Bike Spills, Trampoline Falls and Sips of Sanitizer: How Kids Are Getting Hurt at Home

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Children who left school to avoid exposure to the coronavirus are encountering a new set of hazards while sheltering at home.

Since the pandemic began, fewer children than usual have visited emergency rooms. But doctors across the country say they have seen a growing number of children who suffered broken bones on bikes and trampolines, accidental poisonings and other severe injuries during the widespread lockdowns.

Instead of getting injured on playgrounds or during team sports, many children are getting hurt while playing with outdoor toys and sports equipment at home. Sales of trampolines, scooters, skateboards, bicycles and inflatable pools surged as families looked for ways to keep their kids entertained — and with parents often unable to provide constant supervision because of work and other obligations, injuries have followed.

“We’re seeing an increase in trampoline injuries, scooter injuries, bicycle injuries, and it’s primarily because kids are out of school and there’s nothing else for them to do,” said Dr. Gaia Georgopoulos, an orthopedic surgeon at Children’s Hospital Colorado.

Dr. Georgopoulos and others said that trampolines were a major driver of injuries occurring at home. On one recent Saturday at Dr. Georgopoulos’s hospital, six of the seven children who underwent surgery for traumatic injuries had been hurt on trampolines. In Indianapolis, Dr. Ryan Fitzgerald, an orthopedic surgeon at Riley Children’s Hospital — a level one trauma center that handles cases from Chicago to southern Indiana — said that many of the surgeries he performed in recent weeks were on children who sustained trampoline injuries like broken arms, wrists and elbows.

Trampolines are now such a common cause of injury that at Nationwide Children’s Hospital some E.R. doctors have nicknamed them “orthopedic fracture machines.”

“I have not gone a single call week here without seeing a trampoline injury — many days we’re seeing multiple,” said Dr. Fitzgerald at Riley Children’s Hospital. “It’s so prevalent that it’s a real issue. Every day we’re seeing kids that have to go to surgery for it.”

That was the case for Lily Boardman, an 11-year-old in Moorestown, N.J. Before the pandemic, she was constantly busy with school, gymnastics classes, a homework club, field hockey games and other activities. But when the pandemic struck and New Jersey went on lockdown in March, all of her school and extracurricular activities were canceled. Stuck at home with little to do, she spent much of her time playing on a trampoline in her backyard.

In May, she fractured her left arm and dislocated her elbow while doing a back handspring on her trampoline. Her mother, Meghan McNamee, took her to the emergency room at Children’s Hospital of Philadelphia, where she underwent surgery and had a screw inserted to repair the damage. Ms. McNamee said that many of her friends have similar stories about their children getting injured on bikes or trampolines or in pools during the lockdown.

“I feel like in general everyone has had to have stitches or has had some sort of accident,” she said. “I guess a lot of it is because there isn’t as much to do.”

One study published in May looked at 306 children who were treated for acute fractures at the Children’s Hospital of Philadelphia in March and April and compared them to children who were treated at the hospital during the same months in the previous two years. The study found that the overall number of pediatric fractures treated at the hospital was down this year. But the number of fractures that occurred at home and the percentage that involved “high-energy falls” like those from bikes and trampolines were up.

The study also found that younger children made up a greater share of patients compared to previous years: The average age of children showing up at the hospital with fractures dropped from 9.4 in previous years to 7.5 during the pandemic.

Dr. Apurva Shah, an orthopedic surgeon and senior author of the study, said that sports-related fractures had fallen significantly as a result of children no longer taking part in school activities, baseball and basketball leagues, and other organized sports. He speculated that older children were replacing organized sports with less risky indoor activities like watching television and playing video games, while younger children were more likely to remain outside bouncing on trampolines and riding bikes, scooters and hover boards.

Dr. Shah said that he had seen a lot of “bizarre” accidents occurring inside of homes since the lockdowns began.

“I’ve seen more than one fracture from a child rollerblading inside their home,” he said. “I think that parents and kids are just trying to keep their wits together and trying to be active and busy in not always the safest ways. So there is this rise in oddball, inside-the-home injuries.”

Many people assume that trampolines are safe for children if they have netting around them. But that is not necessarily the case. Dr. Shah said that children frequently injure themselves while simply getting on and off trampolines. A lot of injuries occur when multiple kids are jumping on a trampoline at the same time, especially when young kids are bouncing with older or larger kids.

And Dr. Georgopoulos in Colorado said that she had treated children who broke hips and other bones while jumping by themselves because their bones simply couldn’t handle all the forces that trampolines create.

Dr. Fitzgerald in Indiana published a study in March that showed that from 1998 to 2017 there were almost 1.4 million emergency room visits nationwide resulting from trampoline accidents. The vast majority occurred on home trampolines; about 126,000 injuries occurred at trampoline parks and other recreational facilities. Dr. Fitzgerald said he encourages parents to find ways for their children to be physically active without using trampolines.

  • Frequently Asked Questions and Advice

    Updated June 16, 2020

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

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      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

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      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

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      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

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      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

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      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

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      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

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      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

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“In my line of work I see how many kids get hurt on these things and how severely,” he said. “We’re not suggesting that you wrap your kids in Bubble Wrap. But we want them to go out and be active and healthy in a safe way.”

Experts say that parents can follow basic safety measures when letting their children play outside. Always make sure they wear a helmet when using bikes, scooters, skateboards or inline skates. Keep pools fenced off and outfitted with an alarm if possible: Drowning is a leading cause of death for children ages 1 to 4.

The American Academy of Pediatrics discourages families from buying trampolines. But those who use them should take precautions like placing them on a soft surface, allowing only one child to bounce on them at a time, and not allowing flips.

As for injuries inside the home, safety experts at Nationwide Children’s Hospital developed an app called “Make Safe Happen” that helps parents identify hazards room by room in their homes depending on the age of their children.

The Centers for Disease Control and Prevention reported that calls to poison control centers regarding children who have swallowed cleaning products and disinfectants spiked 20.4 percent during the period from January through March, with children 5 or younger accounting for the largest number of cases. The agency cited one case of a little girl who fainted and hit her head after she drank hand sanitizer from a bottle she found on her kitchen table. At the hospital, doctors discovered her blood alcohol level was more than three times above the limit for driving under the influence in most states.

“We’re worried about all of these germs, and so we’re bringing all of these disinfectants and cleaners into our homes at levels we haven’t seen before,” said Tracy Mehan of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Ohio.

With lockdowns ending and more families allowing children to play outside their homes, Dr. Benjamin Hoffman, chair of the American Academy of Pediatrics’ Council on Injury, Violence and Poison Prevention, said parents should let their children explore and play in fun and creative ways.

“But do it in a way where you’re thinking about what potential harm could come and then have a plan for supervision,” he said.