Trick-or-treating, costume parties, and pumpkin carving are part of the Halloween festivities that families and communities participate in during October. Awareness of the types of injuries that can occur during Halloween and how best to prevent them is beneficial for parents to know to avoid trips to the emergency department.
Halloween Costume Safety
Safe costume choices can help avoid unnecessary harm. When choosing costumes, choose properly fitting outfits and avoid oversized or cumbersome clothing that could be a tripping hazard. Avoid dark colored costumes that are difficult to see at night, and use reflective tape to help drivers see children more easily. The American College of Emergency Physicians (ACEP) recommends dressing appropriately to avoid hypothermia in cold environments. If costumes include props such as swords or spears, ensure the edges are dulled to prevent injury.
Always use caution with face coverings and avoid masks that may obstruct vision or breathing. Non-toxic face makeup can be an alternative option. If using makeup, avoid contact with the eyes, and test it on a patch of skin to assess for any irritation before applying it to the face or other areas of the body. Parents are encouraged to remove childrens makeup before bedtime to avoid skin or eye irritation from prolonged use. Additionally, avoid non-prescription contact lenses that can lead to eye injuries and infections. Choosing safe costumes and accessories can prevent physical injuries such as falls, eye infections, and skin irritation.
Trick-or-Treat Safety
With families trick-or-treating in communities around the nation on October 31st, situational safety and awareness are key to a safe Halloween.
Safety measures include:
- Having an adult accompany children
- Trick-or-treating in familiar neighborhoods and only to familiar houses.
- Review routes with older children so that parents are aware of their whereabouts and establish a curfew
- Remind children not to enter a strangers home or vehicle
- Trick-or-treat in well-lit neighborhoods
- Stay on sidewalks and crosswalks
- Travel in groups
- Be aware of dogs and other animals to reduce the risk of animal bites
- Travel with a flashlight
Halloween Candy and Food Safety Tips
A popular part of Halloween festivities is food and candy. To reduce the harm associated with food, there are important safety measures to consider.
Be aware of allergies, choking hazards, and candy that appears tampered with. For young children, remove any potential choking hazards such as hard candies or marshmallows that can obstruct the airway. Edible marijuana or other products can resemble common food packaging and be confused with candy. Be aware of any unfamiliar candy or candy that appears to have been previously opened and discard them accordingly.
Preventing Common Halloween Injuries
A wide range of injuries can occur during Halloween celebrations. Burns, lacerations, and injuries from pedestrian-auto accidents are some of the many possibilities that can arise on Halloween.
Pedestrian Auto Accidents: According to the National Safety Council, children are twice as likely to be hit by a car and killed on Halloween than on any other day of the year. With distractions prevalent during trick-or-treating, it is crucial that parents and children are aware of their surroundings, walk, not run, and remain conscious of cars and motorists around them.
Laceration Injuries: Carving Jack-O-Lanterns is a tradition that requires careful safety precautions. Use safe knife-handling practices when carving pumpkins to prevent cutting oneself. If possible, use designated pumpkin carving kits that are designed to reduce injury. The American College of Emergency Physicians recommends encouraging young children to help remove pumpkin pulp and seeds rather than using sharp tools that could lead to injury. An alternative to pumpkin carving is decorating pumpkins with art supplies like stickers and paint.
Always receive help if there is any hesitation or question about a laceration. Signs of concern involve cuts that are bleeding excessively, deep, contaminated, or dirty, or involve foreign objects within the skin.
Burn Prevention: Unfortunately, burns are one of the common injuries during the Halloween season. Avoid open flame candles in Jack-O-Lanterns and opt for battery-operated ones instead. If using an open flame, ensure there are no hazards nearby that could catch fire, and never leave a flame unattended. Select fire-resistant costumes and be extremely cautious with flowing or loose costumes that could catch fire.
Burns, even small ones, can require medical intervention. If the burned area is charred, blistered, deep, or has melted fabric from clothing, these are concerns that must be addressed by a medical provider. If a burn is larger than the width of two fingers or is located on the face, hands, or sensitive areas of the body, proper treatment must be sought. Burns can lead to infections and fluid loss and may require specialized procedures to restore skin integrity. Always seek medical assistance if you have any questions or concerns about burns.
