Summer Hazards Part I – Watch Out for the Sun

The heat of summer has arrived, at least temporarily, making it a good time to present some topics related to living in a warm environment.

Let’s discuss the advantage of remaining well hydrated during the time of the year when fluid loss through activities can cause significant problems. Some experts believe that everyone should drink 1 oz of fluid for every 2 pounds of body weight per day. Admittedly that is a large amount of fluids but our bodies are more than half water and the millions of chemical reactions that are ongoing in our bodies every minute of every day require water, among other elements to keep going. In hot and humid weather, the elements work against us to keep that fluid reserve “topped off”. Exercising during this kind of weather exacerbates the potential for water loss and subsequent poor regulation of body temperature. It is this poor regulation of body temperature that can lead to the various forms of disease after heat exposure, ranging from mild to life threatening. So, stay very well hydrated during the summer months and stay alert to the problems that can arise with exercise and poor fluid intake.

Everyone likes the appearance of tan skin and unfortunately the source of that sought after appearance is the sun. A certain amount of sunlight is a very good thing and in fact a lack of sunlight over time can lead to such problems as vitamin D deficiency and poor control of calcium metabolism and regulation. The downside of this exposure is that the UVA and UVB rays given off by the sun and absorption of those rays through your skin can damage the skin leading to lack of elasticity and signs of early aging. Far worse than this effect is the tendency to alter the genetic characteristics of skin cells that can lead to cancer of the skin, especially the most severe form, melanoma, which can be fatal.

Fortunately there are things that can be done to minimize the effects of exposure to the sun. Try to avoid exposure to bright sun between the hours of 10 AM and 3PM when the sun’s rays are most direct and therefore stronger. Make use of the various sun blocks on the market. These sunblocks are usually designated by a SPF number that attempts to give us, the consumers some way of comparing them Regardless of the SPF number, the sun block needs to be applied and reapplied every couple of hours in order to give the protection it promises. The higher the number gives you some idea as to how often it needs to be reapplied. The higher the number, theoretically the less often it needs to be applied. Make it a rule of thumb to reapply all sun block at least every hour or two , and, if your skin gets wet, it may need to be applied more often.

My next post will deal with other summer hazards; insect bites, poison ivy, and miscellaneous others.

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Editor’s Note: this post first appeared in Pediatric Safety in June of 2012. Given the extreme warm weather we are currently experiencing in many areas of the U.S., we thought it might be a good time to run it again

Summer Seatbelt Safety: For Your Family’s Sake

As the school year winds down and summer travel plans go into action, families will get in the car and drive all around this great country of ours. Let’s face it, summer does mean the kids are out of school and usually need someplace to go before they tear the house down and getting in the car and going somewhere, anywhere is usually what happens. But before you head out in the car this summer, whether it is for the cross country journey or the 5 minute ride to the park, please put on your seat belt.

We have all heard the sayings “Seat Belts Save Lives” or “click it or ticket”. In 2009 the NHTSA released a study saying that over 1600 lives could be saved each year and over 22,000 serious injuries could be avoided each year if seat belt use rose to 90% in drivers and passengers in automobiles and I am here to tell you that it is more than true. Having responded to many traffic accidents and seen the results of both wearing and not wearing a seatbelt, I can honestly say that seatbelts do save lives every day. Let’s be honest. How long does it take to put on a seatbelt? A few seconds? , that does not sound too unreasonable to be part of the thousands of lives saved every year does it?.

Many states handle seatbelt laws differently. Some states require seatbelts and some do not. Whether your state requires it or not, before we head out onto the roadway let us think about the people in the car shall we?

The Driver – You. Adults are the WORST offenders about not wearing seatbelts. When you put your seat belt on, you are keeping yourself safer in case of accident and you also give a good example to the other passengers regardless of age.

The Kids – Kids are always watching us to see how we do things and what is acceptable and if you put on your seatbelt every time you get in the car then the kids will begin to model your behavior and after a while it can become an automatic response from them, no matter what car they get in. Now smaller children may need help and may require you to click them in properly and safely before yourself. Infants and smaller children in car seats will obviously need the help but also the children in the booster seats may need some additional help, plus a quick check and tug on the belts they put on by themselves never hurts.

Teenagers – Teenagers are some of the worst offenders of not wearing seatbelts right after adults. Teenagers have an invincibility about them which is normal but should never be allowed to talk you out of making them put on the seatbelt regardless of the distance of the trip.

