bite

Prevention is the key to avoiding insect bites. I recommend insect repellent that contains at least 20 percent DEET. The higher concentration of DEET does not indicate better repellent; it just means that the repellent will last longer. Most repellents can be used on infants and children older than 2 months. Other effective repellents contain permethrin, picaridin, oil of lemon eucalyptus and IR3535. Permethrin-treated clothing is an option if the child will be camping or on wooded hikes. Finally, showering or bathing soon after exposure to tick areas is important to check for and remove ticks. Parents should pay close attention and check children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist and especially in their hair on their scalp. Dogs should be treated for ticks, but also checked as the ticks can ride into the home on the dogs then attach to a person later.

How to remove a tick

If you find a tick attached to your child’s skin, there is no need to panic.

  1. Use a fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Do not twist or jerk the tick, as this often can cause the tick’s mouth to break off and remain in the skin. If the mouth breaks off: try to remove it. If it cannot be removed easily, don’t dig it out; just wash and allow it to fall out on its own.
  3. After removing the tick, clean the skin with soap and water or rubbing alcohol.

Animals are great family members, except when they’re not

Teach kids to respect your animal’s space. (iStock photo / Getty Images)

By Dex Tuttle

Even before the pitter-patter of toddler feet, our house was plenty busy. My wife and I jokingly referred to our dog, Sprocket, and cat, Harvey, as training for parenthood. By the time our daughter, Quinnlyn, came around, we already had learned to keep valuables out of reach and close the doors to the rooms where we didn’t want roaming paws. And we quickly learned the value of eating our meals after distracting the animals to avoid begging eyes.

In addition to providing safety challenges, animals have an uncanny way of creating rules for your house, with or without your approval. Regardless of your expectations of them, they almost always get their way. (Those with toddlers will recognize the similarity here.) In our case, for example, we insisted that Sprocket not be allowed on the furniture – and he most definitely would not be allowed to sleep in our bed. He had different plans, though, and now I’m regularly curled up in the only free corner of our king-sized bed and rarely leave the house without fur-covered pants.

After we introduced the pets to Quinnlyn, Harvey disappeared for what seemed like the better part of a year while Sprocket was quite concerned about losing out on time with us. What remained to be seen was how these interspecies siblings would get along once Quinn became more mobile. We had two animals who thought they owned the house and a new queen who demanded nearly all of our attention. Naturally, there was some ruffled fur.

Recently, Sprocket was lying comfortably on the couch while I was typing away in the recliner near him. Quinn recognized the quiet, relaxing vibe and felt it needed a little chaos. She grabbed her step stool, crawled up on the couch and tried to climb up on Sprocket’s back, hoping to get a free doggie ride. Sprocket alerted me with the warning signs – he first tried to move away then let out a little growl before licking Quinn’s face. Thankfully, I was able to intervene before he got increasingly upset, but his behavior understandably is confusing to Quinn, so she continued to try to climb aboard.

Therein lays the challenge: No matter how well trained, animals are instinctual beings that are territorial, protective and usually inflexible on changing the rules they created. Young children are curious beings who discover their world by poking, prodding, throwing, climbing and chasing. Pairing children and pets can be simultaneously developmentally rewarding and potentially dangerous.

Here are some tips to help keep your kids safe around dogs:

Household pets

  • Dogs typically don’t like hugs and kisses, particularly when it’s not on their own terms. Teach kids to respect your animal’s space.
  • Don’t stare at a dog in close proximity to its face as this can be interpreted as an act of aggression.
  • Dogs that are tied up, cooped in or curled up (sleeping or relaxing) may be more agitated if approached – they either want to get out or be left alone.
  • Know that dogs don’t only attack when they’re angry (growling, barking, hair standing up); they can attack because they’re scared; a dog with its mouth closed, eyes wide and ears forward may indicate that it’s scared or worried.
  • Recognize these behaviors in your family dog to know it’s time to stop playing and give your pet some space:
    • Avoidance – hiding behind something or someone or turning its head away
    • Submission – rolling on its back, licking, or leaving the room; even though the dog is giving up now, it may not some day
    • Body language – tail between legs or low with only the end wagging, ears in a non-neutral position, rapid panting, licking its chops, or shaking out its fur
    • Acting out – tearing up or destroying personal possessions such as toys or other items your family uses frequently, or urinating or defecating in the house; these may be signs that your dog should be seen by a behavioral professional – don’t delay!

