We're all kids in the summertime, playing on sailboats, bicycles, hiking trails, in backyards and poolside. And whether you're going it alone, playing with a partner or having fund with kids or grandkids, it makes sense to do what it takes to protect those heads, shoulders, knees and toes.]

And while no one likes to be a downer, it is true that the season which gets us outdoors is, according to the 2007 Safe Kids U.S. Summer Safety Ranking Report, the one that sees 89 percent more injuries than the rest of the year.

Those injuries aren't limited to just bumps and scrapes, said Chris Green, trauma program manager of SSM Cardinal Glennon Medical Center. "Many result in paralysis, brain damage and even death," she said, which explains why many emergency personnel know summer as "trauma season."

Here are summer's most common injuries, according to Green and to Dr. Timothy Soncasie, medical director of St. Luke's Urgent Care Centers, as well as ways you can help protect yourself and the ones you love -- and maybe save a life.

Bicycle and wheeled-sports injuries. Some kids, the little ones and the grown-up ones, are fond of speed and feats of derring-do, which is why helmets, protective padding and wrist guards are essential when bike riding, using in-line skates or riding scooters.

"A helmet is the single most effective safety device when it comes to reducing the severity of head injuries and the likelihood of death," said Green. "Parents have to be firm about the use of a helmet, and be a good role model and wear one themselves." (That goes for grandparents, too.) "Wearing a helmet decreases the risk of head injury by 85 percent and the risk of brain injury by as much as 88 percent."

Helmets should fit properly and be worn snugly for maximum protection, Green said. Follow the fitting instructions that come with the helmet, or visit a local firehouse or Safe Kids event in your neighborhood (safekids.org) for help. Protective equipment should also be worn when playing sports, especially baseball and soccer.

Water accidents. Drowning is the second leading cause of unintentional death of kids ages 1 to 4 in the United States. "Nine out of 10 fatal drowning events occur during a lapse of supervision," Green reported. "It can even be a brief lapse."

To avoid such accidents, Green said, "there should be one person designated to watch children who are swimming at all times," which means not reading or doing anything else at the same time. "Drowning is a silent event, so you may not hear the child. It only takes a few seconds to drown so visual contact is most important."

When boating, a U.S. Coast Guard-approved life jacket should be worn by everyone, even those who know how to swim, Green said, and all of the safety rules and laws of boating should be followed. In addition, establish a no-diving rule for everyone when the water is less than 9 feet deep. And when you do dive, make sure you know what's below the surface of the water, particularly large boulders. According to Green, "A lot of spinal cord injuries occur this way, especially in teenage males."

Swimming lessons are recommended for children at an early age; and for those more advanced in years, remember: It's never too late to learn.

Motor-vehicle accidents. Everyone in the car should buckle up: those in the front seat and those in the back. Make sure kids are situated properly in a size-appropriate safety seat at all times and that it is installed correctly, Green said.

Leaving a child unattended in the car is another big safety issue, and is one that leads to many deaths. "It doesn't take long for the car to get really hot. Parents should not ever leave a child unattended in the car," Green said.

Pedestrian injuries. Nearly 10 percent of all injuries to child pedestrians occur in the driveway, most involving toddlers between 1 and 2 years old, Green said. "They don't recognize that the car is a danger to them and that the driver can't see them. Many children are so focused on what they are doing that they don't see the car either."

To avoid pedestrian accidents, Green recommended children under 10 follow a few rules of the road when navigating crosswalks: Cross with an adult; use a traffic signal or crosswalk whenever possible; and look left, right, left before leaving the curb. Playing in the street should also be off limits.

Falls. In her experience at Cardinal Glennon, Green has also seen a variety of these injuries. To prevent kids from falling out of a window above the first floor level, she suggested keeping windows closed or using window guards, keeping furniture that can be climbed on away from windows, and using close supervision when a window is open.

"Kids don't realize a screen won't catch their fall," she said. Falls also occur at the playground, which is why Green recommended making sure playgrounds have appropriately cushioned surfaces.

In the event of a bad fall, "proceed to the hospital if there is any loss of consciousness or if the injured person doesn't remember the event, is dazed or confused, is having seizures, vomiting, complaining of a headache, or not acting like themselves," Green said.

