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??

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?

(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!!

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?

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.

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.

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