I n s i d e | H e l p i n g C h i l d r e n F i g h t t h e F l u | P a g e 8

Published by Children’s Hospital, Omaha, NE

Fall2007

Caring for the Tiniest Patients

Protect Your Family from Lead

Understanding Drug Risks in Kids

Published by Children’s Hospital, Omaha, NE

Fall2007

justkids

c h i l d r e n’s s p o t l i g h t

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Caring for the Tiniest Patients

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 five-state 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

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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Nurse Amy Jacobsen soothes a young patient in the Neonatal Intensive Care Unit at Children’s Hospital.

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Children’s Hospital recently announced

plans for a new specialty pediatric center

to accommodate a growing number of

patients and medical staff.

“This project will enable us to

continue providing leading-edge

specialty health care services for children

from the community, Greater Nebraska

and the region,” says Gary A. Perkins,

Children’s Hospital president and chief

executive officer.

The new center will address the

hospital’s need for more specialty clinic space

and increasing demand for specialized and sub-

specialty health-care services for children. It will

include the latest in efficiency design, featuring

easy navigation for patients and their families,

and making it possible to see more than one

specialist in a single visit. The child-friendly

environment of the clinics will cater

to the unique needs of children and

encourage family involvement in

their care. It also will provide space

for teaching and clinical trials.

The new center will occupy the

southeast corner of 84th Street and

West Dodge Road, just north of (and

connected to) Children’s Hospital and

the Scott Pavilion, the site of Children’s

current clinics. Demolition of existing

buildings on the new site will continue

this year, with construction scheduled to begin

in January 2008. The new building is expected

to be open for occupancy in January 2010.

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

conducted a nipple study to determine a premature infant’s acceptance of nipples designed for use in oral feeding.

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 sound-absorbing 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.

Specialty Pediatric Center Answers Growing Demand

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.

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he recent string of toy recalls across the country has brought the dangers

of lead to the public forefront. Lead is a heavy metal that can harm the body. If there’s too much lead, it can cause kidney damage, coma and even death.

Children under 6 years of age are the most at risk for lead poisoning. That’s because their bodies absorb lead more easily. Even small amounts of lead can harm their brains. This can affect their learning, behavior and intelligence. Some results of lead poisoning may be permanent.

“While there is no sure way to prevent a child’s exposure to lead, these negative outcomes can be reduced by conducting routine screenings for lead exposure,” says Robert Woodford, MD a pediatrician with

c h i l d r e n’s s p o t l i g h t

Protect Your Family from Lead

Children’s Physicians and associate clinical professor of pediatrics with the University of Nebraska Medical Center.

Lead also can affect adults, and it is a serious risk for pregnant women or women who may become pregnant. That’s because lead could affect an unborn baby.

The problem wiTh Some painT

The major source of lead in the United States is lead paint. This type of paint was banned in 1978. But homes built before then may still have lead paint. Children can get lead in their bodies by eating lead paint flakes, which taste sweet.

“Recent or ongoing remodeling of these older homes poses a risk for lead exposures,” says Dr. Woodford. “Parents

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Bob Woodford, MD

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.

prevenTion TipS

Here are some other ways to help your family stay safe:■ Do not let children or pets play or have contact with lead-contaminated 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 lead-free 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. ■

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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 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

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Jay Snow, MD

Hospitalists at Your Service 24/7

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, TooInfants 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.

“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.

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

Creating Happy, Healthy Holidays Together

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. ■

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Alka Desai, MD

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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.

roboTripping or

Triple c’S

Overdosing on over-the-counter cough and cold medicine, such as Robitussin or Coricidin Cold and Cough, is gaining popularity among young people.

Such medicines contain a cough suppressant called DXM, which

in large quantities can cause hallucinations. Misusing these medicines also can lead to seizures, brain damage and death. Let children

know that even though these medicines can be bought legally, misusing them isn’t safe.

x and oTher club

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.”

Understanding Drug Risks in Kidsa 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.

iS Your child abuSing

drugS?

You can’t be with children all the time. But you can arm them

with information and a clear understanding of your position on drugs. Observant parents can intervene soon enough to prevent serious problems in the future. Warning signs that a child may be using or abusing drugs include:■ Dropping grades■ Behavior changes■ Changes in sleep patterns■ Lack of interest in appearance or hygiene■ Pulling away from the family■ Seeing objects that suggest drug use.

Also, don’t be afraid to trust your instincts if you think your child may have a problem. ■

Gregory Snyder, PhD

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8200 Dodge StreetOmaha, NE 68114402-955-5400

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PAIDChildren’s Hospital

just kids is published by Children’s Hospital to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2007. All rights reserved. Printed in U.S.A.Gary A. Perkins, President and CEOMartin W. Beerman, Vice President, Marketing and Community RelationsDavid G.J. Kaufman, MD, Medical AdvisorDannee Hartley, Public Relations Coordinator

Printed on Recyclable Paper 881M

Postmaster: Please deliver between October 29 and November 2.

Visit our website at www.chsomaha.org.

justkids

The Centers for Disease Control and Prevention (CDC) recommends annual influenza vaccinations for:■ Children ages 6 to 59 months (6 months to 5 years)■ Children older than age 5 who have chronic medical conditions, such as asthma, HIV or heart disease■ Children older than age 5 who are on long-term aspirin treatment for another illness (Children taking

aspirin therapy could develop the poten-tially fatal Reye’s syndrome if they catch the flu.)■ Household contacts and out-of-home caregivers who care for children ages 6 to 59 months or children with chronic medical conditions, as well as all members of a household with an infant younger 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 December, peaks in mid-February and can end as late as April. That’s why the best time to be vaccinated is between mid-October and mid-November. Contact your pediatrician’s office to schedule flu shots for your children.

flu SYmpTomS

Symptoms of the flu include a fever, cough, headache, chest congestion, fatigue, exhaustion or a general aching feeling. The

Helping Children Fight the Fluetting vaccinated is still the best way to prevent and control the flu—a

viral infection spread by coughing and sneezing or touching flu-infected surfaces.

“Influenza viruses can cause serious infections, not only in individuals with underlying health problems and the elderly, but also in otherwise healthy children and adults,” says Archana Chatterjee, MD, pediatric infectious disease specialist with Children’s Hospital and associate professor of pediatrics at Creighton University. “Annual influenza vaccination is recommended for anyone who would like to avoid becoming infected with these viruses.”

Children’s Hospital has received accreditation or recognition from the following organizations for its delivery of extraordinary health care to children.

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.

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 hand-washing 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. ■

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Archana Chatterjee, MD