April 2016 - Vol. IX
Kids Health Jana Barham, MD
Healthy Kids ! Happy Life!
A Pound of Prevention Worth a Pound of Cure!
Delores and Delilia Ortega
Jana Barham, MD
Dr. Jana Barham M.D., D.A.B.P., F.A.A.P. Caring for you children is my calling and my life’s work. Originally from Kansas City, I moved to Dallas in 1975. I graduated Cum Laude with a B.A. in Economics and Business Administration from Tulane University in New Orleans and returned to Dallas to receive my M.D. from the University of Texas Southwestern Medical School in 1995. I then completed my three year pediatric residency at Children’s Medical Center in Dallas in 1998 and founded my practice in 1990..
Prevention This month’s newsletter is all about prevention. The saddest words in the world of parenting are “if only.” If only I knew how dangerous pool covers could be. If only I knew how important registering my child safety seat was to receive recall notices. If only I knew how dangerous child walkers were. “If only” ... are words that torture parents. This month’s newsletter is dedicated to those “If only’s.” Dr. Jana Barham
2
James, Anna and Laura Jamison
The right choices Understanding where the risk of injury to your child is found may help you assess the risk your child takes every day. Unintentional injuries—such as those caused by burns, drowning, falls, poisoning and road traffic—are the leading cause of morbidity and mortality among children in the United States. The Center for Disease Control (CDC) reports each year, among those 0 to 19 years of age, more than 12,000 people die from unintentional injuries and more than 9.2 million are treated in emergency departments for nonfatal injuries.
Children are more likely to be injured by an accident than adults.
Appendicitis can be a tricky symptom to identify. All too often parents mistake appendicitis for a stomach ache or food poisoning. Learn the signs and sympoms of appendicitix. Making the right health choices for you children can be as simple as understing the risk and the signs and symptoms.
3
Jana Barham, MD
Appendicitis in Children With an appendicitis the pain begins around the belly button eventually relocating down to the lower abdomen right where the appendix is actually located. With an appendicitis there will be mild fever, vomiting, nausea and a loss of appetite.
Because pain associated with appendicitis often starts in the belly button are parents may not be aware of an impending Appendicitis.
Appendicitis in Children Appendicitis can be tricky to identify. It typically occurs between the ages of 10 to 20 and is the most common cause for abdominal surgery in this age group. Most parents recognize the appendix is located on the lower right side of the abdomen but confusingly the pain begins around the belly button eventually relocating down to the lower abdomen right where the appendix is actually located. With an appendicitis there will be mild fever, vomiting, nausea and a loss of appetite.
What Is Appendicitis? Appendicitis is an inflammation of the appendix. The infected appendix can rupture spreading bacteria throughout the abdomen causing peritonitis. An inflamed appendix can burst in 12 to 24 hours after the symptoms begin. If the appendix does burst, the pain may spread across the whole abdomen and the fever may reach 104°F (40°C).
Appendix
Ruptured Appendix After an appendix ruptures there may be a slight relief in the pain. The pain will, however, resume and become worse with additional symptoms. Pain may increase with walking, coughing, or making sudden movements. Later symptoms include: »» Chills and shaking »» Fever »» Nausea and vomiting »» Hard stools »» Diarrhea
4
An inflamed appendix can burst in 12 to 24 hours. About Appendicitis
Appendicitis Treatment
The appendix is attached to the large intestine in the lower right side of the abdomen. The inside of the appendix usually opens into the large intestine.
Appendicitis is treated by surgically removing the inflamed appendix. Surgeons perform the appendectomy with a traditional incision in the abdomen. In some cases a small surgical device known as a laparoscope is used which creates a smaller opening. An appendectomy usually requires a two to three day hospital stay.
When the appendix is blocked, it becomes inflamed and bacteria can overgrow in it. Blockage can be due to several causes including a hard rock-like stool known as fecolith, an inflammation of lymph nodes in the intestines, or parasitic infection. The infection from a ruptured appendix can spread throughout the abdomen causing peritonitis.
Appendicitis Diagnosis Appendicitis signs and symptoms are similar to other medical conditions such as an urinary tract infection, kidney stones and even pneumonia. The abdomen will be examined for signs of pain and tenderness. Tests may include blood and urine tests, an abdomen X-ray, ultrasound, or a CAT scan.
If you suspect that your appendicitis in your child do not give your child anything to eat or drink or any medication until your child is seen by a physician.
Intravenous (IV) fluids and antibiotics administered both before and after surgery will help prevent complications and decrease the risk for wound infections after surgery. Pain medicine is used on an as required basis. If the infected appendix has burst prior to surgery a longer hospital stay may be required to allow antibiotics to kill any bacteria that have spread into the body.
Appendicitis Symptoms Symptoms of appendicitis include significant abdominal pain, especially around the bellybutton or in the lower right part of the abdomen which come and go, ultimately becoming consistent and sharp. Appendicitis is not preventable. Symptoms include: »» Low-grade fever »» Nausea and vomiting »» Diarrhea in small amounts filled with mucus »» Swollen or bloated abdomen »» Loss of appetite
5
Jana Barham, MD
Children and Injury Unintentional injury is the highest cause of death of children in the United States. Injuries due to transportation were the leading cause of death for children. The death rate for males is almost double that of females. Males also have a higher injury death rate.
Paul Mellon
Drowning leading cause of death inone to four year olds.
Suffocation death rate for infants represents 2/3rds of all injury deaths.
