Halloween 2010: Make It a Treat This Year

Close your eyes…think about your favorite childhood Halloween memory? What made halloween-kidsit special?? Was it the year you got the costume you really wanted?? Or maybe the year you got so much candy you had a belly-ache all week, but it didn’t matter?? Think back for a minute. Parents who joined in trick-or-treating came to calm our fears…not their own. Halloween was a kid’s holiday – pure and simple. So when did scary go from what your child was going to wear to fear for their safety?? Can we give them back a kid’s Halloween?

Truth be told, times have changed, but we have too. Parents today have access to so much more information than our own parents did…it’s what we do with it that makes the difference. I propose the following: I’m going to share with you the top safety tips from some of the best sources I know (…my thanks to the American Academy of Pediatrics, the National Center for Missing and Exploited Children and Dr Kristie McNealy)……and in return I’m going to ask the following:

Take 10 minutes – read through the list – highlight the top 4 or 5 tips that most apply to you and your child – and then give yourself a break and toss the rest. We can drive ourselves crazy trying to anticipate every “bad thing” that could possibly happen or we can be smart, prepared and hopefully a little more relaxed…and maybe, just maybe we can give our kids a little glimpse of the Halloween we loved.

Trick-or-Treat…Safely (AAP)

  • Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
  • Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
  • Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes. For the littlest trick-or-treaters, you may want to avoid masks and hats altogether. (Pediatric Safety note: Please keep in mind that studies have found that many face paints have lead and other toxic ingredients, so research any face paints carefully before applying http://ow.ly/xldL )
  • When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
  • If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
  • Obtain flashlights with fresh batteries (or glow-sticks) for all children and their escorts.
  • Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.
  • Feed your kids a meal or small snack before they head out so they’ll be less tempted to sample candy along the way before you’ve had the chance to check it out.
  • Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items. Also, remind kids not to eat or drink anything that is given to them until you look it over. This includes any potions or weird substances that might be part of a haunted house or Halloween decorations. Make sure kids know that even though things may look like food, they might not be.

Don’t Let Food Allergies Spoil the Fun (Dr McNealy)

  • Review the Rules – If they are old enough to understand, remind your child which foods are safe, and which are not. If there are candies or treats that they should be sure to avoid, discuss that. Tell them to bring their loot to you, so you can be sure to remove anything that might be harmful. Also let them know what to do if they do eat something that they might be allergic too.
  • Read Labels: When you check over your kid’s Halloween candy, remember to read labels. Formulations change pretty frequently, so you should even check foods that have been safe in the past. Remove anything that doesn’t have an ingredient list.
  • Keep Your Epi-Pen or Allergy Medication Handy: Remember that accidents happen, and be prepared as usual with your child’s epi-pen, or whatever medication your doctor recommends for an allergic reaction.
  • Keep Safe Treats on Hand: Keep some safe candy, treats or small toys on hand to replace anything you have to confiscate. If you have the chance, you can even make up a few treat bags to drop with friends or neighbors, so you’ll know that at least a few people on your trick-or-treat route will have surprises that your child can keep and enjoy.

And Unfortunately Because There Could Be Predators Out There… (NCMEC)

  • Plan a trick-or-treating route in familiar neighborhoods with well-lit streets. Avoid unfamiliar neighborhoods, streets that are isolated, or homes that are poorly lit inside or outside.
  • Never send young children out alone. They should always be accompanied by a parent or another trusted adult. Older children should always travel in groups.
  • Always walk younger children to the door to receive treats and don’t let children enter a home unless you are with them.
  • Be sure children do not approach any vehicle, occupied or not, unless you are with them.
  • Teach children to say “NO!” or “this is not my mother/father” in a loud voice if someone tries to get them to go somewhere, accept anything other than a treat, or leave with them. And teach them that they should make every effort to get away by kicking, screaming and resisting.
  • Remind children to remain alert and report suspicious incidents to parents and/or law enforcement.

