Wednesday, July 15, 2009

Come On Over - We're Moving Locations - But we're Leaving a Light On For You!

We've been working for quite some time now...and we've finally got it ready... our new community site Pediatric Safety is just about ready to launch.

We've got an Awareness section with the latest news stories; a Community area with a forum where folks can get together, exchange stories and ask questions; an Innovations section where some very creative parents and caregivers are showing off the latest products they've come up with to keep kids healthy and safe...and an Involvement section for a cause I'm pretty sure you're all familiar with - keeping kids safe on ambulances.

Oh...and there's this other thing I heard: "Miley Cyrus and Pediatric Safety - A Winning Ticket!" I'm not sure what that's all about but someone said they'll be details posted on the site this Friday when it launches. :-)

Basically, the only thing that's missing is you. So do us a favor and come on over - we'd love to have you ...and we're leaving a light on for you!

www.pediatricsafety.net - Friday July 17th, 2009

Monday, June 29, 2009

The Littlest Victims of The Recession - Part II

I wrote several weeks ago about the effect the economic crisis was having on our littlest ones. How 44% of children's hospitals were reporting increases in ER visits this year because people were avoiding insurance and doctor's office visits they couldn't afford, and delaying care until it was absolutely necessary. The message was clear: children and their parents, the people working night and day to care for them, were flooding ER's across the country. And the effect this was having on our children's health and wellbeing was starting to take its toll. http://ow.ly/g7yz

But this we knew. I'm not saying we accepted it, but at least in knowing there was a threat we could try and do something about it. I emphasize this because today we discover yet another threat to our little ones courtesy of the recession...and like the one prior, this too has the potential to be deadly if ignored.

The US has a single poison control hot line (800-222-1222) available 24 hours a day, 7 days a week for questions about possible poisonings. About two million people call the hot line each year. Half the calls concern children 5 and younger. And today, according to a report published in the NY Times, as part of an effort to close its $24.3 billion budget deficit, Governor Arnold Schwarzenegger has proposed eliminating the state’s $6 million contribution to its four poison control centers making California the only state without a poison control program. (by Sarah Arnquist, NY Times http://ow.ly/g7Ob)

I sit here and wonder how can that be the right decision. Often I won't question a budget until I can see all the numbers behind it, but there is a basic scenario here I have some difficulty coming to terms with and I can't imagine that anyone - especially our children - come out ahead:

One of the nation's largest poison control program closes - there are huge implications for some of the others since they are all budget constrained - but let's put that aside for now. Unfortunately it is not hard to predict what will happen next. It is highly likely that without a poison hot line, people will either go directly to the emergency rooms or call 911, and the dispatchers who are not poison control experts will send an ambulance. There is a cost associated with this which studies have shown equates to approx. $7 of savings to every dollar spent on poison control. Beyond that is the fact that I am not sure how this will help an already overburdened ER system. Everyone will need to wait longer to be seen. Now we get to where this really hurts.

Forget the cost savings, forget that in the late 1980's Louisiana eliminated its poison control program but later reinstated it after officials realized that it actually saved the state money. If you take nothing from anything else I've written here please remember these 2 points: Poisoning is the second leading cause of death from injuries after car accidents...and HALF of these calls are for little children under 5. Who is more frail...whose bodies are going to run that poison more quickly...who cannot afford to wait in a crowded ER?

Will $6M make a significant impact on a $24.3B budget deficit? Maybe...but is it worth it? I said it the last time I wrote about this subject and I say it again today: It is up to us to make sure this recession's littlest victims do not become its casualties. If not for us, then who??

Wednesday, June 17, 2009

CONTEST #1: What's Wrong With This Picture???

Most of the television shows produced today have a fairly decent budget...especially the "hits" where a large fan base brings in high advertising revenue. To keep the fans coming back, dramas in particular pay close attention to making their show as "realistic" as possible, typically hiring consultants to make sure that what they are showing accurately reflects real life experiences.

For the past decade ER and Grey's Anatomy have been two of the most popular US hospital dramas. Medical consultants are a given at this level. Take a look at the following clips from both of these shows...both show an ambulance arriving at the ER with a young child.

