Tips for having a safe, fun holiday season!

The holidays are an exciting time of year for kids, and to help ensure they have a safe holiday season, here are some tips from the American Academy of Pediatrics (AAP).

Trees

  • When purchasing an artificial tree, look for the labelFire Resistant.”
  • When purchasing a live tree, check for freshness. A fresh tree is green, needles are hard to pull from branches and needles do not break when bent between your fingers. The trunk butt of a fresh tree is sticky with resin, and when tapped on the ground, the tree should not lose many needles.
  • When setting up a tree at home, place it away from fireplaces, radiators or portable heaters. Place the tree out of the way of traffic and do not block doorways.
  • Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help keep your tree from drying out and becoming a fire hazard.
  • Be sure to keep the stand filled with water, because heated rooms can dry live trees out rapidly.

Lights

  • Check all tree lights (even if you’ve just purchased them) before hanging them on your tree. Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.
  • Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could beelectrocuted.
  • Some light stands may contain lead in the bulb sockets and wire coating, sometimes in high amounts. Make sure your lights are out of reach of young children who might try to mouth them, and wash your hands after handling them.
  • Before using lights outdoors, check labels to be sure they have been certified for outdoor use. To hold lights in place, string them through hooks or insulated staples, not nails or tacks. Never pull or tug lights to remove them.
  • Plug all outdoor electric decorations into circuits with ground fault circuit interrupters to avoid potential shocks.
  • Turn off all lights when you go to bed or leave the house. The lights could short out and start a fire.

Decorations

  • Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals.
  • Never use lighted candles on a tree or near other evergreens. Always use non-flammable holders, and place candles where they will not be knocked over.
  • In homes with small children, take special care to avoid decorations that are sharp or breakable. Keep trimmings with small removable parts out of the reach of children to prevent them from swallowing or inhaling small pieces. Avoid trimmings that resemble candy or food that may tempt a young child to eat them.
  • Wear gloves to avoid eye and skin irritation while decorating with spun glass “angel hair.” Follow container directions carefully to avoid lung irritation while decorating with artificial snow sprays.
  • Remove all wrapping papers, bags, paper, ribbons and bows from tree and fireplace areas after gifts are opened. These items can pose suffocation andchoking hazards to a small child or can cause a fire if near flame.
  • Keep potentially poisonous holiday plant decorations, including mistletoe berries, Jerusalem cherry, and holly berry, away from children.

Toy Safety

  • Select toys to suit the age, abilities, skills and interest level of the intended child. Toys too advanced may pose safety hazards for younger children.
  • Before buying a toy or allowing your child to play with a toy that he has received as a gift, read the instructions carefully.
  • To prevent both burns and electrical shocks, don’t give young children (under age 10) a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
  • Young children can choke on small parts contained in toys or games. Government regulations specify that toys for children under age three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long.
  • Children can have serious stomach and intestinal problems – including death — after swallowing button batteries or magnets. In addition to toys, button batteries are often found in musical greeting cards, remote controls, hearing aids and other small electronics. Small, powerful magnets are present in many homes as part of building toy sets. Keep button batteries and magnets away from young children and call your health care provider immediately if your child swallows one.
  • Children can choke or suffocate on uninflated or broken balloons; do not allow children under age 8 to play with them.
  • Remove tags, strings, and ribbons from toys before giving them to young children.
  • Watch for pull toys with strings that are more than 12 inches in length. They could be a strangulation hazard for babies.
  • Parents should store toys in a designated location, such as on a shelf or in atoy chest, and keep older kids’ toys away from young children.

Food Safety

  • Bacteria are often present in raw foods. Fully cook meats and poultry, and thoroughly wash raw vegetables and fruits.
  • Be sure to keep hot liquids and food away from the edges of counters and tables, where they can be easily knocked over by a young child’s exploring hands. Be sure that young children cannot access microwave ovens.
  • Wash your hands frequently, and make sure your children do the same.
  • Never put a spoon used to taste food back into food without washing it.
  • Always keep raw foods and cooked foods separately, and use separate utensils when preparing them.
  • Always thaw meat in the refrigerator, never on the countertop.
  • Foods that require refrigeration should never be left at room temperature for more than two hours.

