Guidelines for Parents

Drawstrings can strangle a child if they get caught on playground equip-ment.

One way to prevent this it to take the drawstrings off the hoods and

collars of your child’s jackets, shirts, and hats and shorten the drawstrings

•Cut all the ends just short enough so that they tie

•Sew a seam at the middle of the hood, collar, or waistband to prevent

either side from pulling out if caught on an object

The best way to prevent drawstrings from getting caught on anything is to

choose clothing that does not have them.

Each year about 250,000 children ages 15 and younger get hurt on playground

equipment and are treated for their injuries in emergency rooms. Between 10

and 20 children die each year from playground injuries. About one-fourth of all

playground injuries happen on home equipment, but most occur at school and

public playgrounds. This brochure can help you determine whether playground equipment—at your home, your child’s school, or in your neighborhood—is as safe as

Falls cause about 75% of playground injuries. Children:

• Fall off equipment

• Fall from heights, especially from climbing structures (such as

monkey bars)

• Trip over equipment

Other playground injuries are caused by:

• Blows from equipment, especially swings

Many injuries, such as cuts, scrapes, and bruises, are not serious. However,

some head injuries can be serious or even fatal. Other common playground

Most important:

• The best way to prevent serious head injuries is to have a surface that will

absorb impact when children land on it. This is especially needed under

and around swings, slides, and other equipment. (See "What are safer

surfaces?").

• To prevent injuries from falls, platforms should not be higher than 8 feet

above the ground and should have guard rails (38 inches high).

• Vertical and horizontal spaces should be less than 3 1/2 inches wide or

more than 9 inches wide. This is to keep a small child’s head from getting

trapped.

• Objects that stick out (bolts, nails, etc.), hooks that are not closed all

the way ("S" hooks), sharp edges, and pinch points also cause many

playground injuries. Equipment must be free of these hazards.

• Even with these measures children still need to be watched closely while

they are playing.

Also important:

• Carefully maintain all equipment. Be sure that it has been installed exactly

according to the manufacturer’s directions.

• Swings should be clear of other equipment by a distance equal to twice the

height of the swing, measured from the center of the swing while it is at

rest. Swing seats should be made of soft materials such as rubber, plastic,

or canvas. Children under 5 years of age should use chair swings. Make

sure open hooks , or "S" hooks, on swing chains are closed to form a

figure "8."

• Make sure equipment is the right size for the children playing on it. For

example, smaller swings are meant for smaller children and can break if

larger children use them.

• Make sure children cannot reach any moving parts that might pinch or

trap any body part.

• Play equipment should be installed at least 6 feet from any barrier, such

as a wall or fence, and should be securely anchored to prevent tipping.

The concrete anchors should be buried below the surface of the dirt and

beneath the full depth of the ground cover of absorbent material. Some

equipment, such as swings and slides, requires a larger "fall zone"

around it.

• Wood fences and equipment should be free of splinters; all fences and

equipment should be free of nails that stick out.

• Metal slides exposed to direct sunlight can burn children’s hands and legs.

Plastic slides are less likely to cause burn injuries. Position slides in the

shade or face them away from the afternoon sun.

• Slides should have a platform with rails at the top for children to hold.

The sides of the slide should be 4 inches high.

• Make sure there are no rocks, pieces of glass, sticks, toys, debris, or other

children at the base of a slide. These could get in the way of a child landing

safely. The cleared and safer-surfaced area should extend from the exit of

Taken from

What Is Impetigo?

In extreme cases, the infection invades a deeper layer of skin and develops into ecthyma, an ulcerated form of the disease. Ecthyma forms small, pus-filled ulcers with a crust much darker and thicker than that of ordinary impetigo. Ecthyma can be very itchy, and scratching the irritated area spreads the infection quickly. Left untreated, the ulcers may cause permanent scars and pigment changes.

The gravest potential complication of impetigo is glomerulonephritis, a severe kidney disease that occurs in about 1% of cases, mainly in children. With antibiotic treatment and dietary restrictions, most patients recover from this disease without lasting effect.

The most common cause of impetigo is Staphylococcus aureus. Beta hemolytic streptococcus is another bacteria that causes it. These bacteria lurk everywhere -- in unclean bathrooms, in spoiled food, and in our own bodies. If a child with an open wound or fresh scratch bathes in an unscrubbed basin or tub, for example, he may contract impetigo. Using a towel or even a bar of soap previously used by a person infected with impetigo can spread the infection. Other skin-related problems, such as body lice, insect bites, fungal or strep infections, boils, or various forms of dermatitis, can make a person susceptible to impetigo.

Most people get this highly infectious disease through physical contact with someone who has it, or from sharing the same clothes, bedding, towels, or other objects. The very nature of childhood, which includes lots of physical contact and large-group activities, makes children the primary victims and carriers of impetigo. Excessive sweating, malnutrition, and poor hygiene can aggravate the condition.

What Are the Symptoms?

A small patch of blisters that after a few hours breaks into a red, moist area that oozes or weeps fluid; appears mainly on the face, but also on exposed areas of the arms and legs.

In a few days, formation of a golden or dark-yellow crust resembling grains of brown sugar. The infection may continue to spread at the edges of the affected area.

Call Your Doctor If:

You have sores on your face that do not go away in 48 hours after starting treatment. An impetigo infection needs prompt medical attention.

Small, very itchy, pus-filled ulcers form, with a dark brown crust. This indicates ecthyma, an ulcerated form of impetigo that penetrates deep into the skin. If left untreated, it may cause scarring and permanent changes in pigmentation.

Symptoms of impetigo appear on a baby. Any persistent skin disorder in infants requires medical attention.

A child suffering from impetigo develops nausea, headaches, low urine output, or puffiness around the face and on limbs. These are signs of glomerulonephritis, a kidney disease caused by bacterial toxins.

NOTE: Sores associated with impetigo may be mistaken for herpes, a viral infection. Impetigo spreads faster, never develops inside the mouth, and is rarely confined to one area of the body. If in doubt, see a doctor for an accurate diagnosis.

What Are the Treatments?

The key to treating -- and preventing -- impetigo is good personal hygiene and a clean environment. Once the infection occurs, prompt attention will keep it under control and prevent its spread.

Even if only one family member has impetigo, everyone in the household should follow the same sanitary regimen. Regular washing with soap and water can clear up mild forms. If the sores don't clear up in 48 hours, or if the infected person is a small child, see a doctor. To break the chain of contagion, the doctor may prescribe antibacterial baths for the entire household as well as for the infected patient.

A topical mupirocin ointment, available only by prescription, is highly successful in treating routine cases. Don't try over-the-counter antibacterial ointments; they are too weak to kill strep and staph infections, and applying the ointment carelessly may actually spread the impetigo. If mupirocin does not help in 48 hours, ask your doctor about an oral antibiotic such as penicillin or erythromycin. Penicillin injections protect against complications of severe infections, shorten healing time, and reduce the chance of recurrence.

If you have only a few small impetigo sores, simply bathing them regularly with soap and warm water, using the medications mentioned above, and exposing them to air will soothe the itchiness and should clear them up. For more severe cases, wash the infected area with antibacterial soap and follow up with an appropriate medical treatment.

Anyone in a household who develops impetigo should use a clean towel with each washing. Be sure to launder those towels separately.