Tag Archive for: Children

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PEDIATRIC CPR GUIDELINES UPDATE

A coordinated effort between the American Academy of Pediatrics and the American Heart Association has produced new CPR and airway obstruction guidelines which went into effect towards the end of 2025. This is an important update and one all families should be aware of.

CHANGES FOR INFANT CPR

The use of two or three fingers on the chest for compressions is no longer in effect. It is now recommended that the rescuer use the palm of their hand between the nipples (as before), 

or alternatively, the two-thumb encircling hands technique.

We still need to move the infant chest at least 1/3 of its depth or about 1.5 inches. The ratio of pumps to breaths remains 30 pumps and 2 rescue breaths.

This change reflects the fact that most rescuers were not pumping deep enough.

The recommendation for foreign body obstruction (choking) is unchanged. Repeated upper back hits (up to 5) followed by up to 5 chest thrusts is still the method of choice until the baby is over one year old.

CHANGES FOR CHILD CPR

CPR technique for a child now includes the use of two hands to ensure adequate depth of compression (at least 1/3 of the chest wall depth).

 

Please remember that if a child is no longer conscious due to airway blockage it is imperative that CPR begin immediately.

The new recommendation for a choking child now includes 5 upper back hits followed by up to 5 abdominal thrusts (inward and upward), alternating until the object is cleared.

  • For best effect, position yourself to the side and slightly behind the choking child. For a small child, you may need to kneel behind them rather than stand. This should be done while the child is bent over. Previously we suggested back hits while the child was standing upright.
  • Give 5 back blows using the heel of the hand to strike between the shoulder blades. If no improvement, then have the child stand up straight.
  • Next, move behind the child; bend your knees slightly for balance and support, and give 5 abdominal thrusts, pulling inward and upward each time.
  • Continue alternating 5 back blows and 5 abdominal thrusts until the child can cough, cry or speak.
  • If they become unresponsive, begin CPR (starting with compressions)

 

CORRECT RESPONSE TO CHOKING 

As always, we continue to encourage parents and care providers to follow the basics of prevention of airway obstruction by adhering to the following principles:

  • Never leave an infant or small child unattended during mealtimes
  • Once they are crawling/walking keep all food and other objects away from them
  • Do not provide food or snacks in the car as it is difficult or impossible to recognize an airway obstruction before it is too late
  • Be extra careful if you enter a small mouth to try and remove an object. If you must, do so by going along the cheek then swipe across the mouth

When someone is choking immediate response is crucial. You can’t rely on Paramedics to save the day as they won’t be able to arrive in time. That is why we cannot stress enough how important it is for ALL family members and care providers to know how to save a choking infant or child. 

 

BE PREPARED. BE SAFE.

 

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CONSUMER WATCH! RECALL ALERT

There’s a lot to think about when you’re having a baby, so many needs to consider – cribs, strollers, clothing, diapers, baby bottles, bassinets, and more. Needless to say, choosing the best and safest products for your infant, toddler, or young child can be a dizzying process, especially when you’re bombarded with so many product choices.

But how to know if you’re buying something that poses a serious risk? An easy way to stay informed is to register with the Consumer Product Safety Commission (cpsc.gov) to receive their email alerts that identify dangerous products and provide information about their risks. They also have an app you can download to your phone. You can find that here. This is a must-have resource. Adult-related products are included as well.

We went over all the alerts that were issued this year up to the writing of this article and identified a number of product categories that seem to continually pose a health and safety risk where infants and toddlers are concerned. And the list of products grows every day.

Here’s a sample of our findings…

  • Several baby bathing seats that are unsafe and present an increased risk of drowning
  • Bassinets which are unsafe for infants, increasing the risk of suffocation or entrapment

  • One or more baby gates that do not meet safety standards
  • More than a few chests of drawers that are top heavy and are easy to tip over by a small child causing serious injury

  • Numerous toys, games and other items powered by small batteries that, if placed in
    the mouth, increase both a choking risk as well as a risk for toxic ingestion

  • Several safety helmets for those starting to ride a bike or skateboard that are not
    adequate for protection of the head
  • Several “self-feeding” pillows with attachments for a small bottle that pose a
    choking risk

  • Any number of medications and/or supplements that violate child resistant
    packaging and can lead to serious or lethal toxic ingestion
  • Infant & toddler bedtime clothing that do not meet flammability standards

There are also a significant number of items that adults use regularly including:

  • Power strips for multiple electrical inputs that pose a fire risk
  • Steam cleaners due to risk of serious burns
  • A number of pool or hot tub drain covers which increase the risk of entrapment and
    drowning
  • Several adult portable side rails that increase the risk of serious falls

 

Save a Little Life™ strongly encourages all parents to register with the CPSC. Here’s a direct link to subscribe to their mailing list.

