By Dr Khutso N. Sebetseba, Paediatrician
Every December, paediatric units across South Africa see a predictable surge in specific emergencies. The combination of school holidays, travel, heat, disrupted routines, and more time spent around water creates a perfect storm for childhood injuries and illnesses.
This article outlines the most common paediatric presentations during the festive period and the evidence-based steps families can take to prevent them.
1. Drowning and Near-Drowning Events
Drowning remains a major cause of accidental injury-related death in children. Risk increases in December as families spend more time near pools, beaches, rivers, and inflatable pools.
Prevention:
• Always have a designated water watcher.
• Toddlers must always be within arm’s reach.
• Ensure pools are fenced and adequately secured.
• Teach children to alert an adult immediately if someone disappears under, or around water.
2. Choking Episodes and Airway Obstruction
Holiday gatherings increase unmonitored exposure to high-risk foods such as grapes, sausages, boerewors pieces, popcorn, nuts, and hard sweets.
Prevention:
• Cut grapes and sausages lengthwise.
• Avoid popcorn and nuts for under-5s.
• Encourage sitting while eating.
• Learn choking first aid.
3. Burns: Thermal, Scald, and Firework Injuries
Burns are common festive emergencies, especially in younger children.
Prevention:
• Create no-go zones around braai areas.
• Keep kettle cords and pot handles out of reach.
• Treat fireworks with caution.
• Cool burns with running tap water for ±20 minutes.
4. Gastroenteritis, Foodborne Illness, and Dehydration
Heat, outdoor eating, and long road trips increase the risk of gastrointestinal illness.
Prevention:
• Keep cold foods cold and hot foods hot.
• Refrigerate perishable foods promptly.
• Encourage handwashing or sanitiser use.
• Start oral rehydration early if vomiting or diarrhoea develops.
5. Interrupted Chronic Medication and Unprepared Travel
Many holiday emergencies involve children with chronic conditions arriving without their regular medication or equipment.
Prevention:
• Pack all chronic medications (plus extra).
• Include inhalers, spacers, auto-injectors if needed.
• Take prescription creams or formula.
• Ensure nebuliser parts are packed.
6. Illness in an Unfamiliar Location: When to Seek Help
Parents often struggle to judge when to seek urgent care while away from their usual healthcare providers.
Red flags requiring immediate medical attention:
• Difficulty breathing or chest indrawing.
• Signs of dehydration.
• Persistent vomiting.
• Lethargy or decreased responsiveness.
• Seizures.
• Any rapidly spreading rash, or a rash that does not blanch.
• Any strong parental sense that “something is very wrong”.
7. Adolescents: Alcohol, Fireworks, and Risk-Taking
Teens are at increased risk of injury during holidays due to more independence and social exposure.
Prevention:
• Have open conversations about alcohol and safety.
• Set firm rules around fireworks and gatherings.
• Ensure responsible adult supervision at social events.