Pets outside of your family (tips courtesy of Children’s Hospital of Michigan)

  • Always ask an adult’s permission before approaching or petting a dog. Start by letting the dog sniff you, then gently pet under its chin or on top of its head, but never its tail, back or legs.
    • Never run or scream if a dog comes up to you
    • Never try to ride a bike away from a dog; they can run faster than you can bike
    • Always be calm around dogs and don’t look them in the eye; they may see this as an act of aggression
    • Stand still like a tree or rock and let the dog sniff you. If a dog starts biting, put whatever you have (backpack, stick, toy, etc.) in its mouth.
      • Avoid dogs that are eating, playing with toys, tied up in a yard, or behind a fence; also avoid dogs who look ill or angry
      • Never tease a dog by throwing things at it, barking at it, etc.

Dex Tuttle is the injury prevention program coordinator at Children’s Hospitals and Clinics of Minnesota.

12 tips to help keep kids safe this summer

Wear a helmet every time you ride a bike, skateboard, scooter or use in-line skates.

Children’s has one of the busiest pediatric emergency programs in the country, with about 90,000 visits each year. We love kids here at Children’s, but we’d rather see them safe at home. With warm weather upon us, we compiled a list of basic tips, with help from our injury prevention experts, to keep kids safe all summer. Together, we can make safe simple.

For more safety tips, read about Making Safe Simple.

Sun and heat

1. On hot days, make sure kids drink plenty of water to stay hydrated.

2. Make sure kids are covered. Apply 1 ounce of sunscreen to the entire body 30 minutes before going outside. Reapply every two hours, or immediately after sweating heavily.

3. When heat and humidity are high, reduce the level of intensity of activities.

Water

4. Kids should wear life jackets at all times when they’re on boats or near bodies of water.

5. Never leave kids alone in or near a pool or open water. In open water, kids should swim with a buddy.

Fireworks

6. Don’t allow kids younger than the age of 12 to use sparklers without close adult supervision. Don’t allow them to wave sparklers or run while holding sparklers.

Playground

7. Always watch kids on a playground. Make sure the equipment is age appropriate and surfaces underneath are soft enough to absorb falls.

Lawnmowers

8. Kids younger than 16 shouldn’t be allowed to use riding mowers, and those younger than 12 shouldn’t use walk-behind mowers.

Bike and wheel-sport safety

9. Make it a rule: Wear a helmet every time you ride a bike, skateboard, scooter or use in-line skates. Skateboarders and scooter-riders should wear additional protective gear.

ATVs

10. Every rider should take a hands-on rider-safety course.

11. All kids should ride size-appropriate ATVs.

12. All riders should wear full protective gear including a helmet, chest protector, gloves and shin guards.

5 tips for home and neighborhood safety

Summer is around the corner, we promise. No matter how much it snows in the next few days, the warm weather isn’t far away.

The season brings neighbors together for all kinds of outdoor activities. While your local barbecue or block party is a great time to reconnect with neighbors and enjoy a potluck, it’s also a great chance to review home and neighborhood safety tips with your children.

Here are five tips to bring up with your kids ahead of summer:

1. Post important personal and contact information in a central place in your home.

  • Include parents’ names, street address, mobile, home and work phone numbers, 911, poison control, fire department, police department, and helpful neighbors.
  • Use a neighborhood party to help children to familiarize themselves with their neighbors and identify whom they can go to for help.

2. Teach your child how and when to call 911.

  • Discuss specifics of what an emergency is and when 911 should be used.
  • Role play different scenarios and make sure kids know what information to give to the 911 operator.
  • For younger kids, discuss the different roles of emergency workers and what they do.

3. Discuss “stranger danger.”

  • Talk with your kids about who is allowed to pick them up from school or activities.
  • Talk to your kids about the importance of walking in pairs.
  • Ensure they always take the same route home from school and do not take shortcuts.

4. Practice proper street safety.

  • Have kids practice looking both ways before stepping into the street, using the crosswalk and obeying the walk-don’t walk signals.
  • Teach kids what different road signs mean, such as a stop sign.
  • Remind children about the importance of biking with a helmet and reflective light.

