Tag Archive for: Home Safety

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.

 

SIDS–WHY SAFE SLEEP PRACTICES MATTER

Nowadays, most first time parents are well-informed about the current guidelines regarding SIDS, but are they practicing them?

Dr. Rachel Moon, MD, FAAP is a widely-renowned pediatrician and the chair of the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome (SIDS). In her most recent study (The Tension Between AAP Safe Guidelines and Infant Sleep, Pediatrics, March 2024) we learned that most people know the ABCs of safe sleep but are not practicing them.

“If I had to follow the safe sleep back is best and nothing in the crib and no contact sleeping, I don’t think that she would get much sleep, nor would I, so I don’t feel too confident in that.” – mom from Dr. Moon’s Study

And what about the other people involved in the care of your baby – Grandparents, family members, babysitters, nannies? Even if you share what you know, cultural and generational differences can sometimes cause people to question and maybe even ignore the information.

The first step towards safety is understanding why Safe Sleep practices are important. There are many resources available to help answer that question and below you’ll find videos, links, and downloads that can help.

For example, did you know…

The risk of sleep-related infant death is up to 67 times higher when infants sleep with someone on a couch, soft armchair or cushion?

Watch Charlie’s Story to find out more…

And did you know that the risk of SIDS is lower for children who breastfeed? If you’re a new parent or planning on having more children, we suggest you read our previous post Breastfeeding May Reduce the Risk of SIDS.

MUST-HAVE RESOURCES

for English and Spanish speakers (hispanohablantes)

DOWNLOADS | DESCARGAS

We highly recommend that all parents and caregivers read the article:

How To Keep Your Sleeping Baby Safe by Dr. Rachel Moon, MD, FAAP which offers excellent advice and numerous resources and practical suggestions on how to reduce the risk of SIDS.

To download a copy of the article, click here.

Recomendamos encarecidamente que todos los padres y cuidadores lean el artículo:

Cómo mantener seguro a su bebé por Dr. Rachel Moon, MD, FAAP que ofrece excelentes consejos y numerosos recursos y sugerencias prácticas sobre cómo reducier el riesgo de SMSL.

Para descargar una copia del artículo, haga clic aquí.

The NIH (National Institute of Health) has many resources available on the topic of SIDS, including videos and brochures for grandparents and other caregivers such as this video:

Video para abuelos y personas que cuidan un bebé 

Safe Infant Sleep for Grandparents and Other Trusted Caregivers

For the English version of this video click here

ADDITIONAL DOWNLOADS | DESCARGAS ADICIÓNALES

 

Safe Sleep For Your Baby (NIH)

Safe Sleep for Your Grandbaby (NIH)

Sueño Seguro Para Su Bebé (NIH)

Sueño Seguro Para Su Nieto (NIH)

 

 

 

 

 

 

 

 

 

For more in-depth info, please visit:

NIH (National Institute of Health) 

Healthy Children.org

 

 

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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.

CAUTION: COLORFUL CURIOSITIES

Parents who have taken our CPR & Family Safety Class will recall that the class highlights poison prevention, and for good reason.

The most recent report from the Consumer Product Safety Commission (CPSC) shows an alarming increase in both serious and fatal poisonings…especially in the 0-4 age group.

The numbers show an increase in fatal poisonings of 37% from 2020 to 2021 with a significant increase of 66% from ’21-’22. These numbers are on the rise and Emergency Departments and the CPSC are sounding the alarm.

In particular we are looking at:

  • All Acetaminophen (Tylenol) products – especially liquid versions
  • Narcotics/opiates
  • Hallucinogenic substances (including ingestible cannabinoids)
  • Ibuprofen agents

One very simple thing to keep in mind is this:

Children are attracted to bright, colorful items whether it’s pills or cleaning supplies and chemicals used for washing clothes and dishes.  It all looks like candy to them.

The essentials of poison prevention are well known  but sometimes we need reminding.

Be sure to follow these essential guidelines:

  • Keep ALL medications well out of reach of children
  • Only administer pediatric medications as prescribed by your pediatrician
  • Check age and size-related dosing of anti-fever drugs. For example: Tylenol and Ibuprofen medications both come in infant and toddler strength
  • Never use words like “sweet” or “candy” when trying to get your little one to take medication as they will get the wrong message
  • Any recreational drugs need to be either very well hidden or in a locked container
  • Make sure that all relatives and/or care providers understand these safety rules

Keep your loved ones safe and healthy.

