Tips from Officer Goldsberry

Here are the notes from our last meeting:

Tips for Halloween:
- masks aren't a good idea. use face paint instead
- add something unique to your child's costume
- walk up to each house with your child
- use your instincts, if you are creeped out by a house/person avoid it!
- search the TBI website to see where the sex offenders are in your neighborhood, then avoid their house.
- have your child use flashlights or something reflective during the dark hours of trick or treating
- try to go trick or treating during the daylight hours if possible
- bring a cell phone and a flashlight of your own along with you.
- know where your kids are at all times
- look at all candy first before allowing your child to eat it
- if you won't be home- leave lights on with a bowl of candy out.  Then your house will be less of a target for any pranks.

General tips:
- teach your children YOUR first and last name, your address and phone number
- when shopping, carry your cell phone on your person, not in your purse.
- When shopping, be aware of your surroundings- walk with your head up and look around.
- have a code word for your family
- don't put names on shirts and backpacks
- teach your children to check with you before doing any activity that involves a stranger (ie- petting a dog, accepting candy, etc)
- talk to your kids about good/bad touches and good/bad kisses...it is no longer known as "stranger danger" because so many kids are hurt by those who are known to them and their parents.

Last night's meeting

I do have notes from the last Friday morning meeting, and I will post them, just not today!

Last night we had a Physician's Assistant who works at a local children's hospital come and talk to us.   She was excellent!  Here are her notes that she was so gracious to share with us: 

Things every mom should have at home:
• acetaminophen (Tylenol)
• ibuprofen (Motrin, Advil)
• diphenhydramine (Benadryl)
• simethicone (Mylicon, gas drops)
• rectal thermometer (if you are uncomfortable taking a rectal temp, get your doc/nurse
to show you how, rectal temp is the most accurate)
• saline drops
• suction bulb
• antibiotic ointment
• bandaids

Basic Child Development: CDC website
www.cdc.gov/ncbddd/actearly/milestones/index.html

Pediatric First Aid:
Every parent and babysitter should take a CPR and first aid class!
unconscious kid basics: call 911
most common cause for cardiac arrest in child is pulmonary arrest.
CAB: circulation, airway, breathing

Have a list of numbers right by the phone:

• poison control
• fire/police department
• your childʼs doctorʼs office
• local ER number
• neighbor/friend/relativeʼs number
• own cell phone numbers in case you have to leave a second child at home with someone.

Have a designated first aid box (can make your own or buy).
Put a a separate first aid kit in your car.

Head injury:

• passed out? threw up? confused or lethargic? = concern for concussion
• IT IS NORMAL FOR A KID TO WANT TO GO TO SLEEP AFTER AN INJURY:adrenaline rush, crying and freaking out, and then dissipates = sleep. It is a PROBLEM when they are sleepy immediately (ie: lethargic).
• the dreaded “pump knot”: apply a cold pack and give them some Tylenol. Unless they fall from a height, are propelled (ie: pushed really hard, car wreck, etc) or are hit really hard with a blunt object, it is almost impossible for a kid to crack their own skull or give themselves a concussion through everyday accidents.
• kids will hit their heads a lot. use your best judgement as to whether or not you think there is an injury that requires medical attention.
• When to go to the ER for sure: dropped newborn, child passed out/threw up/lethargic, or you think something is “just not right” beyond their usual being upset.

Cuts:

• When to get stitches: “deep and wide”, bleeding cannot be controlled at all after an hour of firm pressure
• PLAIN SOAP AND WATER are the best thing to clean a cut. yes, alcohol and peroxide reduce germs, but they also interfere with healing and can actually delay healing. Plus they burn.
• Irrigation is the key!
• Antibiotic ointment: NEOSPORIN can cause allergic reaction (only diff is neomycin component). Get double antibiotic ointment (usually a mix of bacitracin and polymyxin) or plain bacitracin.

Ingestion:

• BEFORE YOU DO ANYTHING, CALL POISON CONTROL:1-800-222-1222!!! They are wonderful and can talk you through everything you need to do at home and they can also give you advice about whether or not you need to seek medical attention. They even call the ER where you will be going to make sure you got there and to get an update on the child. We use them in the ER all the time. 
• What you do about it (ie: make them throw up, make them drink, etc) depends on the type of ingestion. you can accidentally make things worse, so just call poison control.

Burns:

• NO ICE, use cool water.
• minor burns that do not blister: antibiotic ointment and a bandaid.
• DONʼT POP THE BLISTERS (bodyʼs sterile protection). If they pop by accident, apply antibiotic ointment and keep covered until scabbed over and healing.
• large burns or severe burns go to the ER, especially if they involve the hands, feet, or genitals.