5. Talk to your children about fire safety.

  • If fire trucks are present at the neighborhood party, use their presence as an opportunity to discuss what to do if there were a fire.
  • Plan and practice escape routes in your home and designate a meeting spot in case you get separated.

It’s never too early to talk to your children and family about ways to stay safe.

Five Question Friday: Dex Tuttle

We love kids here at Children’s, but we’d rather see them safe at home. Dex Tuttle, our injury prevention program coordinator, tells us more about his role and gives some tips on how to prevent common household injuries in this week’s Five Question Friday.

Dex Tuttle has been the injury prevention program coordinator at Children's since August 2013.

How long have you worked at Children’s?

I started in August of 2013.

Describe your role.

As injury prevention program coordinator, my job is to keep kids out of the emergency room. I plan events and prepare resources in partnership with hospital and community organizations to educate children and families about common types of injury and give them tips on what they can do to stay safe.

What do you love most about your job?

On any given day, I can be in a workshop creating a new display or activity, out in the metro area talking to community members, or at my desk planning, creating and organizing for the future. I love the flexibility and unpredictability of the job, but the most rewarding part of my work is when people who stop by and chat with me have that “a-ha” moment: when I know that the message sunk in and changed behavior. In addition, as a father of an 18-month-old, injury prevention is always on my mind in a very real way. It is great making connections with families where the conversation starts with the commonality of caring for a curious and mobile child and progresses to sharing some advice that can help them keep their own kids safe.

We’re anxiously waiting for warmer weather so we can get outside. What are some simple tips that you give parents to keep their kids safe around their neighborhoods?

A tricky part of parenting is encouraging your kids to learn through exploration and curiosity while maintaining safe behaviors. The tip sheet on this topic is about three miles long, but here is some general advice:

  • If they’re on wheels, make sure they wear a proper-fitting helmet and pads.
  • The same goes for any activity or sport; make sure their equipment is right for their size.
  • Role-play emergency scenarios as a family – severe weather, stranger danger, fire escape, etc.
  • When traveling by vehicle, ensure your child’s car seat or seat belt fits right and is installed/worn properly. ALWAYS wear a seat belt (role model good behavior) and keep kids in a proper car seat or booster until they’re 4-foot-9 or taller to ensure their seat belt fits right.
  • STAY HYDRATED. With the winter we’ve had, it’s hard to think about the weather being warm enough to be dangerous, but developing good habits around drinking plenty of water now will help create safe behavior in the future. Be sure kids understand the importance of sunscreen, too.

For more tips, visit Children’s Making Safe Simple page, but the best advice I can give as a father and educator is to involve your kids in decisions and planning for safety. Encouraging them to provide their input and incorporating their suggestions into your plan and actions helps solidify safe behavior into the future.

What’s your favorite meal?

PIZZA. If my wife would let me, I could eat pizza for every meal, every day … with a few regular breaks for hot wings, anyway.

Poisoning can be prevented

With one of the busiest pediatric emergency medicine programs in the nation and more than 90,000 emergency department visits annually for a variety of reasons, you can trust we’ve treated just about everything. We love kids here at Children’s, but we’d rather see them safe at home.

In recognition of Poison Prevention Week, we’ve gathered tips from our experts. Share these tips with your kids and print them to share at their schools or with your friends. Together, we can make safe simple.

Keep all potential poisons up high and out of the reach of children — in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze. (iStock photo / Getty Images)

What is Poison Prevention Week?

National Poison Prevention Week was established by Congress in 1961 for annual, national recognition. The goal of the week is to educate the public about poisoning risks and what to do to prevent poisonings.

What you should know

Did you know that injuries are a leading cause of death in children? Each year 5,000 children die and another 6 million are hurt as a result of unintentional injuries. One in 4 children is hurt seriously enough to need medical attention. Most childhood injuries occur at home and many of these injuries, including poisoning, could be prevented.

Facts about poisoning

  • More than 1 million accidental poisonings per year occur in children younger than 6 years old.
  • Approximately 1 in 10 poisonings involves cleaning products.
  • Approximately 1 in 10 poisonings involves indoor and outdoor plants.
  • Approximately 1 in 20 poisonings are caused by cosmetic and personal-care products.

