Heads-Up on Teens and Pedestrian Safety

By the time your child reaches his teen years, you’d think you no longer have to worry about him safely crossing the street. Think again.

The teen pedestrian death rate is twice that of younger children and accounts for half of all vehicle-related pedestrian deaths according to Safe Kids Worldwide.

pedestrian safety tips

They have years of maturity and physical development over the younger kids, so why are twice as many teens dying from vehicle-related pedestrian injuries? About half of those injuries may be attributed to “distracted” walking.

According to a 2014 Safe Kids Worldwide study of 1,040 teens, half reported crossing streets while distracted by mobile devices. Of the teens who had actually been hit or nearly hit by a vehicle:

• 47 percent were listening to music
• 20 percent were talking on the phone
• 18 were texting

“Texting while walking is not a good idea, but headphones are especially distracting,” said CHOC Children’s Community Educator Amy Frias, who is also the Safe Kids, Orange County coordinator. “Headphones put kids into their own zone when they should be more aware of their immediate surroundings.”

Additionally, more teens who had been hit or nearly hit reported crossing streets in risky ways. They were more likely to attempt crossing from the middle of the street or from between parked cars, instead of at an intersection or using a crosswalk.

Safe Crossing at Every Age

Unintentional pedestrian injuries are the fifth-leading cause of death for children ages 5 to 19 in this country. Since opening in January 2015, the CHOC Children’s Trauma Center has treated pedestrian injuries in eight children ages 3 to 12 years. The most common times of day these injuries occurred: before school and in the early evening.

Whether your child is 6 or 16, these important safety tips could be lifesaving:

Put down all the devices — Insist your child pay full attention whenever walking on sidewalks or roads.
Cross only at intersections and crosswalks — Make eye contact with the driver before stepping into the street.
Be as visible as possible at night — Light-colored clothing helps make it easier for drivers to see your child.
Instruct teen drivers to check behind their cars before backing up — Be extra careful and take a moment to make sure a small child is not playing or walking behind your vehicle.
Set a good example — Children under age 10 should cross the street with an adult. When walking with your child, explain how you always follow traffic safety rules, too.

The Julia and George Argyros Emergency Department at CHOC Children’s is home to Orange County’s first pediatric-focused trauma center. Serving children ages 14 and younger, our specially trained physicians, surgeons, nurses and respiratory therapists are available around the clock to provide immediate intervention and care for traumatic injuries.

Download this pedestrian safety tip sheet.

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When Should I Take My Child to the ED?

Unfortunately, many parents at some time will face the decision of bringing their child to the emergency department (ED). It can be a scary and confusing situation for children and parents alike, but this list of frequently asked questions about ED visits might help settle confusion.

Q: How do I know if I should take my child to the emergency department?

Knowing when a child’s condition reaches a level that warrants a visit to the ED can be difficult. After all, children are not small adults: They might display different symptoms than adults, and some symptoms that aren’t serious for an adult can be dire for children.

Staff members at the Julia and George Argyros Emergency Department at CHOC Children’s Hospital advise parents to trust their gut.

CHOC’s ED treats a variety of ailments, big and small, from broken bones to small abrasions to headaches. No matter is too small, and no patient is turned away. Whether or not the child needs treatment, parents will leave the ED with reassurance and education.

Q: Can parents direct an ambulance to a particular Emergency Department?

For any parent, the notion of rushing a child to an emergency department in an ambulance is terrifying. In a critical situation, parents want to get their child help as soon as possible at the closest facility possible.

But should the right circumstances occur, parents can request which emergency department the ambulance will visit. As a common courtesy, transport teams will honor the request to the best of their ability.

However, if the child is suffering from critical illness or fatal injury that requires absolute immediate attention, a medic team will not bypass a closer hospital.

Q: I have an HMO: Do I need to go to my healthcare home for emergency services, or can I come to CHOC?

CHOC Children’s does not require approval from a patient’s healthcare provider to offer care at the Julia and George Argyros Emergency Department.

However, families should consult with their provider for more specific information regarding coverage specifics.

Q: How long will my Emergency Department visit take?

CHOC’s ED is designed for fast triage, rapid diagnosis and speedy treatment to streamline each visit, but it is difficult to estimate how long a visit will take.

Many variables factor into the length of a visit, including the type and severity of your child’s ailment, as well as the other patients visiting the ED that day.

Patients are generally seen in the order of their arrival, but children with serious illnesses or injuries may be seen first. In this case, you might notice patients who arrived after you being called ahead of you. Also, the ED physician who is treating your patient might be interrupted to respond to a sudden critical emergency.

Please remain patient and calm during your visit. Know that the comfort of you and your child are a top concern for all ED staff, and they are working hard to provide quality, efficient care to all patients they are privileged to serve.

Q: What’s the difference between an Emergency Room, or ER, and an Emergency Department, or ED?

There’s no difference – except you won’t see “ED” reruns on television.

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Emergency Medicine: Then and Now

EDMy first stop after falling out of that tree 50 years ago was the emergency department. So, it’s been especially fun watching how emergency medicine has changed since 1964 – and, boy, has it.

