Keeping Kids Safe – PediaCast 436

Show Notes

Description

  • Our Pediatrics in Plain Language Panel returns as we consider keeping kids safe at home and away. We share important tips aimed at preventing broken bones, burns, choking, drowning, head injuries, poisoning and more. We hope you can join us!

Topics

  • Home Safety
  • Broken Bones
  • Burns
  • Choking
  • Drowning
  • Head Injuries
  • Poisoning

Guests

Links

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 1: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital. We are in Columbus, Ohio. 

It is Episode 436 for July 11th, 2019. We're calling this one "Keeping Kids Safe." I want to welcome all of you to the program.

So we have another Pediatrics in Plain Language edition of the podcast for you this week. This occur about once a quarter. And even though we always try to speak in plain language on PediaCast. Or when we do use medical jargon, we try to catch ourselves and explain what we're talking about, not necessarily dumbing down the science but just using terms, everyday language that the people can understand, whether you have a medical background or not. 

0:01:22

However, I will admit that there are times when I go back and listen to an episode and I cringe because there it is, medical jargon. It's a term that I did not explain and a few minutes later, there rolls another and sometimes, another. 

So we do our best but jargon still slips through. Why? Because it's second nature for doctors. These are words that are part of our vocabulary, And try as we might, they often slip through. We try our best to pay attention and use words everyone can understand but we slip. Usually that happens more often than we think or, certainly, that we would like.

0:02:02

So there you are, as a parent sitting in the exam room, your child's medical provider, or maybe it's an exam room for you, maybe it's your medical provider. Here she is  talking along and there it is, a word, and you have no idea what it means. Or maybe you think you know the meaning but you're not a 100% sure. 

So you're thinking about it and trying to place that word in context of what's being said and you missed the next three sentences of the conversation, which may well be the most important point that your provider is trying to say. 

So if we care about healthcare communications and improving health literacy, we really have to be aware of what we are saying as providers and how we say it. We need to pay attention to how we talk and use language families can understand.

And likewise, for the moms and dads in the crowd, when your medical provider uses a term that you don't understand, stop the conversation, raise a hand, clear your throat, whatever it takes and ask, "Hey, what exactly does that mean? What are you trying to say?" You're not being rude. You're trying to understand.

0:03:09

And that is very important. In fact, that is the entire point of the conversation with your doctor, understanding. I've had to learn to interrupt at times myself. Not in the context of medical conversations, but when I attend meetings in our hospital's marketing and public relations department, which is part of my job as medical director of Digital Health at Nationwide Children's Hospital. 

The marketing and PR folks, they use many words and phrases and abbreviations and acronyms, tons of acronyms that are totally foreign to my ears. Things like CMS, CTA, CTR, smart goals, KPI, ROI, SEO. And this just roll off their tongues during meetings. 

Sometimes, I have to raise my hand and say, "Wait a minute, what are we talking about?" Of course, everybody laughs because they are not medical and I think they enjoy having a language of their own.

But as medical providers, that is not something we should enjoy. We want our patients and our families and our listeners to understand exactly what we are talking about. 

So in this special episodes of PediaCast, we invite our Pediatrics in Plain Language panel to the studio. And we chat about something we hope you will find useful. And we hold each other accountable when we accidentally let medical jargon slip through. 

0:04:27

We try to have a little fun with it. We hope you enjoy listening and learning. We'll get our usual panel settled into the studio, Dr. Mary Ann Abrams and Dr. Alex Rakowsky, both pediatricians here at Nationwide Children's.

Today, we're going to talk about keeping kids safe with tons of home and outdoor safety tips for you and your family. And we'll also introduce a new road map for these episodes and tell you about a survey that you can take online that will help us focus and improve the listener experience, hopefully, of these episodes moving forward. So we'll have more details on our road map and the survey once our guests arrive and join us here on the studio.

First a couple of housekeeping items for you. One, I want to remind you we are on social media. If you connect with PediaCast on Facebook, Twitter or LinkedIn, you can expect to see daily reminders of what we're talking about on the podcast. 

0:05:24

But then also, everyday, we try to share with you just some news from the pediatric and parenting world. Just some articles that we think would be helpful for you as a parent as you're thinking about child health and the health of your family, raising your kids. Things we think would be helpful but are not necessarily on the podcast. 

So, we try to share those things with you and be helpful in your quest to being the best parent on the planet. And you can find those again on Facebook, Twitter and LinkedIn. Just connect with us, search for PediaCast.

Also on Instagram, that's little more personal -- glimpse into the studio and really just what's going in my family life. I think that's sort of fun to share.

This past weekend, my family took a spontaneous road trip to Chicago to catch Hamilton. My daughter, it was her birthday and she and her husband joined us. It was really fun. We took the road trip. We have some pictures. We visited The Bean. If you're from Chicagoland, you know exactly what I'm talking about.

0:06:25

So, anyway lots of fun and going to share that on Instagram. And likewise, if you connect with PediaCast on Instagram, you'll probably notice that we'll try connect back with you. And that's because I'd like to see what the audience is up to as well.

And sharing those moments, sometimes you get an idea from someone else like, "Oh, hey I haven't done that in a while." For instance, you may see a picture of a family hiking and it's like, "Yeah, you know, we haven't been out for a hiking lately. Let's go do that."

So, I think sharing ideas and images and what's going on with our families is fantastic. We do that on Instagram. So, please do consider connecting with us there.

Also, we want to remind you about our contact page at pediacast.org. Just click on the Contact link if you would like to suggest a show topic or you have a question for me. You just want to let us know what's on your mind. We love to share those things.

0:07:17

Also, I want to remind you the information presented in every episode of our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.

So, if you have a concern about your child's health, be sure to call your doctor and arrange a face-to-face interview and hands on physical examination.

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement which you can find at pediacast.org.

So, let's take a quick break and then I will be back with our Pediatrics in Plain Language Panel to talk about keeping kids safe. That's coming up, right after this.

[Music]

0:08:24

Dr. Mike Patrick: Our Pediatrics in Plain Language Panel joins us again this week. You'll recall that Dr. Mary Ann Abrams is an assistant professor of Pediatrics at the Ohio State University College of Medicine and a pediatrician with the Hilltop Primary Care Center at Nationwide Children's Hospital.

And Dr. Alex Rakowsky, also an assistant professor of Pediatrics at the Ohio State and a pediatrician with Olentangy Primary Care Center at Nationwide Children's. Really appreciate both of you joining us again.

Dr. Alex Rakowsky: Hi, Mike.

Dr. Mary Ann Abrams: Great to be here.

Dr. Mike Patrick: Let's get right into what we mean by Pediatrics in Plain Language. So Dr. Abrams, if you want to remind us what this is all about?

Dr. Mary Ann Abrams: Yeah, we've talked about pain language a lot when we do this podcast. And we've named them, dubbed them Pediatrics in Plain Language because we're really trying to focus on specific pediatric issues that are important for the health of children. 

0:09:15

And to describe those, talk about them, and -- we'll talk about something else in a little bit later on this podcast -- invite your involvement to see how to communicate some of these really important health issues and information in a way that what we call living room language. And we try to feature that work in the series of podcast that we called Pediatrics in Plain Language.

