AEDs, Vaccine Safety, Amusement Rides – PediaCast 251
Join Dr Mike in the PediaCast Studio for more answers to listener questions. This week we cover the Boston Marathon bombing, automated external defibrillators, vaccine safety and the history of the MMR-Autism fiasco, up-close screen time's effect on eyesight, and amusement ride safety.
Boston Marathon Bombing
AEDs – Automated External Defibrillators
Up-Close Screen Time & Eyesight
This is PediaCast.
Announcer: Welcome to PediaCast, a pediatric podcast for parents. And now direct from the campus of Nationwide Children's, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello, everyone and welcome once again to PediaCast. It's a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital in Columbus, Ohio.
It is Episode 251 for May 1st, 2013. We have another Listener Show for you this week, and we'll get to the line up in a moment.
But first, I have yet to weigh in on the Boston Marathon Bombing. And I wanted to do that.
Because I have had questions from folks, like how do we approach the topic of terrorism with our kids? How do you go about presenting this to them and how do you answer their questions? And so I did want to include a little something on it.
First I just want to say, of course, like all of you, my prayers and thoughts and sympathies really go out to all the victims. Nearly 180 injured and three folks dead, including a little guy. Then it's all over the news, the whole hunt for the man involved and the whole terrorism thing, and you just get this feeling that we're going to see more of this sort of thing.
I don't want to think of it that way, but it's the world we live in. There's going to be more this kind of thing in the news. So what do you do? How do you handle this with your kids?
And so, I came up with a list of five things that I think are important, as these things emerge in the future.
Number one, I would say with your kids, really just limit their news exposure. It's there. They're going to find out about it. But you don't want hours on end watching the stuff.
And there have been some studies that show that people who really get into and watch these events can have post-traumatic stress disorder, just as much as the people who are actually involved in the events themselves. That watching it, all the time, can cause stress. So definitely limit that exposure that they're seeing.
Number two, I would answer their questions honestly. It doesn't mean you have to go on the graphic detail but I won't lie to him either. They need to need to know about the world we live in and then the truth of it and what that necessarily means.
But at the same time, and this is number three, I would reassure them. You love them that they're family and the folks and your circle of influence they are loved.
And that you are going to do everything you can to keep them safe. If that means, putting yourself at risk or whatever. I mean, you just want them to feel loved and to feel safe and reassure them, because chances are still pretty low that they're going to be involved in one of these events.
Number four, invoke your faith, whether that be a Christian, Muslim whatever it is whatever your faith is, invoke in your kids the trust of God and pray for those affected. So you definitely want to invoke your faith as part of this.
And then number five, probably, really at the end, redirect them, OK? They asked their questions. They saw it in the news. They heard it about at school. They asked their question. You answered honestly. You've reassured them that you love him. You invoke your faith. It's time to move on and re-direct them to something else and get their mind off of it.
All right, so that's "my two cents". As more events unfold in the future, which we know that they will, hopefully not for a long time.
Something's going to happen at some point in the future and I think those are just some good tips to keep in mind.
All right. So what are we talking about today? AEDs "Automated External Defibrillators". You've seen the little boxes in gyms and parks and pools and shopping centers. But what exactly are they? How do they work? What kind of training do you need to operate one?
More specifically, a listener wanted to know about using adult-sized electrode pads on a child sized victim. Is that something you should do? Is it safe? What can happen if you do? We'll take a look.
Vaccine safety another listener fully vaccinates her kid but she has friends who don't. In fact, her friends buy into the conspiracy theory that vaccines are not dangerous but the vaccine industry knows they're dangerous and are behind the fraudulent research, which shows they're safe. Wow.
She'd liked the best online resources on vaccine safety to check for herself and to pass along to her friends. So I'll provide those.
Plus, we'll take a look at the history of the anti-vaccine movement. How it got started? Why it keeps going? So that's coming up.
Then we'll talk about "up close" screen time like we have with mobile phones, iPads and laptops. Listener has a question about the effect of "up close" screen time on your eyesight. So we'll talk about that.
