Presbyterian/St. Luke’s Medical Center North Suburban Medical Center

Rose Medical CenterSky Ridge Medical Center

The Medical Center of AuroraSwedish Medical Center

ROCKYMOUNTAIN KIDS

SUMMER 2011

A HEALTH PUBLICATION FOR PARENTS

As a parent, there’s nothing worse than seeing your child sick or in pain. And when your son or daughter has a serious medical emergency, you want nothing less than the best care available. That’s why bringing your child to a hospital with an emergency room (ER) designed especially for kids is a good decision. There, doctors and nurses will provide your child with top-quality care and offer you peace of mind.

SPECIALLY TRAINED STAFFPediatric ERs are specially designed and staffed to handle the medical emergencies of babies, children and teens. Doctors receive extra training in pediatric emergencies and must pass a test that certifies them as pediatric emergency physicians. They are trained to deal with emergencies that may require unique techniques or procedures, or use special equipment. Also, they have expertise in easing the pain and anxiety that children’s emergencies can cause families.

Board certified pediatric emergency specialists, nurses and social workers are skilled at:

• Explaining what is happening to your child during treatment• Understanding that children might react differently than adults• Providing instructions on how to care for your child when you get home• Assessing the unique treatment needs of children and teenagers

KID-SIZED AND KID-FRIENDLYCrowded adult ERs can lead to long waits and a scary setting for young patients. But pediatric ERs are specially outfitted with kid-sized equipment, beds and supplies, including:• Lifesaving defibrillators customized for children • Child-sized blood pressure cuffs • Systems that quickly identify equipment and medicines appropriate for a child’s age and weight

The waiting areas, hallways and examining rooms are also decorated and designed to be kid-friendly and put your little one at ease.

COME PREPAREDDevelop an emergency plan with your child’s doctor and get familiar with the pediatric ERs in your community.

Dear Parents:“Children requiring emergency care have unique and special needs. This is especially so for those with serious and life-threatening emergencies.”

These introductory sentences to the Ameri-can Academy of Pediatrics Care of Children in the Emergency Department: Guidelines for Preparedness are the foundation for Rocky Mountain Hospital for Children’s development of superior pediatric emergency care for the communities we serve.

During the past year, more than 50,000 children were seen in HealthONE’s Rocky Mountain Hospital for Children’s emergency departments throughout the metro area.

Because we see so many children in our emergency departments, this issue of Rocky Mountain Kids focuses on injury prevention—to help keep children safe. And, it features information about our innovations in emergency service, particularly our initiatives to minimize a child’s pain and to reduce wait times through coordinated care.

Any parent who has made the trip to an emergency department with a sick or injured child knows the anxiety of wanting their son or daughter to feel better faster. But they also want to be sure that their child will receive quality care.

That’s why the pediatric emergency rooms at HealthONE’s Rocky Mountain Hospital for Children locations are staffed with fully trained, board certified pediatricians and pediatric emergency physicians. Specially trained nurses, pediatric pharmacists, pediatric equipment and all other components required for pediatric emergency services are in place to provide quality support for a child’s care.

We hope you and your family have a safe summer full of healthy fun. But if you do need emergency care for your child, we have the “right stuff” for your summertime accidents and illnesses.

A Note from Dr. Washington

REGINALD WASHINGTON,MD, FAAP, FACC, FAHACHIEF MEDICAL OFFICERROCKY MOUNTAIN HOSPITAL FOR CHILDREN

Presbyterian/St. Luke’s Medical Center19th Avenue and High StreetDenver, CO 80218ER: 720-754-4115

Open 24/7

Sky Ridge Medical CenterI-25 and LincolnLone Tree, CO 80124ER: 720-225-1900

Open 24/7

The Medical Center of AuroraPotomac and Mississippi Aurora, CO 80012ER: 303-695-2780

Rose Medical Center9th and ClermontDenver, CO 80220ER: 303-320-2455

North Suburban Medical CenterGrant and Thornton ParkwayThornton, CO 80229ER: 303-450-4519

Swedish Medical CenterHampden and Logan (three blocks east of Broadway)Englewood, CO 80113ER: 303-788-6911

Swedish SW ER Wadsworth and BowlesLittleton, CO 80123303-932-6911

Visit www.RockyMountainHospitalForChildren.com/maps_and_directions for a map of our locations.

