Sledding Safety

by Edwin King, MD and Felicia Finnegan, PA-C Originally published at www.thePediaBlog.com

True story: Walking through

the woods with sleds in tow to a popular sledding hill in Frick Park, I was pelted with questions from my 5-year-old and 10-year-old. “Why do we have to wear helmets, nobody else wears helmets?!” The pediatrician’s logical explanation followed. Hearing this, the children, unimpressed, remained helmetless and disgruntled. As we approached the busy, massive, steep sledding hill, there was an ambulance at the top. The children, now quite silent, looked up to the ambulance, then looked back at me – repeatedly. I remained silent as we watched the stretcher being loaded into the ambulance. We asked a passerby what had happened. “Some sort of head injury, maybe concussion, maybe worse, they do not know.” The children quickly looked at me and then the ambulance a few more times, jaws agape. They scurried to put their helmets on as soon as they could, and have not questioned wearing helmets while sledding since that day.

Unfortunately, most parents do not have the luxury of an immediate, poignant example to impress their children to follow safety recommendations. Nonetheless, it is our responsibility as parents to keep them safe. Since the American Academy of Pediatrics has recommended helmets for sledding, let’s review some important safety precautions for winter.

Remember as a child the excitement you had of tearing apart the winter bins in the attic looking for matching gloves and snow pants and boots (that hopefully still fit) in angst to celebrate the first snowfall. Winter is here and in Western Pennsylvania there will be no shortage of snowfall. Children of all ages will be participating in sledding and it is our responsibility as adults, parents, and providers to assure their safety.

In 2014, according to the U.S. Consumer Product Safety Commission, more than 52,000 injuries related to sledding, snow tubing, and tobogganing were treated at emergency rooms and doctors’ offices. Injuries associated with sledding ranged from bumps and bruises to broken bones, head and neck injuries, hypothermia, frost bite, and death.

Another study showed that 64% of pediatric hospitalizations from sledding injuries were from hitting trees. In addition, researchers found: > 37% of pediatric hospitalizations involved head injuries, with more than two-thirds (70%) requiring ICU admission, and 10% resulting in permanent disability. > 33% of injured children had fractures, half of which were severe enough to require surgery. > 19% had internal organ damage.

General Sledding Safetyand Gear

GEAR: > We agree with the American Academy of Pediatrics and strongly recommend that your child wear a helmet when sledding. Remember some basic physics when sledding: the faster and steeper the hill, the more force is generated upon collision. Young heads should be protected with helmets! > Wear hats, mittens, boots, and layers of clothing. Generally speaking, young children should have on one more layer of clothing than an adult would wear. Remember that babies and young children’s heads are proportionally larger than the rest of their body. A hat properly fitted under the helmet should be worn at all times. Proper attire prevents traumatic injury and cold injury, which includes hypothermia and frost bite. Instruct your child to come inside if clothing is wet. > Only use sleds that are in good condition and are approved for such activity. Plastic sheets, garbage bags, etc., can tear during activity and should not be used. > If sledding in the evening, assure the area is adequately lighted. > Sleds with steering mechanisms, such as runners, are safer that discs, tubes, and flat sheets.

GENERAL SAFETY TIPS FOR SLEDDING: > Always have an adult present when sledding. Adults’ responsibility is to supervise the number of sledders in one area, control traffic at the bottom of the hill, prevent potential injuries, and monitor for actual injuries. > If your child is 11 or older, be sure he/ she has had a baseline IMPACT concussion test before hitting the slopes. > Reiterate the importance of stranger danger to your child often when he/ she goes outside. > Sun rays are still damaging in the winter, especially with reflection off the snow. Sunscreen on exposed areas of skin and sunglasses will help protect against snow glare. > Feet first and sitting upright is safer than lying down or going head first. > Take turns! One person should be on a path at any given time. > Designate a side of the hill for sledding and a side for climbing back up the trail. > Sled only in areas designated for

sledding. Avoid sledding in areas of trees, fences, streets, cars, curbs, light posts, rocks, snow banks, etc. > Number of sled passengers should never exceed that recommended by the sled’s manufacturer. One passenger per sled is the safest. > Assure that the area at the bottom of the hill is clear – no drop offs, water sources such as ponds, streets, trees, other sledders, etc. > Make sure your child knows to move off the path when the run is complete. > Teach your child to roll off the sled if it won’t stop and assure them the sled will be retrieved later. > Never ride a sled being towed by a street vehicle, ATV, snowmobile, etc. > Do not build your own jumps or obstacles. > Never be under the influence of any substance when supervising your child’s sledding. > Never stand or hang out in the traffic areas of a sledding hill and always keep your eye on speeding sledders heading your way.

The AAP has more winter safety tips here. Have fun and enjoy a safe winter season.