And then we're going to wrap things up with amusement-ride injuries. Lots of kids take advantage of amusement rides in the summer, but are they safe? Is there a difference between fixed-site rides at theme parks and mobile rides at fairs and carnivals, and mall-type rides in and near the around the checkouts of grocery stores inside arcades. You know the ones I'm talking about.
Which ones are most dangerous? How are they regulated? What types of injuries do we see and how many? Should you allow your kids to ride them? And if so, what safety tips should you keep in mind? We'll clue you in on that.
So lots of great information are coming your way and most of it comes from you the listener in a form of questions.
And if you have a question of your own, I'd love to hear it. Just head over to pediacast.org, click on the Contact link and ask me directly.
I read every single one of those that come through and we'll try to get your question on the show. Pediacast.org contact us.
All right. Also, I want to remind you, the information presented in PediaCast is for educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, call your doctor and arrange a face-to-face interview and hands-on physical examination.
All right, let's take a quick break, and I'll be back with your questions, right after this.
[Short Break Music]
All right, first stop is Tiffany in Grants Pass, Oregon. Tiffany says, "Hi, Dr. Mike. I recently took my health provider or health care provider Be Alert class. We were learning about AEDs and the instructor said, "If pediatric pads are not available, use the adult pads."
"Someone asked the instructor if there was an issue with using the adult AED pads on a child. The instructor wasn't sure and I immediately thought of you. I know the typical level of defibrillation for an adult is 300 joules and the recommendation for pediatrics is 2 joules per kilogram."
"So what gives with using the adult pads on a child? Can one do more damage? I know this is somewhat of a technical question, but with the abundance of AEDs these days in places like Wal-Marts, schools and ball fields, I thought other moms and clinicians would be interested in this question.
Thanks so much for your podcast. I love listening can't wait to hear your views on this issue. P.S.: Our local hospital and the pediatric unit and I submitted your flyers for the podcast to be posted can't wait to see them up.
So thanks for the question, Tiffany.
And thanks, too, for the vote of confidence with the PediaCast posters. Those, of course, are available for download under the Resources tab at pediacast.org. They are perfect for bulletin boards at any location, including hospitals, clinics, your doctor's office, day care centers, churches, the local Y.
You get the picture? And enough of this self promotion, but I really do appreciate your efforts, Tiffany. So on to your question. And it's a good one.
AEDs in pediatric versus adult-sized electrodes or pads I'm going to approach this discussion in two parts. Number one, let's talk about AEDs in general and then number two, which really has two parts.
A: Does Tiffany's instructor make a valid point? Should you use adult sized pads on a child? And B: If you do use adult sized pads on a kid, what's the risk?
So let's start with AEDs in general. AEDs stand for automated external defibrillator. So this is a little device comprised of a base unit that houses a battery and a computer.
And then there are two large electrodes or pads that attached to the machine by way of cables. And for victims suffering cardiac arrest, the pads are applied to the chest, usually one at the top right of the chest, and the other at the bottom left, which coincides with the apex of the heart. And these pads maybe color coded or have labels to let you know which one goes where.
Now if the chest is too small to accommodate the two pads, without them touching or coming into close contact with another, as is the case in kids like ages one to eight, or anyone with too small a chest and it just doesn't accommodate both of the pads, then usually one pad goes on the front of the chest and the other is applied to the back, because touching or pads in close proximity to one another could cause a spark, which might result in a burn or a fire.
But again, you want to follow the specific instructions on the specific machine that you are using. So then you turn the machine, and it analyzes the victim's heart rhythm. And if it senses a rhythm that warrants a shock, the user is instructed to make sure everyone is clear and then push the button to deliver electricity.
Now, the systems are designed for use by the general public and there have been studies that showed children as young as sixth graders can follow the included directions and use them correctly.
Having said that, it's a good idea to have some experience handling an AED in a non-emergent situation prior to using one during distress of an actual cardiac arrest. In other words, it's good to have some training.
So as a member of the general public, how do you do that? How do you get that experience? I mean, these machines are everywhere, but you can't take one out and fiddle with it whenever you want, right?
They usually have a rip-away lock and a sign that says, AED is for emergency purposes only. In other words, leave it alone unless there is an actual emergency. So how do you get this experience?
