Minimizing Health Effects of Wildfires

During a wildfire, the biggest health risks to children are fire and smoke. Health effects can include any or all of the following symptoms, per the American Academy of Pediatrics:

  • Chest tightness or pain
  • Shortness of breath
  • Wheezing
  • Coughing
  • Burning or stinging of the nose, throat and eyes
  • Dizziness or lightheadedness
How can parents protect kids from the harmful health effects of fire and smoke?
  • Evacuate the area if recommended by authorities.
  • Stay indoors and minimize smoke exposure. Close all windows and doors.
  • When driving, keep windows and vents closed. Turn the air-conditioning to re-circulate.
  • Avoid sports practices, games or extreme exertion if the air quality is poor.
  • Do NOT give your child a mask to filter contaminants, since masks do not work when not fitted correctly. Smaller sized masks may appear to fit a child’s face, but no manufacturers recommend their use for children.
  • Increase water intake to avoid dehydration, which can happen quicker when breathing is compromised.
  • Continue to minimize exposure to other sources of air pollutants such as cigarette smoke, smoke from wood or coal-burning furnaces, or smoke from a barbecue, as the combined effect of these smoke sources can have a greater impact on your child and family than the fire alone.
  • Children with chronic respiratory problems, such as asthma, are at increased risk. Children at increased risk should remain in a clean-air environment, and be kept indoors until air quality improves. Administer any protective medications to your child as directed by your provider. They should be monitored closely for signs or symptoms of harmful health effects. If they are showing these symptoms and their usual medications cannot bring them under control, they should be taken to a nearby medical facility, despite the risks of traveling.

wildfires

Parents should be mindful of the signs and symptoms of respiratory distress, says Dr. Charles Golden, executive medical director of the CHOC Children’s Primary Care Network.

What are the warning signs of respiratory distress?
  • Rapid breathing
  • Use of accessory muscles (the muscles in the chest, rib cage and neck) become noticeable with each breath
  • Fatigue, lack of energy, and increase in sleepiness in addition to the above symptoms
  • Flaring of the nostrils or grunting with each breath
  • Bluish/purplish discoloration of the lips, tongue and inner mouth in combination with the above symptoms

If your child has these symptoms, seek urgent medical attention despite the risks of travel and outdoor air exposure. If these symptoms are severe, call 911.

 

 

Nursemaid’s Elbow in Kids Caused by Common Activities

Nursemaid’s elbow is one of the most common injuries in small children, and it can happen during the most innocent activities, like swinging a child by the arms or playing tug-of-war.

“There is a natural looseness in the ligaments of little kids’ elbows,” according to CHOC Children’s pediatric orthopaedic surgeon Dr. Jessica McMichael. “Nursemaid’s elbow happens when the arm gets tugged or pulled, which can partially dislocate the radial head portion of the elbow.”

The injury can happen when a baby or small child is lifted by the hands, or when a child tugs their arm while holding someone’s hand. It can also happen when an object is pulled from their hand, when a baby rolls over or because of a fall.

What are Symptoms of Nursemaid’s Elbow?

Parents can look for these characteristic signs of nursemaid’s elbow in their child:

  • The child stops using their arm normally or treats their arm gingerly
  • The elbow appears straight and the child doesn’t want to bend it
  • The child holds their arm limply and away from the body, “like a paralyzed arm”
  • The palm is rotated inward, rather than facing out toward the front of the body
  • The child complains of pain in the elbow, forearm or wrist
  • Someone holding the child’s hand may feel a pop in the child’s wrist when the injury happens

Nursemaid’s elbow is a very common orthopaedic condition treated at CHOC, according to Dr. McMichael. It is likely to happen multiple times after a child has it once.

“Nursemaid’s elbow is not threatening to the limb, but it does need to be treated,” Dr. McMichael says. “It’s okay to wait until the next morning if your child is acting okay. If your child is not acting like themselves, get it checked out.”

How to Fix Nursemaid’s Elbow

To fix nursemaid’s elbow, a medical professional will gently and quickly pop the elbow back in place. A child might feel pain for a brief moment during the procedure but should start using their arm normally within a few minutes.

If a child’s elbow pops out of place three or more times in a month, a cast may be put on to immobilize the arm and promote stiffness.

Nursemaid’s elbow can be treated by a pediatrician, a pediatric orthopaedic specialist or at a pediatric emergency department. Parents should not correct the elbow themselves unless instructed by a doctor.