Dry Ice Safety: Dry ice is often used for theatrical purposes during the Halloween season. Never ingest dry ice and always keep it out of reach of children. Using tongs, insulated gloves, safety goggles, closed-toe shoes, and long-sleeved clothing can help prevent skin and eye injuries. Dry ice turns into carbon dioxide gas, so being in a well-ventilated area is extremely important. Never store dry ice in an airtight container, as the gases released during sublimation (evaporation) can cause an explosion. Allow dry ice to evaporate completely rather than disposing of it in the garbage or down the drain.
Chronic Condition Management
For those with chronic conditions, extra precautions should be taken during Halloween to reduce flare-ups, allergic reactions, or symptom triggers. Precautionary measures can help maintain a fun atmosphere without risking uncomfortable or dangerous symptoms or reactions.
Gastrointestinal Conditions: For parents of a child with gastrointestinal issues such as acid reflux, GERD, gut microbiome imbalance, Crohns Disease, or irritable bowel syndrome, take caution with what is eaten and how much to avoid gastric upset.
Mental Health Considerations: Parents should exercise caution regarding scary or horror-themed Halloween movies, events, and other activities, as these can trigger nightmares and disrupt sleep in children. Halloween activities and characters can be triggers for those with generalized anxiety disorder, a history of panic attacks, or post-traumatic stress disorder.
Allergy Management: Allergy precautions are essential for children with food allergies or sensitivities. Common allergens in candy include nuts, artificial dyes, milk, wheat, and soy. For young children who cannot manage allergies independently, it is best to sort the candy and read food labels to remove any candy that could trigger an allergic reaction. For those with severe allergies, consider taking allergy medications before participating in activities in case of emergency.
Diabetic Considerations: With increased sugar intake from parties and trick-or-treating, those with diabetes can experience blood sugar imbalances. Parents should be aware of insulin and carb-counting needs and should prepare accordingly. It is also beneficial to have diabetic medications readily available if needed. For children who are too young to independently manage their diabetes, help educate them about the importance of sugar intake and management.
Considerations for Healthcare Workers
In the emergency department, Halloween is one of the five busiest days of the year. Nurses can advocate for and raise awareness of safety precautions to promote a fun, yet safe, holiday for families and communities.
Emergency department healthcare professionals are well aware that any injury can come through the ER doors at any time. With there always being an element of unpredictability, common injuries during this holiday can include rashes, allergic reactions, fall injuries, dog bites, lacerations, eye injuries, burns, as well as trauma injuries.
The United States Consumer Product Safety Commission data shows that a little over half of U.S. hospital emergency department visits related to Halloween injuries were due to pumpkin carving injuries. A fourth were due to falls from tripping on costumes, while trick-or-treating, or putting up or taking down decorations. Another approximately 20% are due to other injuries such as costume-related injuries, allergic reactions or rashes, ingestions, or lacerations due to other causes.
Healthcare providers should be prepared for patients with potential diagnoses, such as:
- Compromised airways due to choking
- Severe allergic reactions requiring pharmaceutical interventions
- Lacerations from pumpkin carving, falls, or costume props
- Broken bones
- Severe burns
- Eye infections from makeup or non-prescription costume contact lenses
- Respiratory issues related to costumes that trigger asthma
- Trauma patients from pedestrian-automobile accidents or falls from significant heights
Nurses, physicians, and other medical professionals can help educate parents, families, and communities about Halloween safety and raise awareness about important precautions to reduce common injuries during this holiday season.
Conclusion
The spooky season is filled with excitement, costumes, trick-or-treating, and community activities. Costume safety, situational awareness, food safety, and injury prevention can help families avoid serious harm. Healthcare providers can prepare to provide the most effective, patient-centered care for those who require treatment on Halloween. There is much fun to be had during Halloween while promoting a safe Halloween for children, families, and communities.
About the Author:
Rachel Pugmire is a registered nurse and freelance writer. She received her Bachelor of Science in Nursing in 2018, with a minor in gerontology. Her areas of expertise include emergency medicine, pediatrics, and pharmaceutical clinical trials. Medical writing has given her a platform to do what she is passionate about, which is educating patients, their families, and other healthcare professionals.
Rachel is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
