Tag Archive for: Kids

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.

 

,

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.

,

LET’S TALK ABOUT SEIZURES AND HOW TO RESPOND TO THEM

If you’ve ever witnessed a person having a seizure, it’s likely that you’ve responded with fear or even revulsion. Or maybe you’ve simply felt helpless not knowing what to do.

So what do you do?

Film or TV portrayals of someone having a seizure might misinform you as to what the proper response actually is, and viewing seizures as evidence of demonic possession, while historical, is also likely to be misleading.

Let’s take a look at some basic facts.

Throughout the body there are electrical currents that facilitate many functions. This is especially true of the heart and brain. Sometimes an incident may occur where the current is short-circuited resulting in a seizure. The seizure itself is not the cause but the result of something, an event brought on by one of many possible causes.

Some possible causes are:

  • Use of alcohol and/or drugs
  • Flashing lights (like a strobe light)
  • Not taking medication prescribed to prevent seizures
  • Head injury where the brain is affected
  • Rapidly rising high fever in some babies and small children
  • A significant drop or rise in blood sugar levels
  • A brain tumor

DIFFERENT FORMS OF SEIZURES

Some seizures are short in duration while others last several minutes or longer.

A seizure may exhibit as rapid blinking or staring off into space.  Historically, these types of seizures have been called “petit mal” which are a less serious form.

When a seizure involves the whole body, causing shaking and altered consciousness, it is often referred to as “grand mal.”  

Some seizures only involve certain parts of the body causing involuntary twitching, confusion, and the inability to respond to someone.  

Keep in mind that having a seizure does not mean that a child has epilepsy.

Seizures resulting from rapidly rising, high fevers are the most common seizures seen in the pediatric population. These are referred to as febrile seizures. If you are a parent with infants, toddlers and/or small children it is important that you speak with your pediatrician about fever so you can learn how to treat it.  

ARE ALL SEIZURES A MEDICAL EMERGENCY?  

The short answer is NO. In relation to some of the causes listed above, however, some seizures may require a paramedic response.

For example, when…

  • seizures last more than 5 minutes
  • someone is injured during a seizure
  • a person is experiencing their first seizure
  • someone has breathing problems or the inability to walk normally after a seizure
  • the seizures don’t stop
  • they occur in water

FIRST AID RESPONSES TO A SEIZURE

Shows a young boy lying on the floor in the aftermath of a seizure. A woman's hand resting on her leg can be seen to the left of him.

While someone is having a seizure…

  • do not try to restrain or hold them down during a seizure
  • do not put anything in their mouth
  • expect short periods of absent breathing, changes in skin color
  • do not start CPR or give rescue breaths
  • avoid giving the victim food or water

When someone is convulsing it is common for them to bite their tongue, cheek or lips, and bleeding can occur.  Do not panic if you see this.  Seizure victims DO NOT swallow their tongues.  

Stay with the victim until the seizure ends and the person fully awake is able to communicate normally. Many people will be confused afterward.

Speak softly to the victim.

Once a seizure begins to ease off, it is ok to carefully turn the person on their side.

 

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

IS CAR SEAT SLEEPING DANGEROUS?

We’re all accustomed to seeing infants and toddlers nod off when traveling in a car. The question is, how safe is it?

Safety experts have known for some time that prolonged sleep in a car seat poses the risk of impaired breathing. This is due to the amount of pressure that the infant’s head puts on the breathing passage in a “hyper-flexed” or head down position. Infants, in particular, have heavy heads and very little in the way of support from their neck muscles. Consequently, their head will usually fall forward during the ride.

There seems to be some disparity among experts as to just how long it’s safe for a baby to slumber in that position. Some suggest no longer than one hour while others extend that time closer to two hours.

Parents often ask us what precautions we suggest if they are taking a longer driving trip. Expert opinion suggests that you either have someone in the back seat with the child who can stimulate the infant periodically and/or make more frequent stops.

Be sure to pose the question to your pediatrician during your next well-baby visit.

In a related issue, Congressman Tony Cardenas (D-Panorama City) sponsored the passage of the Safe Sleep for Babies Act which passed both the house and senate. (Finally, something they can agree on!) The bill issues strict guidelines for crib safety that all crib manufacturers are now required to follow.

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.

 

THE #1 PANDEMIC VIRUS THAT COULD AFFECT YOUR FAMILY

Hype or hyperbole? Headlines scare people, for sure. The number of coronavirus comments, articles and statistics can make you shudder. You might even purchase protective masks or simply stay home in fear.

Americans, much like many others, are actually at much greater risk from a virus which is here, now. This season, influenza (the Flu), has already claimed the lives of at least 40 children and it remains a far greater health concern for your family than any other communicable disease.

According to the Centers for Disease Control & Prevention (CDC) the flu has sickened 13 million Americans this winter, putting 120,000 of them in the hospital and has already taken 6,600 lives. The flu season has not yet peaked and when all data is in the flu may take as many as 61,000 American lives.

Protection from the flu takes a number of forms. Although imperfect due to the changing nature of viral illnesses, the flu vaccine is still your best hedge against this awful disease. According to the CDC, fewer than half of American adults got a flu shot last season. For children, who are more vulnerable to the respiratory effects of the flu, only 62% received the vaccine last year.

Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia believes that because the exotic viruses from foreign lands have such different and scary names (Ebola, Zika, Wuhan, etc.) we fear them even more than our generic annual flu strains. When the SARS virus caught our attention, causing a global panic, the U.S. “dodged a bullet” according to the CDC with only 8 Americans becoming infected. There were no deaths from SARS in the U.S. Yet, it caused panic on a global scale.

Children are most often hit the hardest with the flu and statistics reveal that most kids who die from the flu virus have not been immunized against it. Many of these children were previously healthy.

Protection from the flu not only includes getting vaccinated. If you or a family member develops a fever, body aches, headache and/or cough they should be seen by the family physician and screened as early as possible for the flu. Early detection is essential as there are anti-viral medications that can be prescribed to lessen the negative impact.

Other simple methods of disease prevention include keeping sick individuals at home, frequent hand washing and covering ones mouth when coughing.