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How Safe Are Trampolines, Bounce Houses and Other Outdoor Play Equipment?

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Most kids have never met a trampoline, bounce house, Slip 'N Slide or playground they didn't like. These popular summer activities can improve children's strength, agility and balance. But play equipment can also cause serious injuries, especially in small children.

Dr. Lewis First, head of pediatrics at the University of Vermont Children's Hospital, outlines recommendations from the American Academy of Pediatrics (AAP), to help kids avoid those hazards — and still have fun.

KIDS VT: What causes most playground injuries in children?

LEWIS FIRST: The biggest reason for injuries is the lack of adequate protective surfaces to cushion falls, followed by collisions due to swings being too close to each other, head entrapments between pieces of equipment, and puncture wounds and lacerations caused by hooks and nails that stick out. The best surfaces to have around playground equipment are wood chips, mulch, pea gravel or rubber. Concrete, asphalt, blacktop and even grass can be unsafe. Ideally, playgrounds should have separate areas for kids under 2 years old, 2- to 5-year-olds, and 5- to 12-year-olds. Five feet is the maximum recommended height for any structure for kids 5 or younger.

KVT: What is the AAP recommendation for trampoline use?

LF: The AAP recommends that kids not use trampolines at all for recreational purposes. They are a major source of orthopedic injuries, and the most serious injuries involve broken necks, spinal cord injuries and head injuries. The issue of falls is more of a home trampoline event, because home trampolines are typically elevated and kids either fall off of them or fall between the springs. The ones in recreational parks have tighter bindings that cover the springs and sides and lack spaces between trampolines, but kids can still fly pretty high and get hurt.

KVT: How safe are indoor trampoline parks?

LF: There has been an increase in the incidence of injuries occurring in these parks nationally, from about 580 visits to emergency departments in 2010 to more than 7,000 in 2014. Parents should supervise their children at all times, and kids under age 6 shouldn't be on this equipment at all. If kids do use them, only one child should be allowed on a trampoline at any time, in order to prevent collisions. When smaller children are on one with bigger kids, there's a greater risk of collisions and injuries.

KVT: Are home trampolines surrounded by nets safer?

LF: The data on nets and other padding show no reduction rates for injuries. If kids still use them, there should be no somersaults or flips because that's a recipe for orthopedic injuries. The AAP recommends that trampolines only be used in a professional gymnastics setting or under the direct supervision of athletic coaches, physical therapists or others who are using trampolines for rehab, gymnastics or diving training.

KVT: What other potentially hazardous equipment should parents be aware of?

LF: About 6,000 kids are treated annually in emergency rooms for bounce-house injuries. The major issue here is that they're confined spaces that are prone to collisions between kids of different sizes. Other problems that can arise include poor anchoring, house collapse and movement of the bounce house in strong winds with kids still in them. If kids use them, they should avoid bringing food inside and should remove all shoes, eyeglasses, jewelry, hair clips and other accoutrements. Kids should only be allowed inside with other kids of the same size, and adults should never accompany them. Also, kids should stay off the walls and away from the entrance and should never perform flips or somersaults. If parents want to rent one for a birthday party, they should ask the company they are renting the house from about its accident rate, which these companies should have on record.

KVT: Are tree swings safe?

LF: If you're doing a homemade swing, I'd stick to sturdier trees such as oak, sycamore and big maples. The limb should be at least 8 inches thick, and the rope itself should be at least 1 to 1.5 inches thick, ideally slung over a piece of rubber so that it doesn't erode the branch as it moves back and forth. There should be no more than 10 inches between the ground and the swing with someone on it, and it should never extend over water. And having a soft ground surface is just as important as with playground surfaces.

KVT: How about home waterslides, such as Slip 'N Slides?

LF: Parents should inspect the ground for rocks before laying one down. Make sure it ends on level ground, with no hazards nearby to crash into as they come off the mat. These toys are fine for kids ages 5 to 12, but teenagers and adults should never use them because the amount of force they generate literally moves the body into the neck and has resulted in cases of paralysis and significant spinal cord injuries. Also, never add soap bubbles, baby oil or other substances to make kids slide faster, because they can fly way off the mat and suffer lacerations or other injuries.

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