Two questions: What's right with these pictures? ...and more important what's wrong?

video video

(scenes © ER and Grey's Anatomy, all rights reserved. A special thanks to Young Estate Studios for creating these clips and making this possible)

What's right?

  • You are seeing a totally accurate picture of what happens today. Clearly someone was holding the child during transport - whether the parent strapped to a stretcher or the EMT or paramedic who is getting off the ambulance holding the child. Regardless, they did not unstrap the child and pick them up to hop out of the ambulance. The consultant got it right.

What's wrong?

  • The consultant got it right - someone was holding that child on the ambulance while transporting them to the hospital. Noone has strapped that child in and currently there's no law - at least in the US as well as in a number of other countries - requiring them to do so. It is not the medic's fault, for very little is available in terms of equipment to safely secure young children on ambulances. But what if that child needed CPR? Or even more important, what happens to that child if the unimaginable were to happen and that ambulance were to be hit?

Maybe they're safer in an ambulance than a car? If we consider that we are highly likely to be going above the speed limit around curves and passing through intersections against the flow of traffic, I'm not sure I believe that. Also I can say without a doubt there is at least 1 child I know of that will never attend public school because we did not keep her secure in the back of an ambulance. So clearly what we're doing is not working, but until we're ready to say "this is unacceptable" nothing will change.

So are we ready??? Is 1 child's life enough for us to do something???

If you agree with me that the answer is yes...then let's do something about it... Together we can get the message out about keeping kids safe on ambulances... Oh and hey, for the people working the hardest talking to all their followers, there just might be a little something coming your way!

***HERE'S HOW IT WORKS***

The prize: a little something cool - for you truly cool people to thank you for helping out:

  • To one winner - a summer of weekly Frappuccinos (or at least $50 worth on a loaded Starbucks card)
  • To two second place winners - a month of Frappuccinos (or $25 worth on a Starbucks card)

MANDATORY for entry:

  1. You must leave a comment with your twitter URL and a valid email address and tweet this: Starbucks Giveaway! RT @PediatricSafety We need to transport kids safely on ambulances-things have got to change http://ow.ly/auXc

And for EXTRA entries: (please leave a comment for each)

  1. Follow me on twitter @pediatricsafety
  2. Follow KiddiesCorner on twitter @KiddiesCorner
  3. Tweet the following: Starbucks Giveaway! RT @PediatricSafety We need to transport kids safely on ambulances-things have got to change http://ow.ly/auXc (You may tweet daily - 1 entry each)
  4. Follow my blog http://pedsafe.blogspot.com/ (1 entry) - please make sure to verify your email
  5. Follow KiddiesCorner Deals Blog http://kiddiescornerdeals.blogspot.com/ (1entry)
  6. Click on the “Share This” at the bottom of this post & submit this to your favorite social network (1 entry)
  7. Blog about this giveaway and link to this post http://ow.ly/auXc (3 entries)

Contest Rules -

Giveaway is open to USA and Canada readers only. Giveaway starts Friday June 19, 2009 and ends at noon EST Friday July 3, 2009. Please leave email address or make sure it's on your profile or you won't win. You will have 48 hours to email me if you win. Winner chosen using random.org. Good Luck to all entrants!

Finally - for a special prize...I needed a mom who knew how to run contests to help me run this one... so to thank the amazing mom who is helping make this possible, I'd like to send a little personal frappuccino heaven as well - a $20 Starbucks gift card and a huge thank you!

Welcome to our first contest of the summer - we hope to run many more ...because here at Pediatric Safety we firmly believe that ONE OUCH IS TOO MANY!!

****CONGRATULATIONS TO OUR WINNERS****

1ST PRIZE: Stefanie Hartman

2ND PRIZES: Eve and JanetFaye

I will be emailing you shortly with the details.

Enjoy your Starbucks...and Thanks for helping us spread the word about keeping kids safe on ambulances!! Also special thanks to Nichol at Kiddiescornerdeals.blogspot.com for help running this contest!!

