THE AUTOMOBILE DISEASE and other Tragedies

With all medicine’s wonderful advances a new disease now kills more of our children than any other. Sadly, this disease is preventable. The automobile kills 50 times more people in this country than infectious disease. Many states have now passed laws requiring mandatory child safety restraint in all cars. Proper restraints have been shown to drastically lower the death rate. Still children continue to die quite literally in their mother’s arms. A mother’s lap is what we all think of as being the place of ultimate security and safety for our children. In a car, moving at only 30 miles per hour, a mother’s (or father’s) lap becomes deadly for children. At this speed a mother would have to be capable of bench-pressing 300 pounds to keep her 10-pound baby from being torn from her arms. This disease is preventable...do not move the car until your child is in a safety restraint. If you follow no other advice in this book...BUCKLE UP AND LIVE WITH YOUR CHILDREN.

DROWNING

I recently treated a young toddler who fell into a stock tank. The circumstances of his near-drowning episode were typical of how this awful catastrophe can occur. Several small children were playing near the stock tank under adult supervision. The father was distracted for a few minutes, and subsequently heard a story from his small daughter about a baby being in the pond. From her explanation, he took it to mean a baby fish was in the pond. When he realized the baby was a child, three to five minutes had elapsed. The baby child had blown all of the way across the stock tank, but fortunately through heroic measures, this father was able to rescue his child’s playmate. With subsequent medical treatment, the child survived and did well without any problems. It is easy to see how the outcome could have been tragic.

The Central Texas area is fortunate in that we have many swimming pools, lakes and stock tanks to keep us cool during a hot summer. However, so much opportunity is available for drowning, it is almost criminal to not teach your child how to be safe in the water. Beginning at one or two years of age, a child can be taught water safety. Adults who are supervising children near the water need to know what to do in case the child falls in:

POISONING

The poisons that preschool children usually take are in order: plants, soaps and cleaners, aspirin, vitamins, antihistamines, perfumes, deodorizers, insecticides, other medicines, and household bleach. The most dangerous of these poisons, those most likely to cause death are, in order: aspirin, other medicines, petroleum products, lead and mercury, and pesticides. The best protection from these poisons is to never give your child unsupervised access to them. Keep them out of your house or under lock. In the event your child should take one of these, or anything you may consider poisonous, you need to take the following action:

Call 911 if the child if the child needs immediate medical attention. If unsure of your actions, you may call for advice from

If any delay, or after you have talked to the doctor, INDUCE VOMITING.

CONTRADICTIONS:  do not induce vomiting, if petroleum products, strychnine, or caustics such as bleach and dishwasher detergents have been taken.  The most effective way to cause your child to vomit is SYRUP OF IPECAC.  Available over the counter in most drug stores, this should always be in any home where there are children...it can be lifesaving.  With many poisons it can be too late if you wait for the doctor or Emergency Room.  Give Ipecac, 15 ml (1 tbs.) with 2 glasses of water. If no vomiting in 20 minutes, repeat the dose. I always advise children to be seen, or at least call in, after a poisoning episode. If you need to come in, always

INDUCE VOMITING FIRST, unless contraindicated,

BRING THE POISON BOTTLE, with label, and

DRIVE CAREFULLY! OR use the 911 system. The biggest risk is still a car wreck.

PASSIVE SMOKING POISON

As we have all suspected, cigarette smoking by parents does have a detrimental effect on children. Recent studies have shown that there is an increased occurrence of respiratory illnesses, as well as chronic symptoms of breathing difficulty and decreased lung function in young children who have one or two parents who smoke.

Obviously, this is a matter of significant concern to all of us who are in the profession of caring for children’s health because this may lead to problems later in life. In addition, children who have parents that smoke are also likely to become smokers themselves, and therefore continue to expose their bodies to the damaging effect of the smoking throughout their adult life. Children with pre-existing respiratory or heart problems are even more adversely effected, due to exposure to the cigarette smoke. Such children might be those with asthma, cystic fibrosis or a number of congenital heart defects. On the adult side of the coin, nonsmokers, who have a spouse that smokes, have a thirty percent increased risk of developing lung cancer.

SUNBURN

Sunburn is a burn of the superficial layers of the skin, usually with redness, but without blisters, which is caused by the ultraviolet radiation of the sun. As with most illnesses or problems, prevention is far better than treating it once it has occurred. Sunscreens and sun tanning products with PABA do a good job of screening sun from reaching the skin surface without harmful effects. In general, the higher the number or concentration of PABA in the Sunscreens, the greater the protection afforded the skin. In general, infants should not be exposed to extended periods of sunlight for more than approximately l5 minutes. However, this will vary, depending upon the amount of pigment or coloring in the individual’s skin. Very fair skinned infants and children are highly susceptible to sun burning. In addition, it should be remembered that reflected sunrays can cause burning of the skin, and clouds do not provide protection against sunburn.

The usual symptoms experienced are pain and redness of the skin, but if blistering of the skin, dizziness, fever, or impaired vision occur, professional help should be sought. Treatment of sunburns generally is symptomatic. That is, the skin is treated with cool or cold compresses, and paste of baking soda. Aspirin and acetaminophen are given to reduce pain. The physician may prescribe further medication to ease the pain and promote healing. In general, if blistering occurs, it should be considered to be a second-degree burn, and checked by a physician.

The Injury Protection Program (TIPP)

This program, developed by the AmericanAcademy of Pediatrics to combat "the accident diseases," was developed because of the belief that all children should grow up in a safe environment. Parents should get, and use for their children’s safety:

Currently approved Child Safety Restraints for the car.

Smoke detectors and planned escape routes for children in case of fire.

Safe hot water temperatures and protected heaters.

Window and staircase guards and gates to prevent falls.

One-ounce bottles of Syrup of Ipecac to treat poisonings.

Swim lessons to teach their child water safety.