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Summer Trauma

Macauley, Karen DHA, MEd, BSN, TCRN

doi: 10.1097/JTN.0000000000000212
GUEST EDITORIAL
Free

Pediatric Trauma Program, Johns Hopkins All Children's Hospital, Petersburg, Florida.

Correspondence: Karen Macauley, DHA, MEd, BSN, TCRN, Johns Hopkins All Children's Hospital, 501 sixth Ave South, St. Petersburg FL 33701. (Karen.macauley@jhmi.edu)

The author(s) declares no conflicts of interest.

Ah, summer—We dream of it; we wish for it ... no school for the kids; sunny, lazy days; vacations; drinks by the pool; the possibilities are endless and then—BAM! Trauma season enters with a vengeance! Warmer weather, overgrown lawns and bushes, summer sports and recreational activities, and bored kids can result in all kinds of traumatic injury chaos, both in the hospital and at home!

How can we best prepare for this crazy time of year? First and foremost, remind everyone about the potential dangers of summer activities. Maybe that reminder comes in the form of a public service announcement; maybe it is information at the pool store; the possibilities and creativity seem endless in educating your community. As always, determine your audience, craft your message, and put it out there.... It is just something that trauma nurses do.

Although every community is different, there are some common themes of summer traumatic injury mechanisms. Often a person's first priority is to get that yard cleaned up and flowers planted. Along with yard cleanup, there comes exposure to poisonous plants, pollen, and bugs. It also brings risk from tools, exposure to the sun, and lack of hydration. Lawnmowers can be a very deadly tool, and there are a few safety reminders: No one, especially children, should ever be outside when a lawnmower is in motion and no one should ever be a passenger on a lawnmower. Upward of 75,000 people are injured each year from improper use of lawnmower and 25% of all hand and foot injuries result in amputation (McCAllister, 2012). Proper safety equipment should always be used and includes closed toe (preferably reinforced boots) and goggles. Remind people to NEVER stick an extremity near a blade to remove grass or debris—Always use a stick because blades are often engaged even when the mower is off. In addition, motors of lawnmowers can be very hot and a hand on a motor can cause a third-degree burn.

Long summer days bring hours in the sun—Sunscreen and prevention of sunburn should be an important consideration when planning outside activities. In addition, lots of fluids are necessary to prevent dehydration, especially with age extremes (the very old and the very young). Every year many children (and pets) die from being left in a stopped vehicle while adults run an errand or, even more tragically, forget their child is in the car when they park. With lives as hectic as they can be, forgetting a child in a car is not at all impossible. It is recommended that adults put a necessary item in the back seat with the child, especially when the adults are out of routine, to ensure that they must open the back car door and see the child before they lock up and walk away for the day.

Lazy days bring water fun. We cannot survive without water—for cleansing, for drinking, and, often, for summer fun. Water, however, comes with risks, especially for children younger than 5 years, children on the autism spectrum of all ages, and virtually anyone under the influence of alcohol or other drugs. Layers of protection are the best set of protection (though not perfect). A 4-ft fence with a self-locking gate is imperative for residential pools and door alarms on every door in homes with children 5years and younger or any child on the autism spectrum is a must to keep this very vulnerable population from access to water. Eyes on the swimmers is also a must—We would never leave the grill unattended, but we may forget to watch the children closely. Drowning is a silent killer and happens within a matter of minutes. Spinal cord injury becomes a much greater risk for older children and young adults—diving into pools and hitting the bottom or diving into ponds or lakes of unknown depth of water. The risk becomes even higher when combined with alcohol use.

And, in case we didn't see enough risk as summer approaches, bicycle helmets and safe riding skills are a must as are awareness campaigns for drivers to share the road. Motorcycles and all-terrain vehicles get cleaned up and put back out on the road and off. This puts both drivers and passengers at risk for serious injury in a crash. “Everyone buckled up on every ride” never gets old in our trauma world either.

Finally, long, hot, hazy days bring increased irritability and violence to many communities. When patience is frayed, the smallest thing can become the catalyst for violence. Hot, bored, cranky children can become victims of child abuse at the hand of a frazzled caregiver.

Summer brings most families together, but, as trauma nurses, we tend to see risk everywhere and have a wealth of information to share with our communities. Your reminder can be the difference between fun and tragedy—Don't be afraid to talk about it and put it out there. In fact, less injured patients in our trauma centers might actually equate to more time for us to enjoy our summer too!?

Trauma nurses—Never underestimate your influence within your community. You are smart, passionate, knowledgeable, and amazing role models—Thank you for all you do to both prevent injuries and work diligently to ensure best patient outcomes. Have a safe and wonderful summer everyone!

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