Stephanie Oatway, of Sudbury, Ontario, bought her boys a bunk bed. But it was their sister Minah, then 5, who ended up in the hospital because of it.

“She was climbing up the bunk’s steps and her dress got caught underfoot,” Oatway says. “She fell onto her Calico Critters house, which was made of hard plastic, and split her scalp open.” Fortunately, the ER doctors were able to repair Minah’s injury. “Lots of blood,” says Oatway, “but she was okay.”

Scary as the Oatways’ story is, it’s hardly unique, according to a sweeping study of nonfatal bunk-related injuries in the journal “Pediatrics.” It found that more than 35,000 patients under age 21 landed in emergency rooms each year between 1990 and 2005 due to a bunk bed bang-up.

Seventy-three percent of the cases were falls such as Minah’s. Others were caused by jumping, malfunctions of the bed’s structure and other incidents. The most common injuries were lacerations (30 percent), cuts and abrasions (24 percent) and fractures (about 20 percent). Between 1990 and 1999, the Consumer Product Safety Commission also received reports of nearly 60 deaths.

Making bunk beds safer

Given how common bunk bed accidents are, you may want to think twice before buying one. On the other hand, they can save tons of space and kids do love them. If a bunk bed is right for your family, take these steps to avoid a bunk bed nightmare:

  • Follow assembly instructions to the letter. Don’t assume you know which pieces fit together on sight or substitute homemade parts for any included in the box, either.
  • Make sure there are guardrails on both sides of the top bunk. These should extend a minimum of five inches beyond the top of the mattress. Gaps in the guardrails must be three and a half inches or narrower. Otherwise a small child could fit her head between the rails, get stuck and strangle. If necessary, add additional rails to fill in the gaps. Your child shouldn’t be able to slide under the guardrail when the mattress is compressed by his body weight. If he can, put a thick pad under the mattress, or buy a new one that’s thicker by design.
  • Check the upper and lower bunk carefully to make sure there are no openings wide enough for a child’s head, torso, or an arm or leg to pass through.
  • Place the bunk bed in the corner of a room so only two sides are exposed and the bed is braced against two walls.
  • Use the proper size mattress for the top and bottom bunks. Make sure the foundation for each mattress is stable and well supported. There should be slats or wires running directly underneath the mattress that are fastened well on both ends.
  • Teach children to climb the ladder carefully. Thereought to be a light within reach and nightlight nearby. Also tell kids not to horse around on the ladder or the bunk bed. Never set up a bunk bed near a ceiling fan.
  • Lay down the law that kids should use the ladder to climb up to the top bunk and nothing else. Other pieces of furniture, such as dressers and chairs, shouldn’t be used to reach the to

Related: How to Keep Your Kid From Falling Off the Furniture

  • Only let kids 6 and older sleep in the top bunk. Most younger children aren’t coordinated enough to stop themselves from falling off or to climb down safely.
  • Ban kids from tying belts, ropes, scarves or other objects to a bunk bed. They can pose a strangulation risk . Keep the area around the bunk clear of toys or sharp objects a child might fall onto.
  • Remove connectors and dowels if you later separate the bunk beds into twin beds.
  • Go over the rules even if your kids are teens. The “Pediatrics”study found that half of injuries occurred in children under the age of 6, but the other half involved older children and young adults up to age 21. In fact, there were as many injuries among individuals aged 18 to 21 as there were among teens from 14 to 17 years old. It’s never too early — or too late — to be aware of a bunk bed’s potential danger.

Related: Parents Don’t Let Your Child Fall Out of a Window