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Children's, Health and Safety

When to Visit the Emergency Department

Your child doesn’t feel well, but should you take them to the emergency department? Sometimes it can be hard to tell when a child requires urgent medical treatment or if the concern can wait.

Dr. Sam Strachan is a pediatric emergency fellow.  He says the emergency department at Children’s of Alabama alone receives approximately 80,000 visits each year.  That’s an average of 219 patients each day!

Dr. Strachan says the emergency department will never turn anyone away, but a child may be better served and have a shorter wait time by seeing their pediatrician instead.  “Every child should have a pediatrician,” he says.  “If a child isn’t feeling well, even in the middle of the night, you can always call your pediatrician’s on-call number for advice.”

You should always take your child to the emergency department in a true emergency.  These signs include:

Go to Emergency Department

  • serious injury
  • trouble breathing
  • not drinking enough, not urinating enough
  • unusual sleepiness or confusion
  • a head injury and is vomiting
  • an eye injury
  • a serious burn

Call 911 if your child

  • isn’t breathing or is turning blue
  • is unconscious after a fall
  • is having a seizure
  • has a serious allergic reaction
  • has broken a bone that sticks out through the skin
  • is choking
  • has a large cut that is bleeding uncontrollably

A high fever can be scary for a parent to see, however, Dr. Strachan says it’s the body’s natural defense mechanism against infection.  “A lot of parents are concerned with a fever of 104 or 105 in their child,” he says.  “However children can deal with high fevers better than adults can.”  Babies are the exception.  “Any baby under two months old should be seen right away for any fever greater than or equal to 100.4,” he says.

Dr. Strachan offers these tips to help decide if a child needs to go to the emergency department in the event of a fever:

  • If feverish, try Motrin or Tylenol, depending on the age of the child
  • If the child feels well between fever, wait to see pediatrician until the next day

If it’s not a true emergency, it’s always best to wait to see your child’s pediatrician. “On the front end you’re taking away resources from children who really need it,” Dr. Strachan says. There’s another benefit to seeing the pediatrician.

“They know your child, they know your child’s history,” Dr. Strachan says.

Through an established relationship with a pediatrician, a child can receive better long term care.

Children's, Health and Safety

FAQs: 2018-2019 Flu Season

Q: What is influenza or flu?

A: Influenza (also known as the flu) is an infection of the respiratory tract. It is caused by a virus that spreads easily from person to person.  It spreads when people cough or sneeze out droplets that are infected with the virus and other people breathe them in. The droplets also can land on things like doorknobs or shopping carts, infecting people who touch these things.

Q: Is flu contagious?

A: The flu is very contagious. People can spread it from a day before they feel sick until their symptoms are gone. This is about one week for adults, but it can be longer for young children.

Q: How will I know if my child has flu and not just a cold?

A: The fall and winter months are cold and flu season. Both the cold and the flu can present similar symptoms, including cough, congestion and runny nose. In general, the flu hits a lot harder and quicker than a cold. When people have the flu, they usually feel worse than they do with a cold. Most people start to feel sick about two days after they come in contact with the flu virus.

Flu symptoms include:

  • fever
  • chills
  • headache
  • muscle or body aches
  • dizziness
  • loss of appetite
  • tiredness or fatigue
  • cough
  • sore throat
  • runny or stuffy nose
  • nausea or vomiting
  • weakness
  • ear pain
  • diarrhea or vomiting, ( more common in children than adults)

Q: Is it too late for my child to get this season’s flu vaccine?

A: There’s still time to get a flu vaccine this season. Flu season in the United States is from October to May. Vaccines are provided at most pediatricians’ offices. The American Academy of Pediatrics (AAP) recommends the flu shot for everyone over 6 months old.

Q: What is the treatment for flu?

A: Most children with flu get better at home. In the event a child does get sick, you can help mitigate symptoms. Make sure your child is drinking plenty of fluids. You can give appropriate doses of acetaminophen or ibuprofen to relieve fever and aches, and make sure they are getting plenty of rest.

Q: When should I seek medical treatment for my child if I suspect flu?

A: Bring your child to the doctor if you’re concerned about severe symptoms. Most of the time parents can care for their children with plenty of rest, fluids and extra comfort. Some children are more likely to have problems when they get the flu, including:

  • children up to the age of 5, especially babies
  • children and teens whose immune system is weakened from medicines or illnesses
  • children and teens with chronic (long-term) medical conditions, such as asthma or diabetes

Q: In addition to the flu vaccine, how else can we stay healthy during cold and flu season?

A:  The American Academy of Pediatrics (AAP) recommends the flu shot for everyone over 6 months old. Here are some other tips for staying healthy during cold and flu season:

  • Cover your cough and sneeze
  • Wash your hands
  • Clean living and working areas
  • Avoid crowds
  • Stay home from work or school if you are sick
  • Avoid touching your eyes, nose, and mouth

Q: How can we prevent the spread of germs in our house if my child is sick?