Sunday, June 14, 2009

Booster Seats - Are They Old Enough or Tall Enough to Stop Using Them?

Beginning October 7th 2009, Ohio's new booster seat law requires all children 4-8 years old or up to 4 feet 9 inches tall to be in a booster seat. Most US states have passed similar laws...as have many other countries. (New boost to child safety seat laws by Mary Ann Greier http://tinyurl.com/nt5hjl )

In Britain, a child shorter than 135cm (4 feet 5 inches) will stay in a booster seat until they reach 12 years of age, and many European countries have set 1.5m (4 feet 11 inches) as the minimum height for transition from booster seat to adult safety belt. Australia will raise its age to 7 at the end of the year.

In NZ, the Paediatric Society believes youngsters should be kept in booster seats until they reach age 10 "to prevent horrific abdominal or neck injuries". The Plunket Society, another NZ organization believes height rather than age should be the determining factor. The subject is under heavy debate as there is a concern as to whether or not a minimum height requirement will be more difficult to enforce than age. (Call to give kids booster seats until 10 by Mathey Dearnaley http://tinyurl.com/m9fj7a )

What an interesting question this age vs height thing - however not just for the folks in New Zealand but for all of us because wherever you are, the laws are always changing and evolving. So what are our options??? Do we ask the 10 or 12 year old to ride to school in a booster seat because they are shorter than their school friends? One might argue against this in favor of their emotional well being. Or do we allow transition from a booster seat based on age, assuming the majority of a population will have reached a "safe" age by the time they are 8 or 9 years old. Or do we continue to make it an "either/or" decision, allowing the child to graduate to adulthood based on whichever milestone they reach first?

As a strong believer in child safety seats and one of the founders of ANSR for Kids (Ambulances Need Safety Regulations), I can tell you that this is not an easy question and I would not pretend to have the "right" answer. I can only say that I would not give a damn (excuse the language) about what is difficult to enforce - what matters is that they make the choice that's going to keep kids safe. And what I will share...and please believe me when I say I thought long and hard before I wrote this ...is what would be the right answer for me: I can always drop my child off down the block... I can always get my child therapy... but what I can never do is bring them back once they are gone. I choose height because I believe that will keep them safe.

What would you choose?

Tuesday, June 9, 2009

I Forgot the Names...By Jim Love

Years ago I worked with a medic- kind of a grumpy guy. Didn't seem to care much about - well about much of anything. He just came to work and did his thing and went home. Little did I know that behind the scenes he was building the momentum for legislation that would improve kid safety for- well forever.

Once upon a time the State of Florida, yes that one down south almost completely surrounded by water and with a reputation as a water vacation destination, did not require fencing around pools. As a result kids could wander into pools and you can guess the unfortunate outcome. This medic, with no kids of his own, no personal story of loss or tragedy just said enough is enough. His action caused legislation to occur in Florida that for more than two decades now has required fencing around pools saving countless lives.

Years later I met another medic from Alaska of all places. He too had seen too many river drownings and took personal action to prevent these in the future.

I wrote this because I want to say that action by one, and then two and then a hundred people does make a difference. They do work. They do save lives- its how MADD started. The acts and deeds live on beyond the memory of the person-sometimes beyond the life of the person who started it all.

There are still many needs, many opportunities. Getting proper child seats into emergency vehicles is one. There are still states that do not require fencing around swimming pools. You can make a difference by what you do. I don't recall their names- I'll never forget what they did.

Thursday, June 4, 2009

Do we shut off the tv until they reach 2?

We don't think anything of it. Television is such a normal part of our lives that many of us don't think twice about leaving it on in the background. And truth be told, it can be incredibly useful - whether it's providing entertainment for the little one and giving us a few minutes of much needed break time or the only "other" adult voice heard for most of the day - it can feel like a lifesaver.

