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Fire Prevention Week

Every year, most deaths due to a fire occur in the home.  Your family should have a fire escape plan in case of an emergency, and know what to do if you or your child are burned.

Fire prevention

The first step in fire safety is prevention. Look for possible fire hazards in your home, such as:

  • Light bulbs with the incorrect wattage
  • Overused extension cords
  • Overloading an outlet
  • Electrical appliances being in poor condition with frayed cables or wires
  • Portable heaters
  • Cigarettes, matches and candles
  • Grease spills
  • Appliances accidently left plugged in

 

Smoke Alarms and Fire Extinguishers

Having a smoke detector cuts the risk for fatalities in half by alerting residents when there is smoke present. Every bedroom and level of your home should have a smoke detector on the ceiling or high on the wall. Check the batteries often to make sure they are working.

Fire extinguishers can help you put out a fire before it gets too big to handle. There should be a fire extinguisher on each floor and in the kitchen. They work best when the flame is small and in a contained area. The National Fire Protection Association says to remember the word PASS when using an extinguisher:

  • Pull the pin. Release the lock with the nozzle pointing away from you.
  • Aim low. Point the extinguisher at the base of the fire.
  • Squeeze the lever slowly and evenly.
  • Sweep the nozzle from side to side.

Creating a safety plan

Your family should have a safety plan to ensure that you are exiting your home quickly, while still being safe. Make sure every family member is aware of exits, doors and windows, and that they can be opened easily. Make sure your children can open them on their own in the event you cannot help them. You should practice fire drills with your family; know how to get out of the house and where to meet outside. Your meeting place should be a safe distance away from the house, such as the mailbox. Once you are out safely, you must not go back inside for any reason.

First Aid

If a family member gets burned:

  • Remove the heat source and any clothing from the burned area.
  • A first-degree burn will leave skin pink or red, with no blisters or raw areas.
  • A second degree burn will have blisters and clear drainage.
  • A third-degree burn can look charred or leathery.
  • Run cool water over the area for three to five minutes, then cover it with a clean cloth.
  • Never place ice on a burn.
  • Keep the burn elevated and call for emergency medical assistance if needed.

Button Battery Dangers

Parents of small children are usually on-guard against potential choking hazards, but one item that is often overlooked is the button battery or disc battery. These batteries are about the size of a quarter or smaller and pose a dangerous risk to children if ingested.

Ann Slattery is the managing director of the Regional Poison Control Center at Children’s of Alabama. She says they have received 60 calls related to disc batteries in the last three years. Thankfully none resulted in a fatality, but swallowing a disc battery can be extremely dangerous. Not only do they pose a choking hazard, but they can result in actual burns resulting in tissue damage and internal bleeding. When ingestion occurs, it’s crucial for the child to have an X-Ray to determine where the battery is located and if surgery is needed.

Between 1985-2009, more than 56,000 disc battery ingestions were reported to the National Poison Data System. Because these batteries are small, often hidden, and used in so many devices, they can often be overlooked. “These are in so many different products,” Slattery says. “They are in greeting cards, remotes, hearing aids and watches, even in children’s toys so they might get ahold of them.”

More often than not, the parent did not see the ingestion of the battery. Slattery says it’s important to recognize the symptoms. The symptoms of possible poisoning by ingesting a disc battering include coughing, choking, loss of appetite, irritability, and fever.

Slattery says in some cases of ingestion, if the battery is small and moved beyond the esophagus, it may pass uneventfully through the rest of the digestive system and pass within a matter of days. “However if it’s lodged in the esophagus, it is considered an emergency and requires immediate removal,” she says.

It’s important for parents to supervise their children and be aware of what they are playing with, and to think ‘does that have a battery inside?’

If you suspect your child has swallowed a disc battery, call the poison control center at 1-800-222-1222. If it’s an obvious medical emergency, call 911.

Oncology School Liaison Helps Patients Return to School with Ease

School is one of the most important parts of a child’s life. Continuing to keep up academically and stay connected with classmates is important for all children diagnosed with cancer or a blood disorder. Sometimes it is difficult and scary to return to school after their diagnosis and treatment or after a long hospital stay. The struggle may not always be due to medical reasons, but often the fear of classmates teasing them because of a change in appearance, worrying about keeping up with school work, or maybe feeling isolated from their peers.

The Alabama Center for Childhood Cancer and Blood Disorders, is a partnership between Children’s of Alabama, the UAB Division of Pediatric Hematology and Oncology, the UAB Comprehensive Cancer Center, the UAB Institute for Cancer Outcomes and Survivorship, along with childhood cancer research entities, such as the National Cancer Institute and Children’s Oncology Group. The Hope and Cope Psychosocial and Education Program uses a family-centered approach to provide support and services for emotional health and well-being.