The best way is by taking your basic life support class, which includes AED training. And you can find this class by contacting your local Red Cross, the American Heart Association. Even your local hospital, their education department may be able to point you in the right direction.
And I've said this before. I'll say it again. A basic life support class is mandatory training for every parent. And if it's been a while, you should repeat this training and keep it fresh. Seriously, it could save your child's life or another child's life, or your spouse's life, or the life of a grown up that you don't know.
So no excuses just do it. And if you're a teenager babysits, they should take a basic life support class as well. OK, so that's how you get to play with an AED in a safe and non-stressful environment so you feel more comfortable in an emergency.
Now here's an issue. Not all AEDs look alike and there's no guarantee that AED you played within class will be the exact same as the one you encounter in an actual emergency. So the key here is to quickly read the instructions that come with any unit you encounter, even if you've had training, and you should find very simple clear directions with pictures.
But again, a little familiarity will help you do this more efficiently.
I also want to point out. If you work or frequently hang out in a location that has a specific AED machine, it's probably a good idea to become familiar with that particular machine. So how do you do that?
Well, you find out who oversees the device which is usually a medical person. They're responsible for making sure that AED remains functional with non-expired pads and working battery. So hunt down that person and let them know you want a quick tutorial on how to use that machine so you're more comfortable in an emergency.
OK. So let's get a step closer to Tiffany's question. Adult versus pediatric pads or electrodes, what's the deal there?
Run-of the-mill AEDs are designed for adults. In an AED adult world, an adult is defined as someone over the age of eight, so nine years of age or older. So if you encounter a victim who is older than eight, or who weighs more than 55 pounds and the front of their chest accommodates both pads, then you use the adult pads.
But what about those ages one through eight? Ideally, we'd like to use a lower dose of energy because in animal studies, high energy doses of electricity used on smaller hearts has been shown to cause muscle damage and lower doses of electricity are preferred with smaller hearts.
Now to achieve this, many AEDs come with what are called attenuated pediatric pads, which have a smaller surface so they fed on the skin better still one goes on the front; one goes on the back and they attenuate the energy.
This means, they absorb some of the energy and deliver a smaller shock. Now, what if the machine you encountered doesn't have pediatric pads? Then what?
Well, here's where things get dicey. Because, on the one hand, if you don't use the machine, the victim might die; on the other hand, you could resuscitate the victim but they could end up with significant heart muscle damage.
Now you could say, if I do nothing they die. If I shock them with an adult pad, they could have heart muscle damage.
Isn't it better to risk muscle damage, than to die? Probably, but as is often the case, it's not always black and white. And when it's not black and white, the legal system may come into play.
What if the person wasn't really in a "shockable" rhythm? What if they were just unconscious and you assumed they had arrested?
Let's say the AED misread their heart and told you to shock. Now granted it's not very likely, but it is possible.
So after the fact, they have heart muscle damage, maybe life threatening damage, and they should not have received a shock in the first place. Or let's say you deliver a shock, they really did have a life-threatening rhythm, which is corrected. But now, they have heart muscle damage, which maybe life-threatening, could lead to an extended hospital stay and more bills, could lead to a poor neurological outcome, maybe they'll end up needing a heart transplant so you've created lots more trouble although it isn't more trouble than death, probably not.
On the other hand, let's say you don't use the AED because of these fears and the victim dies at the scene and you get blamed for not using the machine, even though they didn't have the right sized pads.
Now in many jurisdictions, if you're a lay person, Good Samaritan laws are going to protect you from these types of scenarios. But in other place or situations or if you're health care professional, you may be held to a higher standard.
You may be held accountable for not following the instructions on the machine, or you may be held accountable for not following the nebulous standard of care in your community.
So where can we get some guidance really on what to do? So, yeah, your instructor said to do it. But you know, really, an instructor can say anything. Where can you find like official guidance on this?
One place is the American Heart Association. They published guidelines called "Use of Automated External Defibrillators in Children: An Update," and they published this in the general circulation in 2003.
And they said, "Ideally the device should deliver a pediatric dose." That's it. Now what is "ideally" mean?
To me, it means use the attenuated pediatric pads if they're available. But if they aren't available, use what you've got.
