Playground injuries; can they be prevented and what do you need to know as a parent?

Playgrounds are not just there to provide a fun activity for children, it provides them with an opportunity to develop important physical, cognitive and social skills. Play is an important development tool that allows children from a young age to develop their imagination, communication and vital skills like; motor planning, speed and direction awareness, flexible thinking, decision making and problem solving.

Despite all these great benefits, playgrounds are also the most common place where children get injured. South African’s have noticed an increase in playground related injuries, mostly due to facility owners not abiding to the playground safety standards as provided by the South African Bureau of standards (SABS) who published the playground safety standards in 2010.

Parents of young children often find themselves in the emergency room after a playground activity and left feeling helpless in preventing future playground injuries. However, most injuries may be prevented if the facility/school/restaurant’s playground abided to the playground safety standards.

Here is what you need to know as a parent when permitting your children to use a public playground facility.

Types of Playground Injuries:

Although minor injuries like bumps, bruises, blisters, splinters and cuts often occur on playgrounds and are frequently the norm for children, there are more severe injuries that question the safety of the playground facility. Severe injuries that are commonly reported are broken bones, skin lacerations, strains and sprains, head injuries, internal organ injuries which all result in medical attention and treatment which in some cases may lead to physical disability or in rare cases may result in death.

Common accidents on playgrounds are expected from time to time as young children are more prone to accidents than adults for the following reasons:

  • They learn by playing and often don’t do things correctly the first time round
  • They are still not observant enough of their environment and unable to determine risky or harmful behaviour of others
  • They are less dexterous and are still developing their motor skills
  • They get easily distracted, excited and often want to impress on-lookers so push their limits.
  • They have little understanding of safety precautions and learn from their mistakes

 

Common accidents seen on the playground include:

  • Swing Injuries: Children often run around the playground and do not observe the other children on swings which may lead to a collision.
  • Slide injuries: May occur when a child is accidentally pushed down the slide or collides with another child at the bottom of the slide. Leg fractures have also been reported when a child tries to stop on his/her way down.
  • Trips and Falls: there are a variety of potential hazards like sticks, rocks and uneven surfaces found on the playground.
  • Falls: Children may lose their grip or slip off playground equipment like monkey bars and seesaws.
  • Eye injuries: Playgrounds often have protruding equipment that may cause eye injuries, other injuries may be caused during play with sticks, toys or fingers.
  • Climbing injuries: Playgrounds often have climbing apparatuses like ladders, robes and rock climbing walls. While in play children may fall off the apparatus not only hurting themselves but may also hurt others playing below.
  • Net injuries: Children may experience entanglement injuries and in some severe cases strangulation has been reported.
  • Dog bite/attack injuries: This may occur in public playgrounds that permit dogs, dog bite/attacks may occur when the dog is not well trained or a child who is not accustomed to dogs plays roughly with their new canine friend.

How to treat minor playground injuries:

Children often suffer minor injuries during their early years, it is part of their natural development and often cannot be avoided. Here are some quick tips how to tend to these injuries as a parent:

  • Minor cuts: Clean the injured area under a running tap using soapy water and remove all visible dirt. Pat the wound dry and apply a disinfectant or antiseptic ointment and cover the wound with band aid. Monitor the cut daily and clean the injured area, applying a new band aid, this process is important as you need to check for infections (infections may only be evident a day or two later). If the wound refused to pat dry and does not stop bleeding after 10 minutes or has something stuck in it, it is advisable to seek medical attention. The same applies if the child experiences numbness beyond the wound or cannot move their fingers and toes. Any deep cuts may require stitches and should not be treated at home.
  • Blisters: Never break the blister, rather wash the affected area with a soapy water. Apply an antibacterial or disinfectant ointment and cover the area with a band aid, remembering to again check for infections daily
  • Splinters: Remove the splinter with tweezers or wrapping tape. Needles may also be used; however always ensure you sterilize it first. When successfully removed, clean the affected area with soapy water and check for infection daily, if redness and pain increases after 24-48 hours seek medical attention.
  • Bruises: It is important to properly inspect the bruised area to ensure there is no indication of internal injuries. Bruises usually heal on their own over a period of a week. If the bruise is rather large and causing swelling and minor pain you can use an ice pack (if one isn’t handy a frozen veg pack can work, however cover it with a cloth and apply every 2 hours for 10-20 minutes for the first 24 hours) to relieve the swelling and pain, a mild pain killer may also be provided. It is important to monitor the bruised area daily, a healing bruise should start turning greenish blue and eventually fade as the area heals. Medical attention is required if the child’s pain continues or worsens after 24 hours or the bruise does not fade within 2 weeks.
  • Black eye: Best option for a black eye is to use cold compression. Similar to the treatment of large bruises above, you may use an ice pack 10-20 minutes every 2 hours to control the swelling. Monitor the affected area daily.
  • Sprains: Elevate your child off the joint immediately and apply ice for cycles of 20 minutes every 2 hours and compress the joint with an elastic bandage to stop the swelling. Ensure that your child rests the joint, stopping further pain and swelling. To reduce further discomfort and promote healing it is best to elevate the joint especially during sleep. Should your child not have normal function of the joint within 24-48 hours medical attention is required. Normal healing of sprains may take up to 2 weeks, however functionality returns within a day or two while the sensitivity may be experienced for up to 2 weeks. Same applies if your child continues to have joint pains after 6 weeks of the incident.
  • Knocked tooth: If it is a milk tooth then treat as usual, let your child rinse their moth with warm water and you can gently clean the area with a warm wash cloth thereafter. Sensitivity is normal for a few days so best ensure your child brushes their teeth around the area. If it is a permanent tooth that is knocked out it may be reattached by a dentist within an hour, pick up the tooth by the crown and avoid touching the root area and rinse off any dirt with warm water, it is important not to scrub off any remaining tissue off the route. Try to place the tooth back in your child’s mouth if it does not hold, place the tooth in a container with milk adding a pinch of salt and see your dentist immediately.
  • Split lip: apply pressure with a clean cloth for 10 minutes, if the bleeding has stopped wash the area soap water to remove any dirt from the affected area. If the area continues to bleed after 10 minutes you need to get medical assistance and may require stitches.
  • Friction burns: Clean the affected area with soapy water and remove any debris with sterilized tweezers or needles. Do not apply ice water or an ice pack as this may inflame the area. You may apply an antiseptic or disinfectant ointment and cover with a gauze pad ensuring that the adhesive does not touch the affected area. Check healing daily for infections and healing progress. You will need medical attention if redness, swelling, puss or pain occurs after 24 hours.
  • Bloody nose: Sit your child up straight and encourage them to lean forward slightly while you pinch their nostrils together with a damp clean cloth and apply pressure with your thumb and index finger. Encourage your child to spit the blood out in their mouth as it may cause nausea and vomiting, further traumatizing the child. The bleeding should stop within 10 minutes, if not continue applying pressure for a further 15-20 minutes and if the bleeding does not stop seek medical attention. Nasal saline sprays or ointments may also be useful in promoting the healing of the tissue, also try avoiding air-conditioning or house heating environments for the next 24-48 hours.

 

What to do in severe playground injuries:

  • Broken Bones: if you suspect your child has a broken bone, it is vital that you get immediate medical attention, signs of a broken bone may include instant swelling, bruising and motion discomfort/disability of the area affected. You may gently remove clothing in the area and apply an ice pack (again not directly) and do not move the limb/area affected. If you suspect a head/neck/back injury or see that the bone broke through the skin do not move your child until medical assistance reaches you to transport them to hospital.
  • Head injuries: Head injuries should never be taken lightly as they may result in long term brain damage, disability and in severe cases death. If your child experiences symptoms of a concussion (which include a headache, unequal pupils, blurred speech or vision and balance problems) seek medical attention immediately.

 

What are the minimum safety standards for Play grounds in South Africa?

Parents of small children should familiarize themselves with the national safety standards for playgrounds and inspect the playground before permitting your child/children to use them.

This standard of care is imposed by the new “Duty of Care” application of the law and the implementation of the playground safety standards has reduced the accident and death rate by 80% worldwide.

According to SANS (South African National Standards) the playground safety standards  apply to playground equipment manufactures and designers, playground equipment suppliers and installers, playground maintenance contractors, schools, primary and pre-primary schools, early childhood development centres and crèches, event organizers, event management and event safety coordinators, amusement ride operators or contractors including inflatable amusement ride hirers and inflatable amusement ride manufacturers, indoor and outdoor adventure play parks and party venues, municipal public parks, holiday resorts, hotels and guest houses, restaurants, travel rest facilities at petrol station, zoo and other park and recreational facilities, garden centres with playgrounds and play equipment, housing complexes with play parks and play equipment, liability insurers, personal injury attorneys.