The STAR (School/Social Transition and Reentry) initiative is a service of the Hope and Cope Psychosocial and Education Program that provides patients with an education/school liaison who maintains ongoing communication between the medical team, the child’s school and their family. This helps the student return to a more normal lifestyle and to feel comfortable going back to school.

 

“We help facilitate the patient’s reentry to school when the oncologist medically releases them to return,” said Education/School Liaison Caroline Davis, MS, CSP. “Our goal in a reentry class presentation is to help the child’s classmates better understand the child’s diagnosis and cancer treatment journey, and to inform the teachers about any special accommodations the student may need in the classroom, or unique learning challenges the student may have.”

 

There are a variety of specialized services that the education/school liaison offers to the child and their family throughout their treatment and into survivorship. Here is a look at how the liaison can help.

  • Aid the familyin understanding their child’s learning needs; to understand federal and state law, and how to advocate and effectively communicate with their child’s school system.
  • Assist the parents in obtaining special education servicesor program modifications when needed, including collaborating on Individualized Education Planning (IEP) meetings.
  • Accompany the parents to school meetings in person or participate through Skype (i.e., a software application that enables users to have video-conferences over the internet).
  • Present workshopsto educate the school system about unique learning patterns of childhood cancer survivors and evidenced based recommendations.
  • Help young people stay in touchwith classmates through use of webcams until they are ready to return to school.
  • Prepare young people, parents, and teachersfor the return to school after a long absence and empower the child to better advocate for themselves.
  • Give classroom presentationsto help classmates understand and support the young person living with a serious illness.
  • Teach problem-solving skills and role playingto help the young person or family members with school adjustments.

 

Davis states, “When we go to the classroom, the child is often overwhelmed and scared about returning to school, but after we show their personalized presentation about their journey to the other students, you can see the child begin to interact with peers and be involved in the discussion. It is extremely rewarding to see such a change in their confidence and self-esteem!”

 

For information about this exceptional benefit and/or our STAR program, please contact Caroline Davis at (205) 638-5421 or csdavis@peds.uab.edu.

 

ATV Safety

 
All-Terrain Vehicles (ATV) are off-road vehicles for recreational use. They are very popular in Alabama, but with the thrill comes major risks.
 
Emergency department physicians at Children’s of Alabama treated more than 230 cases of ATV-related traumas in the past three years. Nationally, more than 100,000 ATV-related traumas are treated every year in emergency departments and more than one-third of those cases involve children under the age of 16.
 
Generally, ATVs can be unstable and prone to tip over. ATVs are more dangerous than bicycles and 12 times more likely to result in death.
 

Dr. Kristyn Jeffries is a resident physician at Children’s of Alabama. She has a personal experience with the dangers of children riding ATVs. A family friend lost their 11-year-old daughter due to an ATV accident. “That’s why I’m so motivated to prevent this tragedy from happening to other families,” she says. Jeffries is working closely with the staff at Children’s to promote ATV safety.
 
If a family does allow their child to ride on an ATV, the American Academy of Pediatrics (AAP) has important recommendations to help keep children safe.
 
ATV Safety Recommendations:
  • Drivers should be at least 16 years old
  • No passengers should ever ride on an ATV
  • Always wear a helmet, eye protection and reflective clothing when riding an ATV
  • Never drive an ATV on roadways
 
Jeffries says these recommendations are not only from the AAP, but from ATV manufacturers as well.
 
Jeffries also advises that it is not safe for an adult to hold a child while riding on an ATV.”Children who are younger than 6 years old are at highest risk of being thrown off of ATVs,” she said.
 
Riding an ATV is never without risk. Even when a rider takes proper precautions, they still may get hurt. That’s why Children’s of Alabama and the Injury Free Coalition for Kids have partnered to educate children and adults about ATV safety. They are available to speak to schools. To schedule a speaker, call 205-638-9587.

Back to School – National Immunization Awareness Month

With school just around the corner, it is important to make sure your child is ready. You have purchased the supplies, met the teacher and walked through their new schedule. What else should you do? Check your child’s immunization chart.

Dr. Peily Soong

“Make sure your child’s shots are up-to-date and they don’t need any vaccinations.” said Dr. Peily Soong with Pediatrics East. “During this time of year, pediatric offices get very busy with people needing immunizations and regular check-ups. Please do not wait until school starts or right after it starts.”