Unfortunately, acording to Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute and professor of pediatrics at the University of Washington School of Medicine, television exposure during the early years can also be associated with language delays and attention problems. So much so that the American Academy of Pediatrics is discouraging television watching before the age of two.
(Even background TV may delay infants' speech: http://www.msnbc.msn.com/id/31051013/ )

According to Christakis' study of 329 2-month to 4-year-old children and their parents, each hour of television exposure was linked to a decrease of 770 words the child heard from an adult. There was also a decrease in child vocalizations and child-adult interactions. Of course the reality is that some of these results were directly related to children being left in front of a TV, however others reflected adults who while present were distracted by the television and not necessarily interacting with their child. And "hearing adults speak and being spoken to are critical exposures that play a role in infants development in language" according to Christakis.

On the surface, having read this article I would be very hesitant to put my child down in front of a tv...after all, there's no way I'm going to be the reason my baby has speech delays or attention problems. The first sentence was clear: "even infants zone out in front of the television, and it turns out this translates into less time interacting with parents and possible lags in language development..." But on another read...and a second and a third, I hesitate and then I slowly rethink my position.

The facts when I sit down and take a good look at them are that the study clearly states it did not measure whether or not anyone - parent or child - was actively watching the tv or if it was just in the background. And the number one stated result was that the child heard 770 words less from an adult for each hour the TV was on but it never stated how many words the adult actually spoke during that time. It points out that interaction is key for babies brain but then proceeds to recommend that children under age 2 be discouraged from watching television. Maybe it's me but my gut says they're missing the point.

The interaction as well as the distraction - they both start and end with us. It's us, not the children that can't handle the tv being on in the background. Maybe we're the ones who need to be reminded to walk away...because if the study told us anything, it's that it can be tough for us to tune it out...and the one thing we never ever want to do is tune them out.

Message received.

Tuesday, May 26, 2009

Sugar makes kids hyper: fact or fiction

"Wait an hour after eating before going swimming." "Don't go out in the rain or you'll catch a cold..." We've all heard these before...mostly because our parents told them to us...but who told it to them? Sometimes their parents...sometimes even doctors...but is there actual science behind the myths that most of us believe - and will more than likely pass on to our own kids?

Pediatricians Andrew Adesman (author of "Babyfacts: The Truth About Your Child's Health From Newborn Through Preschool"), Aaron Carroll and Rachel Vreeman, (co-authors of "Don't Swallow Your Gum! Myths, Half-Truths and Outright Lies About Your Body and Health") all agree - many of the leading myths just don't have the scientific evidence to back them up. When in doubt, doctors often fall back on what their own mentors taught them without questioning the facts on which their advice is based. (Story by Liz Szabo, USA Today http://tinyurl.com/p6nmox)

So what are these wives' tales that parents believe and these pediatricians say are myths? Here are some of my favorite:
  • Adding cereal to a baby's diet will help him sleep longer (...we really do so want to believe)
  • Teething causes a fever (apparently no more so than anything else)
  • Vitamin C, echinacea or zinc will prevent a cold (a number of studies to the contrary)
  • You can catch poison ivy from someone else with poison ivy (only if they haven't washed off the oil )
  • Birth control pills don't work as well on antibiotics (apparently no proof of this)
  • Must stay awake with a concussion (not unless the doctor says so).
  • Timing when you have sex will determine your baby's sex (even if it's not true - this one might be worth double checking...just for the fun)

In reality, there are infinitely more questions than there are answers when it comes to the many important medical decisions we often face. That is why I believe it all comes down to this. If you look at the heart of these "myths" there is one common theme...at the end of the day, their goal is to keep us and our children healthy and safe. And until we are inundated with good, credible scientific data to the contrary, it is highly unlikely we will ever give them up.

Truthfully, if I ask you right now do you believe sugar makes kids hyper - fact or fiction? ...what would you say???

Monday, May 25, 2009

Honoring the brave who have fallen

A 58-year-old man died Sunday in Detroit, MI. after rescuing a 7-year-old boy who fell into a water-filled hole. The boy was playing on Sunday at a home construction site when he fell into the foundation pit that was being dug for the basement. Garrett Townsend who lived nearby in the housing development jumped in to rescue the child but was unable to climb the muddy sides of the pit to pull himself out of the water. He did not survive however he managed to rescue the child who is doing well. (story by the Associated Press http://www.nytimes.com/2009/05/26/us/26brfs-MANDIESAFTER_BRF.html)

Today we honor those who have given their lives for us. We thank all the brave men and women around the world giving their lives each day to protect us and keep us free. We thank every police officer and every fire-fighter and EMS-person who has given their life to keep us alive and safe. But today we cannot forget to thank Garrett Townsend and everyone else like him who probably would have never considered themselves to be particularly brave or to be a hero ...but when a child's life was at stake, made the ultimate sacrifice.

