ER Doc: Keep Your Bike-Riding Kid Alive, Well

As I drive to work each day, through towns like Morton Grove, Niles and Park Ridge, I see a lot of kids out riding their bikes and other kid-powered things like skateboards, rollerblades and scooters.  I see a lot of adults on bikes too.  What I don’t see a lot of are helmets.

It occurs to me that maybe we’ve gotten a little too casual about safety and have forgotten how important the basics -- like helmets -- really are.  As a pediatric emergency medicine physician, I see what happens when kids don’t wear helmets or follow some of the other basic safety rules.  Especially during the summer, when the weather’s good and the kids are out of school, the number of kids coming into the emergency room because of bike accidents increases substantially. 

So here are four tips to keep your children safe this summer, whether they’re on bikes, skateboards, rollerblades or scooters.  The tips are good for adults too, so keep them in mind when you hop on your own bike.  Leading by example is crucial to getting your kids to be safe too.

Tip 1: Wear a helmet

Bet you could have guessed that would be my first tip.  Helmets are absolutely essential to safe biking, skateboarding, rollerblading and scooter-riding.  A helmet acts like a second skull and absorbs a lot of the impact of a fall or collision.  As a result, kids who wear helmets generally suffer less severe head and brain injuries than those who don’t.  Kids who don’t wear helmets have a greater chance for suffering more severe brain injuries. 

At the risk of stating the obvious, head injuries are serious.  Head injuries are especially serious in kids because their brains are still developing.  The brain does not always compensate well after an injury and there can be unforeseen long-term consequences.  Sometimes there are personality changes and the return of previous cognitive abilities can be delayed.

Wearing a helmet should be a no-brainer.  No matter who, no matter where and no matter how old, everyone should wear helmets while biking -- especially kids.  Wearing a helmet can mean the difference between walking out of the ER or going to the OR.

Tip 2: Maintain Your Bikes

Summer is here and everyone’s ready to hit the road for a family bike ride.  Before you do, though, you should think about some basic bicycle maintenance. 

Make sure the chain is in good condition.  Kids (and adults too) can get lacerations on their legs that may require treatment when a chain snaps.  Like the chain, brakes need to be properly lubricated to work the way they’re intended to.  And although it’s not, technically, part of the bike, helmets need to be inspected, as well.  Kids’ heads grow and last year’s helmet may need adjustment or may need to be replaced.  Proper helmet fit is key to its ability to protect the skull and brain.

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You can bring the bikes and helmets in to a local bike shop for a tune-up and a fitting.  Or, with a little online research or a trip to the library, you can learn how to do it yourself.  Bottom line: a well-maintained bike is a safer bike.

Tip 3: Dress Smart

Long sleeves and long pants are safer than short sleeves and shorts because they prevent “road rash.”  Road rash is what we call the abrasions that kids get on their arms and legs when they wipe out on their bikes, skateboards, rollerblades or scooters. 

Treating road rash can be pretty uncomfortable because it requires scrubbing the affected areas to remove all the gravel and dirt.  It’s not fun and it’s best to avoid it, by dressing properly.

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Closed-toe shoes are safer than sandals or flip-flops.  Riders have more control with closed-toe shoes and their feet are much better-protected.

If kids have to be out riding a bike at night or in poor weather, where visibility is reduced, they should not wear dark colors.  Light colors and some sort of reflective clothing are much safer options.  Their bikes should have lights and reflectors, as well, so that drivers are better able to see them.  For optimal safety, though, kids should be off the road before dark.

Tip 4: Be a Defensive Rider

In a showdown between a bike and a car, the car will win every time.  And the biker will get injured, every time.  So you need to make sure your child knows, and follows, the rules of the road. 

I always remind kids to make eye contact with the drivers who are stopped at an intersection, before they start across the street.  With so many distractions inside the car -- passengers, phones, radio, dvd players -- drivers are frequently not focused on what’s going on outside the car.  Making eye contact with the driver is a way of making sure the driver actually sees them. 

I also recommend that kids bike on roads that are less-traveled and that have lower speed limits.  Fewer cars generally mean fewer opportunities for accidents.  Drivers traveling at slower speeds have a better ability to react and avoid striking a biker.

These tips probably sound like common sense...and they are.  But as I see every morning on my drive to work, they’re easy to forget or overlook.  By simply remembering to make your child wear a helmet, keep their bikes in good condition, wear safe clothing and ride defensively, you can go a long way toward assuring that they’re safe on the road.

By Clifford Spanierman, MD, Pediatric-Emergency Medicine, Advocate Lutheran General Hospital