Do your kids love crocs and flip flops and forget to wear their bike helmets and sun screen?  These common kid problems account for most of what I see in the ER all summer.  With a few parenting tricks, you can keep your kids safe and be done with the mommy nagging.  Here are my real-life summer ER stories, and how to avoid making them your family stories:

sandal safety for children

Have your children wear “bump toe” sandals instead of crocs or flip-flops to minimize foot injuries this summer.

1)   Problem: Where are your shoes? Crocs and flip-flops are my job security.  All summer I see kids with broken bones and scraped knees and elbows who fell while wearing crocks or flip flops.  It’s especially dangerous to ride a bike or a scooter in crocks or flip-flops.  I know kids love them because they slip right on without socks, and parents love them because they last a long time and are inexpensive.

Solution: wear “bump-toe sandals” instead of crocs or flip-flops.  They are available affordably at PayLess Shoes.  You don’t have to wear socks, they slip right on, and they dry quickly when wet.

2)     Problem: Where’s your helmet?  Although most kids own bike helmets, they often don’t put them on when they go running out the door to play.  Sadly, I take care of tons of kids who fall off bikes, scooters, rip sticks, and even ATVs who were not wearing helmets.  If they are conscious, they are lucky.  Most suffer concussions.  Many need CAT scans, which increases their lifetime cancer risk.  So here’s the rule: without a helmet there is no riding bike, scooter, ATV or anything with wheels.  So how do you get your kid to actually WEAR his or her helmet?

bicycle helmet safety

Store your child’s helmet on the handlebars of his or her bike or scooter to ensure they see it and remember to put it on.

Solution: Store your helmet on the handlebars of your bike, scooter, ATV or favorite wheeled toy.  That way your child cannot ride it without having to look at (and move) their helmet.

1) Also be sure your child’s helmet fits appropriately.  Check out this guide to helmet safety.

If your child does suffer a head injury, how long should they stay out of sports?  Here are some answers to this complicated question.

3)     Problem: Drowning.  Some of the saddest cases I see in the ER are drownings or near-drownings.  In just seconds a normal child can die or become permanently neurologically impaired.  I still relive the nightmare of my own 2 year-old falling into a pool while I was chatting with a cousin.  Fortunately, my husband jumped in fully clothed and pulled him out.  Any child who is pulled from a pool and inhaled water needs to be evaluated by a physician.  Kids can seem OK at first, but hours later can develop severe respiratory distress, often while they are sleeping.

Solution: My colleague Dr. Sarah Lenhardt answers all your pool safety questions here, from swimming lessons to flotation devices to when it’s OK to leave kids unattended at the pool.  Read more tips to prevent drowning here.

4)     Problem: Sunburn and skin cancer.  Yes, kids come to the ER with severe sunburn, and yes, we are diagnosing skin cancer in kids in growing numbers.  I see boys without shirts all the time—not only at the pool but while mowing the lawn, washing cars, or playing sports.  One of the worst sunburns I’ve seen recently was a teen who spent all day roofing in a tank-top.

Solution:  Shirts are cool.  Literally.  Wear an SPF-protective shirt at all times while in the sun, both while playing and swimming.  According to the CDC, a white T-shirt has an SPF of about 7, and most t-shirts are about SPF 15.  Consider UV-protective clothing which can have an SPF of up to 50.  Cover all unprotected skin areas with SPF 20-50 sunscreen.  There is no benefit to sunscreen with SPF over 50, so save your money!

Don’t forget that UV protective bathing suits are available for both boys AND girls! My kids wear very cute “rash guard” long sleeve swim tops with long swim shorts for boys or a swim skirt for girls. They are available from lots of retailers if you just do a google search.   There are also a lot of “surfer” style wetsuit bathing suits.

For me, this is the ultimate happy-mom bathing suit solution. I have less space to cover with sunscreen, and when the kids dry out they are already dressed for a restaurant or tennis lesson.

Here are some tips for treating sunburn at home.

Never use a tanning bed.  One time use of a tanning-bed increases your risk of skin cancer by 75%.  You do not decrease your risk of sunburn by pre-tanning with a tanning bed.  There is no such thing as a safe tan.

5)     Problem: Swimmers EarSwimmers ear is an infection of the outer ear canal that is common in kids who swim, especially if you swim in pools that are not well chemically balanced, or in fresh or salt water.

Solution: The US Navy figured out the trick for preventing swimmers ear.  Even during World War II, navy sailors had to put a few drops of mineral oil or hydrogen peroxide in their ears every time they got out of the water.  You can do it, too.

6)     Problem: Dog Bites.  Dog bites are some of the most stressful injuries that we see in the ER.  Kids faces are often permanently scarred and we are obligated to call animal control.  Everyone gets upset—no matter who owned the dog.  Often a plastic surgeon has to come in and sew up the wound.  Kids usually require anesthesia/sedation while the wound is repaired, which carries its own risks.

Solution: It’s my controversial medcial opinion that dogs and babies don’t mix.  Even the most docile dogs can bite, and kids die every year from dog bites.  If you have a child, keep him or her away from dogs, at least until about age 10.  There is also evidence that kissing your dog can alter the bacteria in both your mouth and your dog’s mouth.

7)     Problem: vomiting and diarrhea, all night long…  We’ve all lived it.  The stomach flu, or gastroenteritis, is common in the summer.  Summer picnics can also result in food poisoning.

Solution:  If you picnic, be sure to avoid foods that spoil easily such as mayonnaise.  Encourage your kids to wash hands frequently, and use hand sanitizer.   If you are up with a kid that has persistent vomiting and/or diarrhea, call your pediatrician’s exchange or go to the ER.  We have good medications now that can stop vomiting before dehydration sets in.  Dr. Kirstin Lee offers some practical tips for dealing with the stomach flu here.

8)     Problem: sports practice in the high heat.  Every year I see kids in the ER with severe heat exhaustion and mental status changes/confusion.  Usually they are middle and high-school kids  coming from a summer soccer or football practice.

Solution:  If you aren’t urinating before and after sports practices, you aren’t drinking enough water.  Hydrate with both sports drinks and water, especially BEFORE sports practices.  Dr. Colleen Wallace writes about the best fluids to keep kids hydrated here.

Coaches should never limit the amount of water that kids drink, or permit kids to drink only during “water breaks.”  Never depend on a water fountain for hydration during a sports practice—use a water bottle.

9)     Problem: kids can choke and die on hard candy and latex balloons.  Summer is often a time for parties with balloons and candy hunts, but don’t forget that these things can kill kids.

Solution: Use mylar balloons instead of latex, and throw away latex balloons the second they pop.  Never allow kids to play with ballons that have not been blown up.  Don’t allow your kids to run with hard candy in their mouth, and stick with lollypops rather than hard candy in kids under age 5.  Dr. Kelly Ross writes about choking hazards and other things you never knew could kill your kids here.

10)  Problem: your kids are very healthy.  Why is this a problem?

Solution: Because it’s time for their annual well-child checkup.  If you haven’t already scheduled your child’s yearly visit with the pediatrician, summer is a great time to do it.  Another good way to keep your child on schedule with the pediatrician is to plan their well-child visit for the week of their birthday each year.  Even if your child is up-to-date with vaccines and doesn’t need any forms filled out, they still need to be checked by their pediatrician each year.  Prevention is the best medicine!