Now is that how a court or jury or another expert would interpret it? I don't know.
Also the statement came out 10 years ago, and unfortunately, we do not have an update to the "update". OK. So let's check with the American Academy of Pediatrics.
In 2007 so this is a little more recent they published a policy statement in the Journal of Pediatrics, which said, "Rescuers need to be aware that they should still provide care to infants and children with a non-attenuated adult dosage device because the potential for benefit far outweighs the risk."
And they go on to say, "If an AED with a pediatric attenuating system is not available, the responder should use a standard AED rather than delay the delivery of a potentially life-saving intervention."
Great. So we have clear guidance from the AAP that we should use adult pads on kids, if pediatric ones are not available, right?
Well, not quite. As it turns the AAP retired this policy statement in 2011. So what does that mean?
Well, it doesn't mean they don't endorse it or stand behind it anymore? Hmm, not quite. AAP policy statements automatically retire after five years, unless they are re-affirmed. So the AAP did not re-affirm the statement.
Why not? I don't know. They just let it retire and they didn't replace it with another one. They didn't re-affirm it either which makes it a bit more difficult to rely on the advice.
OK. So now what? Well, the American Academy of Pediatrics, their Section of Cardiology and Cardiac Surgery comes along with their own policy statement in 2012. So this is really recent. It's called "Pediatric Sudden Cardiac Arrest" and it's also published in the Journal of Pediatrics.
They addressed AEDs in their statement, which again, it's just one year old. It's not retired. So I'm feeling pretty good about the advice I'm going to get here.
And in their section on the use AEDs in pediatric patients, they say, "A 2007 AAP policy statement addressed recommendations for AED use in children. Readers are referred to this publication for further detail."
So a current policy statement refers made to a retired one for more information. So it's just clear as a mud now, right? I mean you just got to love the system. It just drives me crazy, sometimes.
So do you use the adult pads on a small child when attenuated pediatric pads are not available? According to the American Heart Association, it's not ideal, but they don't say not to do it. And according to a retired AAP policy statement, which still referenced by an active You do. You should use the adult pads, which is the advice of Tiffany's instructor.
So we're back to Tiffany's question. You used the adult pads on a kid, what's the risk? Again, as we've discussed, the risk is the potential of too much energy causing heart muscle damage but the risk of doing nothing is probably death.
Incidentally, you'll notice I've been saying kids from one to eight years old. The 2012 Policy Statement from American Academy of Pediatrics, so the most recent and the active source states, "There is still insufficient scientific evidence to warrant official recommendations for or against AED use in children ages one year or younger." [Laughter] So again, clear as mud.
One of the most important points I can make here, take a basic life support class that includes AED training. Everybody–young teens through adults–if you can hear my voice right now and you haven't had basic life support training, call your local Red Cross or the American Heart Association, or your local hospital.
Get registered for a class. And if you've taken a basic life support class but it's been a while and you forget the details, take a refresher course. You'll never know when you will be called upon to save someone's life.
All right, thanks for the question Tiffany, as always, much appreciated.
Let's move on. This one comes from Anna in New Jersey.
"Hi, Dr. Mike. Love your show and your take on things. "Risk versus benefit" is now part of my everyday language. Anyway, I've lots of friends who are anti-vaccine or vaccine suspicious. What if I go to website I can direct people to, to reassure them of vaccine safety?"
"I really trust that the scientists who formulate and test things are doing their jobs well. And I fully vaccinated my children on the recommended schedule, but I have friends who are really fearful about this and suspected the vaccine industry is really behind the studies that show vaccine safety."
"I don't get into arguments about it but I'd love a level-headed research-based resource to point them to. Thanks so much. Anna."
Thanks for the question, Anna. So, like me, you believe vaccines are safe, or at least that their benefits far outweigh the risks. But you find yourself among friends who aren't so sure. Some are concerned about the vaccine of safety of vaccines, and even worse, some think the vaccine industry is, hmm, maybe engaged in some fraudulent research to protect their products and line their pockets with cash–so that sounds like you're implying.
So first let me say, if this is truly what they believe, that the system is crooked, you may have trouble convincing them. No matter how many evidence-based and peer-reviewed resources you throw at them. That's the conspiracy theory crowd out there.
