Who At Your Kid’s School Is Certified in CPR or Basic First Aid??

Editor’s Note: With the COVID Delta variant placing our kids at a higher risk, and hospitals and EMS systems stretched way beyond capacity, we’re thinking this may be something you just might want to know.

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It’s a simple question really. How many people at your child’s school are certified in life saving CPR and basic first aid? The answer may surprise you. I am often on the other side of this question training the administrators and teachers in cpr and first aid, and praising them for spending the time and money to go beyond the bare minimum and make sure their entire staff is trained and the children are safe, but putting my oldest child in school for the first time this year made me curious to know the answer to this question.

As a concerned parent I placed a call to Miami Dade public schools and was alarmed to find out that at a public school here in Dade county only two people are required to be certified in CPR and basic first aid. This is a dangerously low number considering that some of the schools here in Dade County have over 5000 students. Not to mention what would happen if one or both of these people calls in sick or goes on vacation? Then you run into the possible situation of having nobody on campus that day required to be trained. Not good. With the normal everyday injuries at schools, the knowledge of basic first aid is a must and add to that the growing number of sudden cardiac events in schools around the country and you will see that having a basic knowledge of first aid and CPR together is also a must and therefore the bare minimum of safety by some schools just will not do.

What would cause a school to keep only the bare minimum of people trained in something so important? Is it that the administrators and staff don’t care about the children’s safety and only do the bare minimum because they have to? Of course not. The answer as usual is money. Now obviously what needs to happen is the schools need to increase the number of people trained in cpr and basic first aid, but like anything else training costs money and with school budgets shrinking by the day and teachers coming out of their own pockets more than ever to make up for the lack of funds, asking a school to budget in training for an entire staff just does not seem possible. So what can you as a concerned parent do? Well if you are certified to train the staff in cpr and first aid then you can do as I have done and donate the training to the school and staff for free, or you can do as some parents here in Dade county have done and that is to raise the funds for the training themselves by having a bake sale or a car wash or some other fundraising event and hire a company to come out to the school and train the entire staff. I cannot think of a better use for that money than the safety of our children.

The bottom line is no matter where you live the people looking after your children, whether it is a school, a daycare or even grandparents need to be trained and know how to react when your child needs help. So go ahead and do as I did and ask the question as to who is certified here and what can I do to help?

Be Safe.

Checklist for a SAFE Back to School and Sports. Everyone Ready?

Is it August already? Yes it is! Or soon will be and that means that soon it will be back to school and organized sports and all the things that make the school year so hectic. As a parent returning one child to school and sending one to his first year of school this is a pretty busy time of year in our house. Mixed in with all the fun of summer reading lists and back to school shopping, I would like to give you another list of things to make sure are right before the kids return to school and sports.

First and foremost on my list is always making sure that the school is up to date on its CPR and First Aid training. If you are a parent leaving your child at a school, daycare, or organized sports league you need to inquire and make sure that the staff or at least the staff that will be on hand ALL the time knows what to do in case of an emergency situation, such as an injury or an allergic reaction involving your child. Does your child have any emergency medicine that they need such as an EpiPen or an asthma inhaler, or any other medication that might be needed in a moment’s notice? , and if so, are they expired, does the school need a new one or even know about them and how to use them should the need arise? I have seen people forget their own name when confronted with these situations and the right training and preparation can make all the difference in the world.

Organized sports are another area where things need to be checked off before the new season starts. These activities can be at any age and be anything from baseball and football to cheerleading and gymnastics. Injuries happen in these sports all the time and once again, the coaches, staff, volunteers, and anyone else involved need to be properly trained or refreshed on what to do in case of an emergency. Most of the centers or parks hosting these activities have automated external defibrillators (AED’s) on site for both participants and parents and need to be trained or refreshed on the use of these devices as well. When playing organized sports like baseball and football, there are pieces of safety equipment built into the helmets and pads and other parts of the uniforms. If your children have grown over the summer like mine have then you need to make sure that the equipment they are using fits properly and securely and delivers the maximum amount of safety it was designed for. Whether its helmets, groin protectors or even shoes, these should all be the proper size for best results.

As always, a little preparation makes all the difference and I wish you all the safest and best school/sports year.

