The Q&A: Robert Lapus

With each issue, Trib+Health brings you an interview with experts on issues related to health care. Here is this week's subject:

Dr. Robert Lapus is an emergency medicine physician with McGovern Medical School at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital. We spoke with him recently about how parents and other gift-givers can protect kids from toy-related injury.

Editor's note: This interview has been edited for length and clarity.

Trib+Health: Could you speak to how frequently toy-related injuries occur and what kinds of injuries are children sustaining?

Robert Lapus: There was a study done several years ago that looked at several years, up until 2014.

And they said that every three minutes a kid presents to the emergency room with a toy-related injury. Fortunately, over 97 percent are actually treated and released — minor injuries or parental concerns, checking the kid out. 

Usually, the fatalities are due to things like non-motorized toys. A lot of those are associated with kids getting hit by cars in the streets and things like that. 

And then another common fatality is drowning or asphyxiation, and unfortunately the majority of those kids are under 12. They were actually water toy-related, and playing with the water gun in the pool, and that was how it led to drowning. It wasn't necessarily the "floaties" or inappropriate rescue devices and things like that. It was kids playing with toys in the pool settings 

Trib+Health: Typically what types of injuries do you see as an ER doctor?

Lapus: A lot of them are bumps or bruises because they fall off their bicycle.

I will say, unfortunately, a lot of times parents or relatives or family friends give bikes without the appropriate safety devices like helmets. Or kids have a helmet and don't use them. 

So we see a lot of bumps on heads from falling off bicycles. We also see a lot of handlebar injuries. So they fall off the bike and the handlebar hits them in the belly. A lot of extremity injuries. 

Last year — those hover boards, they were like the "coolest thing" — we were actually seeing a lot of fractures because of those.

We also see some eye injuries — from those little pellet guns or Nerf/dart guns. And again, you know, not using appropriate eye protection, maybe kids who are not the correct age playing with those toys.

And we do see some cuts from falls and projectiles — from people throwing things. 

Ingesting small parts is something we also see.

Trib+Health: What should parents keep in mind when assessing whether a toy is appropriate for their child? 

Lapus: I think the age guidelines are a pretty good place to start. And I think — and I find this for myself, too — one common mistake we make when we buy gifts for our kids is we think that our kid is advanced for their age. Even though it's for 6 years old, my 4- or 5-year-old can play with it.

To some degree, it might frustrate them because it's too advanced, and they don't necessarily have the motor skills to use those toys. If it's not the appropriate age for them, they might get bored with it and try to make a new game out of it.

So you've got to keep those things in mind.

If you're looking at a stuffed animal, make sure that the eyes and the nose — if they're separate pieces — that they're secured appropriately and strongly, versus like eyes or noses that are sewn in, out of fabric.

And then things with small parts that can break, you want to make sure that things can't shatter into sharp pieces.

Kids will throw things around — you want to make sure they can withstand how your child may play with it, or their friends may play with it. They'll find a way to break something.

The other thing is — we can do our best to supervise our kids 24/7 — but things happen pretty quickly. Especially with kids of various ages playing with toys. It's hard to keep an eye out. There might be an 8-year-old that's appropriate to use that toy, and they put it down for a second and then the 4-year-old picks it up.

And it's been talked about a lot — you want to avoid things with small magnets that can be ingested. I think that was one of the things we talked about a couple years ago — the strong Rare Earth Magnets that were really tiny and then if you swallowed it, they would attach to each other in the belly and cause organ damage.

There's a lot of sources out there. We always recommend people signing up for recalls.gov.

The problem with recalls, though, is that those are reactive — it happens after something happens. As parents and consumers, we should be proactive and do research about toys before we buy it and, I think, following the guidelines and proper supervision.