Now, your "more reasonable" friends, those who would take time to look at the facts and are opened to drawing their conclusions based on those facts, I think you can help those friends. But I wouldn't start with a research showing vaccines are safe.
I would start with a research which sparked off the vaccine safety controversy in the first place. The year was 1998, the journal was The Lancet. The researcher was Dr. Andrew Wakefield. And his hypothesis went something like this.
The MMR vaccine leads to chronic infection like low-level infection with measles virus, because remember the MMR is a live virus vaccine. So you've got this live measles virus that's just persistently infecting your child. Again, this is his hypothesis.
This chronic infection with the measles virus leads to inflammatory bowel disease, which leads to toxins from your environment and diet, being more readily able to enter the body, which leads to brain damage, which leads to autism.
So that was his hypothesis and he really wanted this hypothesis to be true. Why? According to investigative reporter, Brian Deer, as published in a 2011 two-part feature in the British Medical Journal, according to Brian Deer, Dr. Wakefield had hopes of designing and distributing the patented test that would identify the supposed chronic measles infection.
And he envisioned millions of lawsuits worldwide against vaccine manufacturers and each case would hinge on the results of his test. Plus every parent with an autistic child would want to "test run" to see if MMR vaccine was responsible for their child's condition.
And as Brian Deer revealed, Dr. Wakefield had investors lined up and companies created. He thought he'd get a Nobel Prize over this, and fame and fortune would follow. The problem of course is his hypothesis was not true and his results were not panning out.
So he concocted a fraudulent study involving 12 children just 12 with autism, whom had received the MMR, who he says had evidence of chronic measles infection and inflammatory bowel disease.
And the study was published in 1998 by the journal Lancet. Because of the Internet, news of this spread, like wild fire. And by the way, even this study, let's say that this is a published study and we're going to get to what ended up happening with this.
But let's just say there it is. That still doesn't mean that this chronic underlying measles infection caused inflammatory bowel disease, which caused the toxins, which caused brain problems, which caused autism.
I mean you could have a kid who happened to have the MMR, who happened to have this measles infection, who happened to have inflammatory bowel disease, who happened to have autism. I mean those things aren't necessarily dependent on one another.
And the kind of research he did, did not show that they were. They just showed that they all co-existed together but not that they were related. In any case, news of this spread, like wild fire in these 12 kids.
Problem was, the research, as I mentioned, was shaky and as investigators around the world poured over it, they began to point out serious issues with the methodology and the analysis. Serious issues.
So to be fair, the medical school and hospital facility that employed Dr. Wakefield in the United Kingdom, they said, "Dude, you need to replicate your results with a 150 kids." Well, Dr. Wakefield dragged his feet and dragged his feet and then dragged his feet some more.
Meanwhile, folks started contacting the families of these 12 kids, and it turned out they didn't really have inflammatory bowel disease. And when these measles virus tests were repeated, the one that checked for chronic infection with the MMR virus, they were negative.
So now, it looks like Dr. Wakefield isn't just conducting bad research. It's likely fraudulent, which is ironic that fraudulent research started this virus storm. But many parents out there still believe and maintained that the well-done, heavily scrutinized investigations today that show vaccines are safe but those are really the fraudulent ones which really just makes no sense.
So Dr. Wakefield was fired. He ended up losing his medical license. His collaborators pulled their support from the project and the journal Lancet retracted the article. But none of that really matter because the news of the association between MMR and autism continued to spread.
And it continues to spread today thanks to social media and parents believing it.
If you'd like to read Brian Deer's entire two-part piece of investigative journalism, which is really quite fascinating, part one is called "Secrets of the MMR Scare: How the Case Against the MMR Vaccine was Fixed" and the second part is "Secrets of the MMR Scare: How the Vaccine Crisis was Meant to Make Money."
And I'll put a link to both of those in the Show Notes Episode 251 over at pediacast.org.
So Anna, that's the first place I would direct your friends. You need to know the history of how this whole thing got started and just how crazy it was.
OK. So what about sites which featured trustworthy information on vaccine safety? The Journal of Pediatrics published the well-done study in March 2013, so very recent, entitled "The Risk of Autism is not Necessarily Increased by Too Many Vaccines Too Soon". That's the name of the article and I'll put a link to that in the Show Notes so you can direct them there.