Dehydration:
Kids can go without eating for days, but they MUST DRINK.

• mild dehydration: not peeing as much as usual but still peeing, not drinking as much as usual but still drinking. This can be managed at home until things perk up.
• things to look for: sunken eyes, cap refill > 2 sec, stick or dry mucus membranes (tongue), major drop in activity level.
• When you need to seek medical attention: putting out more than they are taking in (profuse vomiting and/or diarrhea with little intake), no urine output in 8 hours, lethargic, refusing to drink at all.
• Check capillary refill time.  It should be under 3 seconds. This is easiest to do in a child's foot.
• If you have poor turgor, you are way behind the eight ball and your kid needs immediate medical attention.

Miscellaneous:

Puncture wound: soak the area and wash with soap and water, antibiotic ointment,
bandage. When to seek medical attention: foreign body, deep puncture (esp into hands, feet, or joint).
Tetanus: must have been within the last 5 years for an open wound of any kind.
Tooth trauma: control pain and see the dentist.
Tooth knocked out: baby tooth, leave out and control pain. permanent tooth: rinse with
milk and take to the dentist immediately. There is little we can do at the ER for tooth trauma other than antibiotics and pain control, unless there is an associated laceration.
Ripped off fingernail: unless there is a large cut associated or you cannot control the bleeding with firm pressure after one hour, it will be ok. Nails almost always grow back.

Teething:

• TEETHING DOES NOT CAUSE FEVER, DIARRHEA, OR UPPER RESPIRATORY SYMPTOMS. If your child has these symptoms, they are sick AND teething.
• most common symptoms of teething are drooling, mild fussiness, and sleep disturbance. Teething is not really painful, but it is uncomfortable.
• best things for teething: chewies (toys, teething rings, cold wash cloth)
• Orajel: in small amounts per the packaging
• Tylenol only if other options have failed.
• do not recommend teething tablets: cause diarrhea, gas, and in some cases true illness. Plus the contents untested and unknown in lots of cases. “All Natural” or“homeopathic” label DOES NOT EQUAL SAFE!!! In all cases of medication, whether traditional or alternative, talk to your pediatrician first.

Illness:
Fever: any temp at any age that is 100.4 or higher. It doesnʼt matter if they “normally run low”. It just doesnʼt work that way.
**Any baby 2 months or younger with fever, do not give meds and go straight to the ER.
**Any kid with a temp above 104, have them seen by their doctor.
**Any kid with a temp 105 or higher, give meds and go straight to the ER.
Things you can do at home for fever: lightly dressed, lukewarm bath acetaminophen (Tylenol): for ages 2 mo and up ibuprofen (Motrin, Advil): for ages 6 mo and up
*generic is just as effective.

Vomiting and Diarrhea:

• worrisome colors of vomit: bright Ninja Turtle green, bloody
• worrisome colors of diarrhea: bloody
• what to do about vomiting: fluids (little bit at at time more often --> tablespoon every 5 min and go up from there as tolerated)
• what to do about diarrhea: NO IMMODIUM! may use over-the-counter Culturelle for Kids (1/2 - 1 packet 2-3 times a day), fluids
• bottom line: push fluids and keep a close eye for signs of dehydration.

Cough//Congestion:
Suction, cool mist humidifier
For severe congestion at night: suction their nose and then put one drop of Little Noses Phenylephrine in each side of their nose every six hours as needed.

Miscellaneous:
Listeria causes a febrile gastroenteritis (vomiting and diarrhea with fever) within 24 hours of consumption. The infection is most troublesome for pregnant women, elderly, babies, and immunosuppressed. Usually self-limited. If worried about it, take your child to his/her doctor and have them run a stool culture.
Rice cereal: first food because it is tolerated easily with little risk of allergic reaction, but also because of the iron it supplies. Itʼs not a good idea to initiate it before 4 months of age because 1) babies donʼt need it, and 2) their GI systems arenʼt ready for it and they can become constipated, gassy, etc.

Foods that are choking hazards are any food or piece of food too small, too hard, or too slippery to eat easily for the age of the child. If you think it might be a problem, cut it really small or donʼt give it at all. For an idea of how small to cut it, look at Gerber Graduates in baby food section.

website for vaccine safety and general info: http://www.cdc.gov/vaccinesafety/index.html

Question(s) of the Month!!

Please tell us your answers to these questions:

What is your favorite restaurant for date night?

What is your favorite restaurant to bring small children and why?