‘Last one down is a rotten egg’

January 3, 2011 - Injury Free Coalition for Kids of Baltimore

Last January, after one of the first big snowfalls of the year, Bill Acheson of Owings Mills and his three children suited up to go sledding. They were excited to try out a hill in their development but soon after they arrived, their fun turned to panic. “It all happened so fast,” says Acheson, who watched helplessly as the toboggan his 3-year-old daughter and 9-year-old son were sharing veered into a lone tree at the bottom of the hill. “It was almost as if the tree was a magnet pulling them to it.” Acheson’s son was fine, but his daughter, Elizabeth, who was sitting in front of the sled did not fare so well. Soon after they got home her temple started to swell and she became drowsy. A trip to the emergency room confirmed she had two skull fractures and internal bleeding — injuries that required a stay in the hospital.

“Fortunately Elizabeth made a complete recovery,” says Acheson, but he hopes their story can help prevent other accidents. According to a recent study released by the American Academy of Pediatrics (AAP), an annual average of 20,000 patients under age 19 were treated for sledding-related injuries in United States emergency departments between 1997 and 2007. “Sledding can be a fun winter activity but it has to be done safely,” says Dr. David Monroe, medical director of the Pediatric Emergency Department at Howard County General Hospital in Columbia. Monroe treated numerous children last winter from sledding-related injuries that ranged from cuts and broken bones to head and abdominal trauma. To ensure your children’s sledding outings this winter end with little more than wet bottoms and cold noses, follow these doctor-approved sledding safety tips:

Consider the Environment Out of the thousands of sledding injuries reported, the AAP study found that the majority were the result of a collision with an object on or near the snow hill. “Parents need to look at the environment where children will be sledding,” says Monroe. “Don’t make the mistake of thinking that kids can avoid trees and fences and rocks.” Looking back, Acheson says he realizes the hill wasn’t the best place to sled. It was too short and steep and although there was only one small tree at the bottom, he says that should have been a red flag. “Also keep in mind sledding conditions change every day,” says Monroe. “What’s safe one day may not be the next.” He suggests parents test the hill first to determine if it’s safe. The chance of collisions is higher if it’s snowing hard or getting dark, he says. When it comes to safe sledding hills, many families have found hidden gems in their developments or at local schools and libraries. While both Howard and Baltimore counties’ Department of Recreation and Parks permit sledding in their parks, it is “sled at your own risk.”

Enforce Helmets Considering the large proportion of head injuries found in its study, the AAP suggests parents require their kids wear helmets. In fact, some areas of the United States have sought to make helmet use mandatory for sledders. “If your child wears a helmet for snowboarding, biking and skateboarding, why not sledding, too?” says Dr. Jean Ogborn, a specialist in pediatric emergency medicine at Johns Hopkins Children’s Center in Baltimore. “Children can generate faster speeds sledding than bicycling, so taking measures to protect their heads only makes sense.” According to KidsHealth.org, an educational website featuring doctor-approved health information, kids ages 12 and younger should wear helmets. Although there is no such thing as a sledding helmet, the site recommends those designed for high-speed impact, such as a ski or bike helmet. “If Elizabeth had been wearing a helmet that covered her forehead, it would have most likely helped prevent or lessen her injuries,” says Acheson. Helmets also provide extra protection and insulation on particularly cold days, adds Ogborn.

Inspect the Sled According to the AAP study, the majority of reported sledding collisions were the result of children using sleds without any steering or braking mechanisms. KidsHealth.org recommends avoiding sleds that rotate, such as snow tubes and saucers, as well as sled substitutes like an inner tube, lunch tray, cardboard box or plastic sheets that can be punctured by objects on the ground. Keep in mind that young children have less-developed motor and decision-making skills, such as judging distances, speed and when to stop or to turn. It would be safer to pull them down gentle slopes by hand, says Ogborn. However, the AAP warned against pulling children on a sled behind a motorized vehicle, such as a snowmobile or all-terrain vehicle because numerous accidents occur that way.

Always Supervise Kim Eck of Ellicott City is excited about introducing her daughter to sledding this winter. “My daughter’s only 2, but I can already tell she’s a little daredevil,” says Eck, who plans on easing her into it and teaching her to be safe. Supervising young children should be a given, but don’t make the mistake of thinking just because your kids are older that they require less supervision. According to the AAP study, children ages 10 to 14 accounted for the most sledding-related injuries. “The older the kids, the faster and more daring their sledding runs become,” says Monroe. “By being present, parents can help enforce safe sledding.” Sledding headfirst increases the risk of head injury, so make sure kids are sitting on the top of the sled with their feet pointing downhill, Monroe stresses. In addition, a mass of kids on one sled or forming a train with their sleds increases the odds of someone getting thrown off or collisions. “Make sure kids who are old enough have their own sled,” says Ogborn. It’s also a good idea for parents to enforce a no-sled zone for children to safely walk back up the hill without getting hit by someone sledding down, she adds.

Weather Proof In addition to treating young sledders with head injuries, cuts and broken bones, Monroe has also treated several children who were hypothermic after being exposed to wet and cold conditions. He recalled one child who had slid into a shallow pool of water and kept sledding. “Most parents know about keeping kids warm, but they don’t recognize how quick children can lose their body heat, especially if they get wet,” says Ogborn. She recommends dressing children in layers with the outer layer being water proof. She also suggests bringing along extra dry clothes to change into if necessary, especially socks and gloves. According to the American Academy of Dermatology, snow can reflect up to 80 percent of the sun’s rays making it a good idea for children to apply sunscreen and lip balm, as well.

Take Breaks Sledding injuries often take place after children have been going strong for hours, says Ogborn. This is the result of their muscles getting tired and their reflexes slowing down. “Parents need to make kids take breaks before they reach the point of exhaustion,” she says. “This is a great opportunity for them to come in and enjoy some hot cocoa, put dry clothes on and reenergize before going back out again.”

A SAFE BET With the unpredictability of snow in our area combined with the challenge of finding a safe sledding location, many families opt to sled in a more controlled environment. For some snow tubing fun all winter, check out these three skiresorts, which are about an hour’s drive from Baltimore.

Liberty Mountain Resort 78 Country Club Trail Carroll Valley, PA 17320 717-642-8282 skiliberty.com Ski Roundtop 925 Roundtop Road Lewisberry, PA 17339-9763 717-432-9631 skiroundtop.com Whitetail Resort 13805 Blairs Valley Road Mercersburg, PA 17236 717-328-9400 skiwhitetail.com


Karren L. Johnson
Maryland Family Magazine.com