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Rod Brouhard, EMT  P

The Fun Police are at It Again

By November 27, 2012

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It's time once again to take issue with over protective pediatricians. I've done it before when their recommendations on trampolines made it into Consumer Reports. Now the pediatricians have taken aim at inflatable bounce houses.

What do pediatricians have against jumping anyway?

The story comes from a recently published study in the journal Pediatrics. Authors looked at injuries from bounce houses treated in emergency departments around the US during the 20 year period from 1990-2010. They found 64,657 kids aged 17 and under who were reportedly treated in the ER during this time.

The most alarming trend in the study was how quickly the rate of injuries per year rose during the study period. No mention is made in the study about why this might be happening. I'll discuss that later. The authors do, however, refer to the rise in injuries as an "epidemic" and call for "guidelines for safer bouncer usage and improvements in bouncer design to prevent these injuries among children."

Solve the Problem by Banning Bouncers?

Guidelines for safer use and improving designs are noble goals I suppose, but these studies have a tendency to lead to overreaction. Similar studies of trampoline injuries led to the American Academy of Pediatrics declaring trampolines too dangerous for home or recreational use. I disagreed then and I'm concerned we'll be heading down the same path here. Indeed, the authors think we are, too. Here's what they have to say:

In 2012, the American Academy of Pediatrics reaffirmed its recommendation against any home or other recreational usage of trampolines and recommended use only as part of a structured training program with appropriate safety measures employed. Policy makers must consider whether the similarities observed in bouncer-related injuries warrant a similar response. Because bouncers do not serve training or therapy purposes, a strictly consistent policy would recommend against pediatric bouncer usage.

The authors want to restrict kids from jumping in bounce houses. If kids aren't going to jump in a SpongeBob SquarePants bouncy castle, who is?

Not everyone is in agreement that kids need to be protected from themselves. For example, there is a rather heated debate going on right now about mandatory helmet laws for bicycle riders, including kids. On one side are those who believe helmets are necessary to prevent head injuries and on the other side are those who say helmet laws bar folks from riding bikes and getting the cardiovascular benefits of exercise. Both arguments have merit and the issue of exercise versus safety is not likely to go away anytime soon, whether we're discussing football injuries or bounce houses.

I'm squarely on the side of getting off your pediatric butt and going outside to play. If you break your arm in the process, well, so what? I did. Breaks and sprains are nothing new in childhood. The authors make a point to state concern over the rate of concussions, but I found the numbers in this study rather underwhelming.

Maybe They're All Knocking Their Noggins

The authors pointed out that 4,539 kids were treated for concussions or closed head injuries. They also reported that of the total 64,657 kids in the study, only 3.4% were hospitalized, which included observation, meaning the patients stayed in the hospital less than 24 hours. Finally, they said that 81.7% of the hospitalizations were for fractures.

Let's do the math: 3.4% of 64,657 means that 2,198 kids were injured bad enough to be hospitalized. Of those 2,198 kids, 81.7% (1,795) of them had broken bones. That leaves only 402 kids under 18 years old -- about half of one percent of the original 64,657 kids -- hospitalized for something other than a fracture, including a head injury.

If concussions and other traumatic brain injuries from bounce houses were that bad, I would expect to see significantly more hospitalizations, wouldn't you?

Why Are So Many Getting Hurt?

Back to the rise in injuries. Bounce houses are cheap entertainment in a tough economy. You can rent an inflatable bounce house or bounce castle for pennies as compared to taking your child to an amusement park. Why the increase in injuries? I say it's simple: there are more bounce houses. However, does that really mean more kids are getting hurt?

I have five kids. I promise that kids who are active enough to get injured by jumping in a bounce house would have been injured jumping off buildings, or riding bikes into a river, or hitching a ride on the roof of a car, or any number of other crazy stunts.

Want to impress me? Show me how these 64,657 kids would never had ended up in the ER if it wasn't for a bounce house. Would we have had 64,657 fewer ER visits if bounce houses didn't exist, or would we have had 64,657 different stories to explain what happened?

Kids will jump, fall, run, trip, twist, crash and generally knock themselves senseless eventually. We can chase down every possible source of injury or we can let them play.

Now, who's ready to talk about childhood obesity.

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