Garrett, we will remember you when we honor the brave who have fallen.

Friday, May 22, 2009

The littlest victims of the recession

Times have not been easy. It's no surprise that many of us will leave this recession with more than a few "battle scars". But for the littlest ones, the ones who can't fight their own battles, the economic crisis has begun to take on a much more frightening tone as it threatens their health and in some cases even their lives.

According to CBS Early Show medical correspondent Dr Jennifer Ashton, nationwide 44% of children's hospitals are reporting increases in ER visits this year. At Rainbow Babies and Children's Hospital in Cleveland, Ohio - one of the larger children's hospitals in the country, traffic is up in the ER, even though the population of children in northeast Ohio is down.

Dr Edward Barksdale, chief of pediatric surgery, says the ER is busier than ever because people are waiting to seek care. Too many can't go to a doctor's office and end up coming to the ER instead, delaying care until its necessary. Then there are cases such as baby Hailey Sarubbi, born at 23 weeks and weighing little more than a pound who is struggling to survive because her mother went into premature labor after working seven days a week to make ends meet. And 17-year old Teauna Boysaw who didn't have health coverage when she came into the ER with an infected cyst...her mother, a nursing assistant, couldn't afford the $550 monthly fee to insure her children.
CBS News Interactive: Children In Danger

Unfortunately, the sad reality is that our little ones are ending up in ER's across the country. Do we blame the parents who delay treatment until it is absoutely necessary because it is more important to put food on the table? Do we blame a system where one in nine children lacks health insurance coverage? Do we blame the doctors and nurses who keep the child waiting in the ER, sometimes for hours, because every day there are more and more to treat.

Or is there something simpler we should consider here. Perhaps rather than blame, we could look for a way to help ...a way to support...a way to cheer on every caregiver who is managing to not only survive these unbelievably awful times, but doing their very best to make life a little better for the child in their care - whether it's their own or someone elses. Maybe it's by relying on each other that we find the answers to the problems...for them...and for us. Perhaps its silly to look to a television show for any real meaning, but maybe the castaways on ABC's Lost were on to something when they said "live together, die alone". All I know is its up to us to make sure the littlest victims of the recession never become its casualties.

Tuesday, May 19, 2009

Saving a Baby...All in a Day's Work

On Thursday May 14th, Mathew Cook and Rafael Marrero, two medics working the graveyard shift in lower Manhattan saved a life. That alone was news to celebrate. What made it truly remarkable was that the life they saved was that of a baby girl born 5 months premature and weighing less than a pound.

The call they received at 7am that Thursday morning was for a woman, 36 years old and four months pregnant who was on her way to the hospital, in severe pain. While in the car things progressed from bad to worse...the dispatcher told the medics they were responding to a likely miscarriage. Upon arrival they proceeded to deliver the child with care. And although they thought it was too late, they wrapped the child in blankets, cut the umbilical cord and flicked an unbelievably tiny foot to stimulate breathing. The little girl let out one gasp and started to cry. ...and then, so did her mother.

As caretaker of this blog, and co-founder of a company whose goal is to make it safer for little kids to travel on ambulances, I am often critical of the slow adoption rates I see for new technology in this industry. But what I am never critical of is the job the men and women do everyday who put on an EMS uniform, go out in the field and save lives...because the results speak for themselves. EMS is an unbelievably demanding career. And like so many other individuals to whom we entrust the care and safe-keeping of our families, they are often underpaid and rarely recognized.