Knowing How to Use an AED Can Save a Child’s Life

We have a problem in this country, sudden cardiac arrest. Approximately 450,000 people die each year from sudden cardiac arrest (SCA) in the United States. It can happen to anybody, anywhere, anytime and without any warning, so helping a person suffering from cardiac arrest is all about what you do immediately following the persons collapse. The best “save” rates have been reported when using an automated external defibrillator or AED to deliver an electric shock or defibrillation within three minutes of the patient’s collapse. Early defibrillation in conjunction with C.P.R has been found to be the only definitive treatment for sudden cardiac arrest. For every minute that a person in cardiac arrest goes without being successfully treated by defibrillation the chance of survival decreases by 7 percent per minute in the first minutes, and decreases by 10 percent per minute as time advances beyond 3 minutes, so starting life saving measures such as CPR and using the AED as soon as it arrives it essential.

Symptoms of Sudden Cardiac Arrest include:

• Collapse
• Lack of pulse
• No breathing
• Unconsciousness

With time being of the essence and the average response time for emergency services being 10 to 12 minutes (which may not be fast enough for a patient because after approximately three to five minutes irreversible brain damage may begin to occur if there is no defibrillation), having access to an AED and knowing how to use it is very important. So how do you use an Automated External Defibrillator? As we said before, AED’s are very user friendly and speak in plain English and will walk you through the entire process, even reminding you to call for help if you haven’t already done so. In the basic life support class we have a pneumonic that helps people remember the 4 basic steps to using an AED: P.A.A.S. This stands for Power, Attach, Analyze, and Shock.

• Power: Most AED’s turn on when open but some may have a power button.
• Attach stands for attaching the defibrillator pads to the chest of the patient to match the pictures that are provided on the pads.
• Analyze means to let the machine analyze the patient’s heart rhythm and determine if the patient needs to be defibrillated,
• Shock means to manually press the shock button and shock the patient if and when the machine says it’s time to do so.

Now as we said before, having the proper training will make this whole process much smoother but is not a requirement. I would however recommend it.

Where to find an AED? AED’s either held by trained personnel who will attend events or are public access units which can be found in places including corporate and government offices, shopping centers, airports, airplanes, restaurants , casinos, hotels, sports stadiums, schools, and universities, community centers, fitness centers, health clubs, theme parks, workplaces and any other location where people may congregate. In many areas, emergency vehicles are likely to carry AEDs, with some units carrying an AED in addition to manual defibrillators. Some areas even have dedicated community first responders, who are volunteers tasked with keeping an AED and taking it to any victims in their area. AEDs are also increasingly common on commercial airliners, cruise ships, and other transportation facilities and with advances in technology and policy requiring AED’s to be placed in more and more places AED’s are becoming more accessible as well as more affordable.

Automated External Defibrillators are truly miracle machines and are changing people’s lives for the better and I hope this article has given you a basic understanding of how to use one should the time come. I encourage everyone to take a certified AED instruction course and really become familiar with these machines and the process involved in using them because you never know when you could be called to action and as we said before, there is nothing better you can do in a cardiac arrest situation than using an AED.

Thank you and Have a Safe and Happy Holiday Season.

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Editor’s Note: Sudden cardiac arrest among young athletes is nowhere near as common as it is across the general population, however when it occurs, it is unexpected and the results are often tragic. It’s estimated that between 6,000 and 8,000 young people experience sudden cardiac arrest (or SCA) each year, and only about one in 10 survive. An AED can save their life, however today only 15 states require them on school campuses. Not all of those require them to be present on athletic fields. Parents that means its up to you. Be observant. During the sports season, look out for signs that your child may be struggling. And talk to your school about AED’s. Source: Nemours Children’s Hospital

How to Make Back to School Feel Safe? a Pediatrician Perspective

It is certainly understandable, given the amount of press and official and unofficial commentary through law enforcement, social media discussions, and easily seen news programs, that fear should arise in the minds of both children attending school and parents of those children about their safety in what has traditionally been a bastion of safety, their schools.

This publicly available information, easily seen by children, has always been centered around the person responsible for the shootings occurring in schools and other public places. The information made available in the news media is repeated ad infinitum after the event occurs and only later is there information about the victims.

This public, news-related, policy needs to be changed to include minimal information, if any, about the perpetrator and immediate coverage about the victims and their families.

The American Academy of Pediatrics refers to the situation surrounding school shootings as “a public health threat to children” and has shared their perspective on the general health of the Pediatric population with such statements as: “We can start by working to advance meaningful legislation that keeps children safe….We also call for stronger background checks, solutions addressing firearm trafficking, and encourage safe firearm storage….children and their families (should) have access to appropriate mental health services.”

As a Pediatrician, I absolutely agree with their statements.

This is an issue that should be taken up by the public as a whole, through local involvement in both federal and local government. This is only one method by which fear is spread. The fact that domestic terrorism has occurred at all promotes the initial terror also seen repeatedly on television and written forms of news media in all its gory details. Your child is exposed to this every couple of months in our society. It’s no wonder there is some fear of the school environment.