THE RISING RATE OF PEDIATRIC OPIOID POISONING

When little Enora Lavenir’s parents put her down for a nap during a family vacation they never could have imagined it would result in her death. Vacationing in a Florida Airbnb, the couple didn’t know that the rental home had been a “party house” where the illicit drug Fentanyl had likely been used. Yet, confirmed by autopsy, Enora’s death was due to acute Fentanyl toxicity.

Until now, our perception of the opioid crisis has largely been viewed as an adult problem. However, there is stunning and alarming evidence that infants and children are more likely to die from an opioid overdose than from any other toxic substance.

According to findings published in the journal Pediatrics about 52% of poisoning deaths in children under 5 years of age are due to opioids. “In fact, the number has doubled since 2005, when 24% of poisonings were attributable to opioids” said lead researcher Dr. Christopher Gaw, a pediatric emergency physician at Childrens Hospital of Philadelphia.

Dr. Gaw and colleagues reviewed child death data from the U.S. National Center for Fatality Review and Prevention. Between 2005-2018, 731 poisoning deaths in children aged 5 and younger were reported to the center. Overall, infants, under the age of 1 accounted for 2/5 (40%) of poisoning deaths. During this period opioids were involved in 47% of these deaths. The next leading cause of drug related deaths occurred from over the counter pain & cold medications (15%).

Five years later, the numbers are rising.

Even a small dose of a prescription opioid can put an infant or toddler’s life at risk. This is particularly true of synthetic opioids such as Fentanyl which is 50-100 times more potent than morphine. 

Where are these overdose deaths occurring?

Nearly 2/3 of these poisoning deaths occur in the infant or child’s home.  Roughly 1/3 of these occurred when a child was supervised by someone other than their parents. The data clearly shows that the vast majority of these poisonings were accidental.  Dr. Gaw added “Kids are curious, active and we know from experience and other studies that often kids are exposed accidentally.  They are just exploring their environment when they find an opioid and end up ingesting it.  A lot of these are what we call exploratory ingestions.”

Dr. Sam Wang, a pediatric toxicologist with Childrens Hospital Colorado in Aurora noted ”even legitimate opioids that are not properly stored and kept out of reach of a child can cause a death if a child would get into them.”  On the other hand, illicit drugs are particularly risky in homes where supervision of children is usually not as good.  This type of event is considered drug endangerment.  Our readers need to understand that, even when properly prescribed opioids are in the home, they must be stored safely  –  away from little ones.  

Shows a baby's hands on top of various pill packets

SIGNS OF AN OPIATE OVERDOSE:

  • Very lethargic, hard to arouse
  • Shallow, slower breathing
  • “Pinpoint” pupils

If any of these occur call 9-1-1 immediately and if breathing stops, initiate CPR immediately

Our Pediatric CPR & Family Safety Class begins with a focus on prevention of most household injuries & accidents.  

When it comes to storing any potentially dangerous drugs we emphasize:

  • storing all medication (prescription or otherwise) out of the reach of children
  • keeping opioid drugs under lock and key, if possible
  • that medications of this type be kept in child resistant containers

Consider asking you M.D. for a prescription for Naloxone, the proven life-saving antidote to all opiate drugs.

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WHAT YOU MAY NOT KNOW ABOUT DROWNING

Drowning is a major concern worldwide.

Water is a source of joy for children of all ages but it requires a high degree of respect and caution. 

These days drowning is newly defined as “submersion in a liquid” and doesn’t assume death which may be confusing. That is why the American Academy of Pediatrics (AAP), The Center for Disease Control (CDC) and the World Health Organization (WHO) all want us to have a better understanding not only of what it is, but how drowning can affect anyone, and how it impacts society.

Too often we assume that little ones are safe in water unless we hear a lot of splashing or a call for help but sadly, these responses rarely occur. Drowning is quick and silent. That is why it’s crucial that you be informed as to what actually happens when someone is in real trouble.  