Tips to prevent poisoning

  • Review the poison prevention home checklist from the Minnesota Regional Poison Center.
  • Keep all potential poisons up high and out of the reach of children — preferably in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze.
  • Keep medications and vitamins out of the reach of children. Never call medicine “candy.”
  • Keep foods and household products separated.
  • Keep products in original containers. Do not use food storage containers to store poisonous substances (i.e. plant food in a drink bottle).
  • Destroy old medications.
  • Identify all household plants to determine if poisonous.
  • Post the Poison Center phone number, 1 (800) 222-1222, near each phone in the home.

What do you do if you suspect someone has been poisoned?

  • Swallowed poison: Remove anything remaining in the mouth. If a person is able to swallow, give about 2 ounces of water to drink.
  • Poison in the eye: Gently flush the eye for 10 minutes using medium-warm water.
  • Poison on the skin: Remove any contaminated clothing and rinse skin with large amounts of water for 10 minutes.
  • Inhaled poison: Get fresh air as soon as possible.
  • Call the Poison Center, 1 (800) 222-1222, immediately.
CROSSWORD PUZZLE: Poison Search

Signs and symptoms of a concussion

(iStock photo / Getty Images)

March is Brain Injury Awareness Month. As part of that, we’re sharing some concussion safety tips.

What is a concussion?

A concussion is a type of traumatic brain injury caused by a blow to the head or body. Symptoms can show up right after the injury or may not be noticed until hours or days later.

Signs and symptoms to watch for:

  • Headache or dizziness
  • Drowsiness or sleepiness
  • Focus or concentration problems
  • Blurry or double vision
  • Balance or coordination problems
  • Disorientation or mental confusion
  • Memory loss
  • Slowed thinking or speech
  • Blank or vacant look
  • Loss of consciousness
What to do if your child displays concussion symptoms:
  • Immediately remove your child from activity
  • Seek medical attention
  • Tell your child’s coach or teacher
Children’s Concussion Clinic

651-220-5230
8 a.m. to 4:30 p.m. Monday-Friday

Children’s Specialty Center (ground floor)
2530 Chicago Ave. S.
Minneapolis, MN 55404

Garden View (third floor)
347 N. Smith Ave., Suite 300
St. Paul, MN 55102

Facts on frostbite


Limit the amount of time spent outdoors during cold temperatures. (iStock photo / Getty Images)

By Erin Fritz, CNP

Minnesota winters offer many outdoor activities. While we can appreciate the fun of sledding, the thrill of skiing or the labor-intensive task of shoveling, these activities aren’t without risk. Specifically, prolonged exposure to the cold puts our skin at risk for frostbite, or — a lesser version — frostnip.

What is frostbite?

Frostbite is the damage to a body part caused by cold. While many instances are mild, frostbite can be quite severe. Typically the cold exposure occurs over minutes or hours, but frostbite can be instantaneous if exposed to cold metal. Frostbite is most common on the ears, nose, cheeks, chin, fingers, and toes.

What should I watch for?

It’s important to recognize the signs of frostbite as quickly as possible. Skin will feel cold, and may even be numb or tingling; it may have a gray or white appearance. Due to the numbness, the affected body part may feel clumsy or be difficult to move. Slightly worse symptoms may include blisters. Severe frostbite will have areas of black skin.

What to do if I am concerned?

Once symptoms of frostbite or frostnip are identified, the affected area needs to be rapidly re-warmed. The American Academy of Pediatrics recommends that the water used to re-warm the skin should be warm, but not hot. Avoid rubbing the area as this could make the pain and tissue damage worse. Pain is commonly a factor with frostbite, and can be managed with over-the-counter pain medications or by health care professionals.

How can frostbite be prevented?

Most importantly, frostbite easily can be prevented. Limit the amount of time spent outdoors during cold temperatures. Dress in layers, and cover all areas of uncovered skin with a hat, mittens, face mask and goggles. Warm boots are important. And finally, stay dry. If clothing does get wet, seek shelter and remove wet clothes immediately.

Spring soon will come, bringing warmer temperatures. Until then, dress warmly, stay dry and prevent frostbite.