Happy Visiting

  • Clean up immediately after a holiday party. A toddler could rise early and choke on leftover food or come in contact with alcohol or tobacco.
  • Remember that the homes you visit may not be childproofed. Keep an eye out for danger spots like unlocked cabinets, unattended purses, accessible cleaning or laundry products, stairways, or hot radiators.
  • Keep a list with all of the important phone numbers you or a baby-sitter are likely to need in case of an emergency. Include the police and fire department, your pediatrician and the national Poison Help Line, 1-800-222-1222. Laminating the list will prevent it from being torn or damaged by accidental spills.
  • Always make sure your child rides in an appropriate car seatbooster seat, orseat belt. In cold weather, children in car seats should wear thin layers with a blanket over the top of the harness straps if needed, not a thick coat or snowsuit. Adults should buckle up too, and drivers should never be under the influence of alcohol or drugs.
  • Traveling, visiting family members, getting presents, shopping, etc., can all increase your child’s stress levels. Trying to stick to your child’s usual routines, including sleep schedules and timing of naps, can help you and your child enjoy the holidays and reduce stress.

Fireplaces

  • Before lighting any fire, remove all greens, boughs, papers, and other decorations from fireplace area. Check to see that the flue is open.
  • Use care with “fire salts,” which produce colored flames when thrown on wood fires. They contain heavy metals that can cause intense gastrointestinal irritation and vomiting if eaten. Keep them away from children.
  • Do not burn gift wrap paper in the fireplace. A flash fire may result as wrappings ignite suddenly and burn intensely.
  • If a glass-fronted gas fireplace is used, keep children and others well away from it with a screen or gate. The glass doors can get hot enough to cause serious burns and stay hot long after the fire is out.

Holiday Mental Health Tips

  • Take care of yourselfJust like they say on the airplane, “In the event of an emergency, put your own oxygen mask on first, and then help children travelling with you to put theirs on.” Children respond to the emotional tone of their important adults, so managing your emotions successfully can help your children handle theirs better, too.
  • Make a plan to focus on one thing at a time. Try a few ideas from “mindfulness” as a strategy to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: stop and pay attention to what is happening at the moment, focus your attention on one thing about it, notice how you are feeling at the time, withhold immediate judgment, and instead be curious about the experience.
  • Give to othersMake a new holiday tradition to share your time with families who have less than you do, for example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter. Help your child write a letter to members of the armed forces stationed abroad who can’t be home with their own family during the holidays.
  • Keep routines the same. Stick to your child’s usual sleep and mealtime schedules when you can to reduce stress and help your child and you enjoy the holidays.
  • Keep your household rules in effect. Adults still have to pay the bills and kids still need to brush their teeth before bedtime​!
  • Teach the skills that children will need for the holidays in the weeks and months ahead. For example, if you plan to have a formal, sit-down dinner, practice in advance by having a formal sit-down dinner every Sunday night.
  • Don’t feel pressured to “over-spend.” Think about making one or two gifts instead of buying everything. Help your child make a gift for his or her other parent, grandparents, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons that purchasing presents can’t.
  • Most important of all, enjoy the Holidays for what they are – time to enjoy with your family. So, be a family, do things together like sledding or playing board games, spend time visiting with relatives, neighbors and friends.​
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What does it mean when the Influenza Virus “drifts”?

When Influenza Virus “Drifts”

  • Vaccines for each year’s flu are formulated months in advance to allow time for vaccine manufacturing and distribution.
    • 100 centers around the world provide influenza surveillance and predict which strains will circulate to the US and North America. Decisions are made in February each year for the next year’s vaccine. Researchers look at trends to determine which viruses may be more prevalent.
    • The vaccine (the shot) protects against three (trivalent vaccine) or four flu viruses (the mist),(quadrivalent vaccine), based on the world’s predictions. Typically each flu vaccine has at least two strains of Influenza A and one or two strains of Influenza B. Of anything that is consistent it’s that flu seasons are unpredictable.
  • H3N2 is one strain of Influenza A in this year’s vaccine. The “drifted” vaccine is just another form of H3N2 that has different characteristics.
    • Flu viruses often “drift,” this happens every few years. The drifted H3N2 virus is one specific type selected for the 2015 southern hemisphere influenza vaccine (point being: this isn’t an unknown virus, it was just unknown how much it would spread in the US).