Practicing life-saving skills is the responsibility of everyone involved in the care of your children. 

Save A Little Life™ works with all parents, family members, and trusted care providers regarding the risks, how drowning actually happens, and where it occurs.  We continue to emphasize the importance of drowning prevention and, of course, what we would need to do in the event of a real health emergency.  One thing we emphasize is that drowning victims can be saved if we recognize the problem and start CPR immediately.

Below you’ll find the latest statistics on drowning. We encourage you to read them carefully with the understanding that our intention is not to scare you but to inspire you.

As we like to say, Be Informed. Be Prepared. Be Safe.

GENERAL STATISTICS:

  • There is an average of 4,012 unintentional drownings per year
  • Drowning remains among the top 4 causes of death from age 54 and up
  • Drowning is the single leading cause of death for children ages 1-4, and the second leading cause of injury-related death for children up to 14 years old
  • The U.S. averages 11 fatal drownings per day and an average of 22 non-fatal drownings per day
  • More than 40% of drownings treated in Emergency Departments require hospitalization, transfer or further care (compared with 8% of all unintentional injuries). Many of those who do not die will experience brain damage or other serious outcomes, often with long term disability
  • Drowning can occur in as little as 20-60 seconds
  • Nearly 80% of drowning deaths are among males due to increased exposure to water, risk-taking behavior and alcohol use

CHILD STATISTICS:

  • 88% of child drownings occur with at least 1 adult present
  • For every child that dies from drowning, another 7-8 require emergency department care for non-fatal drowning.  Nearly 70% of drownings of young children occur during non-swimming times
  • Two of three drowning incidents that take place in the home occur in a bathtub
  • 23% of child drownings happen during a family gathering near a pool

RACIAL AND ETHNIC GROUP STATISTICS:

  • Drowning deaths rates for Black people are 1.5 times higher than the rates for White people.  These disparities are highest among Black children  ages 5-9
  • In swimming pools, Black children ages 10-14 years drown at rates 7.6 times higher than White children
  • Black children are more likely to drown in public pools, and White children and youth in residential pools
  • Drowning rates for Native American or Alaskan Native people ages 29 and younger are 2 times higher than the rates for White people

STATISTICS FOR PEOPLE WITH DISABILITIES AND MEDICAL CONDITIONS: 

  • People with seizure disorders such as epilepsy are at a higher risk of fatal and non-fatal drowning than the general population  
  • Other conditions such as autism and heart conditions are also associated with a higher risk of drowning

Let us all be informed and prepared.  There is so much as stake.

7 STRATEGIES FOR SURVIVING REMOTE WORK WITH KIDS AT HOME

Working remotely might be the perfect fit for your career and family. Yet juggling childcare while getting work done can be challenging. With these survival tips from Save a Little Life in mind, you can breathe a little easier during the work week.

Dedicate an Area of Your Home to Work
Because working from home often involves mixing business and pleasure, a dedicated work area is a must. Separating work from daily living can help you focus and avoid distractions. A home office or nook can also create a work-life balance if you close it off at quitting time.

Aim to maintain an ergonomic work area, rather than working from bed or at the kitchen table. Proper posture is crucial for avoiding spine, wrist, and other injuries, notes Healthline; ergonomics matter when working from home.

Establish a Daily Routine or Rhythm
Most parents of young kids scoff at the idea of a “schedule.” What infant or toddler naps exactly when their caregiver needs them to? An alternative is a routine or rhythm that fits your family’s needs.

According to Parents magazine, routines are beneficial for kids and help bedtime go more smoothly, reduce meltdowns, and even teach toddlers flexibility. The exact times don’t matter, but a sequence of events keeps everyone on track.

Set Up Toddler-Safe Solo Activities
Managing a toddler while balancing a full workload isn’t easy. For times when you need to keep little hands busy, set up quiet toddler activities they can do solo. Making sure to avoid potential choking hazards is a no-brainer, but mess-free activities are a must, too.

Toys like blocks, puzzles, and coloring books can be intriguing, especially if they are new or not always available. Stickers, large magnets, and felt boards can also be engaging. Try to keep different toys in rotation to maintain interest, as novelty can wear off quickly.