 

BE PREPARED. BE SAFE.

 

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IS AI READY TO TAKE ON THE ROLE OF PHYSICIAN?

These days, a growing number of people worldwide are consulting AI Chatbots for medical advice. The question is, can we rely on them to give us accurate advice?

A recent study conducted at Oxford University set out to establish whether or not AI systems are effective with regards to diagnosis and appropriate course of action.

The study included nearly 1,300 participants who were asked to identify potential health conditions and recommended courses of action, based on personal medical scenarios developed by doctors.

One group used AI chatbots to assist in their decision-making, while a control group  used other traditional sources of information. The researchers then evaluated how accurately participants identified the likely medical issues and the most appropriate next step, such as visiting a GP or going to the ER.

Results showed that those who relied on the chatbots made the right choice less than half of the time and that AI correctly identified the problem only about a third of the time.

Although AI platforms excel at standardized tests of medical knowledge, they fall short when it comes to accurate diagnosis because they don’t reflect the complexity of interacting with human users.

Researchers found evidence of three specific areas that posed a challenge:

  1. Users often didn’t know what information they should provide
  2. AI provided very different answers based on slight variations in the questions asked
  3. AI often provided a mix of good and bad information which made it difficult for users to identify the best course of action

Ultimately, AI’s advice was not any better than a simple Google search.

Rebecca Payne, one of the study’s authors, said it could be dangerous to rely solely on this new technology which might fail to recognize when a person needs urgent medical attention.

Senior author of the study, Associate Professor Adam Mahdi (Oxford Internet Institute) said: ‘The disconnect between benchmark scores and real-world performance should be a wake-up call for AI developers and regulators. We cannot rely on standardised tests alone to determine if these systems are safe for public use. Just as we require clinical trials for new medications, AI systems need rigorous testing with diverse, real users to understand their true capabilities in high-stakes settings like healthcare.’

Clearly, AI isn’t qualified to provide clear medical guidance…yet.  On the plus side, although still in its infant stages, some doctors find that incorporating information provided by AI into their own assessments can help them spot illnesses in patients which could lead to new discoveries.

As for the rest of us who are still largely flying by the seat of our pants, it’s probably best to continue to rely on traditional doctor/patient interaction, at least for the time being.

 

 

 

 

VACCINE CONFUSION – TO B OR NOT TO B?

In case you haven’t noticed there have been some rather ambiguous statements made by the Centers for Disease Control and Prevention recently regarding previously accepted standards for certain vaccines for infants.

The most recent of these statements and recommendations come from the CDC’s Advisory Committee on Immunization Practices. Specifically, they are referring to the hepatitis B vaccine for infants. The committee voted to make vaccine recommendations “based on the mother’s testing status.” So, if a mother tested negative for hepatitis B parents should decide, with the guidance of their doctor, whether the vaccine is appropriate for their newborn.

The Los Angeles Department of Public Health (DPH) criticized the decision and described it as “a return to selective, risk-based newborn vaccination”, which officials argued was “not based on new evidence suggesting that hepatitis B vaccine birth dose is unsafe or ineffective.” The DPH further argued that a “risk-based strategy” was shown to be inadequate more than 35 years ago, and can reintroduce preventable risks, in particular communities such as L.A. County where hepatitis B prevalence and risks are higher. Consequently, the county has decided to continue the current, science-based recommendation for hepatitis B vaccines for newborn.

To keep this in context, the new CDC recommendations are occurring while other vaccines for newborns are also being brought into question, in particular, the vaccine for measles which has also been questioned by the new CDC while there have been outbreaks in several U.S cities.

House Representative, Judy Chu, D-Pasadena, a member of the House Ways and Means Committee and Chair emerita of the Congressional Asian-Pacific American Caucus, criticized the CDC’s decision as “reckless and dangerous.” She added: “Asian Americans, Native Americans and Pacific Islander communities who make up only 7% of the U.S. population yet account for 60% of chronic hepatitis B cases. She argued that these vaccines have been life- saving protection for these communities.”

We strongly continue to suggest that all expectant and recently delivered parents speak frankly and honestly with their pediatricians regarding newborn vaccines for their newborn.

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MEASLES ARE BACK

It has been a quarter century since measles was officially eliminated in the U.S. Yet here we are in 2025 seeing a resurgence. Numerous cases have been reported in different states which are giving health experts great cause for concern.