Pets – We do not normally think about our pets when it comes to seal belt time but pets are passengers too and if the pets are coming with us in the car then there needs to be a way to make sure they are secure. There are a number of pet friendly carries and devices for the car that make this possible.

The bottom line is that seatbelts DO save lives. I cannot tell you how happy it makes me to look at someone who just had a car accident and tell them “good thing you were wearing your seat belt “.

Have a Great Summer, Be Safe and Buckle Up……..All of you!

Thank You

Photo credit: MoDOT Photos; CC license

“Forgotten Backseat Baby” Syndrome: an Unimaginable Danger

“Huh? Forgotten what???” is what I imagine you are asking after reading the title. The next question that probably comes to mind is, “what kind of idiot would forget his/ her own child in a car?” As the parent survivor of a child who was tragically lost to vehicular #heatstroke in 2011 when her daddy forgot to drop her off at daycare that fateful morning, I WISH I could tell you that only idiots make this kind of mistake; that only a selfish monster could do such a deed…..sadly, most of the more than 600 kids who have died from being left in a hot car since 1998 were victims of what I like to call “forgotten backseat baby” syndrome; a mistake committed not by idiots or monsters, but a mistake made by folks you would never in a million years imagine: caring, loving, responsible parents. Most of them took nearly every precaution to child-proof their homes and to assure that the car seat was installed correctly; many of them also took parenting classes in preparation for their bundle of joy’s arrival. Sadly, most of these parents also never imagined the remote possibility of forgetting their child in the backseat of a vehicle. In other words, folks just like YOU and ME, sadly, are capable of forgetting our most precious cargo in the backseat of our cars under the right conditions.

Your protective defense mechanisms are probably kicking in right now and you are probably saying “yeah right, not a chance lady”. …..but for those of you still in denial that you could make such a mistake, here is a little food for thought.

Have you ever, in a moment of multi-tasking, sleep deprivation, running late for work, or being severely fatigued after a bought of illness (you, your spouse, your kids), done any of the following?

• Forgotten to turn off the headlights before exiting your car? (apparently so many of us in the past drained our batteries by doing this that most cars now have automatic function of headlights, or at least have an alert that “dings” when you open the door to let you know you forgot to turn off the lights)
• Left your ATM card in the machine after a transaction? (again, so many of us were guilty of this behavior that now most ATM machines have quick swipe technology so that we no longer have to wait for our cards to be returned)
• Forgotten to buckle your seatbelt? (are you thinking of that annoying alarm right now? So many front passengers have forgotten this safety routine in the past that the auto industry has decided we need this annoying reminder to protect our front seat cargo)
• Forgotten to turn off the coffee maker? (note that most brands now have an auto-shut-off feature for us poor souls who just aren’t fully awake until chugging a cup o’ joe)
• Walked into a room with a purpose to get/ do something, then arriving only to find that you couldn’t remember why you were there – no matter how hard to try?

If you have ever been guilty of any of those behaviors (or similar cases of stress-induced memory failure), then yes, unfortunately, you too are capable of forgetting a baby in the backseat.

I WISH I could tell you only a monster could do such a thing. Unfortunately, even the best of mortals can suffer the devastating consequences of “forgotten backseat baby” syndrome under the right conditions. That’s why I advocate implementation of safety nets/ plans for ALL child transport activities to verify arrival and/ or absence in a timely manner…..EVEN if you are still in denial that you are capable of forgetting your precious backseat cargo, consider a child transport safety plan an “insurance policy” to make sure you prove me wrong.

I lost my daughter, Sophia Rayne “Ray Ray” Cavaliero, to vehicular #heatstroke on Wednesday afternoon, May 25, 2011. That morning, our entire family overslept. Speaking in retrospect (after observing my 20 month old twins during the same phase of their lives), I think we overslept because it was the first time that Ray Ray finally slept through the night. We always called her our little alarm clock, because without fail she would awaken to nurse at 5:00 am, then sweetly drift back to sleep until about 7:30 am. Then we usually played with her for an hour or so before her daddy took her to daycare around 9:00 am. Ray Ray’s behavior was so predictable that I no longer set an alarm clock to awaken. That morning began with me awakening to my sweet child giving me precious kisses all over my face, followed by a glance at the clock. As I saw the time of 9:43 am, chaos ensued in my home. We had all overslept! Brett rushed to get dressed for work; I rushed to get Ray Ray fed and dressed for daycare. The entire family then hurried to daddy’s truck (I was still in PJs).