Remember – you have 10 minutes with this list…and then move on – smart, prepared and relaxed. Make Halloween 2010 the year you all get a treat!



  1. Dress Safely on Halloween: American Academy of Pediatrics, October 2008
  2. Trick-or-Treat Food Allergy Safety: Dr Kristie McNealy October 26, 2009
  3. Ten Things Parents Can Do To Make Halloween Safer: National Center for Missing and Exploited Kids, October 2010

PMD 1997-98 – Let the “Giant Sucking Sound” Begin

It’s a rainy day here in Atlanta and I’m sitting here thinking back on everything that’s happened from the day my sister The PedREST storyasked me to help her make her “little idea” a reality. Just about a year had passed since we started our journey and it was becoming painfully obvious that there was no way Suzanne and I were going to be able to bring this product to market on our own… The reality was that we were going to have to file some sort of patent application and neither of us had a clue as to where to begin. We would also need better drawings than the concept sketches Suzanne had created so off I went looking for a patent attorney and some engineers.

The patent attorney was not terribly hard to find…although little did I know that he was to be the first in a LONG LINE of patent attorneys we would eventually work our way through…(sorry…I mean work with). By the way – if I ever meet you and you hear this very faint “sucking sound” over my shoulder…that’s the sound of attorney and patent office fees sucking money out of your bank account …and I hate to tell you this, but once that sound starts it doesn’t EVER go away. On a positive note, you do get better at blocking it out…kind of like what happens when you live a few miles from a train track. But my apologies, I’m off topic…

So we needed a patent attorney (no way was I going to even try and file this on my own) and after speaking with a number of friends we were given several recommendations. I won’t bore you with the whole process we went through, but in case you ever find yourself in a similar situation, here are some of the questions we used in our evaluation:

  1. Does your firm handle medical devices?
  2. NDA’s: what’s needed and for whom (mechanical engineers? industry experts?)
  3. Volume of patents submitted last year and would any of those clients be willing to be references?
  4. Costs we can expect (“hourly rate” or by “# of claims” or by “total project”)?
  5. Overview of process : schedule and fees
  6. Patent research / searches: what needs to be done before / during filing?
  7. Path forward/options: a) Make/Sell Product; b) Make/Sell Prototype; c) License Patent
    • Probability of success for each
    • Expected costs
    • Timeline
    • Role of attorney in each of these options (if any)

I was also given some great “tips” from a friend whose brother was a trial attorney.
  • “There’s a lawyer’s address book sort of – called the Martin Hubbell Directory. All law libraries have them as well as some city libraries. It will tell where a lawyer went to school and background info. A lawyer may be unimpressive in school but ELECTED to a position (i.e. president of the national trial lawyers association) by his/her peers. If the lawyers themselves elect someone that’s impressive”
  • “Also check with their insurance company for how long they’ve been insured and how many times they’ve been sued and by whom. The court cases for lawsuits are on public record and you can read them at the court house…if they’ve made lots of stupid mistakes that got their cases thrown out of court, well then look elsewhere.”

In the end we chose an attorney from NYC that passed our due diligence with flying colors. It was from him that we learned some valuable lessons…

First – here’s what a “typical” patent process should look like.

  • Begin with patent search for “prior art” to see if a patent is even worth pursuing). The search is based first on appearance of item and then claims and takes approximately a couple of weeks
  • Choose materials you ultimately expect to use
  • Establish the company / incorporate
  • Contract with a patent draftsman You should end up with 2-3 sheets of drawings in approximately 1-2 weeks
  • The patent application is drafted and submitted: …After 10 days you should be granted “Pending” status; it will take approximately 18 months – 2 years to Issue
  • Create a business plan and begin “selling” to potential investors

Second – given the lack of regulation in the back of an ambulance, our device could likely be considered a “useful article of manufacturing” rather than a medical device…which could potentially save us years and hundreds of thousands of dollars in government approvals.

