Young children seem to constantly have cuts and scrapes from outside play and their fascination with dirt, causing many parents to worry about the bacterial infection known as MRSA. Dr. Steven Buckingham, Le Bonheur Children’s Hospital infectious disease physician and medical director of microbiology for the University of Tennessee Health Science Center, debunks the myth that MRSA is spread through dirt and explains signs to look for. 

It would be very rare to acquire MRSA from playing in the dirt, as it isn't something you'd find in the soil. It's a human organism, not an environmental organism, meaning it is spread from person-to-person. Many people also believe that MRSA infections are contracted through a gym or athletic setting, but that is not the only place MRSA spreads. Many non-athletes get MRSA, too.

The bottom line is if your child’s cut becomes infected, you should watch for signs of MRSA because it can be contracted anywhere. Symptoms to watch for are swelling, redness and any oozing from the wound.

If you notice any of these, it’s best to call your child’s pediatrician. The infection may require an office visit where an examination and possibly a wound culture would be done. As for treating an infection, usually an ointment or oral antibiotic is prescribed.

 

Research was released today indicating that instances of pertussis, or whooping cough are rising. We talked to Dr. Sandy Arnold, infectious disease physician at Le Bonheur Children’s Hospital and the University of Tennessee Health Science Center. Dr. Arnold’s input is below.

Pertussis, or whooping cough, is a bacterial infection characterized by a prolonged cough that can be severe, especially in very young children.  It is called whooping cough because infected people can have spells of cough during which it is difficult to breath, thus making an unusual sound called a whoop.  

Pertussis has three stages. The first stage lasts about seven - 10 days and is indistinguishable from the common cold. The next stage usually lasts several weeks and is the period where the most severe episodes of cough occur. Finally, the patient will enter a healing phase of the infection; this, too, can last several weeks.  Many serious complications can result from pertussis, particularly in young infants, including pneumonia, seizures and rib fractures.

The best way to prevent pertussis is to have your child vaccinated against the infection. In 2005, two new vaccines known as DTaP and Tdap were licensed. DTaP is for children younger than 7 years and has a higher concentration of pertussis than Tdap, which is intended for persons 10 years and older. The DTaP and Tdap vaccines are given as a shot in the muscle.

The usual schedule for infants is a series of four doses given at two, four, six and 15-18 months of age. A fifth dose, or booster, is recommended at 4-6 years of age, unless the fourth dose was given late (after the fourth birthday). All adolescents and adults younger than age 65 years should receive a one-time dose of Tdap.

Now that the lazy days of summer are coming to an end, it’s time to gear up for the hustle and bustle of school days. It’s always hard to say goodbye to summertime, but once you get back into the swing of an everyday routine, your family will be in top shape in no time! Here are a few suggestions to follow before the school year gets into full swing.

Bedtimes –You shouldn’t budge on this one. It’s very important for kids to get enough sleep for good concentration and energy levels. With smaller kids, bedtime can be a tough act to enforce, but keeping a few things consistent can make it easier. After dinner, set the bath ritual as a first step in winding down. After bath time, reward the kids with a snack and have them select a few books. Read together as a family and once the books are finished, it’s lights out – no exceptions! An ideal bedtime for toddlers is between 7 and 8 p.m.

Eating schedules – Make dinnertime a family occasion. Set a certain time and keep it. It’s a wonderful way for family members to be together and communicate the events of their day and other happenings in their lives. Keep this one a rule – it will pay off.

Homework – The optimum time to do homework is immediately after school. Establish an after school routine for kids to come home, unwind a bit, enjoy a snack and get started. You might want to reward finished homework with a favorite television show or movie after dinner. Having this rule and sticking to it will make life much easier for everyone.

Stick to these tips and your routine will be rolling in no time. Remember, rules and boundaries are good for kids. Enforcing them makes you a happier parent and your family a stronger unit.