The defining event that led to Ray Ray’s death due to vehicular heatstroke was something very simple: ONE WRONG TURN. My husband usually made a LEFT turn at the bottom of a major hill near our home to drop our child off at daycare (located less than 10 minutes from our home). After dropping her off, he would circle back onto the same major highway and head to his office, less than 15 minutes from our home. That morning for unknown reasons he made a RIGHT turn at that critical intersection. As Ray Ray sat rear-facing and quietly in the backseat, he had no clue along his work route that she was still in the truck….he couldn’t see her; he couldn’t hear her. WHY did he make this wrong turn? We have asked this question daily for almost three years and still have no answer. What we know (through the criminal investigation) did not contribute to the wrong turn was his phone—records show that he wasn’t talking, emailing, or texting…..Could you ever imagine that ONE WRONG TURN, as I am sure you have probably made a few times in your life as well, could have such devastating consequences???? We couldn’t either….We still can’t; but this is our reality, like a nightmare from which we cannot awaken….cannot awaken because sadly it is not a dream.

The story I have just told to you replicates the story of more than one hundred families since 1998, as forgotten childcare drop-off is the leading source of child hot car death (aka child vehicular heatstroke or hyperthermia). Another resounding theme in nearly every “forgotten backseat baby” syndrome tale resulting in child hot car death is a change in routine on the day of the tragedy. For us, that change in routine was oversleeping, with a resultant chaotic start to our day. For other families, that change in routine was commonly an alternate person dropping the child off at daycare (one not accustomed to doing so). Other common changes in routine that we have seen in these tragedies include changes in school routine–either at the start of summer when grade school has just ended or in August at back to school time, ESPECIALLY where there are multiple siblings in the family and one starts kindergarten and the younger still needs to be dropped off at daycare.

I have shared my story with you today to commemorate the upcoming National Heat Awareness Day (designated by the National Weather Service/ NOAA) this Friday, May 23, 2014. The rate of child vehicular heatstroke tragedies begins to rise exponentially around this date, peaking in August (aka “back to school” time—remember that change in routine risk factor I alluded to earlier???). This year for the first time, numerous national child safety advocates, including the staff at Pediatric Safety, will join forces to commemorate and co-promote this day. We will be posting hourly child vehicular heatstroke facts and prevention tips on social media outlets to raise public awareness of this often unrecognized danger to child passenger safety, focusing on “forgotten backseat baby” syndrome, which is every parent’s unimaginable risk and the leading cause of child hot car deaths. Please join us and help spread vital information to PREVENT child vehicular heatstroke by sharing our social media posts and encouraging your friends and family to do the same. We will be using the tag “#heatstroke” on all of our posts and encourage you to do the same.

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Editor’s Note: We are just at the beginning of summer and 5 children have already died this year. Please reach out to everyone you know, to everyone who follows you on Twitter or Facebook or any other social media you have access to – and help us raise awareness of this terrible tragedy.

All it will take is a minute to post any one of these:

• Call 911 if you see a child alone in a car. ACT to prevent child vehicular #heatstroke
• Most kids who die of vehicular #heatstroke are accidentally forgotten in the backseat by a loving, responsible parent.#LOOKbeforeyouLOCK
• Forgotten childcare drop-off is the #1 source of child vehicular #heatstroke. #RayRaysPledge
• A child overheats 3-5 times faster than an adult. Never leave your child alone in a car. Prevent vehicular #heatstroke
• 30% of kids who died in a hot car gained access to an unlocked vehicle. Prevent vehicular #heatstroke
• The inside temperature of a car increases more than 40 degrees in less than an hour. Prevent vehicular #heatstroke
• Most kids who die in a hot car are less than 2 years of age. Prevent vehicular #heatstroke
• Most common factor associated with parents who forgot their kids in the backseat: change in routine. Prevent vehicular #heatstroke
• Is your child in daycare? Make an absence verification plan w ur provider aka #RayRaysPledge. Prevent vehicular #heatstroke
• Create reminders for all child transport activities eg: purse/ briefcase/ cellphone in backseat. Prevent vehicular #heatstroke

If we can save just one child’s life, all our efforts will have been worth it.

One Decision: Tragic Results – Please Look Before You Lock (Video)

“It could never happen to me.” “I would never leave my child alone in the car – not for a minute.” “No GOOD parent would ever forget their child!”

But it happens every day. According to KidsandCars on average 38 children die in hot cars each year, about one every 10 days from heat-related deaths after being trapped inside motor vehicles. This year alone there have been 23 child vehicular heat-stroke deaths. And this is not counting the life-altering injuries experienced by the children who survive.

