Stay Seen This Halloween

Hey neighbors. It’s that time of year again. As the world re-opens, we are welcoming the fall with various seasonal traditions. However you and your family celebrate the ancient Celtic pagan festival of Samhain — whether it be with pumpkin spice coffee lattes, pumpkin pie with McConnell’s ice cream, Jack-o’-lantern carving parties, lavish masquerade balls, or family trick-or-treating — Halloween is a fun holiday to celebrate as a family. As an emergency physician, I want to be sure that all of our neighbors have a safe and festive Halloween, and here are some tips to keep you and your family out of the emergency department this Halloween.

(1)  Visibility. Children are twice more likely to be hit by a car on Halloween than on any other evening. Be sure your child is visible in the dark. Line their costume with reflective tape. Give them a glow stick or flashlight to carry. I like to use small, inexpensive, flashing clip-on lights (commonly seen in the bicycling world). If you are towing your children in a wagon or bicycle, get some reflective tape or LED lights (any Burning Man festival veteran can give you tips on how to make your bicycle or wagon a well-lit work of art).
•  Be sure your children know to walk on the sidewalk and cross at crosswalks when trick or treating.
•  An adult should accompany children under age 12.
•  If your older children are going out unaccompanied by an adult, go over their route and return time before they head out, and be sure they are in a group.
•  Children should only trick or treat in well lit, familiar neighborhoods, and should be instructed to not enter a strangers’ home or car.
•  And drivers, please, slow down, be alert, don’t text and drive, and watch for trick or treaters between 5:30 p.m. and 9:30 p.m.

(2)  Safe Costumes. A few key steps can ensure preventing an ER visit. Wear good walking shoes. We see a lot of ankle sprains and fractures because people wore cute shoes instead of well-fitting walking shoes.
•  Be sure the costume fits well and does not have loose parts than can trip you or your child resulting in a fall.
•  Avoid any choking hazards for your little ones.
•  Your costume should be weather appropriate.
•  Makeup is better than masks, as many masks impair vision and can result in an injury. If you are wearing make-up, first test it on your skin to ensure you are not allergic before you begin your Hollywood ghoul makeover. If you know you have sensitive skin, keep that in mind when choosing nontoxic makeup.
•  Choose costumes and wigs with a label “flame resistant.” Santa Barbara is already very fire cautious, but this is good to know especially if you know you or your family will be around candles or campfires. You can still have an amazing costume that is also safe and prevents injury.

(3)  Jack-o’lanterns. Use battery-powered lights instead of tea candles.
•  Don’t let children carve pumpkins with sharp knives. If you are carving a pumpkin with your family, use appropriate tools to avoid cutting yourself and supervise your kids carefully. If you do cut yourself, wash your hands under clean water. Your local urgent care or emergency department is always happy to suture any deeper wounds.

(4)  Candy. I am told by my teacher friends, that the day after Halloween is one of the toughest days of the year to teach. Beyond discussing the current child obesity epidemic, our terrible American diet, or talking about good dental hygiene, here are some helpful hints. Tell your children not to eat any candy until they return home. You know how your child reacts after eating a lot of sugar and if they have any food allergies, so behave accordingly. Many parents suggest spacing out the candy consumption to a few pieces a day.
•  Tell your children to only eat candy that is individually packaged to ensure it has not been tampered with, and it is good to avoid homemade treats unless you know the person giving it.
•  Inspect the packaging for anything to suggest marijuana or THC. Marijuana is legal in the state of California, and edibles in the form of gummies, lollipops, cookies, brownies, and candies are readily available. Any marijuana edible should be well labeled in packing that is child resistant, tamper evident, resealable (if more than one serving), and opaque. Marijuana products should all have a universal symbol readily apparent on packaging and are not allowed to use any designs attractive to children including cartoons, images popularly used to advertise to children, imitations of candy labeling, or the words “candy” or “candies.” If you suspect your child has eaten a marijuana edible please call the poison center (available 24/7, 800-222-1222), or take them to the ER so that they can be evaluated and monitored.
•  In almost 20 years of being an ER doc, I have never seen candy with a razor blade in it, though I remember my grandmother warning me years ago. There are easy ways to be safe.

(5)  High School and College Crowd. Isla Vista Halloween is not the Dionysian-mile block party it was in the ’90s thanks to the coordinated interagency response to promote public safety in our community. Having worked disaster response for Isla Vista Halloween for the last 10 years and being a dad, here are some helpful hints for the parents of teenagers.
•  There is no substitute for moderation and having a heart-to-heart conversation with your teenagers. We see far too many young people intoxicated with alcohol, marijuana, and other substances. They are brought to the ER by ambulance, placed in diapers, and monitored for hours before they are sober enough to tell us their names and where they live. Talk to your kids about the dangers of binge drinking, drug use, and how such behaviors increase the risk of assault, sexual assault, injury from falls, drunk driving injuries, and coma with aspiration. A candid conversation about safety, the buddy system, and making informed choices goes a long way.
•   Your teenager should have a phone number memorized so that they can call someone to pick them up if they become separated from their phone (and if they do call, please promptly pick them up without judgment).
•  If they are going to a house party, they should have a bag with a sweatshirt and flip flops to change into, and have a place to store their phone so that they can Uber or Lyft home.
•  Young women, especially, should know who is pouring their drinks and be mindful that nobody tampers with them with potential sedatives.
•  Our teenage neighbors have been cooped up for the last two years, and we need encourage informed decisions so they can have a fun Halloween without compromising their safety. 

You can learn more about how to have a safe family Halloween from some of these trusted websites:

American Academy of Pediatrics – https://www.healthychildren.org/English/safety-prevention/all-around/Pages/Halloween-Safety-Tips.aspx

Safe Kids Worldwide – https://www.safekids.org/search?search_api_views_fulltext=halloween 

As the pandemic comes to an end, we are all ready to get back into the holiday spirit of Halloween and trick-or-treating. I hope all our neighbors have a safe and festive Halloween. Stay safe out there Santa Barbara. And don’t forget to smile, wave, and be kind to one another as is our Santa Barbara custom. 

Jason Prystowsky MD, MPH, aka your friendly, neighborhood, community emergency physician, is a community emergency physician in Southern California. He has a master’s degree in public health and has a background in global health, community health, emergency medical systems, disaster humanitarian response, and medical ethics. Any opinions shared in this article are his own and do not reflect any institutions of which he is affiliated.