To balance my professional opinion with my personal experience, I have three grandchildren who live in Connecticut, not far from Newtown where the Sandy Hook killings took place. I am probably biased, but I consider them to be stable, “normal” children, with good, close ties to their parents compared to the general population.

Although there has been no clinical PTSD, they have certainly become more aware and somewhat fearful of their surroundings. I consider the awareness to be a positive result of this episode, as every person in America has become more aware of their surroundings since 9/11. A fact that has possibly contributed to the absence of further attacks of this magnitude having taken place. They have also become much more tolerant and even thankful for the occasional practice drills in their school.

What can be done to decrease and hopefully eliminate such events and fearsome coverage of those events?

• The ultimate answer to this is involvement by you and your children in local, civic activities. The Federal government can only do so much and every time it tries there is resistance from many sides. The real power lies in local and state governments who can exert a lot of power if supported by their constituency, something that changed in this respect after 9/11.
• Get involved. There is much improvement possible at the local and state levels, but it must arise from the grassroots. To start, sale and ownership of assault rifles and large magazines capable of carrying large volumes of ammunition should be limited. There is always pushback on this and officials are slow to act as a result. We must push such acts, as statistics do not necessarily show either side to be correct on this issue.
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  Photo Credit: Tam High Vigil for Parkland School Shooting by Fabrice Florin, CC BY-SA 2.0

  You must answer your children’s questions honestly in an age-appropriate format and up-play the quality and determination of those people in their schools who are there to protect them from harm: from teachers to any law enforcement officers in place. If your child can grasp the concept of statistics, you might point out to them that 56 million students attend US elementary and secondary schools, and only a relative handful (159, less than 3/1000 of one percent) have been affected by such school tragedies, and many of these involved single episodes. Try to relate those numbers to things in their personal lives that at that statistical rate they clearly would not be involved.

• In the extreme, especially if such events have occurred near to your home and school districts, your child might require a short period of counseling. Although child psychiatry services are not readily available in many smaller communities, a parent can ask his/her Pediatrician, the local medical society or the nearest large children’s medical center for such references.

Understand their fear and as parents there will be no trouble empathizing

The bottom line is, as always, good communication with your children is of paramount importance! Never stop talking to your children, keep all the channels open, and you will be greatly rewarded as your children grow to maturity.

School Bus Stop Arms Are Being Ignored: How to Fix That

Within the next several weeks most or all schools across the country will be back in session. Some already are. Last year, as in previous years, many of the headlines were about school shootings. These are tragedies by every definition. However these are well covered in the media as are many steps to prevent future occurrences. There have also been recent headlines about tragic school bus crashes and this is perhaps the subject of a different article. The National Highway Traffic Safety Administration states that by design and other factors, school buses are the safest transportation method to get children to and from school. Most injuries and fatalities happen off the bus.

In this piece I want to instead focus on a different school hazard and that is the act of driving past school bus stop arms. We will not likely hear much about this in the media until a group of students is run down.

Once a year the state of Kansas conducts a survey asking bus companies/drivers to participate.

• For 30 days they ask the drivers to record and report the number of times other drivers pass an extended stop arm sign.
• In the most recent survey (2017) nearly 10,000 occurrences of stop arm violations were reported.
• Simply multiply this number by 50 states and there could be as many as 500,000 stop arm violations each and every month school is in session.

The laws may vary by state, whether the road is divided and if so how many lanes etc. Confusing laws is no excuse for violating laws- for putting children’s lives in jeopardy. In one study up to 2% of all violations are on the passenger side- the side where the door is when students are being off loaded. The side where the curb is; where students gather to wait for the bus. This is not allowed in any state for any reason. Think about it 2% of 500,000 is 10,000. The number and the potential is staggering. This risk is real. A child hit by a vehicle going often 25 plus MPH has little chance of a good outcome- perhaps little chance of surviving.

What can be done.

Know the laws and obey them. Talk about stop arm safety at back to school orientations and PTA meetings. Get your local police involved. Have them wait at known high hazard bus stops. Contact local TV and radio stations ask them to run public service announcements (PSA’s). There has been considerable media in the past – there is chilling video. This is a story with a real human interest. Consider stop arm cameras. These specialized cameras make it easier to prosecute violators. A few states don’t require stop arms on school buses- ask your legislators to reconsider.

What you should not do.

Don’t wait until tragedy strikes your area- a car strikes a child- a child is crippled or killed. Don’t regret that perhaps being proactive could have prevented the loss. Don’t assume someone else in your community is taking care of this. The more people involved- the higher the success.

