Preventing a Medication Mix-Up

With the number of prescriptions that are handwritten and dispensed by pharmacies across the country each year, it should be no surprise that errors can occur. Even with the most careful doctor writing legibly and pharmacists double checking dosages, when humans are involved no amount of carefulness is error proof.

Recently my 10 month old daughter was given a prescription from the local pharmacy with an incorrect label, instructing us to give her 5 times the amount of medication that was prescribed by her doctor. The doctor had written the prescription for 3 cc (cubic centimeters) three times per day, but the label instructed us to give her 3 teaspoons three times per day. To make matters worse, the technician at the drive-up window reiterated the incorrect instructions to my husband and showed him how to draw up the medication using a 5 ml syringe.

Fortunately, when my husband came home from the pharmacy and told me the instructions he was given I immediately knew what he was telling me was wrong. I grabbed the bottle to prove to him that he had misheard the instructions, but to my surprise, the instructions he was giving me were written clearly on the label.

When it comes to medications, errors will happen. It’s your job as a parent or caregiver to be sure that the errors don’t make it in your front door. While it’s great to have confidence in doctors and pharmacies, confidence isn’t a substitute for being an educated parent or caregiver.

When it comes to kids and medication, always follow these three rules:

• Listen to the instructions of the prescribing doctor and repeat back to the doctor the medication name and dosing instructions. If your doctor seems rushed or if you’re preoccupied with the kids, ask the doctor to slow down or to write the instructions out for you.
• Look at the label. Be sure it’s yours and confirm that the label matches the instructions the prescribing doctor gave you. Always check your prescriptions before leaving the store.
• Ask for clarification. Speak up if things don’t make sense and take advantage of the pharmacist consult that most pharmacies offer. Be sure to speak to the pharmacist, not the technician if you do have questions. If you are given a syringe to administer medication and the units on it don’t match the units on your label, ask for a different measuring tool or for the conversion.

Keep Your Kids Safe in Sports

Of the more than 38 million American kids who play sports, less than 10 percent get seriously injured during practice or a game. But that figure is steadily rising as more kids compete year-round in numerous sports activities.

Growing bones can’t handle the physical demands of so much training and playing. And if damage to bones, muscles and tendons doesn’t have a chance to fully heal, it leads to overuse injuries, according to the American Academy of Pediatrics.

The most dangerous sport is football, which sends 1 million kids under the age of 18 to hospitals, emergency rooms and doctors’ offices, according to the Consumer Product Safety Commission. Soccer is next (with 370,000 visits), and cheerleading (with 75,000 injuries) is the leading cause of serious injury to girls.

To protect your kids from serious sports injuries, prevention is key. Make sure they consistently use proper gear, do warm-up and cool-down exercises, and use facilities that are well-maintained. Check that their coaches are trained in first aid and CPR, or that there is a certified athletic trainer on site to provide immediate care that will put your kids back in the game – without further injury.

But if an accident does occur, be prepared. Here’s how to spot and treat the most common injuries in kids’ sports:

Sprains and Strains

• What they are: Sprains occur when ligaments, the tissue that connects two or more bones, are stretched or torn. Ankle sprains are the most common sports injury, according to the National Institutes of Health. Strains occur when muscles or tendons are stretched or torn.
• What they look like: Symptoms include pain, swelling, bruising and difficulty moving the joint. Strains may also cause muscle spasms.
• What to do: Give them rest, ice, compression and elevation. That usually works for mild injuries, but more serious ones may require surgery, according to the Mayo Clinic. See a doctor if your child can’t walk more than four steps without feeling a lot of pain or numbness, or if he has redness or streaks coming out from the injured site.

Growth Plate Injuries

• What they are: Growth plates are areas of developing tissue at the end of the long bones (hands, forearms, upper and lower legs, and feet). Eventually the plates are replaced by solid bone, but in the meantime, they are particularly vulnerable to injury.
• What to do: See an orthopedic surgeon immediately.

Repetitive Motion Injuries

• What they are: Injuries caused by the overuse of muscles and tendons, such as stress fractures (tiny cracks in the bone) and tendinitis (the inflammation of a tendon).
• What they look like: You can’t always see these injuries on X-rays, but they cause a lot of pain and discomfort. Tendinitis causes tenderness, swelling and a dull ache. Stress fractures cause pain and swelling that increases with activity, and tenderness in a specific spot.
• What to do: Rest the injured area, apply ice or compression, and elevate it. See a doctor if the pain persists even at rest; your child may need crutches, an immobilizing cast, physical therapy or even surgery.

Are Used Bike Helmets Safe to Buy for Kids?