It happens…

Children climb into unlocked cars to play. A child is sleeping in the back-seat and a parent “cracks open the window” and runs into the store for “just one thing” (…illegal in some states but in a NHTSA survey, 25% of parents admitted they had done this at least once). A spouse / partner / caregiver carefully buckles the baby into the car seat to drop them off at daycare. Maybe it wasn’t their day to drive…or maybe something distracts them for just one second. It’s just a little departure from the usual morning routine – only this time they forget the baby sleeping in the back seat (…more likely now since the American Academy of Pediatrics changed their guidelines to recommend that children remain rear-facing in car seats until they reach the age of two. A parent looking in the rear-view mirror no longer sees their child’s face – just the back of the car seat – whether their child is in it, or not).

It happens…

…and it doesn’t have to be 100 degrees outside for the consequences to be devastating. According to NHTSA’s report on “Unattended Children and Cars“, even cool temperatures in the 60s can cause the temperature to rise well above 110 degrees Fahrenheit inside your car. The inside temperature can rise almost 20 degrees F within the first 10 minutes”. Within an hour the temperature jumps around 50 degrees F. If the outside temperature is in the low 80’s F, the temperature inside the vehicle can reach deadly levels in only 10 minutes. Slightly rolling the window down has almost no impact on these temperature increases.

Take a look at this simulation produced by the SafeKids organization of how fast a car can heat up when exposed to direct sunlight

Children’s bodies – in particular infants and children under 4 years of age – are at greatest risk for heat-related illness. They absorb more heat and are less able to lower their body heat by sweating. Because a child’s thermoregulatory system is not fully developed, their bodies warm at a rate 3 to 5 times faster than an adult’s. Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate. A core body temperature of 107 degrees F is considered lethal because cells are damaged and internal organs shut down.

It happens…

To the most loving, caring parents…the most responsible caregivers. These are not “those horrible people who should never have been allowed near children”. Take a minute to read Kristie Reeves-Cavaliero’s story about the day her husband Brett took one wrong turn and drove to the office instead of dropping their beloved daughter Sophia (Ray Ray to those who loved her) off at daycare. It wasn’t until they met for lunch later in the day that they realized something was wrong. By that time Ray Ray had been in his truck for 3 hours. An hour and 19 minutes later she was gone.

But this isn’t just Ray Ray’s story. More than 1 in 5 kids who die of heatstroke in a car were supposed to be dropped off at daycare that morning – and no one questioned their whereabouts until it was too late. Now Kristie has made “Ray Ray’s Pledge” her lives’ work – to establish a “daycare safety net” and make sure this doesn’t happen to another child. Other parents have made similar pledges. To share the story of their children’s tragedies here, in interviews, in every public forum possible – in the hopes of saving just one family the pain they have endured. There are ways to keep your child safe during the hot summer months.

SO WHAT CAN YOU DO TO PREVENT ANOTHER TRAGEDY??

• Child Vehicle Heatstroke Prevention Tips from NHTSA:
  • Never leave a child unattended in a vehicle. Never leave infants or children in a parked vehicle, even if the windows are partially open.
  • Do not let your children play in an unattended vehicle. Teach them that a vehicle is not a play area.
  • Make a habit of looking in the vehicle – front and back – before locking the door and walking away.
  • If you are dropping your child off at childcare, and normally it’s your spouse or partner who drops them off, have them call you to make sure the drop went according to plan. Ask your childcare provider to call you if your child does not show up.
  • Do things to remind yourself that a child is in the vehicle, such as:
    • Keep a large object such as a stuffed animal in the car seat when it’s empty. Move the stuffed animal to the front seat when you place the child in the seat as a visual reminder.
    • Place your purse, briefcase or something else you need in the back seat so that you will have to check the back seat when you leave the vehicle
  • If you see a child alone in a hot vehicle: call the police. If the
    y are in distress get them out as quickly as possible and cool the child rapidly. Call 911 or your local emergency number immediately
• Take Ray Ray’s Pledge
  • You Pledge: to call your child’s teacher if he or she will be late or absent
  • Teacher Pledges: to call YOU immediately if your child does not arrive at his or her usual time
• Download the KidsandCars Safety Checklist and keep it handy
• July 31st is National Heatstroke Prevention Day
  • Join the Office of Emergency Medical Services at NHTSA in a day of social media conversation and help them get the word out about the dangers of heatstroke when children are left in cars. @NHTSAgov will be tweeting and posting on Facebook every hour on the hour from 10am – 5pm using the hashtag #heatstroke. Please join them…
  • For more info and sample tweets click here

