justkids Fall 2007
Published by Children’s Hospital, Omaha, NE
Caring for the Tiniest Patients Protect Your Family from Lead Understanding Drug Risks in Kids Inside | Helping Children Fight the Flu | Page 8
c h i l d r e n’s s p o t l i g h t
Caring for the Tiniest Patients Newborns so tiny they can fit into the palm of your hand need specialized care to help in the hardest fight of their lives. In the Neonatal Intensive Care Unit (NICU) at Children’s Hospital, neonatologists and skilled nurses combine their expertise to increase the chances for these fragile lives.
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he ability to treat infants born as early as four months premature and weighing as little as 1.2 pounds is testimony to the level of skill of the physicians, nurses and staff at Children’s NICU. It is also testimony to Children’s dedication to employing the latest in cutting-edge technology and medical advances within the unit. The 46-bed NICU is a level III facility where technology and compassion combine to create a center of unparalleled medical support. It provides intensive medical, surgical and nursing care, life support systems, electronic monitoring and a complete range of diagnostic and therapeutic capabilities. It is also equipped to provide ECMO services. ECMO, or extracorporeal membrane oxygenation, uses a heart-lung machine to oxygenate the blood. Skilled and experienced Team The NICU treats patients from a fivestate region who receive care from our experienced team of medical experts. In addition, infants in the NICU have access to all the nationally recognized medical and surgical specialists at Children’s Hospital who are available for consultation, including two pediatric cardiothoracic surgeons for cardiac birth anomalies. A neonatologist is a medical doctor who has had at least three years of pediatrics training and at least three years of newborn intensive care training. At Children’s, the NICU team consists of six neonatologists and nine neonatal nurse practitioners who are available 24 hours a day, seven days a week to care for patients and families. The NICU team also includes respiratory therapists, full-time social work and case management staff in the unit, as well as a developmental specialist
Nurse Amy Jacobsen soothes a young patient in the Neonatal Intensive Care Unit at Children’s Hospital.
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conducted a nipple study to determine a premature infant’s acceptance of nipples designed for use in oral feeding.
to ensure the environment remains developmentally friendly, clinical nurse specialists and a lactation consultant. In addition, pharmacists dedicated to the unit manage all medication and IV orders to assure a high level of safety and accuracy. The standard and level of nursing care provided in the NICU is second to none. In fact, three of the unit’s nurses were recognized regionally for their nursing excellence by Nursing Spectrum magazine. Children’s nurses won three of the six categories out of the hundreds of entries from a nine-state region. The work being done by NICU nurses at Children’s Hospital is even helping to change how infants are cared for across the country. Children’s NICU nurses
Designed for Infants and Families The walls in the NICU provide noise-dampening capabilities and privacy, while still allowing NICU staff visual access to the newborns. The wood trim, ceiling tiles and carpeting were all chosen for their soundabsorbing qualities. Sensors were placed in the ceiling throughout the NICU that flash if nearby noise causes the decibel level to exceed 55. In addition, the lighting system allows the environment to be dark for the baby and light for the staff. Waiting rooms are equipped with a kitchenette and sibling play area, which enable families to participate in their infant’s healing. Radiology viewing rooms are located on each NICU floor to help speed in the diagnosis and treatment of neonates. And an education room offers space for staff to teach families how to care for and nurture their newborns.
Transport Program While the environment inside the NICU at Children’s Hospital offers a reassuring haven for children and their families, Children’s takes this environment outside the traditional hospital walls with its transport program. The program provides transport service 24 hours a day, seven days a week for newborns and infants who need to be transferred to Children’s for treatment. Patients are transported with all the necessary life support equipment, medications and monitors. And Children’s own experienced neonatal nurse practitioners and intensive care nurses are there every step of the way, providing a high level of expertise to assess the infant and perform the procedures that need to be done. In fact, their advanced training in medical management and advanced knowledge in nursing are unsurpassed in the area. Infants continue to receive care after being discharged from the NICU through Children’s Neonatal Follow Up Clinic and Developmental Clinic. Here, specialists continue to work with families to follow progress as the baby grows and develops. ■
To find out more about Children’s NICU, visit our web site at www.chsomaha.org, or call 402-955-6950.