Dr. McMichael encourages parents to educate people who are around their child, like grandparents, daycare staff and preschool teachers, about the safest ways to lift a child, hold their hands and play with them.

Nursemaid’s elbow is less likely to occur after age four, when the elbow ligament starts to tighten up and improves with age and growth.

To make an appointment with a CHOC orthopaedic specialist, call 888-770-2462.

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Is Your Teen a Safe Driver?

By Kambria Nguyen, pediatric resident at CHOC Children’s

Motor vehicle accidents are the number one cause of unintentional injuries in adolescents age 15-19. These accidents account for 36 percent of all deaths in this age group ― Six teens die every day due to motor vehicle accidents. Summer months have the highest rates of teen fatalities throughout the year, but it’s not just teen drivers who are at risk; teen passengers are also at increased risk.

There are many factors unique to teens that put them at increased risk of having an accident:

  • Teens are inexperienced drivers and may not be able to recognize dangerous situations.
  • Teens are also more likely to engage in risky behaviors such as speeding and leaving little room between themselves and the car in front of them (known as headway).
  • Teens have the lowest rates of seat belt use.
  • 40 percent of teens report texting while driving.
  • The risk of being in an accident increases with the number of teen passengers.

According to the Centers for Disease Control (CDC), nearly one-third of traffic-related deaths occurred due to an alcohol-impaired driving crash. However, drugged driving is on the rise. A recent study found that the number of people killed in crashes where drugs were present surpassed the number killed in crashes where only alcohol was detected.

In 2014, the most recent data available, 209 child passengers ages 14 and younger died in alcohol-impaired driving crashes. More than half were riding in the vehicle with the alcohol-impaired driver.

Safe Driving Tips for Teens

  • Always wear your seatbelts.
  • Follow the rules of the road.
  • Never drink and drive. Never get into a car with someone who had a drink. Make sure you have a designated driver or someone you can call if you are stuck.
  • Whether it be alcohol, marijuana or recreational drugs, impaired driving of any kind can be deadly.
  • Remember that your texts can wait. Distracted driving is dangerous.

How can you help your teen be a safe driver? Keep in mind the following tips to support your teen and their safe driving habits:

  • Before teens drive alone, supervise them driving during different times of the day and in different weather conditions.
  • Lead by example. Wear your seatbelt and do not text and drive.
  • Stress the importance of a good night’s rest as drowsy driving leads to accidents.
  • Prohibit teen passengers for the first year your teen is licensed. In California, you cannot drive between 11 p.m. and 5 a.m. or transport passengers under 20 years old, unless accompanied by a California-licensed, parent or guardian, driver 25 years or older, or a driving instructor.
  • Talk to your teen about drugs and alcohol. Discuss the dangers of impaired driving and distracted driving.
  • Sign a parent-teen driving agreement. The CDC has a template, or you can make your own.

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Prevent Nursery Product-Related Injuries by Babyproofing the Nursery

When preparing for a new baby, most parents consider baby proofing their home, but the nursery is often overlooked. Children’s products are recalled more than any other type, says Amy Frias, community educator at CHOC Children’s and Safe Kids Orange County coordinator.

“Accidents are going to happen. Parents just need to do what they can to prevent serious injuries,” says Frias. “Nobody thinks a major accident in the home is going to happen to them.”

Frias offers the following tips for baby proofing the nursery. These “babyproofing” rules apply not only to your home, but anywhere else your baby may spend time, such as a grandparent or babysitter’s house or daycare.

Falls

Since children up to age 5 spend most of their time at home, they are more likely to be injured in the home than anywhere else. Most injuries children experience in the home are due to falls.

“If a product for your child comes with a strap, use it. Don’t assume the baby is safe without a strap,” says Frias. “Babies don’t tell you when they’ve learned a new trick like how to roll over and in this case off the changing table. You don’t know what they can do until they do it.”

Lower your crib mattress once your baby is able to sit up. Lower it again once the baby begins to pull themselves up.

Before a baby learns to crawl, secure furniture to the wall, especially heavy items such as tall dresses and changing tables to prevent them from tipping over.

Parents are not immune to falls, so when using a baby carrier, be aware of your surroundings when wearing your baby,” says Frias.

Safe sleep for babies

Although it’s safe for babies to room share with their parents, they need their own sleep surface. Remember the ABC’s of safe sleep: babies should sleep ALONE, on their BACK, in their own CRIB (or other sleep surface).