National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages.

Vaccines are essential to the health of your child. Being at school, where there are large concentrations of people, your child is at higher risk at contracting an illnesses.

“Schools will not let you in without completing necessary vaccinations,” said Dr. Soong. “So, make sure your child is ready.”

Check out Dr. Soong’s interview with Fox 6 News for more tips on getting ready to go back to school.

Why is it important to stay current with your child’s immunizations?

It is important to not only get initial immunizations, but also any other rounds or boosters that are recommended. In some cases, a single shot is not enough to protect your child from that disease.

Good news is if your child has missed shots in a series, there is no need to start over, simply pick up where they left off. Without the full course of a vaccine, your child is still at risk. These vaccinations will not only protect during adolescent years, but also throughout life.

Which vaccines does your child need?

Doctors are now recommending the following immunizations for teens against the following diseases:

  • diphtheria, tetanus and pertussis (Tdap vaccine)
  • measles, mumps and rubella (MMR vaccine)
  • hepatitis A
  • hepatitis B
  • meningococcal disease (meningitis)
  • human papillomavirus (HPV)
  • varicella (chickenpox) if you have not had the disease
  • polio
  • flu (influenza)

According to Dr. Soong, rising kindergarteners and sixth graders are the most likely to need new vaccinations. It is important to check regardless of your child’s age to know if your child is ready for school.

Of course, if your child has a pre-existing disease that affects their immune system, they may need other vaccinations. There are also some cases in which children should not be vaccinated for certain diseases. Check with your pediatrician regarding your specific child’s needs.

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You may be thinking, “My child hates shots and pitches a fit even at the word.” There are techniques to make shots easier, such as encouraging your child to take calming breaths or even coughing as the needle goes in. Regardless of the fear, remind them that the shot itself lasts only for a second, but the protection lasts a long, long time after that.

To find a practice near you, visit childrensal.org/practices.

Insect Bites

It is summer in Alabama; school is out and the sun is shining. Kids are spending more time outside, which can also increase the number of bug bites they get while playing. It is important to teach children about different types of insect bites.

Most bug bites and stings are harmless and will get better on their own without seeing a doctor. Other bug bites can be more painful and serious.  Let’s take a look at the different signs and symptoms of insect bites, and when you should see a doctor.

Common Mild Reactions:

Treat at home with over the counter lotion, antihistamines, pain medicine and ice pack if needed (see package insert for dosing instructions)

  • Red bump
  • Mild swelling
  • Itching
  • Light pain

Example: ant bite, mosquito bite, bee sting without allergic reaction

 

Common Moderate Reactions:

Your child may need to see his/her primary doctor. If you feel that it is an emergency, call 911 or go to your nearest emergency department.

  • Hives
  • Nausea/vomiting
  • Dizziness or fainting

Example: spider bite, bee or wasp sting without allergic reaction

 

Serious Reactions:

Call 911 or go to the nearest Emergency Department

  • Swelling of the face, lips or tongue
  • Difficulty swallowing
  • Difficulty breathing

Example: Bee or ant sting with an allergy, spider bites

 

Special Treatment for Ticks:

Ticks are very common in our area and require different treatment. If you find a tick on your child:

  1. Grasp the tick with tweezers (close to your child’s skin)
  2. Pull firmly until the tick lets go of the skin
  3. Place the tick in a zip locked bag (your doctor might want to test the tick)
  4. Wash your hands
  5. Clean the tick bite site with alcohol
  6. Call your child’s doctor

 

Prevention:

Below are quick tips to keep bugs away

  • Apply bug spray that contains 10-30% DEET
  • Be aware of your surroundings. Stay away from standing water and wood piles
  • Protect yourself by wearing long sleeves and pants in wooded areas
  • Wear gloves while gardening
  • Do not disturb bee or wasp nests

 

Kids should enjoy playing outdoors while they are out of school in the summertime. Knowing what to do for bug bites and stings is very important. Go outside and have some fun with your kids, but be aware of the bugs!

 

The blog was written using content from KidsHealth.org

Playground Safety

Kids love to play on the playground and there are a lot of benefits to outdoor play. Playgrounds are an opportunity for kids to get fresh air, sunshine, exercise and make new friends. Marie Crew agrees. She’s the director of Alabama Safe Kids at Children’s of Alabama. “Alabama has a high obesity rate, so we want the children to be active. We want kids playing at least 60 minutes a day,” she said.

It’s important that parents do their part to ensure their child’s time on the playground is fun and injury-free. Each year, more than 200,000 kids are treated in hospital emergency departments for playground- related injuries. Many of these accidents are preventable with the proper supervision.