Ouch!!

BEFORE AN EMERGENCYBefore an arm breaks or a fever spikes, there are a few actions parents can take to make a visit to the emergency room less stressful.• Organize your family’s medical histories. Keep track of any medications taken, allergies, previous visits to the hospital, operations and pre-existing conditions.• Post emergency numbers near a telephone.• Have health insurance information on hand.

You may want to consider filling out a Consent for Treatment of a Minor form. This form helps your child-care provider find you quickly in case of an emergency. It also gives permission for emergency hospital care when you’re away from home.

WHAT TO EXPECT IN THE ERGenerally, if you go to the hospital by ambulance, your child will be assigned to a bed in the emergency department. If not, your child will be assessed in a waiting room.

A nurse will evaluate your child’s symptoms and vital signs—a practice called triage. The nurse will also ask for your child’s medical history, name and address. Triage may take some time, unless your child’s condition is severe. Emergency rooms are often busy. But the more information you bring with you, the quicker it can go. You may want to bring toys or books along to keep your child occupied.

After triage, a doctor will examine your child in an examining room. At this time, tests might be ordered. The doctor will decide whether your child needs to stay at the hospital or go home with treatment, such as a cast or medications.

HOW TO HELP YOUR CHILDGoing to the hospital can be frightening for young children. Here are some tips on how to help them:• Remain calm. If they see Mom and Dad staying calm, children in turn feel calmer.

Through the kitchen window, you hear a scream, a thud, then crying. Your child has just fallen out of the elm tree while playing with friends. After comforting and taking a quick look, you believe an arm was broken. Here comes your child’s !rst trip to the emergency room.

BAM!!MOM!!Help!!

Emergencies Don't Wait— Neither Should YouFind the closest HealthONE pediatric ER and average wait times with the HealthONE Fast LocatER tools. You can access ER wait times in four convenient ways:

1. Check out our website: www.healthonecares.com/er.2. Download the app for iPhone and iPad. 3. Text “ER” to 720-523-3888.4. Call 720-523-3888 for automated wait time updates.

• Understand their worry about being separated from you and reassure them.• Be honest about what’s happening— if an upcoming test will be painful, let them know.

Visit www.healthonecares.com/er to view ER wait times right now. Or, scan this icon with your smartphone to access the website instantly! Download the free mobile scanning app with easy-to-follow instructions at http://gettag.mobi.

When a Child Needs an IV, It’s Pain-Free with the J-Tip

Itching, redness, swelling—they’re all normal reactions to a run-in with a bee, hornet or wasp. But for some people, insect stings could be severe or even life-threatening. Signs of anaphy-laxis—a potentially deadly reaction—include feeling confused or anxious; trouble breathing; coughing or wheezing; nausea and vomiting; and a rash, itching or hives.

If your child experiences anaphylaxis, call 911 right away. Scrape any visible stingers off the skin within 30 seconds using

Things That Go Buzz in the Summer: All About Insect Stings

The small items children most commonly swallow include coins, batteries, pins, crayons, buttons, small toys, paper clips and marbles.

When an object gets inhaled and caught in your child’s windpipe, it can be life-threatening. If swallowing makes your child suddenly start to wheeze, choke or have trouble breathing, treat it as a medical emergency. Perform the Heimlich maneuver, and immediately call your community’s emergency number.

Rocky Mountain Pediatric Gastroenter-ology, whose five physicians cover a majority of the Denver metro area emergency departments, remove approxi-mately two esophageal or gastric foreign objects each week.

“No swallowed foreign object is safe,” explains Ted Stathos, MD, of RMPGI. “However, there are certain objects that are more concerning than others and may require immediate attention.