Tennessee high schools have a new policy for sports-related concussions, which requires that players who show signs of a concussion be removed from the game and not allowed to resume play until given the clear by a medical professional.

A concussion is a brain injury and all are serious. The majority of concussions do not involve loss of consciousness. Recognition of and proper response to concussions when they first occur can help prevent further injury or even death.

Although symptoms may not occur immediately, common signs include:

• Headache
• Dizziness or vertigo
• Lack of awareness
• Nausea and vomiting
• Poor attention and concentration
• Fatigue
• Double or blurred vision
• Irritability and/or bothered by light or noise
• Memory problems

The Tennessee Secondary School Athletic Association  is following the lead of the National Federation of State High School Associations, which includes the following in every sport rule book publication: Any player who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion or balance problems) shall be immediately removed from the game and shall not return to play until cleared by an appropriate health-care professional.

For more information, visit the Centers for Disease Control and Prevention’s Concussion in Sports site.

Did you see the article in the August issue of Parents magazine about all-terrain vehicle accidents? The research was done by Le Bonheur orthopedic surgeon Jeff Sawyer, M.D.

Sawyer reviewed 10 years of ATV accidents involving children across the country. His research shows that ATV-related injuries, including those in the spine, are increasing at an alarming rate.

From 1997 to 2006, the number of children injured in an ATV-related accident increased 240 percent. The number of spinal injuries children suffered from those accidents increased 467 percent.

“The biggest misconception is that these are toys rather than motor vehicles. We hope to use this data to further educational and legislative efforts to prevent ATV-related injuries in children,” Sawyer said.

In his research, Sawyer found 70 percent of children who incurred a spine injury in an ATV-related accident were younger than 16, the minimum age recommended by the American Academies of Pediatrics and Orthopaedics – and the median age for children who incurred this injury was 12.9 years old.

Most patients were boys (76 percent) and white (85 percent). Sawyer found that while boys tend to be injured more often, older-aged girls are at higher risk for spine injuries when they have an accident.

So what does this mean for parents? Le Bonheur and Safe Kids Mid-South recommend:

• Only those 16 or older, who are licensed to operate motor vehicles, should operate an ATV
• Taking a hands-on safety training course and following the instruction manual.
• Wearing protective gear – especially a helmet – when riding ATVs
• Not operating an ATV with a passenger or riding as a passenger
• Using ATVs only on paved roads.
• Not operating an ATV under the influence of alcohol or drugs

Sawyer’s study was published in the July 2010 edition of Orthopedics Today. He is an assistant professor of orthopedics at the University of Tennessee-Campbell Clinic in Memphis and the American Academy of Orthopaedics spokesperson on ATV safety.

Tylenol Recall Could Hit 2.5 Million Bottles
 
Johnson & Johnson's McNeil Consumer Healthcare Unit has broadened its Tylenol recall because of complaints of a musty, moldy odor in some Tylenol products including Motrin and  Benadryl. For a complete list go to www.mcneilproductrecall.com.

Consumers who purchased product from the lots included in this recall should stop using the product and contact McNeil Consumer Healthcare for instructions on a refund or replacement.  For these instructions or information regarding how to return or dispose of the product, consumers should log on to the internet at www.mcneilproductrecall.com or call 1-888-222-6036 (Monday-Friday 8 a.m. to 10 p.m. Eastern Time, and Saturday-Sunday 9 a.m. to 5 p.m. Eastern Time).

Purchase and administer generic versions of these drugs.

It’s summertime, and kids are having fun and living carefree. But for parents, summer can bring bedtime battles. That’s OK, as long as some simple boundaries are set, especially for the young ones, say Le Bonheur experts. Robert Schoumacher, MD, medical director of the Sleep Disorders Center at Le Bonheur Children’s Hospital, shares some basic rules for parents to follow all year long. Here’s what he had to say:

There are a few basic rules for getting adequate sleep. Set a consistent wake-up time and stick to it. Don't sleep late on weekends or holidays, or even after special late-night events. Getting up on time will help your child’s internal clock keep track of when it is time to go to sleep again. It’s appropriate to go to sleep an hour or two earlier than normal if your child has had a particularly hard day. For a summertime schedule, don't move bedtime and wakeup time by more than an hour, or your child could have trouble getting back on the regular schedule when school starts.