A friend of mine who spent many years in the industry, recently told me not to call them heroes. Apparently it wasn't the right use of the word because what he did wasn't especially heroic...it was just part of his job. Well maybe I was quiet then, but now I'd like to take a moment to disagree. When Mathew Cook said that "That was it. She just started to breathe, then starts to cry, it's a great feeling,"...I have to admit it...I was more than a little impressed. And maybe saving that baby's life was all in a day's work, but to me, it was 100% my kind of hero.

Oh...and before I forget ...welcome to the world little girl :)

(Original Story by Peter N. Spencer, Staten Island Advance

Friday, May 15, 2009

...And Then There's the Joy

For those of you who watched Grey's Anatomy last night, there were some sad moments and some gut-wrenching unbelievably awful ones...and then there was one unbelievably beautiful one...the joy of a child who was given another chance at life. One doctor gathered several of her colleagues to witness it. Together they stood outside her room, quietly smiling and taking in the moment. There wasn't much more that needed to be said - the message was clear. Saving one childs life trumped everything.

Given the project I've been working on, it has meant that over the years most of the news stories I've captured have been the sad stories of the children involved in ambulance crashes. This blog gives me the opportunity to share all kinds of pediatric patient stories. Today, I am grateful to be able to share something incredibly uplifting...

(by Roni Caryn Rabin: NYT 5/13/09 http://www.nytimes.com/2009/05/14/health/14scorpion.html?_r=1&ref=us )

10 year-old Michael Moerdler-Green was stung by a scorpion during a recent family trip to Phoenix. At the emergency room, doctors offered his parents a choice of treatments: heavy sedation to help calm his symptoms or an experimental scorpion venom made in Mexico, but not yet approved for use in the US by the FDA. His father, Dr Moerdler-Green, chose the antivenom. His son was able to leave the hospital ONE HOUR AFTER RECEIVING THE MEDICATION.

No other antivenom specifically for scorpion stings is available in the US. A study published yesterday in the New England Journal of Medicine documents a small clinical trial of young children stung by bark scorpions - most given the drug recovered from most of their symptoms within 2 hours. Dr Leslie Boyer, director of a venom research institute at the University of Arizona College of Medicine in Tucson said wider use of the antivenom could make treatment much easier in rural areas and small towns in the state that do not have PICU's and usually have to helicopter children to hospitals for care.

I would like to thank everyone for sharing this with me today. I am grateful to have your company when the news I have is sad or scary and my hope is to raise awareness about some child safety issue. I am thrilled that the only message I have to pass on today is one of hope...and life. Welcome to the joy.

Monday, May 11, 2009

What I Remember ...by Jim Love

St. Petersburg, FL., the year was probably 1978 or 79. My partner and I had responded to a drowning in a large apartment complex at the north end of town. When we arrived we found a bunch of people doing or trying to do CPR. While we were getting into position to take over care a news crew arrived and began to film the action- the cameraman positioned right behind me.

The child was blue and just had that look and feel. The outcome was not going to change and it was not right that it was being filmed- solely for the benefit of the TV station. Somehow when I stood up I bumped into the cameraman and into the pool he went.

Fencing could have, would have prevented the death of this child. Parental oversight could have, would have prevented the death of this child. These were not the only mistakes to be made. We put the child on the stretcher and began the very long trip to the hospital.

We did not secure the child in any special way to the stretcher. We never had any means to do so and nothing bad ever happened. Each time we transported a child back then, we did so either using the stretcher or more commonly held the baby in our arms- as though we could hold onto a 30 pound baby in a high speed collision. But we did it time and again and nothing bad ever happened.

That's not to say that there could not have been a catastrophic outcome from the transport- it just never happened- to me. Back then we were not taught any better and frankly did not know better. Back then the world was a lot larger. We did not know what happened across the country or the world like we do today- only 'major news' received that level of exposure. And the fact that we did not believe anything bad would happen kept us from seeking change or improvement. As a society we have enacted universal laws that govern how we transport children in ordinary vehicles. We made these changes because bad things do happen. Emergency vehicles are the same as other cars- only riskier- they run red lights and go fast. We need to adopt the same laws as those that apply to all vehicles

How children are transported today is about the same as it was back then and largely for the same reason- we take a risk and nothing bad happens. There are those who advocate for safer transport of children and infants and some states have enacted legislation to require safe transport equipment for emergency vehicles. Most people just assume that EMS, 911 responders, know what to do and do the right thing.