Should You Still Get A Flu Shot?

  • You should still get a vaccinated against influenza via the shot or nasal spray as it’s the most effective prevention tool. Circulating H3N2 and H1N1 strains we are also seeing are in the vaccine, as is the Influenza B strain. In addition, “cross-protection” is likely from the H3N2 in the vaccine for the southern hemisphere strain. Translation: it’s likely the protection you get from the shot will help decrease effects of infections by strains not included in the vaccine.
    • The CDC recommends getting the flu shot or nasal spray as soon as possible to protect yourself and your family. Now is a great time!
    • The nasal spray vaccine is still preferential for healthy children ages 2 – 8. Here’s a detailed post explaining why:
      • This year it’s know that the nasal spray isn’t as effective against the 2009 H1N1 strain, but very little H1N1 is circulating.
      • Get the shot if spray isn’t available. Waiting is not recommended.

Getting Medications For Influenza?

  • Flu shot is still available and recommended, as long as flu is spreading and causing illness the flu vaccine should continue.
  • A big part of the CDC recommendations this past week were about informing the public to seek care if suspected influenza hits. It’s important to see the nurse or physician if you have suspected influenza on day 1 or 2, especially if you are high-risk. Oral medication (Tamiflu or Relenza) can decrease your symptoms, shorten the illness, and prevent serious complications. Call for an appointment if flu symptoms or concern for flu especially
    • Antiviral treatment recommended for high-risk patients:
      • Children under 2 years
      • Adults over 65
      • Pregnant women
      •  Anyone with complicated/severe illness
  • Be smart, like you are, of course!
    • Wash your hands, cough into your elbow, stay home when sick!
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Urgent Care or Emergency Room?

Many times, your child does not get sick during “regular office hours.” Inevitably, it is after 5 PM, when your pediatrician’s office is closed.  As a parent, it is often hard to figure out, can this wait until tomorrow morning when your doctor’s office reopens? And if not, does your infant or child need to be seen in an urgent care or emergency room?

Bumps n’ Bruises would like to provide you with information that may help you determine this.

Life-threatening emergencies should be handled in an Emergency Room and calling 911 is the best way to get to that emergency room.  Breathing difficulties like asthma or wheezing attacks or allergic reactions are common emergencies in babies and children; A child in respiratory distress would not be able to count to ten in one breath or when a baby is not able to feed or nurse because they are breathing too hard. Other emergencies would be severe trauma, including head or neck injuries, broken bones sticking out of the skin, uncontrollable bleeding, seizure or lethargy (decreased level of consciousness, that your child seems very confused or “out of it” or unable to wake up).

If your infant or child has an illness or injury that is not life-threatening, but needs attention when your pediatrician’s office is closed, Bumps n’ Bruises Pediatric Urgent Care is the best place to go.  Bumps n’ Bruises is like going to your pediatrician’s office with some additional services ~ like the ability to perform x-rays to rule out broken bones, places stitches for deep cuts and giving your infant or child IV fluids for dehydration.  EKG’s can be performed as well to rule out some heart problems. Common pediatric illnesses like earaches, runny nose, cough, fever, vomiting/diarrhea, rash, sore throat, influenza, allergies, headaches, mild asthma/wheezing attacks are easily and quickly treated at Bumps n’ Bruises.  Our state of the art in-house lab is able to obtain routine blood labs, urine studies, throat and nasal swabs for strep, flu, mono and RSV.   Bumps n’ Bruises Pediatric Urgent Care is staffed with pediatricians and pediatric trained nurse practitioners to provide specialized care to your infant or child but is not staffed or equipped  for life-threatening emergencies.

If you are not certain if your child’s illness can wait until tomorrow, the best person to call is your pediatrician.  Your doctor will help you decide the most appropriate level of care.  Bumps n’ Bruises would like to strongly remind parents, if you feel like you don’t have time to wait for a call back from your physician, you should call 911 to bring your child to an emergency room.