Specialty Pediatric Center Answers Growing Demand Children’s Hospital recently announced
environment of the clinics will cater
plans for a new specialty pediatric center
to the unique needs of children and
to accommodate a growing number of
encourage family involvement in
patients and medical staff.
their care. It also will provide space
“This project will enable us to
for teaching and clinical trials.
continue providing leading-edge
The new center will occupy the
specialty health care services for children
southeast corner of 84th Street and
from the community, Greater Nebraska
West Dodge Road, just north of (and
and the region,” says Gary A. Perkins,
connected to) Children’s Hospital and
Children’s Hospital president and chief
the Scott Pavilion, the site of Children’s
executive officer.
current clinics. Demolition of existing
The new center will address the
include the latest in efficiency design, featuring
buildings on the new site will continue
hospital’s need for more specialty clinic space
easy navigation for patients and their families,
this year, with construction scheduled to begin
and increasing demand for specialized and sub-
and making it possible to see more than one
in January 2008. The new building is expected
specialty health-care services for children. It will
specialist in a single visit. The child-friendly
to be open for occupancy in January 2010.
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c h i l d r e n’s s p o t l i g h t
Protect Your Family from Lead need to make sure remodeled areas are cleaned thoroughly before allowing children into the area.” If you rent, talk to your landlord about fixing peeling paint. Painting over the peeling layer may lower the risk, but you should consider this a temporary fix.
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he recent string of Children’s Physicians and toy recalls across associate clinical professor of the country has pediatrics with the University brought the dangers of Nebraska Medical Center. of lead to the public forefront. Lead also can affect adults, Lead is a heavy metal that can and it is a serious risk for harm the body. If there’s too pregnant women or women much lead, it can cause kidney who may become pregnant. damage, coma and even death. That’s because lead could Bob Woodford, MD Children under 6 years of age affect an unborn baby. are the most at risk for lead poisoning. That’s because their bodies absorb The problem wiTh Some painT lead more easily. Even small amounts of lead The major source of lead in the United can harm their brains. This can affect their States is lead paint. This type of paint was learning, behavior and intelligence. Some banned in 1978. But homes built before results of lead poisoning may be permanent. then may still have lead paint. Children “While there is no sure way to prevent can get lead in their bodies by eating lead a child’s exposure to lead, these negative paint flakes, which taste sweet. outcomes can be reduced by conducting “Recent or ongoing remodeling of these routine screenings for lead exposure,” says older homes poses a risk for lead Robert Woodford, MD a pediatrician with exposures,” says Dr. Woodford. “Parents
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prevenTion TipS Here are some other ways to help your family stay safe: ■ Do not let children or pets play or have contact with leadcontaminated bare soil. Several zip codes in Douglas and Sarpy County, Nebraska, contain high amounts of lead. To help reduce exposure, put fencing or barriers around bare soil areas and cover bare soil with six inches of leadfree wood chips, mulch, soil or sand. In addition, remove shoes before entering your home, clean all washable floors weekly with a household cleanser and wash all outside toys frequently with soap and water. ■ Tap water can contain lead. Ask your local water company about lead in your water. If it contains some lead, let the water run on cold before using it for drinking or cooking. Don’t cook with or drink warm or hot tap water. This can have much higher levels of lead. Remember, boiling will not help remove lead from water. ■ Clean floors, windowsills and other surfaces each week. This will get rid of dust that may contain lead. ■ Don’t let small children play with metal jewelry or toy metal jewelry, which may be made with lead. If you’re worried about lead affecting you and your family, talk to your doctor. A blood test can check for levels of lead in the body. ■
Hospitalists at Your Service 24/7
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f your child has an illness or injury that requires treatment at Children’s Hospital, he or she may be treated by one of our pediatric hospitalists. A pediatric hospitalist is a board-certified pediatrician who specializes in inpatient care. They have four years of medical school training and an additional three years of pediatric residency training. At Children’s, hospitalists work with your child’s regular physician to coordinate your child’s care while in the hospital. For example, physicians who live outside of Omaha can send their patients to Children’s, and our hospitalists oversee the child’s treatment while in the hospital. They keep the primary care physicians informed on the child’s progress through daily phone calls. And when the child is released from the hospital, the hospitalist provides written discharge instructions for the family and the primary care physician. Hospitalists also coordinate the child’s care with other physicians and specialists within the hospital. “Having hospitalists in the hospital makes a difference because they are able to make quick, on-site assessments and are able to coordinate medical care among different medical specialists,” says Jay Snow, MD, medical Jay Snow, MD director of the hospitalist program at Children’s Hospital. Children’s Hospital currently has six hospitalists who are available for inpatient service 24 hours a day, seven days a week. And while the program is beneficial for families and physicians outside the Omaha
area, hospitalists can help local families and physicians, too. “Our program helps local physicians with busy practices,” says Dr. Snow. “And the partnership is good for us. We can speak to the primary care physician who knows this patient very well, and that physician can provide us with the patient’s history and pertinent health information.” While convenience is one benefit of the hospitalist program, patient care is the driving force behind the service. “The most important feature of the hospitalist service is having an experienced, skilled pediatrician always available to the patient,” says Dr. Snow. ■
Little Hearts Need Healthy Food, Too Infants and toddlers aren’t too young to benefit from a heart-healthy diet. The American Heart Association suggests that parents use the following strategies as they introduce fruits, veggies, whole grains and other new foods to their little ones: ■ Keep offering healthy foods even if your child first refuses them. A new food may need to be introduced up to 10 times until children develop a taste for it. ■ Rest assured that it’s OK if children don’t finish their meals. They know when they’re hungry, and it’s normal for their intake to vary from meal to meal.