So what is the moral to this story? We often get angry when bad things happen and lash out in the wrong direction. Hindsight is most often crystal clear but too often we fail to use this vision to change the future. Learn CPR. Insist that all states require EMS vehicles to carry and use approved child and infant transport equipment. Ask questions and get involved. No Excuses

Jim maintains a website about EMS safety. For more information about this topic please visit: http://www.emsafety.net/.

Saturday, May 9, 2009

For the little ones

A shout out on Mother's Day to those who speak for the little ones...who Twitter and Blogger and help a blind world see, so that "unsafe" and "unfair" might one day be unreal

A shout out on Mother's Day to those who stand for the little ones...who draw swords on the battlefields and demand justice - for the invisible child as well as the one we see everyday but can just as easily fail to protect

A shout out on Mother's Day for all those who hold the little ones...who breathe life where it ebbs, who teach knowledge is strength, who kiss away the boo-boos, and who will always check under the bed and chase away the monsters

To all of you we owe our thanks ...together we can create an amazing world, but if not for the little ones...who are we doing it for???

Wednesday, May 6, 2009

Because she inspired me

My little sister Suzanne and I were always very different...right from childhood. She looked like my mother, blonde and very pale - she always hid from the sun. I was brunette and tanned easily, just like my dad. Her hair was kinky curly (she hated it), while mine was straight. She lived in a world of her own creation and got into trouble at school and at home. I was the "good child" with straight A's who rarely was cause for concern. And boy we hated each other...

According to Suzanne, life came easy to me...anything I wanted I would always get, while she would struggle so hard, "felt stupid" and would always come up short. Her greatest joy was wreaking havoc on my "perfect little world". So I separated myself as far away from her as I could - physically, emotionally - so many of the choices I made were to distance myself and "not be like her" in any way I could.

Suzanne had a very difficult time growing up - and though I was part of it - I know there was quite a bit I did not really see until years later. She struggled with drugs and attempted suicide when she was still a teenager, and depression for a number of years after that, apparently always hating herself more than she hated me.

And just when we all thought she didn't have anything left to give - Suzanne found a new path to follow. To our amazement she chose EMS - to save a life instead of taking her own- she wanted to make a difference. And not only did this "little girl" work as one of the EMS crews that helped secure the scene after the bombing at the Atlanta Olympics, but this same girl who thought she was "stupid" invented the device I blogged about earlier that will one day make it safe for all little kids to ride on ambulances. (...I read this and remember why we teach children that "stupid" is a bad word)

Several years ago Suzanne had to quit EMS. Every day since then, like many of us she struggles with questions of am I good enough...smart enough...am I deserving...can I still make a difference... and every day no matter what anyone tells her, I don't know if she believes it.

I grew up not wanting to be like her...but I would be half the person I am today without her. So much of what I am, what I have and what I do that I am proud of is because of her. And I hope someday she reads this, because I want her to know, if I make a difference with my life...that will be because of her too.

Monday, May 4, 2009

The law of averages

On Tuesday April 7, 2009, a Hermosa Beach ambulance carrying a 3-year-old child to the hospital collided with a pickup truck in a Torrance intersection. The crash happened at 190th Street and Entradero Avenue and occurred about 5:45 p.m. The paramedics immediately called for help and another Hermosa Beach ambulance quickly took the child, who had suffered seizures, to the hospital. Fortunately, the child did not appear to suffer any "physical injuries" from the crash. http://www.dailybreeze.com/latestnews/ci_12095260

On Monday April 13th, 2009 a car struck an ambulance transporting a child to Children's Mercy Hospital in Kansas City, MO. Another ambulance rushed to complete the transport. Luckily in this case, there were no injuries. http://www.kctv5.com/news/19166283/detail.html

People have often asked me why I have stayed with this "cause" for so long. Fourteen years ago there was very little data available for me to document what was really happening. Today, there is so much more information available...and yet so many who have the power to help change things know nothing about this.