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Car Seat Safety

Bumps n’ Bruises Pediatric Urgent Care encourages all parents to talk about their child’s car seat and requirements as they grow with their pediatrician. The American Academy of Pediatrics changed their recommendation in April of 2011, advising parents to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height AND weight for their seat. The AAP also advises that most children will need to ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.  Children no longer require the booster seat when a seat belt fits correctly—the adult lap belt lies snugly across the upper thighs and the shoulder belt is snug across the shoulder and chest – which is not usually until the child is 4 feet 9 inches.

Since 2000, an average of approximately 1,900 children ages 14 and under have died in a motor vehicle-related incident each year.   Motor vehicle crashes were the leading cause of injury-related death to children ages 1 to 14 and the second leading cause of injury-related death for children under 1 year of age from data in 2008.  Bumps n’ Bruises finds these statistics staggering.

When installed and used correctly, child safety seats and safety belts are proven to prevent injuries and save lives. Child safety seats can reduce fatal injury by up to 71% for infants and 54% for toddlers.  Children 2 to 5 years of age using safety belts prematurely are four times more likely to suffer a serious head injury in a crash than those restrained in child safety seats or booster seats.  The use of booster seats reduces the risk of nonfatal injury by 45 percent compared to seat belts only for children 4 to 8 years old.

A video posted on YouTube several years ago by a Swedish company, actually shows a side by side comparison of forward vs backward facing car seats and the obvious head and neck protection the backward facing convertible car seat provides your young child.  http://www.youtube.com/watch?v=fKIeExpDLDA

Yikes!!!

Which carseat do you use?  This is understandably a daunting task. Bumps N’ Bruises wants to make sure you are making your infant, child or teen as safe as possible, so lets try to clarify. Infant car seats are rear-facing, having a three- or a five-point harness. The most common type of harness is a five-point, with two straps that secure the shoulders and two more that secure the hips. The straps all connect to a buckle between the legs.  These seats are usually portable with a carrying handle, making them easily removed and used as infant carriers.  They are generally used up to 22 to 35 pounds but always check the owners manual for your car seats specific weight limits.   Infants that outgrown their infant-only car seat will need a larger seat that can be used rear-racing, such as a convertible car seat.   A convertible child safety seat can be used in both positions of rear-facing and forward-facing. Convertible child car seats must be used in the rear-facing position, in the backseat of your car, until your child is 2 years of age or until they reach the highest weight AND height limit allowed by the manufacturer of the convertible safety seat.  In either the infant car seat or the rear-facing convertible car seat, don’t be concerned if your infant or toddlers legs bend at the knees or touch the back seat of the car when rear-facing; this will not harm their feet or knees, and is still the safest position!

Once the age, weight and height are met, you can then turn your child forward facing but they should remain in the five-point harness forward-facing safety seat as long as possible, up to the upper height or weight limit (40 – 80 pounds) of the harnesses for that manufacturer’s seat and usually over 4 years of age.   At this point, now your child can start using the actual seat belt in your car but needs to be a in a booster seat until over 4 feet 9 inches and 8 to 12 years of age.  When using a booster seat, make sure the lap belt lies low and snug across your child’s upper thighs, below the hip bones and not across their tummy. The shoulder belt should cross the center of your child’s chest and shoulder and not cut across their neck.

Check online for area fitting stations to make sure each car seat or booster seat you are using is installed correctly.  You can check out http://www.seatcheck.org for locations close to your home.

Bumps N’ Bruises wants to make sure your child is in the safest seat and safest position in that seat as they grow and change.   Your pediatrician is a great resource to get your questions answered.  Also, look at your state department of public safety for specific laws and regulations in your area.

Bumps N’ Bruises Pediatric Urgent Care lastly wants to remind you to always mail back in your car seat or booster seat registration card.  This will provide you notification of any safety recalls or problems with your seat.

 

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The Flu

Bumps n’ Bruises Pediatric Urgent Care wants to remind you that the influenza season is in full swing. The “flu,” caused by the influenza virus, is more dangerous to children than a cold, which can be caused any number of other viruses.