All-terrain vehicle accidents. Accounting for more than 100,000 injuries across the U.S., ATVs are the cause of many serious injuries, said Green. "Even the smaller ATVs are very heavy and tip easily. We see many ATV injuries every weekend in the summer." Cases range from severe head injuries to crushed facial bones and internal organs, to multiple and/or open fractures, to cervical spine injuries that cause paralysis and death. Children under age 16 account for 30 percent of these types of injuries.

Based on what she has seen, Green believes no one under age 16 should ride an ATV. However, because she knows that's not realistic, she said young ATV riders can reduce risk and improve safety with formal training before riding; add to that appropriate protective gear, such as a helmet, body protectors and gloves, an appropriately sized ATV, adult supervision and a no-passengers rule -- even if an adult is riding.

Burns. Dr. Soncasie of St. Luke's Urgent Care Centers recommends that anyone planning to soak up some sun, whether on the beach or at the baseball game, apply a sunscreen with an SPF (that's "sun protection factor") of at least 15 approximately 30 minutes before going outdoors.

"This allows the sunscreen to absorb into the skin and prevents it from washing or rubbing off," he said.

Reapply every two hours, even on cloudy days, and try to avoid extensive exposure to the sun between the hours of 11 a.m. and 3 p.m., when the sun's rays are most intense. "This will decrease the likelihood of getting a sunburn," he said.

Burns from motorized vehicles and lawn mowers are also common during the summer, said Soncasie. He suggested making sure legs are properly covered before riding.

Poison ivy. The summer is a great time for off-the-trail exploration, where pleasures and mysteries abound. Unfortunately, so does poison ivy. Learn to recognize the plan (hint: "leaves of three; let it be"). For serious back-woods exploration, long sleeves and pants are the best protection.

"If you're doing an activity where you are exposed, the best thing to do is wash with soap and water immediately following the activity," Soncasie advised.

If you're an avid gardener bent on clearing out the honeysuckle and poison ivy from the back forty, try applying an over-the-counter cream prior to exposure, and wash it off immediately afterward.

Overheating. During the heat of the summer and the height of activity, it's important to moderate activity and drink plenty of fluids, said Dr. Soncasie. "Thirst is a good indication of whether or not you need more fluids. A child needs at least 8 cups of water to replenish fluids, and if playing outside, the amount could triple.

"We lose a lot more water when the humidity is less, too," he explained, which means you and your family should drink extra water if traveling to dry areas, such as the desert Southwest.

Soncasie also warned that those who aren't feeling well should stay indoors, especially if a fever is present, as there is the risk of heat stroke and heart-related illness.

Big bites and small. Approximately 400,000 children require medical attention for dog bites each year, reports the Centers for Disease Control and Prevention, most of which are from family pets or familiar dogs, not strays. The best prevention is adult supervision; however, the CDC also recommends the following safety measures:

* Don't enter a strange dog's environment
* Don't run from a dog and scream
* Remain motionless ("be still like a tree" works for young ones) when approached by an unfamiliar dog
* If knocked over by a dog, roll into a ball and lie still ("be still like a log")
* Immediately report stray dogs or dogs displaying unusual behavior
* Avoid direct eye contact with a dog
* Don't disturb a dog that is sleeping, eating or caring for puppies
* Don't pet a dog without allow it to see and sniff you first
* If bitten, immediately tend to the wound and then report the dog

Although smaller in case, tick bites must also be taken seriously. Left unattended for more than 24 hours, attached tick can put its host at risk for tick-born disease, said Dr. Soncasie, Lyme disease being the most common of these. In 2007, the CDC reported more than 27,000 cases of Lyme disease in the U.S., most of which were in the Northeast and upper Midwest.

To prevent tick bites, Dr. Soncasie advised staying out of wooded areas and other places where ticks are known to be prevalent.

"If you're hiking or camping [in tick-infested areas], wear long sleeves, long pants and socks, and do a daily tick check," he advised. In addition, use a repellent on your skin that contains DEET or picaridin. Repellents with permethrin should be used on clothing only. Avoid applying all repellents to hands, eyes and mouth. Similar precautions can be taken to avoid mosquito bites.

Any injury should be assessed and addressed as quickly as possible, whether it's something minor to be cared for at home or something significant requiring an urgent-care or doctor visit.

In short, make the most of summer fun. Play hard, play safe, and stay whole.