How Safety Around Bikes, Cars, ATVs—Even Mowers—Can Keep Kids Out of the ER

Part 2 of "Summer Safety: 8 Reasons Kids End Up in the ER—and How to Prevent It"

More from U.S. News's conversations with Marie Lozon, division director of pediatric emergency medicine at the University of Michigan Health System, and Chrissy Cianflone, director of program operations at Safe Kids USA:

Bike accidents. Deaths related to biking increase about 45 percent in summer, compared with other times of the year. Certainly, riding around in the warm weather is a favorite childhood pastime, but doing so without wearing a properly fitted helmet could be asking for trouble. "I can't tell you how many times I see kids wearing helmets that are too big, too small, or too far back on their heads," says Cianflone. She says that about 135 kids 14 and younger die in bicycle crashes and about 267,000 sustain nonfatal bike injuries annually.

Plenty of parents and children think of scapes and bruises as badges of honor. Cianflone doesn't disagree. But to parents who gripe about forcing their kid to wear a helmet when they survived their own childhoods without one, she says, "A traumatic brain injury is not a badge of honor." Helmet laws and public awareness campaigns, she explains, have brought down the rate of deaths and injuries significantly in the past two decades.

Bike accidents often occur when the rider hits something and pitches forward. Compounding that, younger kids' heads are, proportionately, bigger than they will be as they get older, says Lozon. As a result, she says, kids "tend to lead with their heads." So ensuring the helmet is covering the front of the head, not cocked back on the crown, is essential. A properly fit helmet should sit on a kid's head two adult finger-widths above the child's eyes, says Cianflone. The strap should fit snugly below the chin but still allow the mouth to open and close. The Y-straps should fall just below the ears—not in the middle of the ear or so low that the Y-straps are down to the chin, she adds.

Cianflone recommends buying a helmet that meets the standards of the Consumer Product Safety Commission, which should be evident by a CPSC sticker inside the helmet. Bell Sports, she adds, makes a helmet for kids called True Fit that requires only one step to adjust the helmet for a proper fit. "We think it takes the guesswork out of trying to fit a helmet," she says, although she notes that Safe Kids USA doesn't endorse specific products.

If a helmet has been involved in any sort of crash, Cianflone says, "replace it."

[Read about the leading causes of summertime head injuries and ways to prevent them]

Motor vehicle-related accidents. Motor vehicle crashes are the leading cause of death among kids ages 3 to 14 in the United States. In 2005, according to the Centers for Disease Control and Prevention, 1,335 passengers ages 14 and younger died and 184,000 were injured in motor vehicle crashes. That's a daily average of four deaths and 504 injuries. And compared with the rest of the year, the rate of motor vehicle-related deaths spikes by about 20 percent in the summer, says Safe Kids. A number of factors are involved, including high-traffic holidays—in particular, Memorial Day, the Fourth of July, and Labor Day—an excess of drinking, and parents who don't bring their children's car seats on vacation.

A properly fitted car or booster seat is essential to preventing a child's injury or death in an accident, says Cianflone. (Safe driving, obviously, is as well.) Size matters—only kids who are at least 4-foot-9 and weigh 80 to 100 pounds can safely wear a seat belt. It is estimated that 73 percent of car seats are either installed wrong or aren't used correctly. Parents can have their work checked at a car-seat inspection station. The Safe Kids USA website can help you find one.