Like this article- share this article- spread the word.

Child Sports Injuries: How to Prevent and Treat The Most Common

The school year will soon be upon us and with the return of homework and uniforms means the return of sports. 38 million children and adolescents participate in organized sports in the United States each year. Still more participate in informal recreational activities. Although sports participation provides numerous physical and social benefits, it also has a downside: the risk of sports-related injuries. In fact, according to a 2002 report by the Centers for Disease Control, nearly 1.9 million children under 15 were treated in emergency departments the year before for sports-related injuries.

These injuries are by far the most common cause of musculoskeletal injuries in children treated in emergency departments. They are also the single most common cause of injury-related primary care office visits.

I. The Most Common Sports-Related Injuries in Kids

Although sports injuries can range from scrapes and bruises to serious brain and spinal cord injuries, most fall somewhere between the two extremes. Here are some of the more common types of injuries.

Sprains and Strains

A sprain is an injury to a ligament, one of the bands of tough, fibrous tissue that connects two or more bones at a joint and prevents excessive movement of the joint. An ankle sprain is the most common athletic injury.

A strain is an injury to either a muscle or a tendon. A muscle is a tissue composed of bundles of specialized cells that, when stimulated by nerve messages, contract and produce movement. A tendon is a tough, fibrous cord of tissue that connects muscle to bone. Muscles in any part of the body can be injured.

Growth Plate Injuries

In some sports accidents and injuries, the growth plate may be injured. The growth plate is the area of developing tissues at the end of the long bones in growing children and adolescents. When growth is complete, sometime during adolescence, the growth plate is replaced by solid bone. The long bones in the body include:

• the long bones of the hand and fingers (metacarpals and phalanges)
• both bones of the forearm (radius and ulna)
• the bone of the upper leg (femur)
• the lower leg bones (tibia and fibula)
• the foot bones (metatarsals and phalanges).

If any of these areas become injured, it’s important to seek professional help from an orthopaedic surgeon, a doctor who specializes in bone injuries.

Repetitive Motion Injuries

Painful injuries such as stress fractures (a hairline fracture of the bone that has been subjected to repeated stress) and tendinitis (inflammation of a tendon) can occur from overuse of muscles and tendons. Some of these injuries don’t always show up on x rays, but they do cause pain and discomfort. The injured area usually responds to rest, ice, compression, and elevation (RICE). Other treatments can include crutches, cast immobilization, and physical therapy.

Heat-Related Illnesses

Heat-related illnesses include:

• dehydration (deficit in body fluids)
• heat exhaustion (nausea, dizziness, weakness, headache, pale and moist skin, heavy perspiration, normal or low body temperature, weak pulse, dilated pupils, disorientation, and fainting spells)
• heat stroke (headache, dizziness, confusion, and hot dry skin, possibly leading to vascular collapse, coma, and death).

Heat injuries are always dangerous and can be fatal. Heat-related injuries are a particular problem for children because children perspire less than adults and require a higher core body temperature to trigger sweating. Playing rigorous sports in the heat requires close monitoring of both body and weather conditions. Fortunately, heat-related illnesses can be prevented.

II. Preventing and Treating Injuries

Injuries can happen to any child who plays sports, but there are some things that can help prevent and treat injuries.

Prevention Basics

• Enroll your child in organized sports through schools, community clubs, and recreation areas that are properly maintained. Any organized team activity should demonstrate a commitment to injury prevention. Coaches should be trained in first aid and CPR, and should have a plan for responding to emergencies. Coaches should be well versed in the proper use of equipment, and should enforce rules on equipment use.
• Organized sports programs may have adults on staff who are Certified Athletic Trainers. These individuals are trained to prevent, recognize, and provide immediate care for athletic injuries.
• Make sure your child has—and consistently uses—proper gear for a particular sport. This may reduce the chances of being injured.
• Make warm-ups and cool downs part of your child’s routine before and after sports participation. Warm-up exercises, such as stretching and light jogging, can help minimize the chance of muscle strain or other soft tissue injury during sports. Warm-up exercises make the body’s tissues warmer and more flexible. Cool down exercises loosen muscles that have tightened during exercise.
• Make sure your child has access to water or a sports drink while playing. Encourage him or her to drink frequently and stay properly hydrated. Remember to include sunscreen and a hat (when possible) to reduce the chance of sunburn, which is a type of injury to the skin. Sun protection may also decrease the chances of malignant melanoma—a potentially deadly skin cancer—or other skin cancers that can occur later in life.
• Learn and follow safety rules and suggestions for your child’s particular sport. You’ll find some more sport-specific safety suggestions below.