“That’s the big thing. We want parents to be with their children,” Crew said. “Parents should check the playground to be sure it’s in good repair. We want parents to put their phones down and interact with their children.”

Children should never play on a playground unsupervised. Young children can’t always judge distances properly and can’t foresee dangerous situations while older children like to test their limits. It’s important for an adult to be there to help keep them safe.

In addition to supervision, before children play on a playground, an adult should always check it for safety. Make sure the playground equipment is in good shape. If it has instructions on it, be sure to read them. Many playgrounds indicate the recommended age range for children.  Toddlers should be on a separate playground with special equipment that is lower to the ground.

Crew said a proper playground surface is important as well. “It’s best to have a soft, spongy surface that can cushion falls. Shredded tires, pea gravel and and mulch are options as well,” she said. Concrete, asphalt, grass and packed earth surfaces are not safe.

Modern playgrounds are often made of plastic instead of metal, which can get too hot. Even still, Crew recommends parents think about the heat of the day and check the equipment before their child plays on it to make sure it isn’t too hot.

Children love for their parents to engage with them when they’re playing on the playground. A good recommendation is for the adult to be close by, encouraging and watching their child while they play. Play is an important part of kids physical, social, intellectual and emotional development. By taking a few extra precautions, they can learn and grow through play while being more likely to stay safe and injury-free.

Juvenile Arthritis Awareness Month

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood and affects about one in 1,000 children. It is a chronic autoimmune disease which does not go away because it is a result of the person’s own immune system.

An autoimmune disease is one in which white blood cells cannot tell the difference between the body’s own healthy cells and germs like bacteria and viruses. The immune system, which is supposed to protect the body from these harmful invaders, instead releases chemicals that can damage healthy tissues and cause inflammation and pain.

“Each year more than 1,000 patients are treated in our rheumatology clinic,” said Dr. Melissa Mannion, pediatric rheumatologist at Children’s of Alabama. “It is our goal to provide patients with resources and treatments to develop growth and development.”

Dr. Melissa Mannion

Signs and Symptoms

The first signs of arthritis can be subtle or obvious, so an early and accurate diagnosis is key to effectively managing JIA. According to Dr. Mannion, the criteria for diagnosis includes age less than 16 at the onset of symptoms, symptoms present for at least six weeks, symptoms including the presence of arthritis on exam, and no other explanation for the arthritis-like cancer or infection.

Understanding the symptoms and characteristics of each type of JIA is crucial. Some of the common symptoms include:

  • Limping
  • Warm joints
  • Sore wrist, finger or knee
  • Sudden swelling of joins that remain enlarged
  • Stiffness in the neck, hips or other joints

“If someone’s disease stays inactive for a long time, usually at least six months, they are said to be in remission,” she said. “Remission means that the disease is quiet, but the disease itself is not gone since there is no cure. Sometimes remission can last for months, years or a person’s lifetime.”

Diagnosis

If a parent is worried that their child has arthritis they should talk to their pediatrician. The pediatrician will evaluate the duration of the symptoms, what hurts, when it hurts, where the swelling occurs, how long it lasts, what makes the pain or swelling better or worse, and if there are any other symptoms like fever or rashes. They will also help determine if your child needs to see a rheumatologist.

To diagnose JIA, the rheumatologist will ask questions about the child’s symptoms, find out whether other family members have had similar problems, and do a thorough physical examination.

It is important that the doctor identifies any additional signs or symptoms to classify or describe the type of JIA, as there are multiple. In some cases, the doctor will use imaging, like musculoskeletal ultrasound or MRI, to look for inflammation inside the joints. The doctor may also order X-rays or blood tests to rule out other conditions or infections, such as Lyme disease, that may cause similar symptoms or occur along with the arthritis.

Treatment

The health care providers, including the primary care physician, rheumatologist, and physical therapist, will work together to develop the best method of treatment for each child.

“Medications are used to control the immune system to stop the symptoms and prevent damage from the disease,” she said. “Some patients can be treated with a steroid injection into the joint, but because the immune system is not only located in one joint most patients will need systemic medications to control their disease.”

The goals of treatment are to relieve pain and inflammation, slow down or prevent the destruction of joints, and restore use and function of the joints to promote optimal growth, physical activity, and social and emotional development.

Facilities

Children’s division consists of five board-certified pediatric rheumatologists, one pediatric rheumatology fellow (in-training), and three nurse practitioners who see patients with the faculty members. Patients can be seen at the Children’s of Alabama main campus, Children’s South on Acton Road, and in satellite clinics in Huntsville, Montgomery, and Mobile.

