Kid safety on the slippery slopes

In their article, “Kid care on the slopes,” in the latest Contemporary Pediatrics, Drs Brown and Fishman draw on their many years of caring for kids in Colorado ski country to provide this special primer on managing pediatric injuries sustained while skiing and snowboarding.

In it, the authors compare and contrast the differences in assessment, diagnosis, and treatment planning for children and adolescents versus that for adults who suffer similar winter sports injuries. In highlighting these differences, we are again reminded that children and adolescents are “not little adults,” as the writers put it. Drs Brown and Fishman offer excellent counsel about post-injury management, including advising that practitioners consider the likelihood of obstructive-type respiratory problems rather than cardiac problems; counseling on the vital need for post-injury hydration; and reviewing head injuries and management for concussions-with a special advisory about second impact syndrome. A must read, in my opinion!

Message safety with tech

So, what’s the take-home message from this article for nurse practitioners (NPs) who provide primary care to children and adolescents? Are there strategies in it we can adopt to prevent winter sports injuries? An NP sees most healthy school-aged children and adolescents once a year-most often just before going to camp, or at the start of the school year. It’s unlikely winter sports would be a topic for anticipatory guidance at those times. However, consider asking about patients’ sports participation at that visit-and then documenting which sports children engage in. An ‘Alert and Reminder’ with this info can then be set in the electronic medical record to prompt NPs to give anticipatory guidance to parents just prior to the winter season concerning their children’s involvement in these winter sports.

Include the essentials

Your preseason “safety briefing” can:

·      Remind parents to help their children prepare for winter sports participation by starting conditioning activities at home prior to heading for the slopes.

·      Recommend that children and teenagers take a refresher ski or snowboarding lesson.

·      Tell parents to remind their kids to always ski and snowboard within their ability level, and never to ski or snowboard alone.

·      Advise parents to schedule regular breaks from the slopes with their children at specified times and places to ensure safety and prevent fatigue.

It’s also critical to remind parents to check all winter sports equipment for safety, and to always ensure that helmets are properly fitted. Finally, Drs Brown and Fishman recommend securing a new helmet if the child has had a “marked fall on the head with a ski helmet, as the helmet has done its job and should be replaced.”

By keeping kids’ winter safety top of mind with parents, NPs can help foster more fun on the slopes-with fewer fractures.