It’s important to insist that your kids wear bike helmets. Research shows that wearing one while riding reduces a child’s risk of brain injury by 88 percent. But, the truth is, it’s best to buy a bike helmet new. It could have been damaged in a crash — even if you don’t see cracks — and might not be able to withstand another one. When purchasing a helmet, look for the CPSC seal, which means it meets the standards of the Consumer Product Safety Commission.

The helmet should sit flat on top of your child’s head and be snug enough so that it doesn’t slide down over the eyes when pushed or pulled. The chin strap should be snug. Many kids wear their helmets loose and tipped back, exposing their foreheads. But this doubles their chances of suffering a serious head injury.

Never buy a helmet that’s too big so that your child can “grow into it.” It might not protect him in an accident.

For a guide to exactly how a bike helmet should fit your child, download these instructions on fitting your bike helmet from the NHTSA (National Highway Traffic Safety Administration.

Arts & Crafts and Poison Control: How to Keep Kids Safe

Did you ever notice how delicious some of those colored markers smell? Ever tempted to taste one? Ok, admit it…you’d never do it, but still you can’t say you haven’t at least thought about it. So, can we blame the 4 year old who thinks that the blueberry marker might just taste as good as it smells?

Unfortunately we sometimes forget that those pretty colored paints and crayons and markers look and smell so good because they’re made up of chemicals that are designed to make them look and smell good. And because little kids are attracted to bright, colorful things, and love to touch and taste (who doesn’t), we need to be extra cautious to make sure that glues, paints, crayons and other arts and crafts supplies are handled with care.

According to the Minnesota Poison Control: In a single year, the nation’s 57 poison control centers received more than 35,000 calls about exposures to art products; of these, more than 26,000 calls concerned children younger than 6. And the Virginia Poison Center highlights this list of art supplies to keep an eye on:

• Chalk contains calcium, and swallowing some typically does not cause poisoning. More serious problems can occur if the chalk lodges in the throat or is breathed into the windpipe, blocking the airway and causing coughs, difficulty breathing, or wheezing.
• Water-soluble markers usually don’t cause harm. Most other felt-tip markers don’t cause poisoning if small amounts of the ink are swallowed. A few markers may contain aniline dyestuffs, which, if a large amount is swallowed, can be poisonous.
• Erasers are not considered poisonous but could cause blockage or injury if lodged in the throat or breathed into the windpipe.
• School-type glues (such as Elmer’s®) generally are considered nonpoisonous. “Super glues” (such as Krazy Glue®) do not cause serious poisoning if a mouthful is swallowed; however, they cause mucous membranes and skin surfaces to stick together instantly. If “super glue” gets into the eye, the eyelids can be sealed together, resulting in lid injury and loss of lashes. Worse, “super glue” can cause serious damage to the eye’s cornea.
• If children swallow small amounts of water-based paint – including latex, tempera and poster paint – poisoning is not likely. Some latex paints do contain measurable amounts (5-10%) of glycols, so poisoning could happen if someone swallows a very large amount. Oil-based paints contain solvents that can cause acute poisoning if swallowed.

The National Capital Poison Center recommends the following safety tips:

• Read the label carefully, and follow all instructions for safe use and disposal.
• Discard products that have passed their expiration dates.
• Don’t eat or drink while using art products.
• Wash up – skin, equipment and environment – after use.
• Never use products to paint skin or decorate food unless the product is specifically labeled for that use.
• Store art products in their original containers locked up and out of the reach of children.
• Handle art products in accordance with your program’s guidelines for safe chemical use and storage.

Virginia Poison Center also suggests that “when choosing art supplies for use by children, consider the product’s certification. Many art supplies are imprinted with the seals of the Arts and Crafts Materials Institute. Products with the AP (Approved Product) seal are best for use by young children. Products with the CL (Cautionary Label) Seal are more appropriate for adult use.”

Finally…always better safe than sorry.

If a young artist eats a crayon or some glue, or gets paint in their eyes…OR …you’re simply unsure whether or not your child has been exposed to (or eaten) a toxic level of art supplies, use

• the webPOISONCONTROL^® online tool for guidance or
• call your local poison center at 1-800-222-1222 for advice or information.

For a more detailed description of arts and crafts Do’s and Don’ts, here is the official Art and Craft Safety Guide from the Consumer Product Safety Commission (CPSC).

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Some time ago, Audra, one of our editors, shared with us her story about her wonderful experience with “edible play dough.” What about you?? Ever called poison control for an arts and crafts mishap?

Carbon Monoxide is a Silent Killer…How to Keep Your Family Safe

As the winter months rapidly approach and the cold starts to set in, It is inevitable that people will start to break out the heaters. It is around this time of year that you will start to see an increase in the number of Carbon Monoxide stories in the news and especially in the hospitals. It’s the Carbon Monoxide I would like to talk about today.

What is Carbon Monoxide and how can I tell where it is?