Dr. Mike Patrick: I mentioned in the intro to the program that we are kind of starting a new road map, so to speak, for these episodes, which we do about once a quarter. We're going to use a book by the title "What To Do When Your Child Gets Sick". This is a publication from the institute for healthcare advancement, which is a non-profit organization that's really committed to communicating with families using plain language.

0:10:12

So, this book is fantastic. It's written by a couple of pediatric nurses with 20+ years of experience working with kids and families. And they really have a knack for communicating clearly, Drs. Gloria Mayer and Ann Kuklierus who wrote the book. And again, published by the Institute for Healthcare Advancement.

And we're going to put a link to this book in the show notes, both at the IHA website also Amazon, Barnes & Noble. It's available in lots of places. But we can offer a 40% discount code for folks who are purchasing it through the Institute for Healthcare Advancement, that non-profit organization. 

And it's pod719. And again, we'll that link to the book in the show notes as well as the code that you can use to get it for 40% off. It's not a very expensive book. It's like $12 and some odd cents at its base. 

0:11:09

The reason that we wanted to use this as sort of a framework is because it does a nice job of covering a lot of topics that parents are wondering about when they think about their kids being well or being sick. And this really does present the material in a way that parents can understand very easily.

So, we would encourage folks as we go through this podcast on a quarterly basis to think about getting that book if you're interested in learning more. Or to have it as a reference, it's really easy to access.

And then, Dr. Abrams, you mentioned that we're going to have a way for parents to engage with us. Tell us about our Plain Language survey that we have.

Dr. Mary Ann Abrams: Yeah, I want to do that. Can I add just two more little points about the book? The book has been used throughout the country. When they tested the use of it in certain groups, they found that it gives parents the information they need to feel more comfortable when their child is sick.

0:12:11

So, it saved parents trips to the emergency room and parents missing work to take their child in when maybe they don't need to. And it is written at a reading level that it's comfortable for everybody. It's a nice summary. It's laid out nicely.

It's also available in other languages like Spanish, Vietnamese and probably half a dozen others. And they do have some other health topics in the series that people are interested. 

 wanted to just add that and then to let you know that today and Dr. Mike is going to take care of all the important details, but we're finished start having a little feedback survey associated with our Plain Language podcast that give us a chance to learn what you're thinking and about each of the podcast individually and the series as a whole.

0:13:02

So, we're interested in learning what you think. We're interested in learning how you heard about it. We're also interest in what questions people may have or complex terms that maybe they're hearing a lot, whether it's in the news or from their friends or family or from their own healthcare provider. 

And maybe you want more explanations. So, the survey gives you a chance to write in a few complicated topics or words or to post a question that we'll try to answer on an upcoming podcast. I know we did that last time and I don't know if there any questions. But we're hoping that through the survey, that gives people an easy way to reach out to us and ask those questions.

Dr. Mike Patrick: Absolutely. And we really want to make this program the best they can be and relevant for families. So, something that you really can get something out of.

There's a couple of way to access the survey that Dr. Abrams is talking about. One is, if you go to PediaCast.org, there's some tabs at the top of the page and one of those tabs says Survey. And if you click the Survey tab, then a page will open up and has a link to the Pediatrics in Plain Language survey. And we encourage you to take that, give us some feedback on this program. Let us know what it is that you want us to talk about.

0:14:16

And actually, the survey allows you to evaluate any of our Pediatrics in Plain Language episodes that we've done in the past. We'll have in the Show Notes for this episode of link to each of those. So, that if you want to listen to more of these, you can. Then there's the opportunity in the survey to pick which of the episodes you listen to and evaluating that, giving us some feedback. So that we can make these things better.

So, it's all at pediacast.org, look in the show notes for this episode, 436, and then also the tab that says Survey and it'll link you there. We'll remind you at the end of the show, too.

So, let's go ahead and get started. we're talking about keeping kids safe. With it being summer, one of the injuries that we see quite often in our urgent care centers and emergency departments are broken bones. I mean kids get a lot of, so the technical term is a fracture. But this just means a broken bone. 

Dr. Rakowsky, what steps can parents take to prevent broken bones? 

0:15:19

Dr. Alex Rakowsky: Just let me give a little bit of a preface here. So, I grew up in...

Dr. Mary Ann Abrams: A what?

[Sound Effect]

Dr. Alex Rakowsky: A preface. So, introductory comment. So, I actually grew in the Philadelphia area which is Lenape Country. And in our elementary school, we had a big poster when you walk into the school. It said, "Do not let me judge my neighbor until I walk a mile or a day in their moccasins." 

So, I want to mention this often, is that the parent should get down to the level of a child and think like a child when it comes to lot of these preventions. So, you'll hear me bringing that up a lot, that the parent should kind of get into their eyes.

0:16:00

So, for bones and breaks of bones, let's start off with older kids. And one common, we both do urgent care. And one common place to kind of see broken bones is because of a bike injury. So, I had the parents actually go up and down the path, the street, the bike path, etc., their child's going to be using to see there's actually major cracks, major bumps, etc., that could be leading to an accident.

Motorized vehicles, which is another sort of massive cause of injuries.

[Sound Effect]

Dr. Alex Rakowsky: Yeah, I was going to get to that. So, you know, you have to...

Dr. Mike Patrick: Wait, wait, wait, I'm sorry. What was the?

Dr. Mary Ann Abrams: Motorized vehicles.

Dr. Alex Rakowsky: But it's sort of... 

Dr. Mary Ann Abrams: How about planes, trains and automobiles? Sorry, I'm...

Dr. Alex Rakowsky: Yeah, you have your little electronics scooters that we see all over the city this time of the year. You have your ATV, which you don't see in the city but in the suburban areas.

Dr. Mike Patrick: All terrain vehicles.

Dr. Alex Rakowsky: The all terrain vehicles. You have your little scooters and the mini-bikes that you see kids on a summer time. And classic way to break a bone is because the kids all suddenly have something powerful underneath them. And they're not used to riding these things. 

0:17:12

Now, I've actually seen a few kids now in urgent care, they were on one of the Lime or similar company scooter, just going down, hit the sidewalk and off they went flying off. And then, all of a sudden, you have an injury.

So, that's for older kids. So kind of think about what can potentially injure them.

At younger kids, I'll start off with the very young ones first. So, for infants, again looking at from the perspective of a baby. If you have a baby who's actually sitting in the crib, make sure that they can reach over. You'll know their strength by a certain age. And you can see what interests them. So make sure that the crib sort of sides are elevated.

Never leave your child alone on a bed. It's amazing how quickly they can roll over. So, people think they can't roll over till about six months but we see kids at two months start rolling off a bed. Make sure that you're actually just keeping an eye on the child specially during in an area that they can fall down.

0:18:06

Locks on windows. I, unfortunately, saw... When I was a resident, one of the most horrific nights I remember was a child falling from the fourth floor of an apartment building. And just the window was open, very good parents, baby just looked out the window and off he went.

Dr. Mike Patrick: And even the older kids, oftentimes will open those windows. And then if you have an overhang out side of that window, to the child it looks like, "Hey, here's a flat surface. I can go out there and play." And then, they fall off the roof of the porch.

Dr. Alex Rakowsky: And then, as far as slightly older kids, make sure that the doors are locked so they can't run outside and get hit by something. 

And another thing is supermarket carts.