As of mid-May 2025, there were more than 1,000 new cases of measles and three measles-related deaths in the U.S., surpassing the 285 cases reported for all of 2024, according to public health statistics.

Researchers at Stanford University just published an article in the Journal of the American Medical Association which suggests that with the current level of immunizations, measles would return to endemic status with more than 850,000 cases in 25 years.

 

WHAT ARE MEASLES AND WHY ARE THEY SO DANGEROUS?

Measles is a highly contagious airborne virus which can lead to serious complications like ear infections, pneumonia, and brain inflammation (encephalitis) which can be fatal. Children are obviously the most vulnerable but it can affect people of all ages, especially those whose immune systems are weak.

According to Jay Varma, MD, an epidemiologist and primary care physician in New York City “The healthcare delivery system is not prepared for the resurgence of measles.” Measles is twice as contagious as COVID-19 so given what occurred during the recent pandemic it is very likely that a measles epidemic would push the healthcare system beyond its capacity.

 

WHY ARE MEASLES ON THE RISE AGAIN?

There is a lot of misinformation out there about vaccines which has resulted in reduced vaccination rates in some communities. That is further compounded by recent policy changes that have taken place in Washington some of which have been spearheaded by the new director of Health and Human Resources who has openly questioned the need for various vaccines,

When it comes to your family’s health we believe it is vital that you always check with your healthcare provider for the best advice.

CHOKING PROTOCOLS – Are Anti-Choking Devices the Best Option?

Choking is a very real threat and scary issue when it comes to infants, toddlers, and small children so it’s a rare occurrence if I don’t get questions in a CPR class regarding the use and benefits of anti-choking devices.

In a previous article, De-Choking Devices – Friend or Foe? we looked at some of the possible dangers and misinformation surrounding these devices. However, if you believe the promotions for the so-called Doctor Endorsed “Dechoker” or “LifeVac” anti-choking devices, you’re still likely to feel compelled to run out and get one immediately.

A closer look at the research and official recommendations for a choking baby or child, however, might have you come away with a different opinion.

First of all, it’s worth noting that the FDA’s recommendations do not include any of the above-mentioned devices. That holds true for the American Heart Association and the American Red Cross. Instead, they recommend that the first line of defense be the skills learned in an infant or child pediatric CPR class.

Why?

Responding to an actual complete airway obstruction requires quick action by a family member or trained care provider/nanny. Anyone responsible for the care of your baby or child must be prepared to act immediately and be well-versed in how to do so. Even a paramedic response may not be of any help because time is of the essence.

So, why not rely on an anti-choking device? They look simple enough to use.

In this video, the first in an excellent 4-part series, Dr. Darria Long Gillespie, an ER doctor and mom talks about the issues:

If you are a previous client of Save a Little Life™ you have learned the necessary skills in class. A reminder, the standard protocol is either back blows and chest pushes for an infant or a measured Heimlich Maneuver for toddlers or older children. If you were to discuss this with your pediatrician, she/he would tell you that those skills are the most important responses for complete obstruction.

If those methods do not work, then as a last resort you might consider the use of an anti-choking product.

In every class we preach the following prevention methods which should be part of your daily choking prevention routine, including:

  • Do not leave the self-feeder alone during mealtimes
  • Once able to crawl or walk do not give them any food or snacks and only do so when in a proper highchair
  • Do not provide food or snacks in the car until they are much older
  • Try to avoid overreacting to gagging episode(s) but if you feel the need to go into a small mouth, always go in along the cheek line and then sweep across. This will avoid an accidental episode of pushing food into their airway

Again, anyone with care responsibilities for a baby or child must know the proper skills…without exception.

For an in-depth comparison and investigation of the most popular anti-choking devices be sure to view the Dr. Darria’s complete series on this topic: Part 1 | Part 2 | Part 3 | Part 4

 

If you’re interested in refreshing your CPR skills or are a first-time parent wanting to learn, please contact us for more information

VISIT OUR CALENDAR FOR UPCOMING CLASSES

PEDIATRIC INTENSIVE CARE UNITS–WHAT YOU NEED TO KNOW

Most expectant and recently delivered parents are familiar with the term Neonatal Intensive Care Unit or NICU (“nick-u”) which might be necessary in the case of a newborn that arrives sick or premature. For that reason, all hospitals who deliver babies are required to have access to a NICU, just in case.

But what happens when an older infant or child requires intensive care? Are they also cared for by the NICU unit?

The answer is no. NICU patients are typically newborns, although some NICUs care for babies up to two months old. Beyond that, a Pediatric Intensive Care Unit or PICU is required for all children, generally up to the age of 18.