Unintentional injury is the highest cause of death for children in the United States. 6
For children under one year of age, two–thirds of injury deaths resulted from suffocation. Drowning was the leading cause injury death for those one to four years of age. For children five to nineteen years of age the greatest number of deaths from injury were by a motor vehicle traffic crash. The suffocation death rate for infants was over 16 times the rates for all older age groups. The poisoning death rate for those older than 15 years of age was at least five times the rates of the younger age groups. Injury death rates were highest for Alaska Natives and American Indians. Asian or Pacific Islanders had the lowest rate of injury deaths. Death rates for African– Americans and White-Americans were approximately the same. Injuries due to transportation were the leading cause of death for children with the highest death rates from occupants of vehicles. There were also a substantial number of pedestrian and pedal cyclist deaths among children. Combining all unintentional injury deaths among those between 0 and 19 years, motor vehicle traffic–related deaths were the leading cause.
Top Five Cause Nonfatal Childhood Injuries Falls were the leading cause of nonfatal injury for all age groups less than 15. Ages 0 to 9: The next two leading causes were being stuck by or against an object and animal bites or insect stings. Ages 10 to 14: The next leading causes were being struck by or against an object and overexertion. Ages 15 to 19: The three leading causes of nonfatal injuries were being struck by or against an object, falls, and motor vehicle occupant injuries.
Edward Greneyer
7
Jana Barham, MD
Infants and Suffocation Deaths Seventy percent of suffocation deaths among infants are from accidental suffocation or strangulation in bed. It is a dangerous practice to take their babies to sleep their parents bed or put blankets or toys in a crib to make it seem like a cozier place. The evidence is clear, this is not safe. Read more at SafeKids.Org on safe sleeping practices: https://www.safekids.org/
Delores and Delilia Ortega
8
Three out of five cases of children suffocating occur in the sleeping environment.
Suffocation and Strangulation Nonfatal suffocation rates were highest for those younger than one year of age. Suffocation for children one and under represents a serious challenge for parents. Suffocation injuries include choking or strangulation. The majority of choking, suffocation, and strangulation incidents occur at home. Three out of five cases of infant suffocation occur in the sleeping environment. This included beds, cribs, bunk beds and sleeping with parents. Strangulation is the primary cause of playground deaths.
Food was the cause of most choking incidents in younger children. Children have small airways which are easily blocked. The size of a young child's trachea or windpipe is approximately the size of a drinking straw in diameter and is easily blocked by ordinary food such as a hot dog or even popcorn. Children suffocate by not getting enough air to breath by playing with plastic bags or balloons. Some toys and playground equipment may cause a risk as well.
Parents are concerned about potential injury at every turn. Understanding the most common causes of injury to children will help you put your focus in those areas. Of course, vigilance is in order but knowledge can be a powerful tool for your parental tool box.
9
Jana Barham, MD
Falls and Infants Infant falls are reported mostly occurring in the home. Usually, these are a result of falling from a bed, sofa, chair, stairs or changing table. As babies begin to roll, kick, pull up and push up against any object the perceive to be solid falls may occur. Safety precautions during this pivotal transition period should be considered. Baby walkers are considered unsafe and should not be used. Babies using them may tip over, fall out, or fall down stairs. The American Academy of Pediatrics recommends stationary walkers which rotate and bounce but do not have wheels. Playpens are considered safe areas for babies to crawl and learn to walk. These safety zones allow the children to hold on to the sides of the play pen for support as they learn to crawl and then to walk. Safety gates at both top and bottom of stairs are crucial. Accordion-style or tension gates are not recommended because of the dangers of a child’s head being caught in it and resulting strangulation.
Baby gates should be placed at both the top and bottom of all stairs.
10
The American Academy of Pediatricians recomends AGAINST walkers with wheels.
Drowning Leading Cause of Injury Related Deaths for Children Drowning is a leading cause of injury-related deaths in children of all age groups. Children aged one through four years are at an especially high risk. Near drowning incidents often result in lifelong medical conditions. Parents or caregivers have a major role in preventing drowning and near drowning incidents. The leading causes of drowning in children are generally preventable. Lack of adult supervision around water, pools, bathtubs, and buckets/pails of water represents the highest cause of death. Pools in homes should have four-sided fencing that isolates a home swimming pool from the house. Pool alarms and pool covers are not as substitute for four-sided fencing. These are not likely to be used appropriately and consistently. Some types of pool covers give the appearance of being solid encouraging a child to believe they can walk on the cover. Actually pool covers can be a dangerous hazard for young children. A young child could fall into the pool and be trapped under the cover. Seizure disorders or heart conditions in children create an additional risk for children when swimming. Drowning is the most common cause of unintentional injury death for persons with seizures. This includes not only swimming but bathing. Children can drown in as little as two inches of water. Teach your child how to swim. Not being able to swim may lead to injuries. Knowing how to swim alone does not prevent drowning but it is a crucial first step. Water temperature is an important factor that contributes to drowning as cold water can lead to hypothermia, or lowered body temperature.
Visit JanaBarhamMD.com Read our blog! Learn More
Sign up for our newsletter. Read out blog at JanaBarhamMD.com Baby Wellness Morning Third Saturday of the month.
11
Jana Barham M.D. Real Life Solutions Real Life Medicine
Hours: M - F 9 AM to 9 PM Sat: 8AM to 12 PM
Cathering and Crocker Colson
Jana Barham, MD 6643 Any Street West Townsville, State 37568 Phone: (444) 544-5444 Fax: (444) 544-5445
12