Dr. Mike Patrick: Oh, yeah, supermarket carts are bad. I cringe when I see kids standing in the basket because most of the time, the edge of it comes up right to their waist and their top heavy. And it just takes leaning a little bit too far over and out they go and hit their head. And those are really hard floors too in the supermarket. So, those are definitely a danger.

0:19:09

Dr. Alex Rakowsky: So, again think about what the child is thinking about, what the child is seeing, and try to walk in what they actually get into.

Dr. Mike Patrick: Absolutely. These things going to happen so fast. I mean, you think, "I'm just going to turn my back for a quick second. The babies on the bed or my child standing in the shopping cart." Or even on a sofa or coffee table. And you just run out to grab something, you're going to run right back. The next thing you know, they're falling off. And we can see fractures.

I did series of podcast with Dr. Lara McKenzie from the Nationwide Children's Center for Injury Research and Policy. We did one together on tipovers and falls. So if you want a whole episode on how safe from as you consider tipping over in the high chair, and falling, and trip hazards, and stairs. 

We didn't mention baby walkers. That's another potential place where folks can get into trouble with the fracture. You really don't want to use infant walkers at all, even if you have gates on the stairs.

0:20:12

Dr. Alex Rakowsky: And even put gates on both side of staircase because you can have a child who... People tend to put a gate at the very top because they don't want them falling down the staircase. But you can have a child, you're on the first floor kind of half staircase and then all sudden, fall back down. So, really, have gates on both sides. And Dr. McKenzie, actually, I think mentioned that in that episode.

Dr. Mike Patrick: Exactly. It was PediaCast 361 and I'll put a link to that in the show notes for this episode, 436, over at pediacast.org. 

Let's move from broken bones to burns, that's another thing that we worry about and we certainly see a lot of burns in our urgent cares and emergency department. Dr. Abrams, how can parents prevent those?

Dr. Mary Ann Abrams: So, there's different kinds of burns that people are think about fire. But you have to think about the heat and how the heat causes burns. So, whether it's water or a hot surface or the sun, all those things can cause burns.

0:21:11

And burns, I don't know that people realize how bad burns can be. Obviously, all people been sunburnt and that's annoying. But anything beyond a mild first degree burn can have really serious consequences, whether it's limited ability to move your fingers or permanent scars and life-threatening complications. 

So, a lot of these things may be things that you've heard before. But I just have to encourage you to think them through and how like Dr. Rakowsky just said, "How do they apply to your children? Where are the places where your child may encounter these hazards?" 

And don't forget, it changes as they get older. Kids get bigger before your very eyes. You blink and suddenly they're walking. You blink and they're climbing, and it goes on and on. 

0:22:05

So, fire, an obvious one. Keep things that burn away from the kids. They're curious, they're naturally curious. So matches and lighters and the opportunity to see other people playing or using lighters and matches is interesting to them. So keep those out of reach and out of sight. 

I'm going to come to smoke detectors. So, that's sort of the focus on the fire. I think water doesn't get enough recognition. So, keeping your water heater at no hotter than 120 degrees because that water can be scalding within a few seconds, especially to a young child's very sensitive, delicate skin. 

And don't forget how curious children are. So, if you are cooking, they're going to be interested in what's going on up there. And if there are pot handles sticking over the side of the stove, that's an open invitation to grab those or to pull on it to see what might be in there. And then you can imagine that hot liquid pouring down right on their face, which is devastating.

0:23:16

Other things to think about are, like microwaving drinks, especially baby formula or warming up breastmilk that may have been in the refrigerator. 

Microwaves are notoriously heat unevenly. So, we really recommend never microwaving something you're going to be feeding your baby because it may feel warm when you test it and then when they start to drink it, they could get a really bad burn.

Dr. Mike Patrick: Yes, so heating up bottles not in the microwave, that's not a good way to do it. 

Dr. Mary Ann Abrams: Absolutely.

Dr. Mike Patrick: What are better alternatives?

Dr. Mary Ann Abrams: You can sit it in a pan that has warm water and let warm in there. It won't be as fast and it doesn't need to be really warm. It can be more like room temperature or a little bit cool.

0:24:06

Dr. Mike Patrick: Or even running warm water from the tap over the bottle is another way to heat it up. But test that water with your hand first or your elbow's a little more sensitive.

Dr. Mary Ann Abrams: Yeah. A sensitive part because our fingers are hardened to daily life.

Dr. Alex Rakowsky: Harley.

Dr. Mary Ann Abrams: But anyway, the other thing too is thinking about what if the worst thing happens. Fire or smoke detectors are critical. You hear about that. You read about how people took the batteries out because they were beeping and they were keeping people awake. Make sure that those smoke detectors are working and the batteries are in them and the batteries work

I won't going to details but we recently had an experience where it did all the difference in the world. And I cannot underscore that enough, emphasize that enough.

0:25:01

And then, teach your kids what to do if a smoke detectors goes off or if something happens and fire is happening before them. Where they find smoke, get out. Don't investigate. Don't try to put it out. Get out and call for help.

Dr. Mike Patrick: Yeah. And it's good to had to practice that and sort of have a plan of what you're going to do in the case the smoke detectors go off in the middle of the night. Or you do see a fire, you smell smoke, you see smoke.

And actually, speaking of Dr. Lara McKenzie with our center for Injury Research and Policy, we also did an entire episode on fire safety. And she talked about emergency plans. So if you're interested in hearing more about that, I hope you are, PediaCast Episode 336 was the one where we did the whole thing on fire safety and we'll put a link to that episode in the show notes for this one, 436, over at PediaCast.org. So folks can find this.

Dr. Alex Rakowsky: If I can add two more?

Dr. Mike Patrick: Yeah.

0:26:00

Dr. Alex Rakowsky: Sparklers and 4th of July just passed. The kids use sparklers for a lot of things in the summer time. They're fun but they can actually give you some good burn, especially for younger kids. 

Another one is hot metal where kids will go on a playground in the dead of summer and even here in Ohio where it doesn't get all that hot, but the sun can heat up a metal slide very quickly. And I've seen some burns where kids will go out on slide and then they'll come to an urgent care, to clinic, with burns on the back or burnt hamstrings.

Dr. Mike Patrick: Yeah, absolutely.

Dr. Mary Ann Abrams: And I'm picking up again on what you said, Mike, and what you said earlier, Alex, the practicing. Because you're walking a mile in your child's shoes, they're not going to be thinking like you are if it's start to go smoky, or they were playing with matches and something went bad.

So, what to do if you can't get out? And I think another thing is what to do if you're in a third or higher floor window without another way to get out. Bedroom with only a window and no way out and the hallway is blocked with smoke.

So, fire ladders, yes, they're a little bulky but you can store those and practice using them. Don't make the first time you've find what they look like be an emergency.

0:27:14

Dr. Mike Patrick: In that episode with Dr. McKenzie, we do talk about those as well.

Then, when think about the kitchen often as terms of hot things and keeping your kids away from the stove, when we talk about hot food. But the bathroom, in addition to the water, you may have a curling iron or a hair straightener, these have a different name, right? Is that the right name? Straightener, you know what I'm talking about. Those things that...

Dr. Mary Ann Abrams: Flat iron, a flat iron.

