FRIDAY, Oct. 31, 2014 (HealthDay News) -- Carving pumpkins and trick-or-treating may seem like harmless fun, but Halloween injuries send many children to emergency rooms in the United States every year, experts say.

Out of eight holidays, Halloween had the fifth highest number of ER visits involving children aged 18 years and younger, according to 2007-2013 data from the National Electronic Injury Surveillance System.

Nearly one in five Halloween injuries involved the head, noted the American Academy of Orthopaedic Surgeons and the Pediatric Orthopaedic Society of North America. Lacerations were also common, the groups noted. The study showed that one-quarter of all hand and finger injuries were lacerations.

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Children younger than 5 and kids between 10 and 14 sustained the greatest proportion of injuries.

"Costumes, candy and scary monsters tend to be top-of-mind for kids during Halloween, not falls and fractures," said Dr. John Gaffney, pediatric orthopedic surgeon and academy spokesman. "It's important for parents to establish clear boundaries with their kids and teach them safety tips to ensure they have a positive experience, rather than having to visit the emergency room."

Experts from both associations provided the following safety tips to parents and their children during Halloween:

For trick-or-treaters:

  • Make sure children walk on sidewalks. Remind them not to cut across people's yards or through their driveways.
  • Buy or make flame-resistant costumes and make sure they fit properly. Masks, hats or other accessories that are too big can obstruct children's vision. Costumes that are too large can cause kids to trip and fall.
  • Choose bright colors. Costumes with noticeable colors will ensure that kids can be seen in the dark. Add reflective tape to costumes and treat bags as an additional safety measure to make sure children are visible.
  • Wear comfortable shoes. Regardless of the costumes children choose, their shoes should be sturdy, comfortable and slip-resistant to prevent falls.
  • Remind children to avoid houses that are not well-lit.
  • Use flashlights. Children and parents should carry flashlights so they can see properly and others can see them. Teach kids that pointing a flashlight above chest level could block the vision of other trick-or-treaters.
  • Be wary of pets. Pets may be threatened when strangers approach their homes.
  • Bring a cellphone. If there's an emergency, a cellphone will allow trick-or-treaters to call for help.

For pumpkin carvers:

  • Use a pumpkin carving kit, or knives designed for carving. These tools are less likely to get stuck in a pumpkin while carving.
  • In the event of a pumpkin carving injury, elevate the injured body part above the heart and apply direct pressure to the wound with a clean towel. If bleeding doesn't stop after 15 minutes, or if the cut is very deep, go to the emergency room.
  • Pumpkin carving always requires adult supervision. Rather than using a knife to carve, children can scoop out pumpkin seeds or decorate the pumpkin.
  • Don't carve a pumpkin if you are under the influence of alcohol or another substance.

More information

The U.S. Centers for Disease Control and Prevention provides more Halloween health and safety tips.