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Tips of the Week for September, 2016

Lightning & Sports Safety: When Thunder Roars Go Indoors

​​​​By: Alex B. Diamond, DO, MPH, FAAP

Chances are wherever you live the weather is probably subject to change at a moment's notice—especially during the spring and summer months. Thunderstorms and lightning can occur with little warning. If your child is playing or practicing in less than ideal weather conditions, you need to be aware of the possible hazards and have a plan worked out ahead of time.

Basic Lightning Facts & Stats

  • It does not have to be raining for lightning to strike.
  • All thunderstorms produce lightning. If you can hear thunder, the storm is close enough for lightning to strike.
  • Lightning strikes can cause death or permanent disability. According to the National Weather Service (NWS), more than 400 people in the United States are struck by lightning each year, resulting in an average of 49 deaths.
  • The NWS reported that 17% of lightning deaths between 2006 and 2013 occurred during outdoor sports or recreational activities. These sports include soccer, golf, running, baseball, and football, in rank order. The greatest number of fatalities occurred in the 10 to 19-year-old and 20 to 29-year-old age groups. Many victims were either headed to safety or just steps away from safety at the time of a fatal lightning strike. Therefore, taking action before the threat is upon you is key!  

Lighting & Sports Safety Tips from the AAP

While our message of getting outside, enjoying nature and promoting physical activity remains unwavering, the American Academy of Pediatrics (AAP) policy statement, Baseball and Softball, advises all coaches and officials to be aware of extreme weather conditions—including lightning—and to postpone or cancel games if conditions worsen and players are at risk.  This same message applies to all organized sports, as well as to all recreational outdoor activities.

Use and follow these recommendations to help prevent lightning injuries during sporting events and outdoor activities:

  • Prior to any practice or activity, the person in charge should check the local weather forecasts. Be aware of whether or not the NWS has issued a thunderstorm "watch" or "warning." A "watch" means conditions are favorable for severe weather to develop in an area; a "warning" means severe weather has been reported in the area and for everyone to take proper precautions. Activities should be delayed if a thunderstorm is approaching before or during a practice or a game.
  • Recognize the signs of a coming storm. Although lightning can strike without warning, when a thunderstorm is on the way, clouds may darken, winds may pick up, and there may be thunder activity. Pay close attention to these signs and any issued warnings.
  • Be sure your child understands the dangers of lightning and the policy that his or her coach needs to follow. If the coach doesn't follow the policy, as a parent, it's time to step in and remove your child from the field. Safety is the most important thing!
  • Be prepared and have established protocols for lightning incorporated into your school or league's Emergency Action Plans (EAPs). Develop and practice lightning strike prevention and treatment protocols as part of your EAP.
    • Designate a "weather watcher" and a clear chain of command to monitor and respond to severe weather.
    • In the event of impending thunderstorms, those in control of the event/venue should cancel the event, warn participants and spectators of the lightning danger, and specifically instruct on the proper procedure for evacuation.
    • The timeframe for evacuation depends on how fast the storm is approaching and the layout of the venue (the timeframe needed for everyone to seek safe shelter).  Generally, a lightning strike within 6 to 8 miles of the venue calls for evacuation.
  • Follow the 30/30 rule. Familiarize yourself with the flash-to-bang count to determine when to seek shelter. Begin counting when you see a flash of lightning. Stop counting when you hear thunder. Your child should be inside a safe shelter before you reach a count of 30. Dividing this number by five will determine the distance (in miles) to the lightning flash. If the activity has been delayed, wait at least 30 minutes following the last sound of thunder or lightning flash before your child resumes activity.
  • Make sure a safe shelter has been designated. Trees, flagpoles/light poles, tents, bleachers, dugouts, storage sheds, and open garages are not safe shelters! In fact, there are very few safe places outdoors when thunderstorms are in the area. The safest shelters are structures with four solid walls, and electrical and telephone wiring. If no safe shelter is available, your child should take shelter in a hardtop vehicle; don't touch the radio dial or the door handles—especially if they are metal.
  • Specifically avoid standing water and open fields. If you are in an open field, avoid being the highest point, in contact with, or near the highest point in the field.
  • If you feel your skin tingling, you are in more immediate danger. Assume the lightning safe position. This means crouching on the ground with your weight on the balls of your feet, your feet together, your head lowered, and your ears covered.
  • Even if you are indoors, stay away from open windows, sinks, toilets, tubs, showers, and electrical outlets. During a lightning storm, electric currents can run through these objects and "jump" onto a person—even inside a safe shelter. In addition, your child should never be permitted to swim during a lightning storm.
  • Invest in a NOAA Weather Radio and download the CoachSmart App. CoachSmart, a collaboration between Vanderbilt Sports Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt, offers real-time information based on a user's GPS location on heat index and lightning strikes. The app also includes sports medicine and safety FAQs and a group contact feature. Coaches, trainers, and field managers who are responsible for several locations will find this CoachSmart incredibly useful! Find CoachSmart on iTunes.
  • Check out other weather apps and resources. There are several free weather apps that may downloaded and used for live-time, verified information. Some examples include the WeatherBug® app,  Storm by Weather Underground, and or the NOAA Weather Radar app. Parents, coaches, and spectators, as well as the designated "weather watcher," can utilize these apps to make objective recommendations whether there is need to cancel the activity and seek shelter.
  • If someone is struck by lightning, get the victim emergency help immediately and move him or her to a safe place. Contrary to what you may have heard, lightning can strike the same place twice. Initiate the chain of survival (call 911, begin CPR, apply AED). People who have been struck by lightning do not carry an electrical charge and are safe to handle.
  • Remember that thunderstorms and lightning aren't the only weather hazards. Extreme heat can be almost as dangerous by posing an unnecessarily high risk of heat illness, such as heat stroke, so your child's team needs to establish a policy on cancelling or modifying practices or games if the heat index is too high.