Carve Out Time for Older Children
Working from home sometimes feels like working 24/7. It can also feel that way for your kids, especially older children who are mostly self-sufficient. Babies and toddlers require a lot of attention, but older kids need one-on-one time, too.

Take care to prioritize your older kids at important times of the day when your little ones aren’t underfoot.

Choose Clothing You Can Live In
An obvious benefit of working from home is the ability to wear comfortable clothes. Of course, if you need to be Zoom-ready on top, professional yet comfortable clothing is paramount.

Versatility is a keyword when it comes to comfortable, functional clothes.

Luckily, nursing parents can find top-rated nursing bras online, making it easy to add them to your shopping cart while ordering diapers and wipes.

Declutter Daily for Less Stress
Every parent knows how stressful having too much stuff is, but you might not realize how much clutter impacts your day. Mayo Clinic confirms that clutter can create stress and even keep you up at night.

Starting your day with a clean space can help you buckle down and get work done. Quick clutter pickups a few times daily can also help you feel accomplished. Try out a quick-clean routine to keep messes from piling up through the work week, and the mental load may ease even more.

Enjoy Downtime as “Me Time”
Though many parents feel guilty about dedicating time to self-care, Romper’s experts say it’s necessary. Carving out even a few minutes a couple of times per day can boost your mood and mental health.

Therapists say to take alone time to recoup, refresh, and be a more active parent when you are with your kids. Asking for help from your partner or family is recommended, too.

Remote work with a baby or toddler (or even older kids) isn’t easy, but it is doable. From setting up the right workspace to planning activities for little ones, lining things up takes effort but pays off when you hit deadlines and end the work week strong.

 

THANKS TO COLLEEN STEWART

from Play Date Fitness 

for contributing this article

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THE BIGGEST MISTAKE YOU CAN MAKE WITH A CAR SEAT

The American Academy of Pediatrics (AAP) wants parents to know that sleeping in their car seats when not in transport has significant risk and has caused an alarming number of deaths nationwide.

Dr. Jeffrey Colvin, the lead author of a study looking at risk for infants in car seats, found that “most of the deaths occurred when the car seat was being used as a sleeping device.” He further noted “It really appears that the deaths in these car seats occurred in the context where the car seat wasn’t being used for its purpose in transporting a child, but instead it was being used as a substitute for a crib or bassinet.”

The AAP study further noted that “compared with other deaths, deaths in sitting devices had higher odds of occurring under the supervision of a child care provider or babysitter (our italics) compared with a parent.”

Dr. Colvin told Today that while there is no definitive reason for the number of deaths in car seats, he suggested the angled position of the device might be a factor, as well as the straps and side padding that could potentially be a strangulation or suffocation risk. He also stressed that “before there is widespread panic every time a child falls asleep in a car seat, parents should absolutely not be concerned if their baby falls asleep during the usual time in transit.” Various experts have opinions as to how long it is safe for them to be sleeping during a car trip. Please discuss this with your pediatrician for their expert advice.

SMALL CHILDREN AND PETS

Staying home during this pandemic has both good and, on occasion, not-so-good implications from an injury standpoint.

There has been a recent surge in dog and cat bites, especially where children are concerned. Let’s face it, small children and pets can be a volatile mix.

Dog bites alone account for tens of millions of injuries annually. A great number of these bites are provoked by toddlers and children. If a dog is frightened, experiences pain or is approached while eating the risk of a bite is greater. Dogs that are ill or older have a lower tolerance and may bite when younger dogs might not.

Dog bites can be minor or severe in nature. Many of them can be treated at home with basic first aid, but others may require a scary visit to the emergency department. Canines have very strong jaws and can exert up to 200 pounds of pressure per square inch while larger dogs are capable of twice that much.

The most common bites are to the hands and arms. These can be very serious due to the pain inflicted and because of the risk of infection. Dog mouths have as many as 64 types of bacteria including staph and strep microbes.

As a community we have done well by adopting dogs of every shape and size. The vast majority of these animals are welcomed into our homes and become our loving pets. All the same, you should be aware of the dog’s history and if that history includes aggression and/or unprovoked biting.

One of your best resources is your own veterinarian. Make sure that you discuss issues of safety if a dog has come from unsafe circumstances.