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Creating Happy, Healthy Holidays Together W
Alka Desai, MD
hile the holidays can be a great source of lasting childhood memories, they also can be a time of stress and anxiety if not handled properly. As parents, it’s important for you to take control. The best way to do this is to plan ahead, stick to priorities and let your child come first. “The holiday season means a lot of family gatherings in homes that may not be child-friendly,” says Dr. Alka Desai, a Children’s Physicians pediatrician. “It is important to watch your children closely to keep them safe.” If you’re so busy that you become careless and distracted, you may leave hazards around the house. There may be accidents. If you wear down yourself and your child with a demanding schedule of shopping and parties, you both may become susceptible to illness. Instead, do only what you can and no more. Follow these tips to help ensure a happy holiday season: ■ Drive safely. There are more cars on the road during the long holiday season, weather and road conditions are often bad and other drivers may be` distracted or drunk. Drive defensively and watch for children walking home from parties at dusk. Don’t let your mind wander to your to-do list while driving, and keep children younger than age 6 in an approved child safety seat. ■ Be a safe host. Be sure to keep snacks
and appetizers that could cause choking— such as nuts, grapes and hard candies— out of the reach of small children. Be sure to clean up and clear away ashtrays and alcoholic beverages at the end of a get-together. If you leave them out, your child could wake early and become intoxicated on half-finished drinks or consume cigarette butts without your knowledge. ■ Let the children participate. One way to reduce stress is to let your children help. They can help prepare simple dishes, as well as make their own wrapping paper or holiday cards. ■ Get rid of plastic bags. Dispose of plastic bags as soon as you get home. Don’t just toss them in the wastebasket, but make sure they are completely out of children’s reach. Plastic bags are a major cause of suffocation in small children. ■ Suggest games that you can play together. Grandparents and children alike will enjoy these games, especially when they bring friends and family together. “Keep in mind that although poinsettias are festive, they are poisonous,” says Dr. Desai. “Keep all festive holiday plants, like holly, mistletoe, berries and ivy, out of reach of children.” In addition, remember to take time for hugs and quiet family time during the holidays. And above all, remember the secret of the season, a child’s wonder and delight, are yours to share if only you take the time to enjoy it. ■
“healthy holidays” is one of several topics available for parents on the children’s hospital website at www.chsomaha.org. Simply click on “health information,” and then “pediatric hints.” once there, parents can choose from 98 pediatric hints on a variety of subjects, including picky eaters, allergies, sibling rivalry and more.
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Understanding Drug Risks in Kids W
hile you may not think you can be cool in your child’s eyes, you can be hip to some of the drug dangers that today’s teens face. “Adolescence can be a time of intense emotions,” says Gregory Snyder, PhD, a child psychologist with the Family Support Center at Children’s Hospital. “While adolescents often talk like adults, they often struggle to adequately temper their emotions and make rational decisions. Their brains are still developing, and it places adolescents at significant risk for engaging in high risk behavior, like alcohol and drug use.” Here’s the 411 on the latest drugs— and how to spot signs of abuse in your child or teen. Sniffing, bagging and huffing To get a quick buzz, some young people inhale the vapors of household products that contain solvents or aerosols. These include glues, canned whipped cream, correction fluid, nail polish remover, gasoline, spray paint, shoe polish and hair sprays. They may inhale directly from the container or pour the substance on a rag or in a bag and then inhale. But abusing inhalants has a price. It can lead to dependence, and it damages the brain, heart, liver and
kidneys—and can even cause sudden death.
a depressant usually taken as a pill. Club drugs can be addictive. They also can trigger depression, seizures and organ damage. Some young people die from using club drugs.