A wise person reminded me today of the law of averages or in simple terms from Wikipedia: a belief that outcomes of a random event shall "even out" within a small sample. If that is the case, then I guess my best answer would be to say that I have stayed with this cause so long because I have seen what happens when there isn't a happy ending. And my goal - my determination - is to find a way to ensure our kids are safe before mother nature, the law of averages - or anything else gets a chance to "balance out the scales".

An EMT's Story

Below is a story told to me by a young EMT back in 1995 - what is truly amazing is how little has changed:
“On Tuesday, September 19, 1995 at approx. 4:00pm, while working on an ambulance, my partner and I were called to do a routine transport at Hugh Spalding Children’s Hospital, an affiliate of Grady Memorial Hospital in Atlanta, Georgia. We were dispatched to pick up a mother and her infant and bring them back to their residence. I informed my dispatcher that we were not equipped with an infant seat on the truck. I was told to follow usual procedures (strap the mother to the stretcher and have her hold the baby on her lap) and to transport them . I felt this was wrong, but did as I was advised. When I returned to the station I sat down with my supervisor and told him that what I had just done went against everything I believed in. My supervisor respected how I felt and said that what he could try to do was get an infant and toddler seat and keep it in his car and first respond to the scene with us from now on. While I appreciated his efforts, I still felt that this was not enough.

I thought about when I had worked at Egleston’s Children’s Hospital in Atlanta. We used infant and child seats for transport but they were always so difficult to attach to the stretcher. The seat is shaped to fit a car’s seat belts. To attach it to a stretcher meant adjusting the stretcher to an upright position and strapping it in. In doing so, the bottom of the child seat was suspended mid-air and needed to be held in place by sheets and blankets propped up underneath it. No matter how we attempted to manipulate it, it was still unsteady.

And attaching the child to the stretcher was simply not an option. The reality is they are just too small: the straps cover half of their body and can’t restrain them. The straps can’t be tied tight enough to keep them in place or it will hurt them, and when the straps are loose, the child slides all over the stretcher. This makes for a miserable trip for all involved: crying child, stressed parent and helpless crew.

Which brings to mind the dangers of the everyday baby seat being strapped to a stretcher. While working on the ambulance at Egleston’s Children’s Hospital, 9 out of 10 children transported were going from one hospital’s emergency room to the PICU (Pediatric Intensive Care Unit) at another because they were in severe danger (they were having seizures, their airways were compromised, they had head injuries or were intubated). If any of those children went into arrest along the way, there were approximately 6 time consuming steps that had to be taken before CPR could even begin:
  1. The safety seat shoulder straps had to be removed from the infant/child
  2. The infant/child had to be removed from the seat. (Remember that at this point in time, someone is standing up in a fast moving ambulance, holding a non-breathing infant in their arms, trying to support themselves and the child without falling over)
  3. All of the sheets and blankets that were previously holding the seat in place on the stretcher have to be removed. (These get tossed on the floor and everyone involved keeps kicking them out of the way so that they can help during the trauma…in effect more time wasted).
  4. The straps holding the child seat in place have to be found (under the bar of the seat) and released, and the seat has to be removed from the stretcher.
  5. A short back-board must be placed on the stretcher so that heart compressions may begin
  6. The baby is positioned on the board, and resuscitation can begin.

But that is not the end to this emergency. The infant/child is still sliding all over the place. The technician’s hands can easily be misplaced while doing compressions and there are many other dangers that can occur to this un-restrained child while racing to the hospital.

My partner and I conducted a run-through of this procedure using a doll as a prop Going as fast as we could, it took us 2 minutes and 4 seconds. According to the “Brady Emergency Care” book, “all cells in the body need oxygen for survival. Lethal changes will begin to take place in the brain within 4-6 minutes without a constant and adequate supply of oxygen. Brain cells begin to die within 10 minutes.” It’s clear that two minutes without air for an infant or child is way too long!"

The EMT went home and drew what she believed was needed to solve this problem. It is my hope that somehow, someday, I will help her do that.