CHOC Children’s has Orange County’s only emergency department that’s dedicated exclusively to the care of kids. The Julia and George Argyros Emergency Department at CHOC Children’s Hospital opened a year ago this month, and it’s much different from where I first received care all those years ago.

CHOC’s ED strives to be as ouchless as possible. Child Life specialists are on hand to help distract patients from pain and discomfort. They use gadgets like iPads, games, bubbles and more to make the trip easier.

Also, ED staff have techniques to help minimize pain from injections, blood draws and stitches. For example, they might use an ultrasound machine to find a patient’s vein before drawing blood. Numbing medication like lidocaine is also used o minimize pain before injections.

And even without pain, kids want their moms and dads nearby. CHOC understands this, and has ensured that its ED exam rooms are larger to accommodate multiple family members and strollers.

_____________________________________________________________________________________________________________________________

The Julia and George Argyros Emergency Department at CHOC Children’s Hospital is exclusively dedicated to the treatment of pediatric patients. The 22,000-square-foot, full-service emergency department is designed to meet the unique needs of children. Doctors, board-certified in emergency medicine, and specially trained nurses provide the very best patient- and family-centered care 24 hours, seven days a week.

 

 

The Role of Parents and Family in CHOC’s Emergency Department

The idea of being apart from a child in an emergency situation is troubling for most parents. But there’s no need to worry at the Julia and George Argyros Emergency Department (ED) at CHOC Children’s Hospital: Here, parents and siblings are encouraged to stay with their patient throughout treatment.

As a staunch advocate of family-centered care, CHOC Children’s believes that a child’s family plays a critical role in treatment and healing. We know that a parent’s presence is the best coping mechanism around.

Parents’ and guardian’s input and presence are highly valued – and it shows in the design of our ED: Exam rooms are larger to accommodate family members, siblings and their strollers, and each room has a television to help distract restless little ones.

However, there may be times that only parents will be allowed with the patient due to the urgency of care needs. In general, parents should use good judgment when bringing siblings to the Emergency Department. A visit can be a long process, and small children might grow inpatient. Further, parents must be able to focus on their ill child: They’ll receive a lot of information, and will be asked many questions by our staff. Rest assured, however, because along the way, parents, patients and siblings alike will receive guidance and support from ED staff.

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Kids and Emergency Care

Kid with thumbs upCAREFUL CARE?

When it comes to children, a level of unique and specialized care is necessary. “There are a number of  considerations in children you have to focus on, whether dealing with an infant, a neonate (less than 28 days  old), a child or an adolescent,” says Dr. Pierog. “There are many different features that are obvious, as well as  those from a physiological standpoint that determine how their systems function,” says Dr. Pierog.

UNIQUE NEEDS

“Kids are much more prone to have facial and intracranial (brain) injuries than adults because of their larger head-to-body size. Because of their propensity to fall, we see a higher number of upper extremity injuries such as wrist and elbow fractures,” says Dr. Pierog. In addition, because they have a higher hydration requirements, children need two to three times as much fluid than do adults.

EMERGENCY ROOM ETIQUETTE

“Children require special treatment, not just for their size, but also when it comes to the equipment needed to treat their conditions,” says Dr. Pierog. CHOC’s emergency department has all the bases covered, including master’s prepared child-life specialists who are trained to understand and treat the emotional and physiological needs of little ones. “There are a number of features that pediatric emergency physicians are aware of and prepared to treat, including respiratory, gastrointestinal, and environmental conditions, such as pesticide exposure from children putting items in their mouths.”

HOW MUCH IS TOO MUCH?

For adults, medication dispensing is generalized, but not for children. To ensure parents are giving the right amount, pay attention to the levels. “The dosages of common medications are going to be on a weight-based formula,” says Dr. Pierog.

FAST FACTS

  • What is the decrease in childrens illnesses because of the use of vaccines: 90%
  • What is the amount of body fluids children turns over: 25%
  • What is the average number of colds an adolescents get each year: 2 to 4


HEALTH PLANS

CHOC Children’s contracts with most major public and private health care programs including Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs.) Click here for a list of hospital contracted health plans. You are advised to check with your health plan or insurance network to confirm that CHOC and your physicians are contracted providers. For questions regarding your insurance or eligibility, please contact the CHOC Admitting Department at (714) 509-8400. When you choose your physician and medical group, call the office and make sure they refer to CHOC.

View the full feature on Kids and Emergency Care

Dr. James Pierog
Dr. James Pierog
Emergency Medicine

PHYSICIAN FOCUS: DR. JAMES PIEROG

Dr. Pierog is the medical director of emergency medical services at CHOC Children’s. He completed his internship in internal medicine and his residency in emergency medicine at the University of Southern California, Los Angeles County Medical Center. He served in the United States Army, achieving the rank of Captain as a General Medical Officer.

Dr. Pierog’s philosophy of care: “Giving cutting-edge care to the children of Orange County. To, protect, nurture, and develop them in an optimal setting.”

EDUCATION:
University of California, Los Angeles Medical School

BOARD CERTIFICATIONS:
Emergency Medicine and Pediatric Emergency Medicine

More about Dr. Pierog

This article was featured in the Orange County Register on October 7, 2013 and was written by Shaleek Wilson.