Primary Treatment

Treatment for sports-related injuries will vary by injury. But if your child suffers a soft tissue injury (such as a sprain or strain) or a bone injury, the best immediate treatment is easy to remember: RICE (rest, ice, compression, elevation) the injury (see below). Get professional treatment if any injury is severe. A severe injury means having an obvious fracture or dislocation of a joint, prolonged swelling, or prolonged or severe pain.

Treat Injuries with “RICE”

• Rest: Reduce or stop using the injured area for at least 48 hours. If you have a leg injury, you may need to stay off of it completely.
• Ice: Put an ice pack on the injured area for 20 minutes at a time, four to eight times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel.
• Compression: Ask your child’s doctor about elastics wraps, air casts, special boots, or splints that can be used to compress an injured ankle, knee, or wrist to reduce swelling.
• Elevation: Keep the injured area elevated above the level of the heart to help decrease swelling. Use a pillow to help elevate an injured limb.

For Basketball…

• Common injuries and locations: sprains; strains; bruises; fractures; scrapes; dislocations; cuts; injuries to teeth, ankles and knees. (Injury rates are higher in girls, especially for the anterior cruciate ligament (ACL), the wide ligament that limits rotation and forward movement of the shin bone.)
• Safest playing with: eye protection, elbow and knee pads, mouth guard, athletic supporters for males, proper shoes, water. If playing outdoors, wear sunscreen and, when possible, a hat.
• Injury prevention: strength training (particularly knees and shoulders), aerobics (exercises that develop the strength and endurance of heart and lungs), warmup exercises, proper coaching, and use of safety equipment.

For Track and Field…

• Common injuries: strains, sprains, scrapes from falls.
• Safest playing with: proper shoes, athletic supporters for males, sunscreen, water.
• Injury prevention: proper conditioning and coaching.

For Football…

• Common injuries and locations: bruises; sprains; strains; pulled muscles; tears to soft tissues such as ligaments; broken bones; internal injures (bruised or damaged organs); concussions; back injuries; sunburn. Knees and ankles are the most common injury sites.
• Safest playing with: helmet; mouth guard; shoulder pads; athletic supporters for males; chest/rib pads; forearm, elbow, and thigh pads; shin guards; proper shoes; sunscreen; water.
• Injury prevention: proper use of safety equipment, warmup exercises, proper coaching techniques and conditioning.

For Baseball and Softball…

• Common injuries: soft tissue strains; impact injuries that include fractures caused by sliding and being hit by a ball; sunburn.
• Safest playing with: batting helmet; shin guards; elbow guards; athletic supporters for males; mouth guard; sunscreen; cleats; hat; detachable,“breakaway bases” rather than traditional, stationary ones.
• Injury prevention: proper conditioning and warmups.

For Soccer…

• Common injuries: bruises, cuts and scrapes, headaches, sunburn.
• Safest playing with: shin guards, athletic supporters for males, cleats, sunscreen, water.
• Injury prevention: aerobic conditioning and warmups, and proper training in “heading” (that is, using the head to strike or make a play with the ball).

For Gymnastics…

• Common injuries: sprains and strains of soft tissues.
• Safest playing with: athletic supporters for males, safety harness, joint supports (such as neoprene wraps), water.
• Injury prevention: proper conditioning and warmups.

III. Safety Tips for ALL Sports

• Be in proper physical condition to play the sport.
• Follow the rules of the sport.
• Wear appropriate protective gear (for example, shin guards for soccer, a hard-shell helmet when facing a baseball or softball pitcher, a helmet and body padding for ice hockey).
• Know how to use athletic equipment.
• Always warm up before playing.
• Avoid playing when very tired or in pain.
• Get a preseason physical examination.
• Make sure adequate water or other liquids are available to maintain proper hydration.

Adapted from Play It Safe, a Guide to Safety for Young Athletes, with permission of the American Academy of Orthopaedic Surgeons.

Play It Safe in the Heat

• Schedule regular fluid breaks during practice and games. Kids need to drink 8 ounces of fluid—preferably water—every 20 minutes, and more after playing.
• Have your child wear light-colored,“breathable” clothing.
• Make player substitutions more frequently in the heat.
• Use misting sprays on the body to keep cool.
• Know the signs of heat-related problems, including confusion; dilated pupils; dizziness; fainting; headache; heavy perspiration; nausea; pale and moist or hot, dry skin; weak pulse; and weakness. If your child experiences any combination of these symptoms or doesn’t seem quite right, seek medical attention immediately.

Adapted with permission from Patient Care magazine, copyrighted by Medical Economics.

Please keep your children active and safe and have a great school year.

 

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