A: The flu virus spreads when people cough or sneeze out droplets that are infected with the virus and other people breathe them in. The droplets also can land on things like doorknobs or shopping carts, infecting people who touch these things.

Teaching children the importance of hand washing is the best way to stop germs from causing sickness. It’s especially important after coughing or nose blowing, after using the bathroom and before preparing or eating food.

There’s a right way to wash hands, too. Use warm water and plenty of soap, then rub your hands together vigorously for at least 15 seconds (away from the water). Children can sing a short song — try “Happy Birthday” — during the process to make sure they spend enough time washing. Rinse your hands and finish by drying them well on a clean towel. Hand sanitizer can be a good way for children to kill germs on their hands when soap and water aren’t available.

Cleaning household surfaces well is also important. Wipe down frequently handled objects around the house, such as toys, doorknobs, light switches, sink fixtures, and flushing handles on the toilets.

Soap and water are perfectly fine for cleaning. If you want something stronger, you can try an antibacterial cleanser. It may not kill all the germs that can lead to sickness, but it can reduce the amount of bacteria on an object.

It’s generally safe to use any cleaning agent that’s sold in stores but try to avoid using multiple cleaning agents or chemical sprays on a single object because the mix of chemicals can irritate skin and eyes.

Q: If my child has had flu, when can he return to school, child care, etc.?

A: Children with the flu should stay home from school and childcare until they feel better. They should only go back when they have been fever-free for at least 24 hours without using a fever-reducing medicine. Some children need to stay home longer. Ask the doctor what’s best for your child.

 

Find more information and resources at https://www.childrensal.org/cold-and-flu-updates-and-resources.

Children's, Health and Safety

Seasonal Flu

According to the Jefferson County Department of Health, activity levels for this 2018-2019 flu season across the state of Alabama are at 4.20%, which is above Alabama’s baseline of 3.32%. This puts Alabama in the red zone for incidence.

Delphene Hobby-Noland, Manager of Infection Prevention and Control at Children’s of Alabama, said that the answer to avoiding the flu is as simple as taking basic precautionary steps.flustockpicture

“The two biggest preventative measures you can take are to get your annual flu immunization and to wash your hands,” Hobby-Noland said. “Our hands are the primary way that we transmit germs.”

Hobby-Noland said that those most susceptible to the flu are children and the elderly because their immune systems tend to be weaker. Children under the age of 5, especially those younger than 2 years old, are particularly more likely to suffer from flu-related complications. These complications include pneumonia, dehydration, worsening of long-term medical problems like heart disease or asthma, swelling in the brain, sinus problems and ear infections. Children younger than 6 months cannot receive the flu shot, meaning that it is important for everyone who is of age to be immunized, especially caregivers and parents of young children. There is still time to get the flu shot. While the shot does not cover all strains of the flu, it can shorten or cause the case to be less severe even if someone does get the illness.

Other preventative measures involve disinfecting commonly used surfaces, as well as encouraging children to cover their mouths with a tissue when coughing or sneezing and to avoid touching their faces.

The Jefferson County Health Department encourages people experiencing milder flu-like symptoms to stay at home or call their personal doctor instead of going to the hospital. This helps to prevent further overcrowding, risking exposure to more serious illnesses and spreading the flu.

Common symptoms of the flu include:

  • Fever or feeling feverish with chills, though not all people with the flu will have a fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea, which are more common in children

For more information, visit https://www.childrensal.org/.

 

Children's, Health and Safety

Holiday Hazards

The holidays are one of the most wonderful times of the year. Keep you and your family safe this season by reading the tips below on how to avoid potential holiday hazards!

Fire Hazards

The National Child Protection Association and the U.S. Fire Administration estimates that there are 240 house fires from Christmas trees alone and 150 fires from holiday lights each year. When deciding on a Christmas tree this year, make sure it is fresh and watered appropriately. The tree needles should be green, and the stump sticky with sap and they should be placed away from any heat sources that may cause it to catch fire. You should water the tree daily, and if you notice the tree beginning to dry out and die, you should remove the tree from your home. All artificial trees should be flame resistant.

Poisoning Risks

Many holiday plants can be poisonous if ingested. This includes mistletoe, holly, and Jerusalem cherry plants. Symptoms of potential plant poisoning are rashes, vomiting, and diarrhea. If you suspect that your child has eaten any part of the plant, please contact the Regional Poison Control Center at 1-800-222-1222. Bubble lights and snow sprays can also be poisonous to children. Bubble lights contain a hazardous chemical called methylene chloride and should not be ingested.

