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As the weather warms, grass grows green and schools let out for the highly anticipated summer break, healthcare practitioners across the country brace for the heightened incidence of injury among children that accompanies traditional summertime activities. In fact, one study found emergency room visits for trauma in children peak in the month of June.

Hospital and pre-hospital clinicians with pediatric advanced life support (PALS) training and PALS certifications are well-versed in the widely recognized protocol designed to help pediatric healthcare practitioners efficiently and effectively manage the many emergency situations that can arise from favorite summer pastimes. Injuries stemming from swimming, playground visits and backyard playtime necessitate knowledge of PALS guidelines and competencies to address emergency assessment; respiratory distress and failure; shock; cardiac arrest; and post-resuscitation management for children

Among the most common causes of injuries to children are:

1. Swimming pool accidents

An alert issued by the U. S. Consumer Product Safety Commission reports that drowning remains the leading cause of accidental death in homes of children under five years of age. Each year, more than 2,000 children under the age of five are treated in hospital emergency rooms for submersion injuries.

The CDC reports that for every one child who dies from drowning in a pool accident, another four will require emergency medical treatment, and many of these children will suffer serious and often permanent injuries. Other types of injuries or trauma commonly sustained by children in swimming pool accidents include head and neck injuries, disembowelment and limb injuries.

2. Playground accidents

Warm weather is inviting for trips to the local park’s playground or lazy afternoons on the backyard swing set. The National Center for Injury Prevention and Control reports that each year in the United States, emergency departments treat more than 200,000 children aged 14 and younger for playground-related injuries, the most common of which are injuries caused by a fall. Children between the ages of five and nine are at the highest risk of traumatic injury from playground accidents.

3. Lawn mower accidents

Summertime means yard work and mowing long green grass. Between 1990 and 2004 there were 140,700 lawn mower-related injuries in children with a mean age of 10. These injuries included lacerations, soft tissue injuries, burns and fractures. Many of these injuries required surgical intervention ranging from repair to amputation. These injuries can be devastating, as they may be accompanied by a high risk of infection, soft tissue and bone loss or growth arrest of the susceptible growth plates in small children.

4. Trampoline accidents

Bouncing on backyard trampolines is a favorite, albeit often dangerous, warm-weather activity for many children. A study by Rhode Island’s Hasbro Children\'s Hospital found that trampoline injuries hit their peak in spring and summer months, and over 90 percent of trampoline injuries happen at home. While only six trampoline-related deaths have been reported since 1990, some of the more common injuries include ankle, wrist and elbow fractures, concussions and spinal injuries.

Injuries and trauma in children are greatly influenced by weather and season, and an up-to-date PALS certification is critical for pediatric healthcare providers as the warm summer months draw near. For more information, see PALS certification and PALS recertification course overviews.


The information included in this article is based on the 2020 guidelines for CPR, first aid and advanced cardiovascular care. Read more about the 2020 changes to the online PALS course.