Tuesday, July 30th, 2013
Thirty four US children per day are seen in emergency rooms nationwide for choking incidents where the culprit is food, according to a new study published in the journal Pediatrics. More from NBC News:
That amounts to more than 12,000 emergency visits a year from kids ages birth to 14, but the problem is actually even more significant since most kids who choke don’t wind up at the hospital.
“As dramatic as this study is, this is clearly an underestimate,” says Dr. Gary Smith, the study’s senior author and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio.
Those children between the ages of birth to 4 were most likely to choke on food, with hard candy accounting for 15 percent of choking incidents. Other kinds of candy and gum were the culprit behind 13 percent of episodes, followed by meat — not including hot dogs — and bones. Nuts, seeds and hot dogs were the foods most likely to end up in a hospital stay — nuts and seeds because they’re difficult for little teeth to chew and hot dogs because they can be sucked into the airway and cause more serious choking.
“If you were going to get the best engineer in the world, you couldn’t design a better plug for a child’s airway than a hot dog,” says Smith.
Children’s airways are relatively small compared to those of adults, notes Dr. Phyllis Agran, a pediatric gastroenterologist and professor emerita at the University of California, Irvine’s medical school. “The bigger you are, the more room there is,” says Agran.
The American Academy of Pediatrics recommends keeping foods including hot dogs, nuts, chunks of meat or cheese, whole grapes and hard candy away from kids younger than 4.
Image: Whole grapes, via Shutterstock
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Wednesday, July 24th, 2013
Falling television sets–usually older models that are moved to other rooms when the family upgrades its main TV–are injuring a growing number of kids when the TVs fall. Every 45 minutes, according to a new, longitudinal study conducted by the Child Injury Prevention Alliance, a child arrives at the emergency room with a TV related injury. More from Reuters:
More than half of the injuries were caused by falling TVs, another 38 percent were caused by children running into the units and about 9 percent were caused by other situations, including televisions being moved from one location to another.
The majority of the injuries were to boys and about 64 percent of the injuries were to children less than five years old. Two-year olds were the age group most likely to be hurt. There were six deaths.
The head and neck area was the most common site of injury, and cuts, bruises and concussions the most common types of injury.
The overall rate of TV-related injuries held steady at about 17,000 per year over the 22-year period.
The percentage of injuries related to “striking” TVs fell dramatically over time, however, while the rate of injuries caused by falling TVs doubled from about 1 per 10,000 children in 1990 to about 2 per 10,000 children in 2011.
Image: Television and family, via Shutterstock
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Friday, July 19th, 2013
The simple act of listening to music has been found to reduce the amount of pain children perceive when they’re in the emergency room, a new study by medical researchers at the University of Alberta has found. More from ScienceDaily.com:
The team conducted a clinical research trial of 42 children between the ages of 3 and 11 who came to the pediatric emergency department at the Stollery Children’s Hospital and needed IVs. Some of the children listened to music while getting an IV, while others did not. Researchers measured the children’s distress, perceived pain levels and heart rates, as well as satisfaction levels of parents, and satisfaction levels of health-care providers who administered the IVs. The trial took place between January 2009 and March 2010.
“We did find a difference in the children’s reported pain — the children in the music group had less pain immediately after the procedure,” says Hartling. “The finding is clinically important and it’s a simple intervention that can make a big difference. Playing music for kids during painful medical procedures would be an inexpensive and easy-to-use intervention in clinical settings.”
The research showed that the children who listened to music reported significantly less pain, some demonstrated significantly less distress, and the children’s parents were more satisfied with care.
In the music listening group, 76 per cent of health-care providers said the IVs were very easy to administer — a markedly higher number than the non-music group where only 38 per cent of health-care providers said the procedure was very easy. Researchers also noticed that the children who had been born premature experienced more distress overall.
Image: Music, via Shutterstock
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Friday, June 21st, 2013
The lids or top-seats of toilets are the culprits in a type of potty training injury that has been growing slowly but steadily among boys over the past decade, new research has found. More from Reuters:
Researchers found the number of emergency room visits for toilet-related injuries to the penis, while still rare, increased by about 100 visits each year between 2002 and 2010.
Usually, the injuries happen when boys are learning how to urinate into the toilet while standing up and the seat falls unexpectedly – although a few adults did get snagged by the seat, too.
“It’s a toddler basically potty training who doesn’t have the most advanced motor skills and they just don’t have the reflexes to move fast enough,” said Dr. Benjamin Breyer, the study’s lead author from the University of California, San Francisco.
Previously, the researchers found that about 16,000 men and women are sent to U.S. emergency rooms (ERs) with genital injuries every year.
Breyer’s team was “pretty surprised” to learn that one in 30 genitourinary injuries showing up to the ER involved toilets….
….About 68 percent were so-called crush injuries, which is when the penis gets trapped between the seat and the bowl. Of those, about 97 percent were in children seven years old and younger. Only five adults were caught by falling lids.
Image: Toilet seat, via Shutterstock
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Thursday, June 13th, 2013
Constipation and the pain associated with it is the number one specific diagnosis children receive when they visit the emergency room, according to a new study published in the journal Pediatrics. The New York Times has more on the reasons, which are often related to potty training, for the frequent diagnoses:
[The study] looked at almost 10,000 visits to the emergency room at the Children’s Hospital of Pittsburgh by children 1 to 18 years old with abdominal pain. Constipation was the most common specific diagnosis, the cause of the pain in more than a quarter of the childrenwho had any diagnosis made. “Parents are shocked that that’s their child’s diagnosis,” said Dr. Kerry S. Caperell, an assistant professor of pediatrics at the University of Louisville School of Medicine and lead author of the study.
The highest rate of constipation, he said, was found in boys around 10. “My experience is the kids don’t like to go to the bathroom at school, so there’s a sort of voluntary retention that exacerbates itself.”
Constipation is often attributed to deficiencies in our modern diet — not enough fiber, not enough fruits and vegetables — or to the same combination of overprocessed foods and sedentary lifestyle that puts children (and adults) at risk for obesity. So there is often something judgmental in the air when the subject is raised. And mind you, it isn’t always raised. It is not, shall we say, a sexy topic.
Children often run into problems with constipation around the age of potty training, when toddlers find themselves in a test of wills with their parents. Jessica Hankinson, a pediatric psychologist at Johns Hopkins Children’s Center, said: “We definitely see around potty training what can be considered withholding behavior. They start doing the potty dance, crossing their legs, bending down.” Anything, in other words, to keep from cooperating with the parental agenda.
Sometimes those patterns persist. Some children may be physiologically predisposed. Pediatric gastroenterologists and specialty clinics see children with refractory constipation who haven’t gotten better with the treatments suggested by their regular doctors.
“Maybe the problem has been underrecognized and undertreated,” said Dr. Maria Oliva-Hemker, the chief of pediatric gastroenterology and nutrition at Johns Hopkins University School of Medicine and founder of a constipation clinic there.
And the longer children struggle with the problem, the more severe it can get, for reasons both behavioral and physiological.
“We call it defecation anxiety,” Dr. Hankinson said. “You have hard, difficult stools to pass, you have a painful bowel movement, you start withholding.” That, in turn, affects the functioning of the colon.
In extreme cases, children can develop what is called encopresis, when liquid stool leaks out around the hard, impacted stuff clogging up the colon. Parents may be worried about diarrhea, or angry about “accidents,” when the real problem is constipation.
Image: Emergency room, via Shutterstock
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