Other great sites include–Vaccine Safety: The Facts at healthychildren.org, Vaccine Safety, the Childhood Immunization Support Program–and this one is nice. It not only addresses MMR and autism but also thimerosal mercury and aluminum–then, Vaccine Safety from the Centers for Disease Control and Prevention, Vaccine Safety from the U.S. Food and Drug Administration and the National Network for Immunization Information.
These are all great sites and I'll put links to all of them in the Show Notes for Episode 251 over at pediacast.org. So hope that helps, Anna, and thanks for the question.
All right. Next stop, we have Melissa in California. She says, "Hi, Dr. Mike. Love your show. I was wondering if you could address the topic of children's eyesight and if it is affected by too much screen time, up close to their face, as in using iPads and computers."
"I just heard about this and wondered if there's any validity to the notion. Thanks for your evidence-based information. Sincerely, Melissa."
Thanks for the question, Melissa. So there's nothing new under the sun and this question proves it.
When I was a kid, my mom would say, "Don't stay so close to the TV. It will ruin your eyes." Or another one, "Turn on the light." Because there was this belief that reading in low light levels was bad for your vision. And another one not related to vision but involving the eyes, "Don't crash your eyes. They'll get stuck that way."
Do you remember those? OK.
I'm sure many of you out there right now are just shaking your heads, saying, "Yup, yup. I remember."
None of them were true, by the way. There's no evidence that being close to a normal everyday light source is hazardous to your eyes or your sight. Now that's not the case for high-energy light sources like laser beams or looking directly at the sun. Yeah, that's hazardous.
But your normal everyday screens like TVs, iPads, iPhones, other mobile phones there are other mobile phones? OK and laptops. I just lost some listeners on that. No. OK. And the Androids are fine. They're fine.
There is no evidence that attempting to read in low light environments. There is no evidence that that's hazardous to your eyes. And there's no evidence that crossing your eyes will lead to any problems, although eyes that are crossed involuntarily could be a symptom of another problem.
OK, having said that, there are some issues that could develop from too much "up close" screen time. They are not hazard, these issues. But they're issues nonetheless, and some of them we've covered on PediaCast in the past.
We know that too much screen time robs a child of social activities within the home and robs them from physical activity, both of which can affect your long-term health, whether that'd be physical or mental health.
We know that too much screen time prior to bed time can interfere with sleep quantity and quality by stimulating brain activity. And the light from these devices stimulates the pineal gland, which can also interfere with normal sleep cycles.
Another possibility when we stare the screen intently for a long period of time, really if we stared at anything for a long period of time, some of us don't blink as often as we should, because you're really paying attention, and that can allow our tear film to evaporate and keeps our tears from being properly replenished.
And this can result in "dry eye" which can result in blurry vision. But this condition is not dangerous, and it usually resolves on its own, if you blink a few times and rehydrate your eye then your vision is fine again.
Now I do want to point out dry eyes and totally benign and chronic severe dry eye can lead to corneal ulcerations. But when that happens, there's usually an underlying medical condition. It's not from incidental dry eye related to staring at a screen too long.
But I suspect it's this occasional temporary blurry vision related to mild dry eye, from not blinking enough, while intently staring at anything, including screens that leads to this notion that "up close" screen time is bad for your eyes.
As you get a kid who's intently staring at something and they're like, "Mom, everything is blurry." And the next thing, "And Mom, you know, that's bad. It's bad for your eyes." But there's really an explanation behind it.
So there's your answer, Melissa. Too much "up close" screen time could result in temporary blurry vision, which is usually not hazardous, unless there's an underlying dry eye condition. But in the vast majority of kids, up close screen time is not expected to result in any eye or vision problem that's serious at all.
All right. That wraps up our Listener questions this week.
Don't forget if you have a question of your own, it's easy to get a hold of me. Just head over to pediacast.org and click on the Contact link. I do read each and every one of those that come through and just send me your question and we'll try to get it on the show for you.
All right, we're going to take a quick break. I'm going to be back with a final word on the "Safety of Amusement Rides". That's coming up, right after this.