Important note: Cell phones and/or email can transmit notifications to parents and families, but they should only supplement the other safety procedures listed above.  

Additional Information & Resources:

 About Dr. Diamond:

Alex Diamond, DO, MPH, FAAP is a member of the executive committee for the AAP Council on Sports Medicine and Fitness. He is an Assistant Professor of Pediatrics and Orthopaedics at Vanderbilt University Medical Center and the Monroe Carell Jr. Children's Hospital at Vanderbilt where he specializes in pediatric sports medicine. Dr. Diamond is also a team physician for Vanderbilt University, the Nashville Predators, the Nashville Sounds, and several local middle and high schools. In addition, he is the co-founder and director of the Program for Injury Prevention in Youth Sports (PIPYS) and a blessed husband and father of two. Follow Dr. Diamond on Twitter @VandyPedsSports

​ Author

Alex B. Diamond, DO, MPH, FAAP

Last Updated



American Academy of Pediatrics (Copyright © 2016)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


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Flu Shots

We have received our flu vaccine in all of our locations (Goldsboro, Mt. Olive, Princeton, and LaGrange.) We have a full supply of the shots for our privately insured patients.  Unfortunately, the State of North Carolina has a shortage on state shots so we only have a limited number of shots available for our Medicaid and self-pay patients.  We apologize for the inconvenience, but the availability of the state shots is up to the State of NC.  Please feel free to call us for availability.

Our normal flu clinic hours are from 10 am – 12 pm and 2 pm - 4 pm in all locations, no appointment necessary.  At times, the flu clinics are crowded, so please be patient.  Those receiving state shots may want to call for availability first to make sure we have the shots before the come.

Just a reminder, the Flu Mist is not available this year.  The Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) both recommended that due to a lack of effectiveness the last couple of years, the Flu Mist not be provided.  Hopefully it will return next year, but for this year it is unavailable.  That being said please don’t let your child go without a Flu Shot.  They are saying that it will be a tough year for the flu, so please have your child vaccinated this year with the shot.  This is especially true for patients with a chronic illness.