The amount of time in bed needs to be appropriate for the child's age. Children need more sleep than adults.

• 5 to 7 year olds need 11 hours per day
• 8 to 10 year olds need 10
•  11 to 13 year olds need 10.5 hours
•  14 to 16 year olds need nine hours

Most toddlers need two naps or one long nap every day, plus 11 hours of sleep at night. Most preschoolers (ages 4-5) are fine with one 30-60-minute nap per day. Most children stop napping around age 5 or 6, if they are getting adequate sleep at night.

It’s important to establish an appropriate bedtime routine, which generally starts with bath time about 45 minutes before bedtime. Turn the television, computers and videogames off when bath time starts, and don’t turn them back on until the next day. Fill the last 45 minutes before bed with relaxing activities that the child enjoys, like bedtime stories, nightly prayers, cuddling with parents or quiet playtime. Help your child find the activities he or she enjoys that are relaxing and stick to them in the same order every night. 

End the bedtime routine by tucking the child in, giving a good night kiss and leaving the child alone in bed. Always leave the room once the routine is complete. The child needs to put himself to sleep without your help on this final important step. Younger children may need frequent checks and reinforcement to stay in the bed.

If these simple steps are not enough to achieve good sleep, parents should discuss their problem with the child's doctor. A referral to the Sleep Clinic may be helpful.

Before children go to school this fall, parents should make sure they have the appropriate immunizations and documentation. For the first time in a decade, the Tennessee Department of Health has issued new immunization requirements.

Two things parents should know:

1. The state requires that children who start pre-school, pre-kindergarten, kindergarten, seventh grade, or a new student starting school in Tennessee for the first time, turn in an immunization certificate to the school or child care provider. This new form was distributed to physicians and health departments in April.  

2. The new requirements call for vaccines that previously were not required to enter school. However, these vaccines were routinely recommended for children by Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP). The school requirements reflect recommendations many physicians were already following, according to Keith English, MD, chief of Infectious Disease at Le Bonheur Children's Hospital.

Cost should not prevent parents from vaccinating their children. Children and teens younger than 19 years-old who have TennCare or don’t have health insurance can receive free vaccines through the federal Vaccines for Children (VFC) program in participating medical offices and health departments. Parents should ask their providers if they participate in VFC. If a child has insurance that doesn’t pay for vaccines and parents can’t afford them, local health departments can provide the vaccine. Health departments and VFC providers charge a small administration fee to give the free vaccine, which can be adjusted based on your income.

 For more information visit the Tennessee Department of Health’s web site at http://health.state.tn.us/CEDS/required.htm. If you have questions, please contact your child’s physician or the health department.

Le Bonheur Children’s Hospital wants to help parents learn more about back-to-school vaccines. Noel "Kip" Frizzell, MD, medical director of Care Coordination and local pediatrician, answered some frequently asked questions regarding immunizations.

From Practical Parenting Blog photos

 Q: At what age do children begin getting school immunizations?

A: The typical "school shots" are usually given anytime from age 4 to age 6.

 Q: Many children begin pre-school at the age of 3. Do their yearly vaccinations from wellness checkups cover the school vaccines, or do they need a separate round of school-specific vaccines

A: Most children who are entering pre-school will be up to date on their shots. They will have received all of the necessary vaccines by age 2 if they are getting the recommended checkups.

Q: What vaccines are included in school immunizations?

A: Most children entering kindergarten need four things: DTaP, IPV, MMR and Varicella vaccine. Beginning in January 2011, all children will need to have two documented doses of Hepatitis A vaccine. Children entering the seventh grade are now required to have a TdaP booster and a second dose of the Varicella vaccine.