Finally – the process would cost approximately $6k for the initial filing with the assumption that 2 amendments would have to be filed at a total additional estimate of approximately $1.7k.

15 years, 2 US patents, 2 International patents (…and 2 others pending), a possible lawsuit and somewhere around $200,000 later, I have learned a valuable lesson:

When it comes to patents and lawyers – the word “approximately” has numerous definitions…the word “naïve” however is now perfectly clear.

Until next time…thanks for listening…

Seasonal Flu and Swine Flu Fundamentals

To keep your family healthy and safe this flu season, it’s important to know all you can about the two types of influenza circulating. Seasonal flu and H1N1 (swine flu) share some important similarities, but they also differ in critical ways. Here are the flu fundamentals on everything from symptoms to prevention.

Seasonal and Swine Flu Differences

Who’s at risk: Seasonal flu and swine the joys of the flu2flu appear to infect different populations. For seasonal flu, the elderly are the most likely to contract the virus and to develop complications. For swine flu, children and young adults are at highest risk. “While older adults can get H1N1, it is infecting those 25 and younger at a much higher rate,” explains Dr. Aaron Milstone, an infectious disease specialist at Johns Hopkins Children’s Center in Baltimore.

Vaccines: Because swine flu and seasonal flu are different illnesses, they involve two separate flu vaccines. That means there is one vaccine to protect against seasonal flu and a second to prevent H1N1. Both vaccines can be delivered by either nasal spray or injection.

Seasonal and Swine Flu Similarities

Symptoms: Both viruses usually trigger fever, cough, runny nose or congestion, and body aches. “The viruses are very similar in terms of the symptoms they cause,” says Dr. Matthew Davis, associate professor of pediatrics and internal medicine at the Child Health Evaluation and Research Unit of the University of Michigan Medical School.

Red-flag warnings: Most people with swine flu and seasonal flu get a mild illness that might make them feel miserable for a few days but isn’t life-threatening. But with both types of flu, it’s important to watch for red-flag warning signs that suggest a person is developing severe complications.

  • In children, look for fast breathing or breathing difficulty. Also, act fast if skin appears bluish or the child has a fever with a rash. Failure to wake up or interact, and extreme irritability, are also warning signs. In addition, symptoms that improve but then return with fever and a worse cough need immediate attention.
  • In adults, red flags include breathing difficulty, pain or pressure in the chest or abdomen, sudden dizziness, confusion, or severe or persistent vomiting.

Prevention: Both viruses are transmitted through tiny amounts of mucus released when you talk, sneeze or cough, explains Dr. Robert W. Frenck Jr., professor of pediatrics in the division of infectious diseases at Cincinnati Children’s Hospital Medical Center. You can prevent the spread of both flu viruses by developing these healthy habits:

  • Wash your hands. Several times a day, wash your hands with soap and water, especially before eating. If you don’t have sink access, use an alcohol-based hand sanitizer.
  • Cover your cough. If you feel the urge to cough or sneeze, cover your mouth with a tissue and then throw the tissue away. If you don’t have a tissue handy, cough into your elbow.
  • Stay home. If you get sick, plan on staying home for four days, or until the fever has been gone for 24 hours without the aid of fever-reducing medication.
  • Get vaccinated. “Vaccination is the best way to prevent influenza, whether it’s seasonal flu or H1N1,” says Dr. Davis. To find H1N1 and seasonal flu vaccination clinics near you, contact your local or state health department.