Dr. Mike Patrick: Flat iron, that's was the word that I was looking for. But anything that gets hot that you're going to put on the counter, keep those out of reach of your kids for sure. We do see a lot of burns from those as well, too.

Moving on to choking, this is another hazard around the home. Alex, what's choking? How do we define that? And how can parents prevent it?

0:28:05

Dr. Alex Rakowsky: Choking is having some objects in your airway. So, you swallow and then it got stuck in your airway and now you can't get air pass it. So just to be real basic about it.

Again, starting off with older kids, most kids can swallow fine. But the things that you worry about are not concentrating on the food. 

So, for example, grabbing a hotdog, chewing on a hotdog and go play basketball while also chewing a hotdog. Running around with popcorn, a notorious sort of choker, or running around with other pieces of something which is fairly large and you're not paying attention, you gag on something also and you can choke. 

There are probably thousands of adults who choke every year. So, this isn't just a toddler issue. So, just make that when you're eating especially in the summertime when having a good time, you're outside, you're snacking, just to kind of make sure that the food is still being consumed in a way that people focus on the food.

0:29:08

For little kids, we're really trying to avoid... I actually read something recently. One of the residents kind of run by me is that we don't have our swallowing reflex, gustatory reflex. You forgot the dong here.  

So, but the swallowing reflex doesn't actually...

Dr. Mike Patrick: I would have to raise my hand and say, "What you're talking, what reflex is that?"

Dr. Alex Rakowsky: It's called the gustatory. I think I said that right. That doesn't develop till age seven. So, actually a lot of kids have problems fully swallowing until on age seven.I didn't realize it was that way, but there are some studies that have looked at that. 

So, kids in general have some problem just kind of swallowing quickly. So, again, if they're in a rush, they are not paying attention, they're goofing off, they're goofing off with the dog during a meal, then they can choke.

And then, for little kids, never let a child eat in the backseat by themselves in a car because you don't know what's going on.

Then, avoid objects that are smaller than -- the book actually has it -- almost like a quarter size. So, if you have anything that kind of is larger than a quarter size, they can gag on it. And that can be anything from peanuts to grapes to batteries to little LEGOs. There are things that kids can actually choke on. It is just amazing how quickly they can just gag on something.

0:30:23

Dr. Mike Patrick: Yeah, hotdog slices?

Dr. Alex Rakowsky: Yeah.

Dr. Mike Patrick: Those are better to slice it but then quarter them. So that they're really very small.

Dr. Mary Ann Abrams: They say smaller than the size of a toilet paper tube or paper towel tube, that's another way you could try and see if it fits on that, that a way to see if it's... 

Dr. Alex Rakowsky: But again, it boils down to the fact of just observing, you know. To think like your child. If there is a chaos going around, everybody's running around the pool, may I going to focus on swallowing properly? So, if that's not going to be the case, sit everybody down, make sure they're eating and not goofing off.

0:31:02

Dr. Mike Patrick: There really is kind of that the medium size. So, if you have really tiny bits, like if you slice a hotdog and then quarter it into very small ones, that's going to be safer than something slightly bigger that could potentially lodge in the airway. So, either want something kind of big that they're not going to get tiny bits off of or very small. But there's that medium range or about quarter size or so that's particularly dangerous. Maybe even more, nickel size.

Dr. Mary Ann Abrams: I was going to say don't forget about peanut butter. Something that, "Oh, that's a nice soft thing. I can give that on a spoon to a young child." But if it's a big serving and what is big for a small child? We may underestimate what big is or underestimate.

And if that get stuck in their throat, that's almost impossible to get out. So, don't feed peanut butter on a spoon to a young child. You could spread on bread and have take a little bites but don't just feed it with a spoon.

0:32:09

Dr. Alex Rakowsky: If I can also bring up balloons. Having unfortunately seen... I'm an older guy who have seen probably 10 or 12 kids who actually had to have a tracheotomy done or some kind of...

[Sound Effect]

Dr. Alex Rakowsky: Ooh, I knew you'd get that one. So, actually having like a artificial airway placed because...


Dr. Mike Patrick: In the throat. A hole put in the throat, you've seen it on TV.

Dr. Alex Rakowsky: Yeah. And you'll see it in the ER and urgent care -- and hopefully just ER -- but balloons can really lodge in there. And even the kids who like will take the medical gloves in the clinic and blow them up and then are chewing on them, just gives me...

Dr. Mike Patrick: Yeah, you can easily get a piece in your mouth and those latex balloons and the gloves, maybe not be latex, but it's the rubbery... Like I said it's latex or the plastic ones, you can certainly get pieces off of that and get them in the airway and that can be very deadly.

0:33:03

Dr. Alex Rakowsky: And they're really hard to dislodge, to get out there.

Dr. Mike Patrick: Pieces of pacifiers. So, old pacifiers they get brittle. Sometimes, kids will suck off or bite off a piece of that. They can be really small and they can choke. So, you don want to make sure you'll get a new pacifier every couple of months to avoid that.

Dr. Mary Ann Abrams: And the other thing that came to mind when you were talking, Alex, was don't let ourselves be distracted. I saw a child -- this was several years ago now -- there were some broken glass. So the parent was trying to clean this up. And while they were doing that, they've weren't able keep an eye on the child, the toddler, who being a normal toddler found this kind of bright, shiny thing and put it in his mouth to see what it might be like.

Had horrible, almost life-threatening injuries because that piece of glass got stuck in his airway. And it took multiple surgeries to get it out because it got embedded.

0:34:01

So, not to create horror stories but again, remind us to make sure that the child is safe while you're cleaning up or attending to something seems very important as well.

Dr. Mike Patrick: Absolutely. For when kids are choking, it's going to be good to know what to do. Especially if they have they're not able to move air, they're not breathing. Maybe they turned blue, they passed out. It's going to be good to take a first aid class and a CPR class for parents. So you have some understanding of what you ought to do if a child is choking.

The American Red Cross has parent classes for this very thing all across the country. I'm going to put a link in the show notes for the American Red Cross. The link is actually to find a first aid and CPR class in your area and I'll put a link to that in the Show Notes for this episode 436.

Dr. Alex Rakowsky: If I can also add that the Red Cross will more than happy to come to your event. So, if you actually have a church group, some kind of social group, your softball team, they can come out on this. Not on a spur of a moment, but they can set something off for a small group. I mean, they really do want to teach every parent basic CPR skills or every adult basic CPR skills. I think it's free or very low payment. And it's easy enough to set up.

0:35:27

Dr. Mary Ann Abrams: And if you have teenagers who babysit. Babysitters are another target group to get advantage of those kinds of classes.

Dr. Mike Patrick: They'll teach you things like the Heimlich maneuver and back blows and those kind of things to help if someone is choking. But again, American Red Cross, they're fantastic. And again, link in the show notes for folks.

Let's move on to drowning. So, it's summer, it's really hot and humid out in the Midwest right now. A lot of people wanting to swim in pools. Mary Ann, tell us about drowning and how parents can prevent that?

0:36:01

Dr. Mary Ann Abrams: Well, I think we talked a little bit about drowning once before we went into a lot more detail about water safety and things like that. But, the take-aways, as I was thinking about this and kind of reviewing the chapter in the book that we're referencing today that provides tips for parents, just a couple of key points.