Button batteries, sharp objects and multiple magnets are items that, if swallowed, should be treated as a life-threatening medical emergency.

Pennies, Batteries, Toys, Oh My! When Your Child SWALLOWS Something

These objects are more likely to cause a perforation or tear, which is a very serious matter.”

Babies and young kids aren’t the only ones at risk. Small magnetic balls called Buckyballs, popular among school-age children, can stick to intestines and cause serious injury or death if swallowed. Many schools have banned them.

RMPGI has removed some quite unusual objects over the years, including a plastic dinosaur, Lego man, toothbrush, golf tee, nuts and bolts and even a sewing needle.

Here’s how you can help prevent your child from swallowing or inhaling foreign objects:• Watch your kids carefully when they eat and play.• Baby-proof your house by bringing yourself down to your child’s level. Get on your hands and knees and search for dangerous items your child might find. • Keep small household items and toys with small removable parts out of toddlers’ reach. • Never give children younger than age 4 small foods like whole grapes, nuts, seeds or large chunks of meat or cheese.

Babies and young children explore the world by putting objects into their mouth. Gulp.

Taking your child to the emergency room is stressful enough. Now we have a way to take some of the pain out of the experience.

Placing IVs or drawing blood hurts even when we use the smallest of nee-dles. Thanks to a new technology called the J-Tip, patients at Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s Medical Center are able to get treatment without feeling the stick of a needle. The J-Tip allows us to numb the skin without a needle before plac-ing an IV or drawing blood. We’ll still use the tiniest needle to insert the IV or collect the blood, but now without pain. We’re proud to be the first and only pediatric hospital in Colorado to offer this revolutionary treatment to families in our community.

something firm, such as a fingernail or credit card. Your child might only have a mild reaction the first time he or

she is stung. But the second sting could cause an allergic reaction. After a severe reaction, have your child see an allergist.

Teach kids to walk calmly and slowly away if they spot flying insects. Keep food covered and check inside straws or canned drinks before sipping. Avoid perfumes and floral-patterned clothing, which can mimic pollen sources and attract bugs.

Put your baby’s face on our Facebook page and win a FREE book!

The first 250 people who visit our page, confirm that they “like” us and post pictures and stories about their great

experiences at North Suburban Medical Center will win a FREE copy of the book, “25,000 Best Baby Names.” Visit us

at www.facebook.com/NorthSuburbanMedicalCenter.

North Suburban Medical Center

5 First-Aid Mistakes to Avoid

You hear a crash and a yell from the other room. Your adrenaline starts !owing. Do you know what to do when your child needs "rst aid? You can avoid panic and be ready to help by knowing how to avoid these "rst-aid mistakes: 1. Don’t put ice, butter or petroleum jelly on a burn. Instead, run cool water over the area and cover it with a bandage or antibiotic cream. Seek help for bad burns, such as those that blister. “Burns, which can be prevented, are one of the most common reasons children need to visit the ER,” says Sasha Gubser, MD, pediatric emergency department director, North Suburban Medical Center.

“One type of burn we commonly see is due to children reaching for hot pots on the stove and accidentally!tipping them onto themselves. If this happens, the first thing to do is remove any!of the child’s clothing that is wet and then run cool water over the affected area!as quickly as possible. Both of these steps stop the burning process and are the first things we do if children come to the ER for burns,” says Dr. Gubser.

“The other common burn we see is from baths that are too hot. Parents should always check the bath temperature before bathing children. The younger the child, the!shorter the time it takes for the child’s skin to burn!and even blister, and young children should never be unattended in the bath.”

2. Don’t try to put a knocked-out tooth back in the socket. Instead, rinse the tooth gently and put it in a cup of milk. See your dentist as soon as possible. 3. Don’t try to remove small items stuck in your child’s ears or nose. Using objects such as swabs and hairpins in these areas can be dangerous. Call your doctor for advice. 4. Don’t move someone who might have a head injury unless it’s absolutely necessary. Signs of head injury include loss of consciousness, stiff neck or headache. In this case, call 911. 5. If you suspect poisoning, don’t immediately give ipecac syrup. This can make some situations worse. The first step is to call the Rocky Mountain Poison Center at 800-222-1222.