Pediatric Safety Editor’s Notes

  • With regards to vaccinations for the 2010-2011 flu season, the CDC states that “Each year, the seasonal influenza vaccine contains three influenza viruses – one influenza A (H3N2) virus, one influenza A (H1N1) virus, and one influenza B virus. The 2009 H1N1 influenza virus strain is included in the 2010-2011 seasonal flu vaccine because scientists continue to see this virus strain circulate in the U.S.” UPDATE: The H1N1 vaccine was included in the 2010-2011 seasonal flu shot

Life Lessons Are the Same No Matter Where You Are…

Greetings from the Emerald Isle. I am typing this from my hotel in beautiful Tullamore in Ireland. The legendary green of the countryside is truly deserved. From almost the beginning of my time here I have realized how connected we are the world over. For example when I arrived I Greetings from Ireland2decided to go for a walk around this quaint village type town. On the street I saw a sign; it looked homemade, offering “Breast Checks Here”. Being somewhat slow it took me to the next day to realize that this was not a ruse by some college frat boys. Lesson 1 it was breast cancer awareness month here- just like in the US and it was a legitimate offer for free screening. The lesson is that we are concerned for our wives, mothers and daughters on both sides of the pond. The message- ladies get checked- please.

My host took me home one night to meet his wife and children but I am getting ahead of myself. We were to take a side trip one day to England but we did not make it. The airline was grossly overbooked. So each non European Union citizen (that includes Americans) were pulled out of line and told we had to go through a separate security screening. We missed out flight but the airline got to keep our money. The passport control officers all told us it was a money making trick by this one airline. Lesson 2– sometimes the answer is no and it is no for all the wrong reasons. As parents we need to help teach this is a reality of life.

My host has, in my mind; a serious flaw- speed limits and safe driving have no meaning to him. We darted through some of the narrowest roads at speeds I could never have imagined. It was his manner of driving and in part the way he dealt with stress- driving was his release. One night he met me with his son before going to a concert (Christy Moore a famous Irish folk singer). As we headed to the show I was amazed…with his son in the car he slowed down and was a safe and cautious driver. I jokingly asked his son about Daddy’s driving. His response was sometimes he’s not allowed to tell Mum. Lesson 3– different standards rarely work. The real lesson is that as devastating as it would be to us to lose a child- especially due to our own driving- it would be equally devastating to the child to lose a parent. The real, real lesson is that above all else our children need us to be there for them and with them.

So as I said my host took me to his home to meet his wife and other children. Greetings were exchanged all around. I was informed that his five year old daughter had been allowed to stay up late- she had never seen an American before. Lesson 4– we are all curious about each other and when done right and taught at an early age- when we teach about each other we achieve peace. So Dad asked his daughter, So what do you think, doesn’t he look just like us?” She enthusiastically nodded her head but in a small, soft voice proclaimed, “but he talks funny.”

Epilogue- one night over a pint, as they call it, I decided to relay my concerns to my friend. Another of his friends was with us and he wholeheartedly agreed there was a problem. I know my host and friend listened. Whether there will be any change only time will tell. Lesson 5 is to observe and take action, or as they say in the post 911 days, ‘if you see something, say something’. These are basic tenets of safety and leadership- whether in the workplace or at home.

From Ireland- Jim, out.

New Campaign on Crib Safety for New and Expecting Parents

We all know that new parents cannot leave a hospital with a newborn baby unless they have a safe car seat. As of this week, the U.S. Consumer Product Safety Commission (CPSC), Sleep safethe American Academy of Pediatrics (AAP), Keeping Babies Safe (KBS) and NewYork-Presbyterian/Morgan Stanley Children’s Hospital are collaborating to educate new and expectant parents and caregivers on crib safety before they leave the hospital or after when they are visiting their pediatrician’s office. A new video called “Safe Sleep for Babies” demonstrates how to avoid suffocation, strangulation and entrapment in cribs, bassinets and play yards.

According to the CPSC press release: “This education effort is part of CPSC’s Safe Sleep Initiative, a multi-pronged effort aimed at reducing deaths and injuries associated with unsafe sleep environments. In addition to this education effort, CPSC’s Safe Sleep Initiative includes the development of new crib standards, warnings about drop-side cribs, sleep positioners, and infant slings, and the recall of millions of cribs in the past five years.”