“If you think it can’t happen to you, then it could and it might… Tell yourself it COULD happen to me and then do whatever it takes to make sure it doesn’t.” …kidsandcars.org

And if you ever catch yourself saying…”I’ll only be gone for a moment”… please do two things:

1. Consider the following question: If someone gave you a million dollars – would you leave it sitting there unattended in your car – even for a moment? Isn’t your baby’s life worth more?
2. Consider watching this video…and then maybe even share it:
   Before you do, know that it is very graphic and may be upsetting…so please think twice before you watch it.

Please also know that this was a re-enactment – no one was harmed in the making of this film

Summer is Here – How to Keep Your Kids Safe & Healthy

For much of the country, the arrival of summer, officially at 7:09 PM on Wednesday, was anything but subtle. In many areas the heat index (temperature plus humidity) was well over 100. For many people this level of heat can rapidly lead to true health emergencies. This is true for everyone but especially the very young or old, those with certain health conditions and your pets. Here are some keys to help assure you survive and have a safety and healthy summer:

• Never leave a child or pet in a car when you leave. Even running cars can stall and doors can become locked. Temperatures can reach FATAL level within minutes. Don’t do it- ever not even for just a minute. If you encounter a child or pet locked in a vehicle- don’t hesitate to call 911.
• Drink plenty of fluids- before you are thirsty.
• Stay in the air conditioning/shade when possible.
• Wear sunscreen and replenish often. Recent headlines suggest there is no such thing as a truly waterproof sunscreen.

Look for the signs of the affects of heat- these may include the following. Remember it is not necessary for all these to be present to suggest a problem.

• Nausea/vomiting
• Headache
• Dizziness
• Flushed, pale skin
• Rapid pulse
• Profuse sweating.
• If you are someone else is sweating and the sweating stops this may be a sign of a serious life threatening condition known as heat stroke. Call 911!

If any of the above are present the first rule is get out of the heat move into the shade- air conditioning is better.

Drink cool fluids- ice cold may enhance nausea.

Ice and wet towels may be applied to the skin. Areas where arteries are close to the skin may result in faster cooling.

If you are affected by the heat- you are done for the day- don’t try to rest up and go back out. Your body can succumb much quicker a second time. You need time to recuperate.

As this is now summer and pools are open- remember pool safety and making sure your pool is child proof. That water looks like a sure relieve from the heat- not for young kids and never alone.

Warning: Where’s Baby? Look Before You Lock Your Car!

As a former paramedic, I can tell you there are few things as heart-wrenching as responding to an event dealing with a child. Especially those events that are preventable such as drowning, poisoning and the following. Please read.

This week the National Highway Traffic Safety Administration (NHTSA) launched its first-ever national campaign to get the message out about the harmful and potentially fatal effects of leaving children in hot cars.

The Where’s baby? Look Before You Lock message asks all parents, grandparents, and other care-givers to be mindful when leaving your vehicle.

Cars heat up quickly – even with a window rolled down two inches, if the outside temperature is in the low 80s, the temperature inside a vehicle can reach deadly levels in just 10 minutes. Young children, those under 4 years old, are particularly at risk because their bodies overheat more easily.

So this campaign is a call-to-action for parents, families, and everyone who cares about the safety of children. As NHTSA Administrator David Strickland said, “While parents are the first line of defense when it comes to preventing heatstroke in hot cars, everyone in the community has a role to play in keeping kids safe.” Keep your children safe this summer.

NHTSA also offers Hyperthermia Prevention Safety Tips:

• Never leave a baby or young child unattended in a vehicle—even if you leave the windows partly open or the air conditioning on.
• Make a habit of looking in the vehicle – front and back – before locking the door and walking away.
• Do things to remind yourself that a child is in the vehicle, such as:
  • Writing yourself a note and putting it where you will see it when you leave the vehicle;
  • Placing your purse, briefcase or something else you need in the back seat so that you will have to check the back when you leave the vehicle;
  • Keeping an object in the car seat, such as a stuffed toy. When the child is buckled in, place the object where you’ll notice it when leaving the vehicle.
• If you see a child alone in a vehicle, call the police. If they are in distress due to heat, get them out as quickly as possible. Cool the child rapidly. Call 911 or your local emergency number immediately.

PS. Dogs left in cars can suffer the same fate as children.

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