Brad Ball, MDSasha Mary-Helen Gubser, MD, DirectorMegan Harkless, MDVongpheth Luangphaxay, MD

Kehinde Oheuwa Obeto, MDBriana Jean Spooner, MD Melissa Serlen, MDJennifer Norsworthy Vernon, MD

To make an appointment with any of our outstanding

pediatricians, call our Physician Referral Center at

303-575-0055 or toll-free at 877-HealthONE (877-432-5846).

You can also visit our website at www.NorthSuburban.com

and click on “Find a Doctor.”

Meet the North Suburban Medical Center Emergency Department Pediatricians

6 Summer 2011 ROCKY MOUNTAIN KIDS North Suburban Medical Center

Both prescription and over-the-counter (OTC) drugs are among the worst culprits, including:

anti-inflammatory drugs

antihistamines and cold and cough remediesMost of these hospital visits result from little ones finding

and swallowing medicines not meant for them. To prevent an accidental overdose:

younger than 2.When your doctor advises medicine for your child:

if you miss a dose.

taking and any drug allergies.“Keep all medication—whether over-the-counter, prescription, for

children or for adults—out of the reach of children,” says Sasha Gubser, MD, pediatric emergency department director, North Suburban Medical Center.!“For any medication ingestion or reaction, I recommend immediately calling the Rocky Mountain Poison Center at 800-222-1222, as the nurses and doctors can tell you whether your child needs to be seen in an ER or whether he or she can safely be watched at home.”

Keep Kids Safe from Medications

Every year, medication mistakes send nearly 160,000 children and teenagers to hospital emergency rooms. Accidental overdoses account for almost half of these problems. Allergic reactions cause another one in three.

RockyMountainHospitalForChildren.com 7

10 Ways to Keep Windows Safe2. Keep windows closed and locked when children are around.3. Don’t allow kids to play near windows, balconies or decks.4. Install and maintain window and door safety devices.5. Do not consider a window screen to be a safety device; screens keep bugs out, but don’t keep children in.6. Make sure the window safety devices have emer-

gency release mechanisms in case an emergency escape or rescue is needed.

Approximately 4,700 children ages 14 and younger require treatment each year for window fall-related injuries. (National Safe Kids Campaign)

While some falls occur from windows, it is important to realize that in the event of a fire, a window can also save a child’s life by providing a secondary means of escape or rescue.

WINDOW SAFETY CHECKLIST1. Make sure windows are not painted or sealed shut.

“Watch Your Fingers”

Is Still Good Advice

“Children have a remarkable power to heal hand injuries and return to a lifetime of full function. Timely treatment can make the difference.”—Laurel Benson, MD, orthopedic surgeon

According to a study published in Pediatrics, about half of all childhood amputations treated in U.S. emergency rooms occur to fingers that have been slammed or pinched in doors. Children ages 2 and younger are at greatest risk. Older kids are vulner-able to door injuries, too. But they’re more likely to lose a finger from a lawn mower.

Prevent injuries with these tips: • Hang a towel over the top of doors and close to the hinges so they can’t close completely.• Buy doorstops or door guards to prevent doors from slamming.• Be watchful when children play together. In one study, about half of door-related finger injuries occurred when another child shut the door.

• Make sure all riding mowers have a no-mow-in-reverse (NMIR) feature to prevent injuries.• Don’t let kids use a push mower until age 12 or a riding mower until age 16.

“Children have a remarkable power to heal hand injuries and return to a lifetime of full function. Timely treatment can make the difference, though, in the length of recovery and the cosmetic result,” says Laurel Benson, MD, orthopedic surgeon. “We prefer seeing our little patients within a week of the injury, as most hand injuries have more favorable outcomes if the treatment is completed within 10 days. The patient and the family can then be assured that they are on the road to get up and go!”