roboTripping or Triple c’S Overdosing on over-thecounter cough and cold iS Your child abuSing medicine, such as Robitussin drugS? or Coricidin Cold and Gregory Snyder, PhD You can’t be with children all Cough, is gaining popularity the time. But you can arm them among young people. with information and a clear understanding Such medicines contain a cough of your position on drugs. Observant parents suppressant called DXM, which can intervene soon enough to prevent serious in large quantities can cause problems in the future. Warning signs that a hallucinations. Misusing these medicines also can lead child may be using or abusing drugs include: ■ Dropping grades to seizures, brain damage ■ Behavior changes and death. Let children ■ Changes in sleep patterns know that even though ■ Lack of interest in appearance or hygiene these medicines can be ■ Pulling away from the family bought legally, misusing ■ Seeing objects that suggest drug use. them isn’t safe. Also, don’t be afraid to trust your instincts if you think your child may x and oTher club have a problem. ■ drugS So-called club drugs are usually taken by teens who attend all-night dance parties, or raves. The most popular club drugs include: ■ MDMA, known as ecstasy, X and E, is a synthetic stimulant and hallucinogen usually taken in tablet form. ■ GHB, or max, is a depressant taken by mouth as liquid or powder. ■ Ketamine, known as K and jet, is a tranquilizer that is injected, snorted or put in drinks. ■ Rohypnol, or roofie, is
keeping Your kids drug-free Whether you are a parent, grandparent or any other person who cares about a child’s future, it’s hard to imagine that a child we love could end up using drugs. But chances are, most children will be faced with, “Should I, or shouldn’t I?” Call 402-955-6950 to receive a FREE copy of our booklet, Keeping Your Kids Drug-Free, to help you teach your child to know that the answer is, “I shouldn’t, and I won’t.”
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Helping Children Fight the Flu
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The Centers for Disease etting vaccinated is Control and Prevention (CDC) still the best way to recommends annual influenza prevent and vaccinations for: control the flu—a ■ Children ages 6 to 59 months viral infection spread by (6 months to 5 years) coughing and sneezing or ■ Children older than age 5 who touching flu-infected surfaces. have chronic medical conditions, “Influenza viruses can cause such as asthma, HIV or heart disease serious infections, not only in Archana Chatterjee, ■ Children older than age 5 who individuals with underlying MD are on long-term aspirin treatment health problems and the for another illness (Children taking elderly, but also in otherwise aspirin therapy could develop the potenhealthy children and adults,” says Archana tially fatal Reye’s syndrome if they catch Chatterjee, MD, pediatric infectious the flu.) disease specialist with Children’s Hospital ■ Household contacts and out-of-home and associate professor of pediatrics at caregivers who care for children ages 6 to Creighton University. “Annual influenza 59 months or children with chronic vaccination is recommended for anyone medical conditions, as well as all members who would like to avoid becoming of a household with an infant younger infected with these viruses.” than 6 months of age ■ Pregnant women. Remember, children younger than age 9 who have never received a flu vaccine need two doses in their first year of influenza vaccination to maximize effectiveness during the year. The flu season normally begins in Children’s Hospital has received accreditation or recognition from the following organizations for its delivery of December, peaks in mid-February and can extraordinary health care to children. end as late as April. That’s why the best time to be vaccinated is between midOctober and mid-November. Contact your just kids is published by Children’s Hospital to provide general pediatrician’s office to schedule flu shots health information. It is not intended to provide personal for your children.
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medical advice, which should be obtained directly from a physician. © 2007. All rights reserved. Printed in U.S.A. Gary A. Perkins, President and CEO Martin W. Beerman, Vice President, Marketing and Community Relations David G.J. Kaufman, MD, Medical Advisor Dannee Hartley, Public Relations Coordinator Printed on Recyclable Paper
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flu SYmpTomS Symptoms of the flu include a fever, cough, headache, chest congestion, fatigue, exhaustion or a general aching feeling. The
illness is most often spread from person to person by coughing or sneezing. Aside from vaccination, the best way to prevent the spread of the flu is through good handwashing hygiene, covering your mouth when you cough or sneeze and avoiding contact with those who are sick when possible. TreaTmenT What do you do if—in spite of precautions—your child still catches the flu? Emphasize bed rest and drinking plenty of fluids. Over-the-counter medicines like cough suppressants and nasal decongestants also may help. But never give aspirin to children and adolescents with the flu. Antiviral medications are available for treatment of selected cases. Contact your health-care provider about these medications and when they should be used. ■
Immunization is an important aspect of preventive medicine, especially for children. Call 402-955-6950 to receive a free immunization magnet complete with a schedule for your child’s vaccinations.