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Health & Wellness: ERs see spike in traumatic injuries when warm weather begins

Leigh Ann Laube • May 26, 2010 at 12:34 PM

It was a beautiful summer afternoon, the perfect day to enjoy time on the lake with friends.Carley King, 14, was seated third on a large personal watercraft (PWC), behind two friends.The driver slowed the watercraft, then gunned it. King slid off the back and directly into the path of the PWC’s high pressure jet of water.Thinking she had the breath knocked out of her, King was able to climb back aboard. Her friends took her back to her family’s lake house and she made her way inside to the bathroom.What she didn’t realize was she was tracking bloody footprints across the floor.The incident, which occurred in June 2009, left King with a hole in her colon, a hole in her bowel and a rectal tear.King, who is finishing her freshman year at Sullivan Central High School, was transported to Holston Valley Medical Center. Surgery was needed to repair the damage, and she was fitted with a temporary colostomy bag.“Just the force of the water did all that damage,” King said.Andi Hooper doesn’t need a calendar to know when spring has arrived. She needs only to check her computer at Holston Valley Medical Center for records of who was admitted to the hospital’s emergency department, and for what reason.The weekend of April 23, Hooper said, was unseasonably warm. During that weekend, the ER had 12 trauma alerts — three of them motorcycle accidents, another three involving all-terrain vehicles (ATVs).“Our trauma volume picks up significantly in springtime and drops down in October when it starts to get cooler,” said Hooper, Holston Valley’s clinical director of emergency services.Joanna Swinehart, communications and outreach coordinator at Niswonger Children’s Hospital in Johnson City, says summertime sees an increase in preventable injuries — injuries that didn’t have to happen.“We call them accidents, but they could have been prevented with education,” she said.Summer is the time to enjoy the great outdoors, to swim, hike, travel and barbecue. But it can also be a deadly time of year. Consider these statistics:• In 2006, the Centers for Disease Control reported 11 deaths and an estimated 9,200 injuries related to fireworks in the United States.• In 2008, the United States Coast Guard counted 4,789 recreational boating accidents that resulted in 709 deaths, 3,331 injuries and approximately $54 million worth of damage to property. More than two-thirds of all fatal boating accident victims drowned, and of those, 90 percent percent were not wearing a life jacket. The most common types of vessels involved in reported accidents were open motorboats (43 percent), personal watercraft (23 percent), and cabin motorboats (15 percent).• Statistics from the American Academy of Orthopaedic Surgeons indicate that 100,000 people in the United States suffered an injury in a lawn mower accident in 2006. Most injuries occurred among adults age 25 to 64, followed by children younger than 5. More than 22 percent of injuries involved the wrist, hand or finger; nearly 14 percent involved the foot, ankle or toes.• According to the Consumer Product Safety’s Commissions Web site, www.atvsafety.gov, there were a reported 410 deaths in 2008 related to ATVs, with another 135,100 ATV-related injuries treated in emergency departments. Of the 410 reported deaths, 74 occurred in children younger than 16.• According to the National Safe Kids Campaign and the American Academy of Pediatrics, almost 50 percent of head injuries sustained in sports or recreational activities occur during bicycling, skateboarding or skating incidents.“A May 2001 report by Safe Kids called summer trauma season and most of the emergency care physicians nationwide would probably agree with that,” Swinehart said. “Statistics say there is a marked increase in the middle of summer. … I think a lot of it has to do with access. Children have a lot of access to things they don’t when they’re in school. And the lack of supervision is a huge, huge issue. National research has shown that July is the deadliest time of the year.”According to Safe Kids, drowning deaths increase by 89 percent during the summer.With regard to water injuries, Hooper said, the lucky ones are the ones who make it to the emergency department.“The unlucky ones aren’t wearing life jackets and they’re knocked unconscious and drown,” she said.Summertime injuries often occur to unsupervised children, and children between the ages of 10 and 14 are more likely to engage in risky behaviors, Swinehart said.“And parents start to give their children a little more freedom and that may not necessary be the right time do so,” she said. “Riding a bicycle without a helmet. Shooting off fireworks without supervision. Going out swimming without supervision. Diving head first without checking the depth of the water. Those are the kinds of things adolescents would be more prone to engage in.”When the weather turns warm, local emergency departments see injuries ranging from heat stroke and sunburn to fractures and head injuries.The increasing popularity of ATVs means emergency departments are treating more traumatic injuries.“An ATV is not supposed to be used on asphalt, but parents think of them as play Jeeps instead of a real motor vehicle,” Swinehart said. “They’re made to be on terrain. Children, specifically under the age of 16, psychologically and emotionally, are not capable of handing the decisions made with motor vehicles. … Then there’s not wearing helmets or appropriate gear, which could prevent traumatic brain injury.”Hooper said Holston Valley sees more ATV accidents than any other type of accident during the summer, and that more times than not, the rider isn’t wearing a helmet. Ranked behind ATV accidents are car accidents followed by lawnmower/tractor accidents.Swinehart said she’s seen lawn mower accidents that have been life-changing.“These are the kinds of injuries that in many cases can’t be repaired. These can result in amputations,” she said.While ATVs are pet peeves of both Swinehart and Hooper, Swinehart adds trampolines to her list.“I’ve seen enough here that I don’t want one for anyone in my family, or any child for that matter. Trampolines are very dangerous, maybe not so much for fatalities. A lot of it is education. When you get more than one person jumping on a trampoline, that’s when the risk really increases because you have these two forces that collide. You have someone jumping and that momentum going, and they fall off and land on their head or land on their back,” she said.While bug bites might send someone to the emergency department, Swinehart said she’s seen an increase in animal bites.“Animal bites, locally and regionally, are a big issue and from the research I’ve done it’s domestic animals, not someone living on a farm. Safety around animals is a huge issue — teaching kids not to reach down and pet the dog while he’s eating. Sometimes it’s a breed issue, other times it’s teaching a child when it’s appropriate to pet an animal or approach one,” she said. “Injuries are typically to the face or neck. Dog bites are severe and can be life changing.”The Safe Kids USA Web site (safekids.org) offers basic safety tips, but Swinehart says the bottom line is parental supervision, regardless of the age of the child.“You need to know what they’re doing, when they’re doing it,” she said. “All children develop differently. Just because your child has a friend whose parents let them do something … know what your child is able to handle, what their maturity level is. A lot of it is individual based on the child, and a lot is pure supervision.”With school almost out for the summer, Carley King is looking forward to being back out on the lake.She got a clean bill of health from her doctor in January and resumed cheerleading and tumbling.She’s not gun shy, and she’s already been out on the lake some — jumping off cliffs and riding on a PWC, though this time at the front.“I won’t go on the back of it,” she said.

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