Selected Podcast

Pediatric Emergencies

Children face a wide variety of health concerns during this time of year as the summer starts to fade and shifts into the fall.

Sunburn and other heat-related hazards are still present, as are the threats of animal and insect bites, swimming in backyard pools and other bodies of water, and the bumps, bruises and breaks that may happen when children make their way to the playground.

Meanwhile, with the approach of fall and cooler weather, children tend to spend more time inside the home – a place that can present a whole new set of worries and challenges for keeping kids safe.
Pediatric Emergencies
Arnaldo Abreu, MD
Arnaldo Abreu, MD, director of the pediatric emergency department at The Children’s Hospital at Saint Peter’s University Hospital in New Brunswick, N.J., is an expert in treating children suddenly injured or sick and in advising parents about the precautions they can take.

For more information about Saint Peter’s Healthcare System

Bill Klaproth (Host): Children face a wide variety of health concerns during this time of year as the summer starts to fade and shifts into the fall. Arnaldo Abreu, MD, director of the Pediatric Emergency Department at The Children's Hospital at St. Peter's University Hospital in New Brunswick, New Jersey, is an expert in treating children suddenly injured or sick, and in advising parents about the precautions that they can take. Dr. Abreu, thanks so much for being on with us today. So, what are the most common childhood injuries that are seen by physicians in the Pediatric Emergency Department in the summer as it transitions into fall?

Dr. Arnaldo Abreu (Guest): I guess the most common injuries are fall-related, either indoors or outdoors, especially associated with bicycles or skateboards, and anything from minor bruises and scrapes to fractures.

Bill: Okay, so those type of injuries that you see, I mean, it's just common sense at that point, right? You should wear a helmet; you should wear knee pads. What other things would you suggest to keep kids safe from this type of falls?

Dr. Abreu: Right. As you mentioned, wearing a helmet especially while bike riding or being on a skateboard are extremely important. Unfortunately, there's still a lot of kids out there that do not and unfortunately sustain significant injuries, so helmet use is very important. Proper gear, sneakers, just being overall careful is very important, and that's basically up to the parents to make sure that it's done.

Bill: Wearing a helmet for kids can be uncool. You know, "I don't want to wear the helmet, Mom, because that's uncool." As a physician, what type of advice would you give a parent in trying to communicate to their child, "Hey, you need to have this helmet on. This is for your own good." But kids don't want to listen to that. What kind of tips would you have for parents to help them make their child understand they need to have that helmet on?

Dr. Abreu: Well, the most important thing is if Mom or Dad are going to ride a bike, they should wear a helmet as well. You're not going to be too credible in enforcing helmet use if you yourself do not. So the number one thing, if Mom and Dad wear one, then obviously the kids will be more likely to do so as well.

Bill: So leading by example then certainly is one of the better ways to do that.

Dr. Abreu: Absolutely.

Bill: Is there a certain type of helmet that you would recommend or any thoughts on helmets or just any decent helmet you buy in a sporting goods store work?

Dr. Abreu: I mean, they're all safety-rated so I guess in order to make it more, I guess, cool-looking for the child, have the child pick his/her helmet. They come in different colors, design, so pick one that the child will like and you’ll probably get more use out of it.

Bill: Moving from injuries to illnesses, what are the common seasonal illnesses then as kids get into that group environment in school, the contagious diseases, what are the common things that you see?

Dr. Abreu: Well, I mean, once school gets in full swing, the more kids are in contact with each other. Obviously, contagious illnesses such as the common colds, stomach bugs, are pretty much more common. A very good way to prevent that is obviously if a child is sick, don't send them to school, and try to make sure that they wash their hands especially before eating or when they come home from school as well.

Bill: Any other tips to help parents protect their children against these illnesses?

Dr. Abreu: Well, the number one thing is strict hand washing and, as I mentioned, if they are sick, even if they don't have a fever, it’s probably better for err on the side of caution and just keep them home.

Bill: Okay. So kids are back at school now; they're healthy, they're good, they join their baseball team or football team or track team. Can you talk a little bit about sports-related injuries as well as kids go back to school?

Dr. Abreu: Right. Once the kids go back to their school-related sports, we do see an uptake in injuries. So before the season starts, it may be a good idea to get your child exercising again so that it's not something that they just start all of a sudden without being efficient, that would be important. Also, again, the proper gear and equipment, is important.

Bill: Okay, any other specific advice for parents as far as sports-related type of injuries? Obviously, kids playing football run the risk of hurting themselves in different ways versus track athletes, etc. – any other sports-related advice for parents or kids that are in sports or other extracurricular activities?

Dr. Abreu: What I see sometimes is that while they are participating in whatever sport under the guidance of the coach or trainer, they do wear their appropriate gear, but a lot of times, these kids will then go off on their own with their teammates and play in someone's yard or in a park and they don’t use their protective gears such as helmets and I see a lot of things to be that way.

Bill: Great point. Great point. When they're under supervision of a coach, they have all the proper equipment, but you're right, when they get in the backyard or out in the fields somewhere, they're not. So, great tip for parents to make sure that those kids that are in those types of sports are using the proper gear when they are practicing away from school – great point. That's a perfect segue. So now, say they're back at home, are there certain things in the home that kids need to be aware of, as far as a childproofing a home for children?

Dr. Abreu: Oh, that's a good topic. Again, falls are the most common injury that kids sustain while inside the home but there's a lot of things as well that parents need to be aware of. If you have little children, toddlers, obviously small items that they can pick and choke on are very common and you should keep them away from their reach. Things in particular, small magnets, button batteries can be quite dangerous if a little child does ingest them. Keeping medications and cleaning products out of their reach is very important as well.

Bill: And if a child does get injured, when should a parent bring their child to the emergency room? When do you know, yes, I should or, no, I shouldn't?

Dr. Abreu: Well, anything that involves any type of loss of consciousness obviously not just going to the local emergency department but calling 911 as well. Anything that involves any kind of significant bleeding, any kind of extremity injury where you see significant swelling or a deformity, anything that causes a child to be in intense pain for more than just a couple of minutes, anything that causes change in their behavior or alertness shall prompt a visit to the ER.

Bill: And what should parents expect when they arrive at the emergency room?

Dr. Abreu: Well, usually when patients arrive to the ER, there is a process called triage where they are assessed usually by a nurse or an emergency technician to sort of make a determination as to how serious or acute the illness or injury is, and if it's something really important, they usually get brought in right away. If it's something that they determine is not that urgent, they may wait a little bit especially if the ER is packed, which does happen on occasion.

Bill: And, Dr. Abreu, is there anything that I missed that you want to mention to parents about keeping their children safe as a transition from summer into fall?

Dr. Abreu: Well, I guess the swimming pools are still open so we always need to be vigilant in terms of more children being around not just the pool but any body of water, whether it be a pond, a lake, the beach, and keeping in mind that just because your young child has taken swimming lessons does not necessarily make them drown-proof. There should always be close, direct adult supervision whenever you have small children around any body of water.

Bill: Excellent point. So thank you so much, Dr. Abreu. We really appreciate it. And for more information, please visit I'm Bill Klaproth and this is St. Peter's Better Heath Update. Thanks for listening.