One, it doesn't take a lot of water for at least a young child to drown. So, whether it's the bathtub or a bucket with water like a five-gallon bucket with some water that you're cleaning with, a toilet, any of those kinds of things, a young child or toddler can drown very quickly. They can fall in and can't get back out.

So, constantly being aware and with those kids, not leaving them even for a second. Because everybody thinks, "It'll just be a second," and that's all it takes. Or you get distracted or something happen to you, trip and fall or something. So, a small amount is still a hazard. 

0:37:07

And then you think larger bodies of water like pools and natural waters. So, pools, just because your child knows how to swim, just because they have water wings, all those things are good but they're not a guarantee. 

So, really you need to watch young children in a pool and if they're really young, you want hands-on. And if they're a little bit older, you still want to be close enough to them and watching them and not be involved in conversations with other people or allow yourself to be distracted.

Fencing around pool is so important. There's a lot of good information about how those fences should be set up and how high they are and how the gate should work. And if you really want to be extra careful, you have a gate around the pool and another gate around your yard. 

So that say you come out a patio door, that doesn't go right out to the pool. You still have to go through another gate to get to the pool because children wander out that door.

0:38:09

Dr. Mike Patrick: If you do have a gate, then you want a self-closing, self-latching, so you don't have to remember to do it. It's just going to do it on its own. And if you do have a door that goes directly into a pool area, let's say, there's nothing you can do about it with the design of your house, so you don't have the finances to be able to do it. You definitely want a deadbolt that's out of the reach of young children, something that they cannot unlock and open.

Dr. Mary Ann Abrams: Yeah, because...

Dr. Mike Patrick: Yeah. We only want to think about it, yeah.

Now, there has been research that has come out recently that kids who have swimming lessons, it is somewhat protective. That there's a less chance for drowning if you have had swimming lessons. And so, those are good idea, even starting at age 12 months and older, as long as it's an age-appropriate fashion with folks who know what they're doing. Your local aquatic center or YMCA may be able to help provide those kind of classes. 

0:39:08

Those are really great idea but at the same time then, you don't want trust those. Because even though your child has had swimming lessons, there's plenty of kids who drown every year who had swimming lessons. And so, they do help but at the same time, they're not a substitute for direct supervision at all times for any kid that's in a pool.

Dr. Mary Ann Abrams: Don't let those swimming lessons give you a false sense of security. You're right, there is research that shows that. And it may help them be able to stay above water a little bit longer until you notice that they're struggling. I mean, there's a lot of reasons that it may be helpful but not a 100%.

Dr. Mike Patrick: And then, I will say there is some disparity.

[Sound Effect]

Dr. Mike Patrick: I had to do myself there. There's differences from one group to another. Is that good for disparity? When we look at folks who come from lower economic levels. I mean, there's less family income. There's less opportunity in terms of being able to access swimming lessons. 

0:40:10

And so, in your individual community, that may be something where you can really make a difference in people's lives, in family's lives, if you can figure out a way to maybe provide swimming lessons. Maybe support financially an organization that could provide swimming lessons to low-income people. It's just a way that you could sort of give back to your community and help kids who may not have an opportunity to learn how to swim.

Dr. Alex Rakowsky: One of our residents, for all the program directors listening, got a grant to do just that in a neighborhood around two miles north of here. And she ended up teaching close to 400 kids.

Dr. Mike Patrick: Wow, yeah.

Dr. Mary Ann Abrams: That's great.

Dr. Mike Patrick: And who knows how many lives that could potentially save.

Dr. Alex Rakowsky: Not just her, but the group that she works with, with the grant.

Dr. Mary Ann Abrams: That is really wonderful.

Dr. Alex Rakowsky: Can I also add alcohol in teenagers? Pool parties are common. We can pretend that they don't have alcohol there but it's probably going to happen in some of these parties. And something just to keep an eye on, to have a responsible just watching the whole proceeding.

0:41:09

Dr. Mike Patrick: Great. Great idea. 

And when you're talking about a small amount of standing water especially for the little kids, when you think about water in a bucket, but water in the toilet can actually be an issue. And if you think about a toddler just being the right height, and then they fall head first into the toilet, kids can drown that way, too.

So you want to keep your toilets closed. And you can either keep the bathroom door locked and you can keep a latch on the toilet. Both of those will be helpful.

Dr. Mary Ann Abrams: They can't get out because the way their bodies are built. They're heavier at the top, so their head is sort of stuck down in the bucket or whatever. And they don't have the arm coordination and strength to try to maneuver out. So it's not just, "Goodness, they fell. Why don't they just get back out?" It's really hard. 

Dr. Mike Patrick: Yeah, absolutely. 

While we're on the topic of drowning, this comes up on the podcast pretty much every year, and I've not talked about it yet this year. So I'm going to take this opportunity to make this my 2019 version of the speech.

0:42:09

And that is that you hear about delayed drowning, or secondary drowning, or dry drowning. And drowning is drowning. There are some times where kids can have problems a few hours out, but you're not going to have a kid who has zero symptoms and suddenly, they have a really big problem.

So there would something little to let you know. Like a little persistent cough. Or seem to be clearing their throat after they've had an event in the water. Maybe if they have asthma, they suddenly need to use their inhaler when they hadn't need to use it in the more recent past.

So really pay attention to those clues. And if your child is having any respiratory symptom, even very minor within the first few hours after an event in the water, make sure that someone takes a look and listen to him. 

0:43:02

But on the other hand, don't stay awake worrying at night if your child has zero symptoms and they look great, and especially if it's more than 24 hours after the incident.

Dr. Mary Ann Abrams: The other thing I just want to touch on too is going swimming or playing in the water in what we call a natural body of water, a pond or a lake. Some of those beaches are well-kept and kind of meant for people to go swimming. But you still to keep in mind the fact that the bottom of those are uneven. You can't judge whether there's a sudden dropoff. Sometimes, the water's dirtier or cloudier.

So you may be watching a little one, and it's a little above their knees, and the next step, it's above their head. And then, they go under and the water's murky. That can just be a disaster waiting to happen.

0:44:00

Older kids, too. Some kids, it's hot and they're out playing and it's not that deep. So they go further and further and suddenly, there's a dropoff where they slip. And maybe they don't know how to swim. And if there's not -- vigilant -- lifeguards and others who are really keeping a close eye, they can be...

[Sound Effect]

Dr. Mary Ann Abrams: I caught it before... 

Dr. Mike Patrick: There was the word vigilant. Yeah, yeah, okay.

Dr. Mary Ann Abrams:  But I caught myself. If they're not keeping a close eye, they could be underwater for a long time before anybody realizes they're missing.

Dr. Alex Rakowsky: You speak of the true with Wesner about murky water and uneven bottoms of lakes.

Dr. Mike Patrick: Yeah, yeah. And I think you raised a really good point. Even if there's a dedicated lifeguard, as a parent, you really ought to have your eyes on your kids at all times when they're in water. Because drowning is not a loud event usually. 

Usually, it's a silent event. They slip under the water and they don't come back up. And so, there's not a lot of splashing. There's no yelling, so it's not going to grab your attention unless you're watching.