For more information, visit childrensal.org/rheumatology.

Brain Tumor Awareness Month

More than 3,000 children across the country are diagnosed each year with central nervous system tumors.  When brain cells grow abnormally or out of control, a tumor can form. If the tumor puts pressure on certain areas of the brain, it can affect how the body functions. 

Although there are many different types of brain tumors, doctors don’t know what causes them. Researchers believe that genetics and the environment may play a role. Doctors categorize a tumor based on its location, the type of cells involved and how quickly it grows. Some are cancerous while others are not.

The Pediatric Neuro-Oncology Program at Children’s of Alabama is the only program of its kind in the state and treats more than 300 children diagnosed with brain tumors. It is one of the largest programs in the Southeast.

When discovered early enough, brain tumors are usually treatable. Dr. Elizabeth Alva, assistant professor of pediatrics, said that there are different types of options depending on the kind of tumor.

Treatment requires a multidisciplinary approach and the appropriate treatment varies by the type of brain tumor,” she said. “Through our multidisciplinary team, we are able to provide the best care available to patients with brain tumors.”

Many slow-growing tumors are cured with surgery alone. Faster-growing tumors might need additional treatment with radiation therapy, chemotherapy or both.

One of the most exciting treatments currently happening at Children’s is the oncolytic virotherapy trial using herpes simplex virus. This approach is only available at Children’s and is evidence of Children’s commitment to providing more treatment opportunities for patients with difficult to treat recurrent or progressive brain tumors.

Signs and Symptoms

A brain tumor can cause symptoms by directly pressing on the surrounding parts of the brain that control certain body functions or by causing a buildup of spinal fluid and pressure throughout the brain. Signs or symptoms vary depending on a child’s age and the location of the tumor. They include:

  • vomiting
  • seizures
  • weakness of the face, trunk, arms or legs
  • slurred speech
  • difficulty standing or walking
  • poor coordination
  • headache
  • in babies and young toddlers, a rapidly enlarging head

 

Because symptoms might develop gradually and can be like those of other common childhood illnesses, brain tumors can be difficult to diagnose. If there are ever concerns about symptoms a child is having, a physician should be contacted right away.

For more information, visit childrensal.org/neuro-oncology.

Children’s of Alabama is a member of the Children’s Oncology Group (COG) that provides patients the opportunity to participate in the latest clinical trials and advanced care for pediatric brain tumors.  In addition, they are one of only 21 COG sites designated as a Phase 1 institution, which offers patients with brain tumors and other cancers with the newest therapies not available at other institutions and help further advance the knowledge of new treatments. Children’s clinical trials are open through the National Experimental Therapeutics (NEXT) Consortium, including the newest Head Start 4 protocol, which aims to improve the cure rates and quality of survival with young patients diagnosed with medulloblastoma and primitive neuro-ectodermal tumors.  

Scoliosis

Scoliosis is an abnormal side to side curvature of the spine. Instead of a straight line, it may form more of an “S” shape or “C” shape.  Scoliosis usually occurs during the growth spurt just before puberty.

Angela Doctor is a registered nurse and the Scoliosis Screening Coordinator for Children’s of Alabama.  In 1984, the state of Alabama mandated that all public school students between the ages of 11 and 14 be screened for scoliosis. “The importance of scoliosis screening is early detection,” Doctor says. “Children are doing a lot of growing during the adolescent period, so our goal is to halt the progression of scoliosis.”

Types of Scoliosis

Doctor says there are three types of scoliosis. The most common is adolescent idiopathic, in which case the cause is unknown.  But scoliosis can congenital, caused by a defect at birth, or due to a neuromuscular disease like cerebral palsy.

Treatment

For most children, scoliosis is not a problem. Some may require ongoing monitoring.  But a curve that gets worse can be bad for a child’s health. If an orthopedic specialist determines treatment is necessary, the options include a back brace to halt the deformity, or spinal surgery.

Possible Signs

Parents may wonder if their child has scoliosis. Doctor says signs to look for include:

-Uneven shoulders

-Uneven scapulas

-Uneven waist and hips

-One side of the back higher than the other when bending forward

If a parent suspects their child may have scoliosis, they should see their pediatrician.  He or she may refer the child to an orthopedic specialist to confirm a diagnosis and decide whether treatment is necessary.

It’s crucial to identify scoliosis early while the spine is still growing. When treatment is over, people with scoliosis are able to live full and active lives.