Carbon Monoxide or CO, is a colorless, odorless, tasteless gas that is created from unburned Fuel Sources such as gas, oil or coal. So any appliance that uses fuel can create carbon monoxide. Heaters, Furnaces, Dryers, Cars, Fire Places, Chimneys, Generators, Barbecues, etc.. all have the ability to create carbon monoxide. Please make sure that any fuel burning item in your home has been properly installed and sealed, and that all manufacturer instructions for doing so have been followed.

Items that use electricity do not burn a fuel and do not emit carbon monoxide. While these items may pose a significant risk of fire when used improperly or left unattended, they do not burn fuel and do not pose a risk of Carbon Monoxide.

Common Locations of Carbon Monoxide:

• Automobile Garage – Cars warming up or left running in a garage will cause a build-up of Carbon Monoxide.
• Laundry Room – Laundry machines that run on natural gas or propane can emit propane.
• Basement – Furnaces and Heaters located in a basement or enclosed area can cause a build-up of Carbon Monoxide.
• Kitchen – Gas Appliances like ovens can emit Carbon Monoxide.
• Bedroom – Fuel burning heaters such as gas lamps and heaters can emit Carbon Monoxide.

What are the Signs of CO Poisoning?

• Dizziness
• Fatigue
• Headache
• Nausea
• Difficulty Breathing.

How Can I Detect CO In My Home?

While CO is an odorless, colorless, and tasteless gas it can be detected with Carbon Monoxide monitors that can be bought at many stores. Things to know about CO detectors before you purchase:

• CO detectors come in many sizes.
• CO detectors are NOT all the same. Some detect non-lethal low levels of CO while others only detect potentially lethal high levels of CO. Please read the package on the detector you purchase.
• Some can be hardwired to your house alarm system and some use batteries AA or 9volt batteries.

Where In My Home Should I Place CO Detectors?

• CO detectors should be placed in areas of the house you spend the most time in. The living room, Family Room areas are great places to put them and they should also be placed outside the bedroom areas to alert occupants Before it reaches the bedrooms.
• CO detectors should not be placed next to or near items that emit a lot of heat as it may cause the device to malfunction. As always, please read and follow the instructions on whichever device you purchase.

What should I do if my CO detector is activated OR someone in my home begins to have the symptoms of CO poisoning?

• If the detector is activated you should immediately open doors and windows and go outside.
• Once outside, assess to see if anyone is having symptoms of CO poisoning.
• If anyone is having symptoms CALL 911 AND Follow the instructions they give you.
• If the alarm continues to sound call 911 and let the fire department clear the home.

For more information on Carbon monoxide you can contact the following:

• Your local Fire Department
• Underwriter Laboratories – 1-847-272-8800
• Utility Companies in your area. The Gas company for example.

As always, I urge everyone to err on the side of caution and CALL 911 if any concern exists about CO in your home. Please be safe and use your items carefully. Here in South Florida during hurricane Irma there were fatalities due to CO because people ran generators and motors inside of their homes while they slept and succumb to CO poisoning. Always run motors and any fuel burning device in an opened, ventilated area!

Be Safe and stay warm.

Kids and Animal Bites – a Pediatrician’s Perspective

Animal bites are very common, particularly in young children due to their inquisitive nature.

The smaller the child is the more likely are the bites liable to be on the head and or neck – the most common place is however on the hands and arms. The most common bites are from our domesticated animals, cats and dogs. While a family pet is a good thing for teaching responsibility, a healthy dose of respect for other families’ pets should also be taught as not all pets are as friendly as yours, especially with strangers.

Children should be taught to approach other pets carefully and always from the front, offering a hand for the animal to smell first before touching. Wild animals are another issue entirely and it is best to be very conservative and teach your child to never go near a wild animal, no matter how “cute and cuddly” it looks. If your child comes in proximity with a wild animal that has been “domesticated” by ownership, the same should apply. More and more now there are increasing limits on the type of wild animals allowed to be kept as pets.

Let’s get back to cats and dogs.

A dog bite can be quite severe as dogs will grab and hold on to an arm or leg and toss their heads back and forth in an effort to subdue an “enemy”. If a dog unknown to you bites your child, and after seeking the care for the injury, you should contact your local health department as that animal will need to be investigated and sometimes placed under surveillance for several weeks. Your own pets should be vaccinated by your vet as recommended by authorities. Some dog bites, if severe enough, can be sutured closed but this must be done carefully and sometimes left open to avoid infection.

Cat bites while usually not as severe as dog bites, stand a greater chance of becoming infected as these are usually more of a puncture wound quality making infection a higher risk.

Contact your Doctor immediately should any bite occur for further information, but please teach your children the do’s and don’ts of approaching animals of all kinds.

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