What’s important to know is that PICUs are specialized units that don’t exist in all hospitals. Therefore, it is important that parents find out where the nearest PICU is located so their little ones can receive the best care if and when they are seriously or critically ill or injured.

For example, let’s say a 3-year-old child has fallen from a height that caused a brain injury and they are showing signs of a severe concussion or worse. That child would require hospitalization in a PICU for intensive monitoring and treatment by specialized physicians and nurses until they were stable and continuing to improve.

PICUs are most often located in medical centers that are teaching hospitals. A teaching hospital trains physicians in all areas of medicine, from pediatrics to neurology to orthopedics and so on. They have 24/7/365 capacity to provide rapid care to babies, children and adolescent patients.

What you need to bear in mind is that these represent only a small percentage of the hospitals in the greater Los Angeles area.

So what happens if the paramedics arrive and determine that your baby or child requires hospitalization?

Paramedics are extensively trained to evaluate and treat infants and children both in your home and en route to the hospital. Please follow their instructions and lead as they are making decisions based on sound clinical judgement.

If they determine that your little one will likely need intensive care, they will not take them to a hospital that cannot care for them, however, it is also possible that they will go to a medical center where your pediatrician does not have admitting privileges.

It goes without saying that ideally, you would want your child to go to a medical center where your pediatrician admits and practices.

So, an important question to ask and one that all parents should know the answer to is where does your pediatrician admit the most serious patients? 

It’s helpful to know that pediatricians have admitting privileges at one or more of these medical centers – in fact, many have done their resident training at these centers – but don’t take anything for granted. If you don’t already know, please ask your pediatrician where she or he admits little ones.

In Los Angeles, the following medical centers have a PICU:

  • UCLA Medical Center (Westwood)
  • Cedars-Sinai Medical Center
  • Children’s Hospital of L A.
  • County USC Medical Center
  • most Kaiser Permanente hospitals
  • The recently enlarged Providence/Cedars Tarzana hospital also has a critical care unit for pediatrics
  • In outlying areas, Loma Linda Medical Center and Harbor UCLA Medical Center should be included in the list

Save a Little Life™ is dedicated to educating parents, family members, and care providers to respond to most pediatric health emergencies, if needed. Never underestimate the importance of that knowledge. Keeping CPR and airway emergency skills current can make the biggest difference in critical health events.

 

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BEE PREPARED

Most of us will likely be stung by a bee or yellow Jacket at some point in our lives. What should you expect if this happens to your little one?

As you might expect, there will be some pain or discomfort at the site and it is usually accompanied by local swelling, a feeling of heat and itching around the location. On occasion, the swelling might move from one hand to the forearm. This is not that uncommon. Itching may continue for several days and can be alleviated by a cool compress to the area.

How do I remove the stinger?

The stinger itself is a hollow tube through which venom enters the body. The preferred method for removal is to use something firm like a credit card to sweep the stinger off from the side. Grabbing the stinger with tweezers or your fingernail will likely eject additional venom into the person.

What does a severe reaction look like?

The following reaction(s) to a bee sting that require immediate attention include:

  • Hives, in parts or larger sections of the body
  • Nausea/vomiting
  • Stomach cramps
  • Any swelling of the body not associated with the site…particularly in the neck, face, tongue that might affect breathing

Some reactions are not specific to the site itself. If there is some swelling elsewhere, consider using an anti-histamine such as Benadryl. The liquid version enters the body more quickly, plus many young ones cannot swallow a pill.

Continue to observe the person closely and if needed, go to a local emergency department.

What to do when the bite victim has a known, severe allergic history to bee stings

If the bite victim has a known, severe allergic history to bee stings you should expect severe symptoms within minutes. If an EpiPen is available, use it as directed, then call 9-1-1. Driving to a hospital under these circumstances has risks, including traffic accidents.

What is an EpiPen?

EpiPen is a commonly known brand name of an auto-injectable device that delivers the drug epinephrine, a life-saving medication used when someone is experiencing a severe allergic reaction, known as anaphylaxis.

Do I need an EpiPen at home, even if no one in the household has a known allergy?

Most pediatricians will not prescribe one unless there is a confirmed history of a severe reaction to any substance that could cause a life-threatening event.

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CANDY OR CANNABIS?

California authorities recently seized 2.2 million illicit cannabis packages designed to look like popular food snacks and candy. The sting operation focused on 11 storefronts in the city’s Toy District where businesses were making and selling packaging used to deceive customers.

According to the L.A. Times, “The packages seized in the sweep were empty, but designed to mimic popular food and candy, including Sweet Tarts sour gummies and Twinkies adorned with rainbow sprinkles, which officials said could make them attractive to children. Such packages would not be permitted in the legal marijuana market.”