If you go to a pool with other parents, just assign someone, "Hey, it's your turn to watch the pool," maybe for 10-15 minutes, then it will be someone else's turn. But that means that you're not on your phone. You're not reading a book. Your eyes are on the water. And that can save your kids life when then you can get the lifeguard's attention when they go under, they're not coming back up.

0:45:20

Dr. Alex Rakowsky: So my youngest son is a lifeguard for the last four summers. He's just turned 20. So the pool that he's at is a YMCA pool from the neighborhood we live in. And there are four chairs. And on any given hot day, there'd be over 200 people. So they're looking at 50 people per chair. 

And this is a well-guarded pool. I mean, there's a YMCA, so they actually will spend the money to have additional lifeguards. But he's still saying, "I'm scanning 50 people at any given time."

Dr. Mary Ann Abrams: And they're busy people.

Dr. Mike Patrick: And they're busy, yeah.

Dr. Mary Ann Abrams: They're running, yelling, and jumping.

Dr. Alex Rakowsky: So I mean, from the perspective of the lifeguard, he's like, "I can't see everybody. People jump under water. We have the kids who pretend that they're sea divers and they're underwater for like a minute." He's spending the time to make sure they're coming back out. And the kid next door to them may be drowning, he won't pick it up.

0:46:09

Dr. Mike Patrick: But as a parent, then you can get the lifeguard's attention. 

Dr. Alex Rakowsky: Yeah.

Dr. Mary Ann Abrams: And whenever you go to a pool, whether you're a motel or a hotel or the Y, look around when you get there and look to find where those life preservers, those life rings, and that long pole that you're like, "What's that for?" Know where those are, because it can be hard to jump in and save somebody, especially if they're in the deep water. 

But you can throw that so that they can grab on to it or they can reach it. And you can pull them in while you're getting the lifeguard or other things. But know where those things are. They're there for a reason and they make a difference.

Dr. Mike Patrick: Yeah, absolutely.

I did a show with Dr. Lara McKenzie from Nationwide Children's Center for Injury Research and Policy on water safety. That was Episode 348. We also did one of sun safety, Episode 433. And I'll put links to both of those in the show notes.

0:47:03

The one of sun safety, she talked about do-it-yourself sunscreen. That it's not good to make your own sunscreen at home. But apparently, there are thousands of Pinterest recipes out there. 

And they do have some SPF. The things like grapefruit juice actually have a natural SPF. The problem is you can't get it to stick on the skin. And the commercial products, of course, are much better. And the do-it-yourself stuff's not recommended at all. We go into much more detail about that in Episode 433, which folks can find in the show notes. 

Alex, what about head injuries?

Dr. Alex Rakowsky: So again, starting off the perspective of go through the cycle of what your child's going to see, do, etc. So if your child's going to ride a bike down the street for three blocks, maybe you should walk that sidewalk one morning or one evening just to see how many cracks there are or if there's anything unsafe. 

We have a bike path not far from our house that actually crosses a hospital entrance, a mall entrance, and an entrance to like three restaurants. And it's a bike path. So even though there's a designated bike path, you still have to cross three or five fairly busy places. Again, the assumption is that adults will look, but a lot of kids may not. 

0:48:19

So head injuries do occur. So try to be cognizant or aware of where these things can happen. I got myself. 

And then, to kind of prevent it even further, helmets. I can't underestimate the importance of wearing a helmet. It's not going to save you from a broken bone. It probably not going to save your from a concussion, but it can save you from a major head injury.

So people are like, "I wear helmet, it makes me uncomfortable," or "I wear a helmet, it makes me a little more unbalanced." But the benefit is the fact that if you do have a fall -- and we have all had falls -- it's going to prevent a major head injury compared to not wearing a helmet.

Dr. Mike Patrick: Yeah, you only have one head. Got to protect it. 

Dr. Alex Rakowsky: Yeah, exactly. And the head's pretty well-designed but it you hit it hard enough, especially if you're on a bike on 25 miles an hour and you run it through a tree, there's really going to be a difference between life and death. So helmets cannot be underestimated.

0:49:15

Another thing for head injuries for little kids is to prevent large falls. So again, gates on the staircase, locks on the windows or making sure there's no way to get the window for a smaller child.

If you're at the park, monkey bars where they can actually climb really high and make sure that your child is comfortable going that high and they know what they're doing if they get to that height.

And then, just areas that you're worried about just falling down. You're in the boardwalk, you're some place where you're standing above something, you're looking down and off you go. So again, just being preventative. 

Dr. Mike Patrick: Yeah, absolutely. And then, another thing as we think about head injuries, especially with little babies, they don't even have to hit their head. If their head just shakes very strongly, then that can tear some blood vessels and can cause internal bleeding. And so, that's why we should never shake a baby. 

0:50:14

You can see when, especially colicky babies who just cry, cry, cry, and you can't really seem to do anything to soothe them, especially when it's a pattern and it's established that it's colic and that there's not something else going on, it can be very frustrating as a parent. 

And so, you really do have to give permission to say, "I'm going to lay my baby down in a safe place on their back in the crib alone, and walk away." And certainly, especially if you have a colicky baby, it's going to be important to get appropriate childcare and get away now and then. You have to have some life baby balance. You got to do something else.

Because you can see how a parent could just snap. Because you are just at your wit's end and frustrated. 

0:51:02

Dr. Mary Ann Abrams: And tired.

Dr. Mike Patrick: And tired, yeah. Yeah, and that's how these things happen. But realize that shaking a baby, they don't have to hit their head in order to have a significant brain injury. 

Dr. Alex Rakowsky: Yeah.

Dr. Mike Patrick: Good. So lots of ways to prevent head injuries. Of course, also car seats. 

Dr. Alex Rakowsky: I wasn't going to go into car seats. It's a whole topic. I think we've had one about that. 

Dr. Mike Patrick: Yeah. And your local fire station usually will help if you have any questions about how car seats are, if you're doing it the right way. Sometimes, they even have events at the firehouse where they can inspect car seats and make sure that you're using those appropriately.

Dr. Alex Rakowsky: And actually, most states will have their public safety groups. I think in Ohio, the Department of Motor Vehicles actually has a YouTube video about this is how tall a child can be and here's a reverse car seat and this high to put it in. So there are so many resources now for a parent to use. 

The biggest difference now compared to a few years ago is there really are evidence studies that would show that kids are safer rear facing until they're two years of age.

Dr. Mary Ann Abrams: As long as possible. 

Dr. Mike Patrick: Yeah. It used to be one year, and that's really two years of age, regardless of their height and their weight. At least, age two.

Dr. Mary Ann Abrams: As long as they fit on the seat, I should have said that. In a seat that fits their weight and height. 

0:52:24

Dr. Mike Patrick: And you can look at the numbers for your child to make sure that they're still within the parameters of that particular car seat. But even if their legs fold uncomfortably, they're still safer rear-facing. That's an important thing to remember. 

Dr. Mary Ann Abrams: And don't minimize booster seats. They're still not, I guess, cool, but older kids who are above ground the car seat often are not yet ready for a seatbelt. It doesn't fit them right. So if there is a crash, they're more likely to have that seatbelt cut across their abdomen, their belly, where it could hurt their liver and their spleen. They can bleed severely. 