Medication Risks

With your holiday parties, make sure guests and relatives coming into your home keep their medications out of reach for your children. Store all medicines — prescription and nonprescription — out of sight and out of reach of children, preferably in a locked cabinet. Even items that seem harmless, such as mouthwash, can be hazardous if ingested in large quantities by children. All packages and bottles should be child resistant. If you are visiting someone else’s home, make sure your kids are in a safe area of the house that is properly childproofed.

Alcohol and Food Poisoning

The risk of alcohol and food poisoning is all too common amongst children during the holidays. To lower the risk, make sure you dispose of all empty or partially empty containers immediately. All alcohol should be kept away and out of reach of children. Practice food safety by thoroughly washing hands, utensils, dishes, and anything else that comes in contact with raw meat, including poultry and fish, raw eggs before and after use. Store your leftovers properly, and heat them thoroughly before serving again.

Choking and Swallowing

Tree ornaments, light bulbs, icicles, tinsel, and small toys are all potential choking hazards for small children. If it is small enough to fit in a baby or toddler’s mouth, then it is too small to play with. Button batteries are common in most children’s toys and are very dangerous if swallowed. The symptoms of button battery ingestion are coughing, choking, irritability, loss of appetite, and fever. If swallowed, visit your nearest emergency department or call 911. Small treats such as peanuts or popcorn, tree needles, angel hair (made from finely spun glass) and ornament hangers are all potentially harmful and should be kept away from children.

Gift Giving

The number one thing to remember when picking gifts for your little ones this season is that you must choose a gift that is age appropriate. For young children, toys without strings, batteries and removable parts are best and reduce the risk of choking.

If your child ingests something toxic this holiday season, call the Regional Poison Control Center at Children’s of Alabama at 1-800-222-1222.  The Regional Poison Control Center can give recommendations for how to treat ingestion as well as dermal and ocular exposures.

 

Children's, Health and Safety

Tips for New Parents

Bringing your new baby home is one of the most exciting moments in a new parent’s life, but there are a few tips you must keep in mind to ensure their safety.

Placement of the crib

  • Should be a safe distance away from any window or furniture.
  • Should be away from all cords (blinds, electrical cords)

Smoke and carbon monoxide alarms

  • Have a working smoke and carbon monoxide alarms
  • If an alarm goes off, grab your baby and exit the house right away.
  • Call 911 and do not re-enter the house until the fire department says it is safe.
  • If your baby becomes drowsy or abnormally fussy, seek medical attention right away.

Car Seat Installation

  • Choose a car seat that is the right size for your child
  • Read your car seat’s manual and car manual to ensure it is installed correctly
  • The American Academy of Pediatrics recommends that infant car seats should be rear facing until they reach the highest weight or height allowed by the car seat manufacturer.

Items in your baby’s crib

  • Crib should contain a firm mattress and fitted sheet only
  • Do not place blankets or stuffed animals in the crib
  • Infants should be placed on their back for naps and bedtime

Water heater temperature

  • Set your water heater no higher than 120 degrees to avoid the risk of burns.
  • Test water temperature by placing your elbow into the bath water.

 

 

For more information and resources, please visit https://www.safekids.org/

Children's, Health and Safety

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.
Children's, Health and Safety

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.

Children's, Health and Safety

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.  

Children's, Development, Health and Safety

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.

Children's, Health and Safety

Protecting Children from Sexual Abuse

It’s estimated that 1 million children are abused every year. Many abuse victims suffer from sexual abuse. Deb Schneider is the executive director of the Children’s Hospital Intervention and Prevention Services (CHIPS) Center at Children’s of Alabama. She says even though it’s a difficult subject, it’s important parents teach children that their bodies are “private property.”

“Parents should be having an ongoing conversation with their kids. This is not a one-time thing,” Schneider says. “It’s good to look for teachable moments, like when you see a private property sign, or during bath time, or when you see an Amber Alert.”
Schneider says often when people try to entice children, they trick them with what she calls bait. “They use things like toys, candy or money,” she says. “They also will try to keep them from telling about the abuse. They may threaten to harm them or someone they love if they tell.”

She advises parents to educate children to understand what “bait” may look like and how to seek help if they find themselves in an uncomfortable situation.
Children should understand the “I Can Plan.”
Teach Children the “I Can Plan:”
  • Try to say NO
  • Try to Get Away
  • Tell Someone
  • It’s Not Your Fault
If a child reports a suspected incident of sexual abuse, Schneider advises parents to stay calm, thank the child for telling, assure the child you will get help and contact the authorities, whether it’s the local police or Department of Human Resources.
Schneider says hard as it may seem to stay calm, it’s very important to not frighten the child and not ask too many questions so the child will continue to share when asked by authorities. Authorities are trained to conduct interviews with children to help prosecute an abuser.
The CHIPS Center has abuse prevention resources available. For more information, 205- 638-2751 or go to childrensal.org/CHIPS.