Remember that a baby’s sleep surface should be naked. Remove any blankets, stuffed animals or other items from their crib.

The biggest risk factors in nurseries are tied to suffocation, strangulation and entrapment, says Frias:

  • Suffocation: don’t keep bumpers, blankets, stuffed animals, or anything else besides a mattress and fitted sheet in the baby’s crib.
  • Strangulation: avoid using mobiles. Furniture should be kept away from windows that have cords, since baby can pull themselves up and become entangled in the cords.
  • Entrapment: there should be no gaps larger than two fingers between the crib side and mattress. The crib mattress should be firm and fit well in the crib. It is important that parents only use a Consumer Product Safety Commission approved crib. Cribs with drop sides do not meet the current standards, are not safe, and should not be used. If your child will be in a used crib make sure it does not have a drop side. Do not use infant positioners such as wedges or pillows due to risk of suffocation and entrapment. Avoid using crib bumpers.

The dangers of baby walkers

Walkers are safer now than they used to be, but the risks outweigh any perceived benefits, says Frias. “Research shows that baby walkers are not developmentally helpful for children as they learn to walk.”

Using baby walkers can calm and entertain a baby while a parent needs their hands free, but it allows babies to move faster than they can on their own— often faster than a parent’s reaction time, she says.

They also give babies a boost to reach hot, heavy or poisonous objects.

“Even though some walkers come with locking wheels that prevent a spill down the stairs, they can fit through a lot of doorways you wouldn’t expect them to,” Frias says. “It’s best not to have them in the house, especially if you have stairs.”

The American Academy of Pediatrics has recommended a ban on the manufacture and sale of baby walkers in the United States. Canada banned the sale, advertising and import of baby walkers in 2004.

Research baby products carefully

Before making a purchase, research the product via the United States Consumer Product Safety Commission, which offers specific product-related information on recalls, research and safety standards.

Used products should be researched the same way, if not more stringently than new products.

Remember to register your products with the manufacturer to ensure that you will be notified in the event of a recall.

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Importance of Stretching for the Young Athlete

By Victor Araiza, physical therapy assistant at CHOC Children’s

Stretching can often take a back seat to your general exercise routine and sport-related activities, but these are an essential part of any conditioning or physical therapy program. Stretching decreases the risk of injury or re-injury and promotes wellness.

Why is stretching so important?

Stretching the right way will help improve flexibility and make it easier for you to move. Stretching properly can increase and improve motion in your joints, increase blood flow, and decrease feelings of stiffness. Other potential benefits of stretching can include reducing delayed onset muscle soreness, increasing athletic performance and reducing the risk of tendon or muscle tears.

It is important to stretch correctly and know which muscle groups you want to stretch. Often, the muscles that tend to be tight are the hamstrings, hip flexors, quadriceps, calves and chest muscles. If proper technique is used when stretching, it will help improve flexibility and increase range of motion. This will increase blood flow and decrease stiffness, in turn decreasing the risk of injury or reinjury.

When to stretch

It is recommended that you perform static stretches after exercising, engaging in strenuous physical activity or participating in an athletic event. Static stretches target specific muscles based on the position you are in with the intent to elongate just past the point of a moderate pulling sensation. The static stretch should be held in the same position for 30-60 seconds and repeated two to three times. For an athlete, it is common to perform a dynamic warm-up prior to sport related activities and static stretches after activities. The American College of Sports Medicine guidelines recommends stretching activities be done at least two days per week. It is also important to know and understand which stretches would benefit you based on your limitations and desired activity participation.

Stretching is encouraged:

  •  When range of motion is limited.
  • Prior to or after vigorous exercises.
  • As a component of your sport-specific conditioning program, team warm-up/cool down and before/after a participation in a sporting event.

When is stretching not encouraged?

  • When someone has excessive movement in their joint(s)
  • An athlete who has experienced a recent fracture
  • After sudden onset of inflammation or swelling
  • When you feel a sharp pain when attempting to stretch

 Tips on how to stretch

It is important to remember that just because you perform stretches doesn’t mean that you will never get injured. Stretching won’t prevent an overuse injury that is predominant in sports that involve the repetition of similar movement patterns. There are other important factors such as strength and endurance training, essential to reducing the risk of injury. Please consult your pediatrician for a referral to physical therapy if you and your child need assistance with an exercise and stretching program.

Learn more about rehabilitation services at CHOC.

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