Have an active winter: Stay safe with these tips

Minnesota winters bring with them plenty of opportunity for fun in the snow and on the ice, especially when kids are home from school during winter break.

Follow these tips to help keep you and your family safe during the cold winter months.

Before venturing outside, be aware of conditions that may cause frostbite (freezing of skin exposed to cold temperatures) and hypothermia (dangerously low body temperature).

Wear the right clothes
Wind, moisture and contact with cold surfaces can all contribute to body heat loss, so dressing appropriately is important to avoid frostbite or hypothermia.

  • Waterproof coat, snow pants and boots will help keep moisture out and warmth in.
  • Cover exposed skin as much as possible with gloves, a scarf and long socks, and be sure to wear a hat that covers your ears.
  • Dress in layers and avoid materials like cotton that soak up moisture.

Be sure an adult is nearby when kids are playing outside and make sure everyone goes inside regularly to warm up.

Sledding

  • Never sled in an area where there is traffic.
  • Wear a ski or bike helmet. A light stocking cap can fit under most helmets while still fitting appropriately.
  • Sleds that you can steer tend to be safer than disks, flat or roll-up sleds or toboggans.
  • Choose hills free of trees, ponds, ice, fences, ditches, and large bumps.
  • Take turns; wait for others to sled and get out of the way before following behind.
  • Always go feet first down the hill.

Skiing and snowboarding

  • Wear a helmet approved for skiing, goggles and other appropriate equipment, such as wrist guards.
  • Go on hills appropriate for your skill level.
  • Remember skiing and snowboarding are sports; you should stretch to warm up your muscles beforehand, eat well and stay hydrated.

Skating
Choose to skate on groomed ice rinks like the ones you find at arenas or parks rather than lakes or ponds when possible. If you do go out on open water, check with the Department of Natural Resources to make sure the ice is thick enough. No matter where you skate, follow these tips:

  • Wear a properly-fitting helmet and other safety gear to protect your head and joints from injury if you fall.
  • Make sure your skates fit right and are laced up tight.
  • If you skate outside, avoid ice with cracks, slush, and darker area of ice – these are all indicators that it’s not safe.

The Minnesota Department of Public Safety also has information on winter safety, which is available here.

Five tips for home and neighborhood safety

On Tuesday, Aug. 6, communities across the United States will gather to celebrate National Night Out, an evening dedicated to strengthening communities and promoting safer streets. While your local barbecue or block party is a great time to reconnect with your neighbors and enjoy a potluck, it’s also a great opportunity to review home and neighborhood safety tips with your children. Here are five quick tips to bring up with your kids during your neighborhood event this week.

1. Post important personal and contact information in a central place in your home.

  • Include parents’ names, street address, mobile, home and work phone numbers, 911, poison control, fire department, police department, and helpful neighbors.
  • Use a neighborhood party to help children to familiarize themselves with their neighbors and identify whom they can go to for help.

2. Teach your child how and when to call 911.

  • Discuss specifics of what an emergency is and when 911 should be used.
  • Role play different scenarios and make sure kids know what information to give to the 911 operator.
  • For younger kids, discuss the different roles of emergency workers and what they do.

3. Discuss “stranger danger.”

  • Talk with your kids about who is allowed to pick them up from school or activities.
  • Talk to your kids about the importance of walking in pairs.
  • Ensure they always take the same route home from school and do not take shortcuts.

4. Practice proper street safety.

  • Have children practice looking both ways before stepping into the street, using the crosswalk and obeying the walk/don’t walk signals.
  • Teach kids what different road signs mean, such as a stop sign.
  • Remind children about the importance of biking with a helmet and reflective light.

5. Talk to your children about fire safety.

  • If fire trucks are present at the neighborhood party, use their presence as an opportunity to discuss what to do if there were a fire.
  • Plan and practice escape routes in your home and designate a meeting spot in case you get separated.

Children’s will join our neighbors in Minneapolis at the Phillips West neighborhood’s 17th annual National Night Out block party from 5-8 p.m., along 27th Street between Columbus and Portland avenues. All are welcome to attend the evening of food, entertainment and kids’ activities, including the Children’s Making Safe Simple booth, where we’ll play games and give away prizes as part of Making Safe Simple: 100 Ways in 100 Days. We hope to see you there!