In order to create a safe sleep environment for your baby, the video urges parents and caregivers to follow these crib safety tips below:

  • Place infants to sleep on their backs
  • Use a firm, tight-fitting mattress
  • Never use extra padding, blankets or pillows under baby
  • Remove pillows or thick comforters
  • Do not use positioning devices – they are not necessary and can be deadly
  • Regularly check cribs for loose, missing or broken parts or slats
  • Do not try to fix a broken crib
  • Place cribs or playpens away from windows and window covering cords to avoid fall and strangulation hazards
  • Place baby monitor cords away from cribs or playpens to avoid strangulation

The “safe sleep” video will be distributed to hospitals nationwide and can also be viewed online.

For additional information on drop-side crib recalls, please go to www.cpsc.gov

PMD 1996 or “…of course I can find data…I’m a consultant…”

Gather data??? No problem…that’s what I do…and I’m pretty good at it. …or at least I thought I was. But I didn’t really know the EMS market – especially for a pediatric product…and I was soon to find out no one else did either.

I started with what I thought was a pretty good list of some very basic questions:

I. General Market Insights:The PedREST story2

  1. Overview of stretcher market
    • Key players / competitors
    • Listing of stretcher models
      • Which stretchers are unique (independently manufactured)
      • Which are market leaders
    • Market share
    • Distribution channels
      • % VARS / Direct / Wholesale
      • Means of communication (Internet, catalogue, sales personnel, etc.)
  2. Overview of US emergency medical transport (e.g. ambulance) market
    • Ambulance company data:
      • company size (public, private & govt.) by region (if available)
        • # small (<20 ambulances)
        • # medium (21-50 ambulances)
        • # large 50+
        • how has this changed over past 5 years
      • average number of sites per company (small/medium/large)
      • average number of ambulances per site (small/medium/large)
    • Purchases (last 5 years) ambulances and stretchers

II. Pediatric “Emergencies” (1994+)

  1. Infant/pediatric ambulance (ground and air) transports
    • age distribution
    • geographic distribution (if significant)
  2. Volume of infant/pediatric transports as % of total transports conducted by various services
  3. Breakdown of call “codes” (as initially called/diagnosed)
    • % code 3: stable transport
    • % code 2: unstable or potentially unstable – not usually life threatening
    • % code 1: medical emergency – life threatening
    • Frequency of code escalation (eg. How often code 3 or 2 becomes code 1)
  4. % of infant/pediatric transports requiring “medication” administration en-route

Truth be told there were more questions on my list, but you get the idea. It seemed like this would be a good place to start. So armed with my questionnaire I started my research. Unfortunately at this point the internet was still in its infancy. While today you could type in “ambulance crash child transport” and get tens of thousands of references, back then the results barely registered.

My luck didn’t get any better by phone…I tried the American Ambulance Association and was referred to a nurse at the Walter Reed Hospital who referred me to an editor at JEMS magazine (an EMS trade publication) who referred me …and referred me…and so on. The list was endless…and no matter who I contacted no-one had the information I was looking for. What amazed me was the difficulty I was having even finding “the basics” – i.e. the number of ambulances in the US…and the number of crashes they had – forget trying to locate anything pediatric specific.

It wasn’t that the people I encountered weren’t helpful. The basic fact was the information was not available because it wasn’t being gathered. No-one was tracking the number of ambulance crashes taking place in the US primarily because no-one was reporting them. And why would they??? The only crashes required to be reported were the ones that resulted in a fatality. It would not in fact be until late 1999, with the creation of an internet site called EMS Network News that we would finally see how “big of a deal” the issue of ambulance crashes truly was. In the meantime, I was beyond frustrated – feeling like I had failed before I’d even begun. Still I had made a promise that I wasn’t quite willing to let go of… so I made a decision – a leap of faith so to speak, that this was (or would be) something that really mattered once people finally knew about it. I hoped for the best …and jumped. …thanks for listening…