The flu generally has some or all of these symptoms:  fever or feverish/chills, cough, sore throat, runny nose or stuffy nose, body aches, headache, very tired, sometimes vomiting or diarrhea. Children under the age of 5 are at the highest risk of complications from the influenza virus, including ear infections, pneumonia, sinus infection, dehydration, encephalopathy (swelling of the brain) and though rare, even death.  Each year about 20,000 children are hospitalized due to influenza complications.

Bumps n’ Bruises would like to remind parents that the Center for Disease Control (cdc.gov) recommends everyone 6 months and older to get the influenza vaccine annually, as this is the BEST way not to get the flu.  Children under the age of 6 months are not old enough for the influenza vaccine, therefore their best protection is their household contacts getting the vaccine.  Bumps n’ Bruises would like to remind breastfeeding mom’s that by getting the influenza vaccine, it will provide immune protection to your infants through your breast milk.  The influenza vaccine can be given as early as September and can be given through the following spring, as the flu season can be unpredictable in its timing and severity.

Other important ways to prevent getting or spreading the flu or other germs, is making sure you cover your mouth when you cough or sneeze with a tissue and disposing of the tissue.  Avoid touching your eyes, nose or mouth, which is how germs are introduced.  Washing your hands frequently with soap and water or alcohol based hand sanitizer.  Staying away from people who are sick or if you are sick yourself, staying home and away from other household contacts.

You can monitor the influenza virus activity through the CDC’s website at http://www.cdc.gov/flu/weekly/usmap.htm

Bumps n Bruises recommends that you take care of yourself and your little ones by talking to your doctor about the vaccine and if able, getting it early and annually.  If your child is not feeling well and you are concerned, you should contact their pediatrician.

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Athletes & Concussions

Bumps n’ Bruises is aware that contact sports including football, but any other activities that put a child or adolescent at risk of a violent movement or blow to the head or body that causes the brain to move rapidly inside the skull can cause a concussion. It is estimated that 136,000 high school students experience concussions during each academic year. Many people believe that you have to lose consciousness to have a concussion, which is not true.  Very few concussions actually have a loss of consciousness.  A concussion is damage to the brain and it is important to allow that injury to completely heal before resuming play.  Bumps n’ Bruises would like to remind parents and coaches that children and teens are at risk to be the most vulnerable to long-term cognitive, emotional and physical problems as a result of the brain injury caused by concussions.

Concussions used to be brushed aside as “not a big deal.”  However, much more is known and further care and awareness is being brought to the attention of the medical as well as the sport community.  Many states now require young athletes who have experienced a concussion to be cleared by a physician prior to restarting their sport. 

Close observation of an injured athlete is critical to the prevention of catastrophic brain injury and potential cumulative neuropsychological deficits. Bumps n’ Bruises would like to remind parents and coaches that repeated concussions can cause cumulative brain injury in an individual injured over months or years.  The American Academy of Neurology (AAN) has just updated the recommendations for the practice guidelines for return to play after a Grade I, Grade II or Grade III concussion in November 2012.  There is also free education on the AAN web page for physicians and coaches for concussion recognition and training (http://www.aan.com/go/practice/concussion).   

Bumps n’ Bruises would like to encourage young athletes to continue perfecting their sport but also be aware of this common and very serious injury.  It is important for parents, coaches and physicians to help these young athletes to compete safely.

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Thanksgiving Safety

The holidays are upon us and in full swing; Bumps n’ Bruises would like to remind parents about some kitchen safety.  Never hold your child while you are trying to cook over a range top.  This is a burn hazard from splashing food as well as the heat from the range. Always turn the handles of your pots and pans in and away from the edge, so a young child can’t reach up and accidentally pull something hot down. Bumps n’ Bruises would also remind you to be caution of children’s toys on floor in your kitchen.  It is the gathering room of your home but not the playroom, these can be a fall hazard.  Always keep knives out of reach of children and never leave children unattended in a kitchen with the stove top on or with lit fires, like candles.  Bumps n’ Bruises would also like to remind you about kitchen fires; It is always a good idea to have a fire extinguisher in your kitchen; And never put water on a grease fire!

Bumps n Bruises Pediatric Urgent Care wishes your family a very Happy Thanksgiving!!

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