Under state law, cannabis goods must be labeled to ensure that consumers know what they are buying and to prevent products from being misused. Sellers are required to have packaging that is child-resistant, resealable and opaque if it’s an edible product. Vetted products feature a marijuana leaf symbol and an exclamation mark inside a triangle.

Unfortunately, the illegal weed market is aware of this, so some are now illegally creating packaging with a forged seal to sell their black market products.

Each of the seized packages was labeled with a forged California marijuana seal, giving would-be purchasers the false impression that the products inside had been vetted by the state. 

Obviously, this poses a danger to consumers.

Governor Newsom responded stating “We will not tolerate criminal activity that undermines the legal market, especially when it puts children at risk.”

Department of Cannabis Control Director Nicole Elliot added that such counterfeit packaging can potentially pose danger to consumers, “especially when it is ripping-off well-known brands that are attractive to children.”

Why is cannabis such a risk to children?

Children react very differently to cannabis than adults. Their reaction is extremely variable with symptoms varying from none at all to a coma. In a previous post we took a look at this issue and why it has become such a concern.  You can find that article Cannabis Poisoning In Children Is On The Rise here.

In our Pediatric CPR & Family Safety Class we always discuss potential risks to little ones who might accidentally consume any substance that might harm them. Our emphasis is on the 4 specific groups of potential toxins including drugs (of all kinds), plants, flowers and common chemicals used around the home for cleaning.

We strongly recommend the following guidelines:

• Keep all medications well hidden and out of sight of toddlers and children
• Be aware that little ones are always observing adults and might think that what they consume is OK for them
• Know the toxicity of common (indoor plants) as well as those in your garden
• All chemicals used for cleaning, disinfecting, or insecticides must be kept well out of reach and in cabinets that have good quality locks

If you believe that there has been an ingestion of any substance by your little one, please call California Poison Control immediately @ 1-800-222-1222.

HOW TO RECOGNIZE CANINE STRESS RESPONSES

The L.A. Times recently ran an article on the rising increase of dog bites that are sending record numbers of us to local Emergency Rooms. The numbers are actually quite troublesome.

A recent study cited 48,596 ER visits that were related to dog bites, a number that reflects a 12% increase from the previous year and 70% higher than 2005. That equates to 125 ER visits for dog bites per 100,000 California residents.

Why the increase?

As many a 45% of American households now have at least 1 dog. That number is higher than it’s ever been owing to the large number of adoptions that took place during the pandemic when people were suffering from isolation.

Some dogs, like people, respond to unusual stress with aggressive behavior but unfortunately, the initial warning signs may go unnoticed. According to the article, a large number of puppies (and adult dogs as well) were hastily adopted during the pandemic and never properly socialized which has resulted in unaddressed behavioral issues.

State figures and a recent study by public health researchers show that, in California, children and young adults are the age groups most likely to make ER visits for dog bites.

The most serious injuries often involve the head and neck, making little children especially vulnerable. Nationwide, children under 5 were more than twice as likely to die from dog bites as members of other age groups.

What to look for?

Canine aggression occurs “on a ladder” of escalating behaviors and not all of them are obvious unless you know what to look for.

Easy to remember are the 5 Fs:

  • fret
  • fidget
  • fight
  • flight
  • freeze

Initial signs of discomfort also might include lip-licking, looking away, or yawning. The behavior starts to escalate when the dog begins stiffening up, staring, or crouching with a tucked tail. And things can worsen if an active toddler or small child gets too handsy.

According to Elizabeth Stelow, chief of the Behavior Service at the UC Davis Veterinary Medical Teaching Hospital,  owners should learn to recognize anxiety in dogs and understand their body language. When dogs owners repeatedly miss the signs of distress, biting may occur.

Dogs who are punished regularly are  also more inclined to bite. Negative feedback such as collars that deliver electronic stimulation, choke chains, and/or pronged collars were also identified in the article as another source of great stress.

Although aversive techniques appear to work by subduing the animal’s behavior, that result is often deceptive. Fear-based learning can push dogs to stop engaging in any behavior, good or bad, as the dog becomes fearful of a negative response.

The American Veterinary Society of Animal Behavior encourages owners to focus on positive reinforcement, rewarding dogs for what they do right. Motivating good behavior with treats, toys, verbal praise, and other positive choices make for a much happier and better-behaved pet.

Be sensitive to any signs that might lead to aggressive behavior.

Dogs are such an important part of our family, our lives, and our wellbeing. Let’s make sure that we equally value the wellbeing of our canine friends.