Tag Archive for: Save a Little Life

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.

 

,

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.

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

 

 

,

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.

INFANT NURSING SUPPORT PILLOWS SAFETY ALERT

Infant nursing support pillows are a great concept and can provide some much needed support for a nursing mother. As comfortable as they might look, however, a breastfeeding support pillow is never a safe place for babies to sleep. To date, misusage of them have been linked to over 160 infant deaths.

In this short video pediatrician Dr. Edith Branco, MD, FAAP talks about the ins and outs of using nursing support pillows:

If you’re considering a nursing support pillow for you and your baby, be sure to follow this criteria:

Pillows designed for breastfeeding should be firm and used only during feeding.

Some breastfeeding support pillows on the market already meet the following safety standards but the CPSC (U.S. Consumer Product Safety Commission) is currently considering safety rules that would ensure that all infant pillows meet standards for firmness, air flow, positional use, and shape to prevent injury or death.

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.

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.

,

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.

,

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.

 

,

WHY TUMMY TIME IS IMPORTANT FOR INFANTS

Did you know that with all the emphasis on back sleeping, it’s very important that  infants spend a short but regular amount of time on their stomachs? This allows your baby to strengthen their shoulder, neck, back and core muscles which lay the foundation for sitting up, rolling over and eventually crawling and walking.

Parents and caregivers can start this very early, even within days of birth.  

The American Academy of Pediatrics suggests 2 or 3 tummy time sessions every day.  

Each session should only be a few minutes long.  As the infant grows and their strength improves these sessions can be more frequent and for longer periods.

For those who aren’t sure how to get started here are some suggestions that will help:

  • Try short tummy time sessions after a diaper change or after the baby wakes up from a nap
  • Prop up young babies by placing a rolled-up towel or small blanket under their arms and chest
  • To encourage play, put toys or a small mirror within baby’s reach to enable them to interact with their surroundings
  • Join your baby on the floor at their eye level and interact with them by singing, holding objects and talking to them
  • Tummy time can also occur when an adult is on their back and baby is lying on them or across the parent’s lap

All family members can participate in tummy time, including grandparents, or older siblings as long as an adult is watching.

These moments not only encourage growth and development but also offer a change from the safest sleeping position…on their backs.