If you have any questions, please call any of our offices and we’ll be glad to help you.

Car Seats: Information for Families

One of the most important jobs you have as a parent is keeping your child safe when riding in a vehicle. Each year, thousands of young children are killed or injured in car crashes. Proper use of car seats helps keep children safe. But with so many different seats on the market, many parents find this overwhelming.

The type of seat your child needs depends on several things, including your child's age and size and the type of vehicle you have. Read go to the following link for more information from the American Academy of Pediatrics (AAP) about choosing the most appropriate car seat for your child.

Last Updated



Car Safety Seats: A Guide for Families 2016 (Copyright © 2016 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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Laundry Room and Detergent Safety

​​​Any family with young children spends a great deal of time doing laundry! 

In order to stay one step ahead, parents need to make sure that anything little fingers may try to open, pull on, or play with in their laundry room won't cause an injury. 

Read on for help protecting not only your small child, but your entire family from laundry room dangers.

Laundry Products

Parents need to pay close attention to how they store laundry products before, during, and after use.

  • Keep laundry products in their original containers with the original label intact.
  • Read and follow all instructions on the product label. Know where the safety information is located on the label and what to do in case an injury occurs.
  • Never combine laundry detergent with ammonia or other household cleaners, because some chemical mixtures may release irritating or dangerous fumes.
  • Always put products away in a secure location after use, out of the reach of children and pets. Consider storing them in a high, locked cabinet. Do not store products on top of the washer and dryer.
  • If a product container is empty, throw it away properly. Do not reuse detergent buckets or bottles for other uses.
  • Clean up any spills, and immediately wash your hands and any items you use to pour or measure products.
  • Close and lock the laundry room door when you are finished, so curious young children cannot get in.
  • Pay special attention to spray bottles. They are a common source of exposure to cleaning solutions and should be kept out of a child’s reach.

​Laundry Detergent Packets: A Warning for Parents

Detergent in single-use laundry packets are very concentrated and can be toxic. Even a small amount of the detergent can cause serious breathing or stomach problems or eye irritation.

Between May 17 and June 17, 2012, the Centers for Disease Control and Prevention (CDC) reported 1,008 cases of laundry detergent poiso​nings. Of these, almost half were from laundry packets.

  • Never let your children handle or play with the packs. The packs dissolve quickly when in contact with water, wet hands, or saliva.
  • Remember to seal the container and store it in a locked cabinet after each use. Make sure the container is out of sight and reach of children.
  • Adults should follow the instructions on the product label.
  • If your child does put one of these packets in his mouth or gets any in his eye, call Poison Help at 1-800-222-1222 immediately.

Washers & Dryers

To avoid injuries from washers and dryers, try to:

  • Use childproof locks on front-loading washers and dryers to prevent small children from opening the doors while they are in use and also to prevent them from ever crawling in the machines.
  • Clean the lint trap after each use to help prevent fires. Clogged lint traps are a common cause of house fires. In fact, the Consumer Product Safety Commission (CPSC) reports that washers and dryers were involved in 1 out of every 22 home fires reported in 2006-2010.
  • Do not lean or allow children to play or hang on the doors of washers and dryers, as this can cause them to tip over.
  • Vent the dryer outside the home to prevent mold and mildew build-up.
  • Make a rule in your house that the washer and dryer are not toys.

​​Laundry Chutes

Young children may want to explore this “mysterious opening” we call the laundry chute. While convenient for adults, it poses a great danger for small children. 

  • Make sure laundry chute doors are out of the reach of a small child (36 inches or more off the floor).
  • Consider installing childproof locks to keep your child from opening the chute.
  • Tell your children that the laundry chute is meant only for clothes. Toys and people should never go in the laundry chute.

​Additional Information on

Last Updated



American Academy of Pediatrics (Copyright © 2013)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


All information provided by  For additional information including links and audio, please go to the following web address:


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