Q: When should children receive the meningitis vaccine?

A: The meningitis vaccine is now recommended for children ages 11 and older. Younger children are not required to receive the vaccine because the risk of acquiring meningitis increases among teens and young adults.

 Q: What do colleges or universities require? 

A: College students will need to make sure they had a Tdap booster, a second MMR and a meningitis vaccine. Hepatitis A and B are recommended but usually not required.

Q: To avoid the back-to-school rush, is it appropriate for children  to receive their school vaccinations any time during the summer months?

A: Parents should be making these appointments for check-ups as soon as possible. The visit will include an exam, possible hearing and vision screen, vaccines and completion of all the school forms. For more information contact your pediatrician’s office or visit http://health.state.tn.us/CEDS/required.htm.

Don’t let dangerous sparks stand between your family and a wonderful Fourth of July celebration. Dr. Barry Gilmore, medical director of Emergency Services at Le Bonheur Children’s Hospital provides parents with some good safety guidelines for the holiday weekend. Following them can help keep your holiday festivities enjoyable and safe. Read his advice below.

Now that summer is here, thoughts turn to the bright and colorful fireworks displays that take place on the Fourth of July. While many families gather at community parks or organized events to view professional fireworks shows, some families hold their own festivities in neighborhoods and backyards. Every year, more than 3,000 children age 14 and younger are treated in emergency rooms for fireworks-related injuries, and children ages 10 to 14 account for most of these incidents.

Sparklers, while often considered the safest type of fireworks, join firecrackers and rockets as those causing the bulk of emergency room treated injuries. Fireworks-related injuries usually involve the hands/fingers, eyes or head. While they are an exciting part of the celebration, no parent or child should underestimate their capability to injure if the proper precautions are not taken.

During your fireworks displays, please remember to practice caution and remember these vital safety guidelines:

·         Only adults should handle fireworks. Tell children that they should leave the area immediately if their friends are using fireworks and keep a bucket of water handy.

·         Discuss safety procedures with children. Teach children to “stop, drop and roll” if their clothes catch fire. Make sure they know how to call 9-1-1. Show them how to put out fireworks by using water or a fire extinguisher.

·         Read labels and carefully follow instructions.

·         Never use fireworks indoors.

·         Be sure spectators are out of range before lighting fireworks.

·         Never aim or throw fireworks at another person.

·         Never place your face or any other body part over fireworks.

·         Never try to re-ignite fireworks that malfunction.

·         Never carry fireworks in your pocket.

·         Only light fireworks on a smooth, flat surface away from the house, dry leaves and flammable materials.

 

From proper sleep environments to toys to child safety seats, these juvenile products play a supporting role in you and your children's daily lives.  But how do you know that your children's products are safe?

The federal government recalls hundreds of products a year and some may be in your home.  Recalls shouldn't be ignored since this means an item is defective and doesn't work as intended.  2 million cribs were recently recalled! One of them could be yours.

Safe Kids monitors recalls for children's products to help you keep your children safe.  Safe Kids Mid-South, led by Le Bonheur Children's Hospital, encourages you to sign up for the monthly email to learn about the latest juvenile product recalls.

 Coaches, Parents and Athletes!

Learn the importance of pre-season physicals, how to prevent common sports injuries, proper hydration, prevention and treatment of concussion and sports first aid.

June 26, 2010 from 11 am - 1 pm at Dick's Sporting Goods, 2393 N. Germantown Parkway, Cordova, Tennessee 38016.

Sponsored by Safe Kids Mid-South, led by Le Bonheur Children's Hospital.

 

As the local heat index continues to linger around 105 degrees, Mid-South kids are at risk for heat-related illness.

Heat-related illnesses are more common in the summer, but can occur at other times, depending on environmental factors, said Dr. Barry Gilmore, medical director of Emergency Services at Le Bonheur Children’s. In fact, heat stroke ranks as the third-leading cause of death among U.S. high school athletes.