About 18 children ages 10 and younger die each year from falls from windows

Little fingers are constantly exploring—and getting in the way. And when it comes to pinched fingers, accidents can be serious.

7. Don’t install window air conditioner units in bedroom or other windows that may be needed for escape or rescue in an emergency.8. Keep furniture and other climbing hazards away from windows, balconies and decks.9. Make sure landscaping underneath windows will help lessen the impact of a fall if one does occur.10. Do not underestimate children’s mobility and/or ability to learn how to release safety devices.

!PULL OUT AND SAVE! KEEP THIS CHECKLIST HANDY AND HELP KEEP YOUR KIDS SAFE.

8 Summer 2011 ROCKY MOUNTAIN KIDS

www.NorthSuburban.com

WHAT’S IMPORTANT WHEN HAVING A BABY?Our docs know.

To receive your FREE, personalized e-newsletter with information based on your due date, including keeping healthy, exercise, nutrition, your baby’s development and preparing for childbirth, visit Baby on the Way Club at www.NorthSuburban.com. We’ll help guide you through pregnancy and infancy.

10334MC

Prevent Common Sports Injuries

The clavicle is one of the most frequently fractured bones during childhood, according to John Polousky, MD, medical director of Rocky Mountain Hospital for Children’s Youth Sports Medicine Institute.

Clavicle fractures most often happen when a child falls on to an outstretched arm. This injury is most frequent in athletes who participate in football, hockey and soccer, or in sports with a high risk of falling, such as biking or horseback riding.

Initial treatment is focused on making the child more comfort-able by immobilizing the injury and giving pain medication.

Wearing a sling with the arm in a cradled position is often the most comfortable position for most people with this type of injury. Clavicle fractures in children and adolescents rarely require surgery. However, surgery may be needed if the fracture breaks the skin or if there is nerve or blood vessel damage.

Young children tend to heal fractures very quickly and are often able to return to sports more quickly than adolescents and adults with the same type of injury. After allowing enough time for the bone to heal, most children don’t experience pain or limited movement, and they can gradually return to full activity.

What Parents Should Know About Clavicle Fractures

Doctors treat about 8,000 kids for sports injuries every day. But many of these mishaps can be prevented. This chart shows the most commonly hurt parts of the body for 10 activities and ways to make playing safer.

Visit www.youthsportsmed.com to learn more about children’s sports injuries and tips for parents on preventing injury.

Shoulder, ankle, head/face

Batting helmet with face guard, safety-release bases

Little League mandates pitch count limits that vary by age (see www.littleleague.org).

Ankle, foot, knee

Sport-specific footwear, mouth guard

After jumping, land with knees bent, not straight.

Arm, wrist Helmet* Avoid riding at night or on uneven or slippery surfaces; consider taking a riding skills course.

Ankle, face, head

Mouth guard, shin guards Sticks should be kept below shoulder level at all times.

Ankle, knee,head (concussion)

Helmet, mouth guard, shoulder pads

Strength training and stretching can help prepare for this contact sport; don’t lead with the helmet when tackling.

Arm, wrist Helmet**, wrist guard, knee and elbow pads

Skate on smooth surfaces, away from traffic.

Ankle, head/face, wrist

Helmet**, wrist guard, knee and elbow pads

Using a skate park or other controlled environment may increase safety; children younger than 5 should not skateboard.

BASEBALL

BASKETBALL

BICYCLING

FIELD HOCKEY

FOOTBALL

IN-LINE SKATING

SKATEBOARDING

{{{{{{{

Ankle, knee Shin guards, sport-specific footwear, mouth guard

Collisions with other players, not heading the ball, cause most concussions, but some leagues prohibit heading by players younger than age 10.

Elbow, shoulder, wrist

Sport-specific footwear, racquet with proper grip size

Strengthening the muscles used to extend and bend back the wrist can help prevent common injuries.

Ankle, fingers, shoulder

Ankle brace or taping Use resistance training to strengthen lower back, legs and shoulders; avoid jumping on hard surfaces in practice.

