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.