“The best thing parents need to practice during extreme heat is common sense,” Gilmore added. “Young children don’t need to be out in the heat at all, if possible. However, if they must, keep it brief.

At greater risk
Temperature, humidity, sun exposure, wind and clothing can all contribute to heat-related illnesses. Prolonged exposure to the hot environment, recent illness with mild dehydration, certain medications and even caffeinated drinks can contribute to increased risk of heat-related illness.

According to Gilmore, young children are particularly susceptible to heat injuries because they have a decreased ability to sweat and actually require a higher core temperature to start sweating. They also have decreased cardiac output at a given metabolic rate and are slower to acclimate to temperature changes. Moreover, they produce more heat than adults for the same level of activity.

“There are five recognized heat related illnesses – heat edema, heat cramps, heat syncope, heat exhaustion and heat stroke.” Gilmore said. “The last is a medical emergency and requires immediate attention. These patients tend to have a high heart rate, low blood pressure, increased body temperature and be confused or in a comatose state. They can suffer from failure of their kidneys, bleeding problems and cell breakdown, which can cause up to a 10 percent death rate.”

How to help
If you think someone might be having a heat stroke, call emergency medical personnel immediately, Gilmore said. While you are waiting for medical assistance, take the person into an air-conditioned building or a cool, shady place. Remove the person’s unnecessary clothing to help cool him or her down. Try to fan air over the person while wetting the skin with water. You can also apply ice packs to the person’s armpits, groin, neck and back. These areas contain a lot of blood vessels close the surface of the skin. Cooling them with ice packs can help the person cool down.

“Kids need to hydrate with water and parents should keep them drinking it before they have a chance to get thirsty. If your child has dark-colored urine that is a key indication they are dehydrated. Eliminate that problem and prevent it by continuously providing cold water as their main source of fluids. Hydration is the best prevention.”

The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. In fact, per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash.

Among teen drivers, those at especially high risk for motor vehicle crashes are:

• Males
• Teens driving with teen passengers
• Newly licensed teens

Here are some facts from the Center for Disease Control and Prevention:

Teens are more likely than older drivers to underestimate dangerous situations or not be able to recognize hazardous situations.

Teens are more likely than older drivers to speed and allow shorter headways (the distance from the front of one vehicle to the front of the next).

The presence of male teenage passengers increases the likelihood of this risky driving behavior. Among male drivers between 15 and 20 years of age who were involved in fatal crashes in 2005, 37% were speeding at the time of the crash and 26% had been drinking.

Compared with other age groups, teens have the lowest rate of seat belt use.

At all levels of blood alcohol concentration (BAC), the risk of involvement in a motor vehicle crash is greater for teens than for older drivers. In a national survey conducted in 2007, nearly three out of ten teens reported that, within the previous month, they had ridden with a driver who had been drinking alcohol. One in ten reported having driven after drinking alcohol within the same one-month period.

In 2008, nearly three out of every four teen drivers killed in motor vehicle crashes after drinking and driving were not wearing a seat belt. In 2008, half of teen deaths from motor vehicle crashes occurred between 3 p.m. and midnight and 56% occurred on Friday, Saturday, or Sunday.

How can deaths and injuries resulting from crashes involving teen drivers be prevented?

There are proven methods to helping teens become safer drivers. The obvious solutions are to buckle up, drive the speed limit, avoid distractions (such as driving with other teens, texting, driving under the influence of alcohol, etc.). Research also suggests that the most comprehensive graduated drivers licensing (GDL) programs are associated with reductions of 38% and 40% in fatal and injury crashes, respectively, among 16-year-old drivers.

The Future of Safety Tour

In addition, companies such as the Ford Motor Company are pioneering new technologies that will help ensure that accidents don’t happen in the first place. In their "Future of Safety" 2010 grassroots tour, they are showcasing technologies such as ultra-high-strength, lighter-weight steel and advanced new air bag systems.