[Short Break Music]
All right. We are back. And I have a final word for you on amusement rides. As we head into summer season, here in the United States and elsewhere, many kids including mine including me will be taking advantage of amusement rides at theme parks, county fairs, state fairs, street festivals, parking-lot carnivals, indoor amusement centers, malls, grocery stores, department stores, restaurants and arcades.
They're everywhere. But are they safe? How many kids are injured enjoying these attractions? Should you let your kids ride? And if so, what can you do to keep them safe? Researchers here at Nationwide Children's Hospital set out to answer those questions in an article recently published in the journal Clinical Pediatrics.
Investigators found from 1990 to 2010, over 90,000 children under the age of 18 sought treatment in U.S. emergency departments for injuries related to amusement rides. That works out to an average of 4,423 injuries each year.
Now, more than 70% of these injuries occurred during the warm summer months, from May through September, with more than 20 injuries a day during this time frame.
Now, mind you, that's across the entire United States. So what kinds of injuries are we talking about and how severe are they?
Head and neck injuries were most common, representing 28% of all injuries followed by injuries to the arms, face and legs. What specific types of injuries? Well, 29% were soft tissue injuries, things like bruises, followed by strains and sprains, cuts, and broken bones. And broken bones by the way represented 10% of all the injuries.
Fortunately, hospitalization for these injuries is rare, with roughly one injury requiring hospitalization every three days during the summer months. The most common mechanism of injury was a ride-associated fall followed by hitting part of the body on the ride, or being hit by something while riding.
Thirty-three percent of injuries involved fixed-site rides, like ones at theme parks. Twenty-nine percent involved the mobile rides, like ones at carnivals and fairs, and 12% involved mall-type rides, which are also found at grocery stores and arcades.
As it turns out, the mall-type rides were more likely to be associated with injuries to the head, neck and face; and mall-type rides injuries were more likely to result in concussions and cuts when compared to fixed site and mobile rides.
Investigators say nearly three-quarters of mall-ride injuries occur when a child falls off the ride or against the ride, plus these rides are typically placed on hard surfaces and do not have child restraints which contribute to the types of injury seen.
Dr. Gary Smith, the study's lead author and director of the Center for Injury Research and Policy at Nationwide Children's and a professor of pediatrics at Ohio State University College of Medicine says, "Although the U.S. Consumer Products Safety Commission has jurisdiction over mobile rides, regulation of fixed-site rides is currently left to state or local governments leading to a fragmented system. A coordinated national system would help us prevent amusement ride-related injuries through better injury surveillance and more consistent enforcement of standards."
He goes on to say, "Injuries from smaller amusement rides located in malls, stores, restaurants, and arcades are typically given less attention by legal and public health professionals than injuries from larger amusement park rides.
Yeah, our study showed that in the U.S. a child is treated in an emergency department on average every day for an injury from amusement ride located in a mall, store, restaurant, or arcade.
We need to raise awareness of this issue and determine the best way to prevent injuries from these types of rides. Investigators offer some tips to keep your kids safe on amusement rides this summer and beyond.
Be sure to follow all posted height, age, weight, and health restrictions. Make sure you follow any special seating order and/or loading instructions–those orders are there for a reason.
Also use safety equipment such as seat belts and safety bars. Keep your hands and arms and feet inside the ride at all times–that sounds familiar.
Know your kids. If you don't intent to follow the rules, keep them off the ride. Also trust your instincts if you're worried about the safety of a ride. I know that like, you go to some of these county fairs and like "OK, I'm not getting on that ride."
Yeah, that's it. If you're worried about the safety, don't get on.
Avoid mall rides if they're on a hard, unpadded surface, or if they don't have a child restraint such as a seat belt.
So there you have it. My kids and myself, we're going to get on rides this summer. There's no question about that. I mean, my kids are like avid roller coaster fans and they pretty talk me into getting on just about everything.
So get out there and enjoy but be smart and stay safe. That's my final word.
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All right, again, thanks all of you for stopping by.
And until next time, this is Dr. Mike saying, stay safe, stay healthy and stay involved with your kids.
So long everybody!
Announcer: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.