Safety audits are recommended annually by a playground safety professional that is registered with the Playground Safety Institute. You need to ensure that the playground facilities your children use can produce a valid safety certificate and note that these certificates are only valid for 3 years.

 

Playground safety standards include:

  • Proper Surfacing

Impact absorbing surfacing to a minimum depth of 30cm for any structure higher than 50cm should be installed. Playground equipment may not be higher than 1.5 meters for early childhood development playgrounds. Hardwood fibre/mulch, sand, rubber chips or matting surfaces are acceptable and should be clear debris and other objects. Grass, concrete, bricks or other hard surfaces are not acceptable.

  • Spacing: Fall zones

Fall zones are calculated both around and under playground equipment. The safety zone standard is set at 2 meters and must cover the safety space area by 2meters from the edge of any equipment.

  • Spacing: Equipment

No overlap of equipment is permitted and must have a minimum space of 2 meters apart.

  • Risk of Protrusion or Entanglement

Protrusions are usually hardware that protrudes from any equipment. Standards require a risk assessment to determine whether protrusions are a risk for injury, for instant loose hanging ropes and chains must be firmly fixed at both ends and not able to form a loop or noose to avoid accidental entanglement.

  • Size of Openings

Openings should not fall within the sizes of 8 and 23cm to avoid the risk of entrapment or strangulation.

  • Possibility of Trip

It is recommended to avoid raised structures at ground level or sudden high changes in ground levels.

  • Crushing, Pinching and Sharp Edges

Playgrounds should be free of sharp edges.

  • Handrails/Guardrails on Raised Platforms

For Pre-schoolers, any platform higher than 30cm is required to have a rail and for Primary age and up, any platform higher than 76cm.

  • Lack of Maintenance

Annual safety audit should take place and safety conditions programes for preventative maintenance is required for playground facilities to check for worn-out equipment and high risk components.

  • Suitability

Playground equipment must be selected and installed for the appropriate age group standards.

  • Supervision

Supervision is vital in Playground areas and minimizes risk of injury particularly with pre-schoolers. Playground design should be thoughtful in making it easy to supervise and observe children at play.

  • Shading

Our climate is very hot and children are prone to sun-burn and heat stroke. All outdoor equipment must provide shaded areas (trees are acceptable shading) and additional shading for sun exposed equipment.

 

For more information regarding the safety standards please refer to the Playground Safety Standards for SA 2010- S.A.N.S (SABS) document

 

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Who is liable for playground injuries?

When playground injuries occur a few parties may be liable:

  • Care taker such as a nanny or babysitter of the child that caused the accident or injury
  • Parents of the other child that caused the accident or injury
  • Playground owner, if the accident occurred because the playground did not meet the playground standards for South Africa
  • Playground equipment manufacturer if the accident occurred because the playground equipment was faulty.

 

Types of legal liability in a personal injury claim

There are three types of legal liabilities that affect your personal injury claim namely:

  • Intentional Liability: This liability is present when one person intentionally harms another and may even lead to criminal charges in a civil case. An example of intentional liability occurs when one child pushes another off a raised platform resulting in the child losing balance, falling to the ground and breaking their arm.
  • Negligence: Negligence occurs when a school or playground owner fails to adhere to the playground standards. An example of negligence occurs when a playground owner has not met the minimum playground surface requirements resulting in a child tripping and breaking their ankle.
  • Strict Liability: with these cases the party claiming for personal injury does not have to prove negligence but only that an act occurred (intentional or unintentional) and that it harmed the injured person. An example of strict liability occurs when playground equipment is faulty for instance a defective swing that may cause a serious injury. This would make the swing manufacturer strictly liable for the defective swing as long as the defect was caused by a manufacturing fault.

 

How do you claim for compensation?

If your child has suffered a serious playground injury due to negligence or omission by a school or playground owner it is best to use an attorney who specializes in personal injury cases. A personal injury attorney will assess your claim, prepare your evidence and represent you in legal proceedings.

When you have grounds for a personal injury case you may claim for the following:

  • Medical bills related to the injury
  • Future medical expenses related to the injury
  • Future loss of income as a result of the injury
  • Pain and suffering

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