And if the shoulder belt doesn't fit right, it can hit their neck. So keeping your kids in a booster seat in the backseat until they can really sit comfortably. Comfortably meaning their bottom and back are against the back of the seat. Their knees bend at the front of the seat. They should be using a booster seat. 

0:53:29

Dr. Mike Patrick: Absolutely. Let's move on to poison, poison prevention. What do mean by the term 'poisoning' and how can parents prevent that, Dr. Abrams?

Dr. Mary Ann Abrams: Well, poison sound like something really, really bad. But it's important to know that good things can cause poisoning because too much of any good thing is not good for you.

So a lot of the medicines that we take or our grandparents take or other people, visitors take are fine for the adult if they're taking one or two pills a day. But when it looks like colorful M&Ms or something similar or just interesting to a child, if they take one adult pill, that can be dangerous.

But if they take a handful and they swallow half of them or half of them melt in their mouth before they spit it out because it doesn't taste good, that can cause a bad case of poisoning. 

0:54:29

So one of the things that, when I used to work in the emergency room, I could not believe how often we saw where children who came in doing just that when people were moving. It's such a hazardous time because you're busy and you're packing and you just put things down. And the kids are running around the house. 

So try to think ahead of time. This is sort of a high-risk situation. So put those medicines and the cleaning products and the other things that are really poisonous to drink up and out of sight.
 
0:55:05

And that goes for when people come over. When grandparents come to visit, when you have a party. Purses, always have those put up on a high shelf. 

Don't leave alcohol, leftover drinks sitting out on the tables and say you'll clean them up in the morning because lower kids can come and drink that leftover alcohol. 

Dr. Alex Rakowsky: They'll clean it for you. 

Dr. Mary Ann Abrams: And they'll be sick, very very sick. 

So all of these things that are kind of normal things can be very unhealthy, very dangerous to children. And then, of course, poisons themselves should be kept in locked cabinets that kids can't figure out how to open. 

All medicines should be up and out of sight. Never call them candy or try to call it candy to help your child take a medicine. It's better just to be honest about what it is. 

And then, I think you'll put this on the website. Everybody should have the number for the Poison Control Center. It used to be a lot of different phone numbers, and now there's one central number. And that's 1-800-222-1222. And they will connect with you someone who's relatively close to where you live. 

0:56:19

They will answer your questions. They will tell you whether or not, you need to go to the emergency room. It's an incredibly helpful, knowledgeable, and rare resource. And we're really lucky to have those Poison Control centers.

And don't be afraid to call them. You can call them if your child ate a whole tube of toothpaste and you didn't know if that was safe or not. What would happen? They take calls like that all the time, as well as really bad dangerous calls. 

Dr. Mike Patrick: Yeah. Whenever we see an ingestion, which...

[Sound Effect]

Dr. Mike Patrick: I know, I know, ingestion. When we see kids who have taken a poisonous substance and eaten it, in the emergency department, we always call Poison Control. Even medical professionals call that same phone number and talk to the Poison Center and just make sure that we're doing all the right things and that the families get the right follow-up.

0:57:13

So they're wonderful resource. And the number again, 1-800-222-1222. Everyone should have that in their smart phone. Just have it under, call it Poison Center. In that way, you can find it very easily. And if you still have a stationary home phone, having that near the home phone is a good idea as well because you don't want to waste time looking up the number. 

Although, it's easy to remember. They do have a jingle that's out there. So whenever they say that number, I always hear that jingle in my head, the 1-800-222-1222.

Dr. Alex Rakowsky: Can I make a plea?

Dr. Mike Patrick: Yeah, to not say...

Dr. Alex Rakowsky: No, no, that's a bigger plea. Actually, if the parents or the grandparents, whoever takes care of the child can have a list of the medicines that are in the house. 

A child got into an orange round candy. And the parents brought this  child because they were eating on an orange medicine. And the grandma had no idea what medicines she had at home. There were like 30 of them.

0:58:13

So we're like scouring the databases to find what mom was describing. It ended up being I think it was like Skittle or whatever they're called.

And if you can just have a list, so if a child gets into grandma's medicine or -- let's blame grandpa here -- grandpa's medicine or the visiting uncle's medicine to list and say "This is the potential medicine this child got into." Because we can't magically tell what the child ate. 

Orange was easy. There aren't many orange pills out there. A round white pills, if you do a database search, it was like 2,000. You have no idea. 

So that really is helpful to at least say, "They got into something. This is what I think they got into." So then, you can call Poison Control and make a better decision. 

Dr. Mike Patrick: And we'll at least know what the options are and what the possibilities are.

Dr. Alex Rakowsky: One more sort of thing about in the summertime of poisoning -- pesticides, garden sprays, bee killers, gasoline are all products that kids can get into. And gasoline especially, we've seen kids who will try gasoline because they're toddlers and they're just like oh, sitting there, they're going to cough and they'll just down it.

And that can give you some horrific changes to your lungs and to your airways. So it's important to kind of make sure that if you have those things, put them on a higher shelf and then lock that whatever place that you have them in at night.

0:59:42

Dr. Mary Ann Abrams: And probably, people have heard, don't take it out of one container and put it in another one. A, you want to know if they did get into it, what it actually is, a labeled container that say it's gasoline or antifreeze. And if you pour something out into a milk jug, it looks like where milk comes in. So that's an invitation to try it or taste or have a sip.

So keep it in the original container, keep it up out of sight, and lock it. 

Dr. Mike Patrick: Yeah, all really great points. 

And going along with this team of Dr. Lara McKenzie with our Center for Injury Research and Policy, we did an episode on poison safety as well. That was PediaCast 344. And lots more information about keeping your kids safe around chemicals, in the home, in medications. We'll put a link to that in the show notes as well.

Dr. McKenzie, she was involved in creating a website and an app called Make Safe Happen. And I'll put a link to this in the show notes as well. But this is a fantastic resource for really child proofing your home, whether we're talking about preventing falls and broken bones or burns or head injuries, fire safety, water safety, poison safety. 

It's really one place kind of as you said, Alex, walk around the house and pretending like you're a kid and just seeing what the hazards are and how you can make the home as safe as possible. 

1:01:11

So it's a fantastic resource. Again, it's available as a website, but also a mobile app on iOS and Android. And I'll put a link to their main site where then you can get to the mobile apps and all. Make Safe Happen, we'll put a link to that in the show notes for folks. 

Dr. Mary Ann Abrams: Did you say that... And if you did, I apologize. Did you point out how it's organized according to the ages of the kids?

Dr. Mike Patrick: No, I didn't. But it is. 

Dr. Mary Ann Abrams: That's one of the things that Lara actually talks about. It's not so overwhelming because you can get 20 pages of safety information. But you're child's only a year old. So it allows you to focus on, "What should I do for my one-year-old?" And then, when they're suddenly two, it's like "How can I do that?" And then, different products or different locations in your home. 

Dr. Alex Rakowsky: It does room by room which is really amazing. I've had a few parents use it and they love it. Because you just walk through the house and just work on the app. 

1:02:00

Dr. Mike Patrick: And it's a free app, free to download. Really helpful.

Dr. Mary Ann Abrams: It's nice to tell new parents about it. If you have somebody who's going to be having a baby, nice gift.

Dr. Alex Rakowsky: Sounds like Christmas gift, and they're free. 