On Monday, June 28, 2010, the tour will be at Le Bonheur from 10:30- 12 noon. Everyone is invited to come learn more about Ford’s cutting-edge safety technologies.

What is Heat Exhaustion? What is Heat Stoke? What are the Warning Signs? What To Do?

Prevent heat-related illnesses by staying cool, drinking plenty of fluids and monitoring activity.

Heat Exhaustion occurs when at exercise (work or play) in a hot, humid environment and body fluids are lost through sweating causing the body to overheat.  Warning Signs- Heavy sweating; Pale, cool skin; Fast, weak pulse; Fast, shallow breathing; Muscle cramps; Tiredness; Dizziness; Headache; Nausea or vomiting; Fainting.  What to do- Cool off; Drink fluids (non alcoholic and non caffeine drinks); Seek medical attention if symptoms last longer than one hour. 

Heat Stroke is an emergency heat-related illness with high body temperature (103- 106 degrees F) that can cause death within 10- 15 minutes.  Warning Signs- No sweating; Red, hot, dry skin; Rapid, strong pulse; Throbbing headache; Dizziness; Nausea; Confusion; Unconsciousness.  What to do- Call 911; Seek a cooler place; Moisten skin with lukewarm water and use a fan to blow cool air across the body; Monitor body temperature; Do not give fluids unless in a normal state and can tolerate. 

Did you know that a child’s body heats up 3 to 5 times faster than an adult’s does?  It only takes a few short minutes before a child can become dangerously overheated.

Every year, more than 30 children die because they are left alone in a car.  In just 10 minutes a car’s temperature can increase by nearly 20 degrees and it continues to rise as time goes on.  There is no evidence that cracking the windows helps keep a car cool. In fact, sunshine coming through car windows makes the car work like an oven.

"I know that it seems like an innocent act to leave a child in a back seat while you make a quick run into a store to pick up a few things,’’ remarks Susan A. Helms, Director of Injury Prevention and Safe Kids Mid-South, "however, this is dangerous because it only takes a few minutes to put your child at risk. Make it a habit to check the back seat every time you exit and remember to Never Leave Your Child Alone in a Car."

Safe Kids Mid-South offers these safety tips:

• Place your cell phone, PDA, purse, briefcase, gym bag or lunch bag on the floor in front of your child’s car seat.  Be sure it is something that you always carry with you.
• Set your cell phone to go off at the same time each day to remind you that your child should have been dropped off at childcare.
• Set your daily calendar in Outlook to remind you that your child should be at childcare.  Many tragedies have happened as the caregiver drove on to work instead of stopping at childcare first.
• Call 911 if you see children unattended in a car.  First responders tell us they would rather have those calls so they can determine if the child is at risk than have the emergency call later when a child is in deep trouble.
• Keep car doors and trunks locked so children do not have access to get in and play in a car.  Keep keys and remote entry keyfobs out of children’s reach. Children may be able to use a remote entry keyfob to unlock a car from inside a house leaving an unlocked car for others to enter.
• Make it a habit to check the back seat when you exit the car.

Safe Kids Mid-South is frequently asked, "At what age is it okay to leave children alone in a car for a few minutes while I run errands?"  Our answer is that there is NO safe way for you to leave a child of any age alone in a car- even for one minute.  We have recorded deaths of children all the way up to age 13 who were overcome by heat in a car.  The car can be a very scary place for a young child as it heats up quickly on a cool day.  Think of it on a typically hot, Memphis day!  Also, children left alone in a car are vulnerable to car jacking, strangers who may be up to no good and a myriad of other dangers if they are unrestrained.  Some children have been able to set cars in motion by releasing brakes and putting the car in gear.  They have been entangled in seat belts and trapped in power windows.  So please make it a practice to Never Leave Your Child Alone in a Car!