Every Halloween, kids across the country parade neighborhoods in search of the most glorious prize: candy. The build-up for Halloween is almost as exciting as the day itself with pre-Halloween festivities such as selecting a pumpkin, carving it and choosing the perfect costume for the big day. Though the holiday calls for fun, the American Academy of Orthopaedic Surgeons (AAOS) stresses the importance of taking proper precautions to avoid Halloween injuries.

A nine-year study examined holiday-related pediatric emergency room visits between 1997 and 2006. Results of this study show Halloween among the top three holidays producing the most ER visits:
• Finger/hand injuries accounted for the greatest proportion of injuries on Halloween (17.6 percent). 
• Of the finger/hand injuries sustained on Halloween, 33.3 percent were lacerations and 20.1 percent were fractures.
• Children ages 10-14 sustained the greatest proportion of injuries (30.3 percent).
Source: D’Ippolito A. Collins CL, Comstock RD. Epidemiology of pediatric holiday-related injuries presenting to U.S. emergency departments. Pediatrics. 2010 May;125(5):931-7.

American Academy of Orthopaedic Surgeons Safetty Tips:
• Never let children carve pumpkins. Adults carving pumpkins should remember to use specially designed carving knives rather than kitchen knives, as they are less likely to get stuck in the thick pumpkin skin. Carve the pumpkin in small, controlled strokes, away from oneself on a strong, sturdy surface.
• Carving knives should be kept in a clean, dry, well-lit area. Any moisture on the tools, hands or table can cause the knife to slip, leading to injuries.
• Should a pumpkin carver cut a finger or hand, make sure the hand is elevated higher than the heart, and apply direct pressure to the wound with a clean cloth to stop the bleeding. If continuous pressure does not slow or stop the bleeding after 15 minutes, an emergency room visit may be necessary. Additionally, it may be wise to follow-up with a hand surgeon.
• Be considerate of fire hazards when lighting jack-o-lantern candles or use non-flammable light sources such as glow sticks or artificial pumpkin lights. Alternatively, try painting pumpkins for a fun, creative option that removes the risks of carving.
• Halloween costumes should be light and bright, so children are clearly visible to motorists and other pedestrians. Trim costumes and bags with reflective tape that glows in the dark.
• Costumes should be flame-resistant and fit properly. Be sure the child’s vision is not obstructed by masks, face paint or hats. Costumes that are too long may cause kids to trip and fall. Trim or hem costumes as necessary.
• Children should wear sturdy, comfortable, slip-resistant shoes to avoid falls.
• It is important that children walk on sidewalks and never cut across yards or driveways. They also should obey all traffic signals and remain in designated crosswalks when crossing streets.
• Trick-or-treaters should approach only houses that are well lit. Children and parents should carry flashlights so they can see and be seen.
• Be aware of neighborhood dogs when trick-or-treating and remember these pets can impose a threat when you approach their home.
• It’s also a good idea to carry a cell phone while trick-or-treating in case of an emergency.

AAOS EXPERT ADVICE: “It’s so important to realize there is a wrong way to carve a pumpkin! You should always use a carving knife, carve away from the body and never rush. It’s possible to cut tendons, particularly when your finger slides down the knife and the knife gets stuck in the pumpkin,” said Elizabeth A. Ouellette, MD. “For this reason, children and adults should not carve pumpkins with kitchen knives. Besides the potential dangers of pumpkin carving, parents and kids need to be aware of their surroundings and instinctually participate in activities safely no matter the holiday.”