SOCCER

TENNIS

VOLLEYBALL {{{

* Some form of bicycle helmet legislation is enforced by 21 states, the District of Columbia and more than 140 local governments.** Children are required to wear helmets while using in-line skates, scooters or skateboards in eight states and the District of Columbia.

Commonly HurtRequired or

Recommended Gear Safety Tip

Biking Do’s & Don’tsBicycling is a great way for children to stay active this summer. To keep their cycling safe, review these important do’s and don’ts:

Do• Make sure children wear helmets designed for bicycle use every time they ride, even if the law doesn’t require helmets where you live. If you ride, wear a helmet, too—to protect yourself and set an example.• Dress cyclists in bright, fluorescent-colored or reflective clothing so drivers can easily see them. • Teach your child to avoid bicycling at night. • Explain the proper hand signals and make sure children use them.• Make sure cyclists check the bike’s brakes and tires before riding.

Don’t• Let any rider wear a helmet that fits poorly.• Buy a bike for your child to “grow into.” There should be about an inch between the child and the bike frame when the child’s feet are flat on the ground. • Ride against traffic or let kids do so. Teach children to ride with the traffic flow, as far to the right as possible.• Ride into a street or through an intersection without stopping and checking for traffic—even if there’s no stop sign or stoplight. • Let children ride without supervision until they’ve shown they can always follow the rules.

RIGHT STOP LEFT

75%HELMETS COULD PREVENT AN ESTIMATED 75 PERCENT OF FATAL HEAD INJURIES AND UP TO 45,000 HEAD INJURIES TO CHILDREN WHO RIDE BIKES EACH YEAR.—Safe Kids USA

A helmet can reduce a biker’s risk for head injury by up to 85 percent. Buy a helmet with the U.S. Consumer Product Safety Commission sticker inside. Make sure the helmet fits and your child knows how to put it on correctly:

• The helmet should be level on the head, so the front of the helmet rests just above the eyebrows.

• Straps should fasten under the chin so the “Y” of the side straps comes just below the ears. Straps should be tight enough so that the helmet cannot rock back-to-front or side-to-side.

• The chin strap should fit comfortably and securely under the chin. If the strap is uncomfortable and cuts into the chin, it’s too tight and should be loosened slightly.

• Replace the helmet after an accident where the rider’s head hits something.

TIPS FOR A GOOD

HELMET FIT

Connect with us on Facebook, Twitter and YouTube for the latest kids’ health news.

PRESORTED STD US Postage

PAID Rocky Mountain

Hospital for Children

ROCKYMOUNTAIN KIDS

A well-stocked first-aid kit is your first line of defense in treating injuries and scrapes. Keep one in your home and each car, and stash one away in your suitcase. Prepackaged kits can be purchased at drugstores or you can assemble one of your own in a durable, waterproof case (plastic tackle, sewing or art supply boxes work well).

Keep your first-aid items in one convenient

place with this FREE zippered pouch from Rocky Mountain

Hospital for Children. To get yours, visit www.RockyMountainHospitalForChildren.com. Offer available to the first 250 applicants in the four-state region only (Colorado, Wyoming, Nebraska and Kansas).

A well-organized first-aid manual

Sterile gauze pads of different sizes

Adhesive tape

Bandages in several sizes

An elastic bandage/wrap

A splint

Antiseptic wipes

Antibiotic ointment

Antiseptic solution (i.e. hydrogen peroxide)

Hydrocortisone cream

Pain relievers (i.e. acetaminophen and/or ibuprofen)

Tweezers

Sharp scissors

Disposable instant cold packs

Anti-itch cream (i.e. Calamine lotion)

Alcohol wipes or rubbing alcohol

Burn gel or aloe vera

A thermometer

A blanket and a jar of distilled water (stored in your cars)

Any prescription medications used by your family members

Plastic non-latex gloves

A flashlight and extra batteries

A list of emergency phone numbers

A mouthpiece for administering CPR (can be obtained

from your local Red Cross)