[Laughter]

Dr. Mike Patrick: So we've talked about lots of different sorts of injuries that can happen as we're trying to keep our kids safe. 

And I think the next question becomes what happens if "Okay, I've done my best. We're all human, mistakes happen, injuries happen." When an accident does occur, what should folks do, Alex? 

Dr. Alex Rakowsky: And this is a tough one because it really depends on your comfort level and basically your sort of knowledge of what may be a serious injury or not. When in doubt, call 911. 

And I think that's sort of rule number one. If you're uncomfortable of the way the child is breathing, bleeding, the arm looks acting, get him seen. I think that's sort of, a lot of parents, they're like, "When do I get my child seen because they fell?" 

Is it four feet? Is it six feet? Is it ten feet? Is it two feet? If you're uncomfortable, just get him seen. 

1:03:10

And then, it really boils down to any breathing issues or airway issues, should get seen quickly. If it's something more emergent, then 911. The EMSs in this country are very well trained for airway emergencies. 

If you're child actually is acting really out of ordinary. So not so much as loss of consciousness, doesn't have to be that. But they're just not acting their normal selves after an injury or potentially swallowing something, call 911.

Then, a bleed that you just can't stop. Most kids have more blood than you realized and you can get a bloody nose and get the whole shirt covered with blood. If it's not stopping, then it's probably worth getting seen. 

There are plenty of urgent cares in both our area and nationwide. They can see it pretty quickly.

1:04:01

Dr. Mike Patrick: In your area, if there's an urgent care that is dedicated to seeing kids, they're obviously going to be more expertise available among the providers and the staff at that location wherever your are. 

And then, your  primary care doctor is really a great resource. If you're just not sure, is this something that can wait till tomorrow? Is there some home first aid that I can do? Shall we go to an urgent care? Do we need to go to emergency department, or do we call 911?

Of course, if you think, you might call 911, just call 911. But if there's question about the other ones, give your regular doctor a phone call and they can help kind of let you know where it is that you ought to go. I almost said triage, Mary Ann. But they can help you figure out the best place for your particular injury.

And it's also a good idea to bring this up at your office visit when there's not an injury. So just when you're in for a well check up, just say, "Hey, if my child were to be injured, where should I take him? Where should I go?" Because your doctor will know what is available in your community and what are the best resources in your area.

1:05:05

Dr. Mary Ann Abrams: I'd also like to just point out. What we've been talking about today is kind of base on the first chapter of the What To Do book. But Chapter 11 actually has some good answers to the question that we're talking about right now. 

Chapter 11's called What To Do When Your Child Gets Hurt. So all these different things we've talked about, if you've heard about it and you want to learn more, you might check out that chapter as well as other useful resources. 

Dr. Mike Patrick: The book you're talking about  is What To Do When Your Child Gets Sick. We'll put a link to that book in the show notes for this episode, 436, over at pediacast.org, including that 40% discount code. So folks can access that from the non-profit organization Institute for Healthcare Advancement. It's really a fantastic book.

Then, also remind us about the Pediatrics in Plain Language survey.

Dr. Mary Ann Abrams: So just a reminder, we really welcome and look forward to hearing your opinions and ideas. So the survey link will be in the podcast materials. And take a couple of minutes, it's not too long and we tried to make it pretty easy to go through. 

But we want to know what you think. We want to know what questions you have and what we can do to help answer those questions. 

1:06:25

Dr. Mike Patrick: And folks can find that very easily. Just head to pediacast.org. Up at the top, you'll see a tab that says Survey. Click on that and there'll be a link to the survey that we're talking about. We just want to try to make these episodes the best that they can be. And we really would value your feedback in terms of what works, what doesn't work, what you want to hear about in the future. 

Lots of links in the show notes this week. So again, that book, the survey, American Red Cross so you can find first aid and CPR classes, the National Poison Center hotline number. All of our past Pediatrics in Plain Language episodes, we'll have links to those.

And then, all of those safety podcasts, fire safety, poison, safety, water safety, tipovers and falls, sun safety all of those episodes, we'll put links to those in the show notes too just to give you a ton of resources. 

1:07:16

So Dr. Mary Ann Abrams and Dr. Alex Rakowsky, both with Primary Care Pediatrics here at Nationwide Children's Hospital, thanks once again for joining us. 

Dr. Alex Rakowsky: I'd do one shoutout. So this month is the 50th anniversary of the first moon landing. So as proud Ohioans, Neil Armstrong was actually from Ohio. This is a good opportunity to take your kids outside and look at the moon. There's actually somebody walking around that thing 50 years ago.

Dr. Mike Patrick: Then, go to the library and find an age-appropriate book about the space program and the moon landing. And yeah, that's a fantastic idea. 

[Music] 

1:08:23

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that.

Also, thanks to our guests, Dr. Mary Ann Abrams and Dr. Alex Rakowsky, our Pediatrics in Plain Language Panel. They are both general pediatricians here at Nationwide Children's.

Don't forget, you can find us in all sorts of places. We are in the Apple Podcast app, iTunes, Google Play, Google Podcasts, iHeart Radio, Spotify, most mobile podcasting apps, and also SoundCloud.

SoundCloud, you'll find some special playlists including all of our past Pediatrics in Plain Language Panel episodes. So if you enjoy listening to these, you'll find all of the past ones packaged up into a convenient playlist. Again, that's over at SoundCloud. 

1:09:09

We also have our landing site at pediacast.org. You will find our entire collection of past programs there, all 436 of them, as well as show notes for each of those episodes, written transcripts for many of them, our Terms of Use Agreement, and then that Contact page if you would like to ask a question or suggest a topic of your own. 

We also appreciate it when you write reviews of the program. It's always really helpful for other parents who come along and are trying to decide, "Hey, is this worth a listen or not?" It's really, really good to hear what other parents have to say and thinking what their experience has been, 

So we really do appreciate it if you just take a couple of minutes out of your day and write a quick review for PediaCast, wherever you listen to your podcast.

We're also on social media and love to connect with you on Facebook, Twitter, LinkedIn, and Instagram. Just search for PediaCast. 

Then, always really appreciate it when you tell others about the program the old-fashion way, in a face-to-face conversation. Please do let your family, friends, neighbors, co-workers, baby sitters, daycare providers, anybody who has kids or takes care of children.

Of course, that includes your child's pediatric healthcare provider. Please do let them know about the program so they can share it with their other families.

1:10:20

And while you have their ear, please tell them we have a podcast for them as well. It's called PediaCast CME. That stands for Continuing Medical Education. It is similar to this program. We turn up the science a couple notches and offer free Category 1 Continuing Medical Education Credit for those who listen. 

By the way, not so much on the plain language side on those podcasts. A lot of medical jargon gets through. But our target audience in that case are pediatric providers, so these are terms that they should know. 

Shows and details for that program are available at the landing site, pediacastcme.org. Those are also in Apple Podcast, iTunes, Google Play, iHeartRadio, Spotify and most mobile podcast apps. Simply by searching for PediaCast CME.

1:11:07

Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.

[Music]

Announcer 1: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

One thought on “Keeping Kids Safe – PediaCast 436

  1. You mention getting car seats inspected at local fire stations. Also, most AAA stores will install or inspect car seats with certified technicians. You just have to call and schedule an appointment. That way, you don’t need to wait for a local event.

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