For this study, recently presented at the American Academy of Pediatrics National Conference, researchers wanted to examine the circumstances prior to at-home pool drowning, in hopes of crafting messages that would help prevent future deaths. Researchers reviewed 2000 to 20007 data from the Orange County, Calif., Coroner for their study.

Information on 46 drownings was analyzed, including incident site, barriers and pool access, supervision, emergency preparedness and response, and family/social history.

According to the study, 67 percent of the younger children (ages 1 and 2) were last seen in the house prior to the drowning, while 69 percent of the older children (ages 3 and 4) were more often last seen in or near the water.

In addition, three specific patterns or scenarios emerged from this study:

• The 1- or 2-year-old children who were last seen in the house were most often under the supervision of a parent or caregiver who was distracted with household or childcare activities, or they were in a changed daily routine;
• The 3- or 4-year-old children were in or near the water just prior to drowning;
• The 1- or 2-year-old children were last seen outside, often with more neglectful supervision and environments.

“Most of the 1- to 2-year-olds were able to access the pool without the adult supervisor realizing it,” said lead study author Dr. Phyllis Agran, in a news release.

That is why fencing around pools is so very important, Dr. Agran said.

Safety experts say all home pools should have a four-sided fence with a self-closing, self-latching gate, which is never left open.

Dr. Agran said hands-on supervision is a must when children are in the pool or playing around the pool. In most cases, older children who drown were often outside with inadequate supervision.

Researchers say parents may overestimate their child’s abilities to be safe in and around water. Teaching children water safety and to swim will also help to reduce the risk of drowning.

Pool fencing is first and foremost, Dr. Agran said, so children cannot gain access to the pool by themselves.

Researchers suggest that children should be older than 5 years before living in a home  with a swimming pool in the yard.

The Florida Office of Injury Prevention offers these three steps that can help prevent drowning of young children:

• Supervision is the first and most crucial step, officials say. Someone should always be actively watching when a child is in or around the pool.
• Physical barriers like gates or fences are a necessity. A child should never be able to enter the pool area without supervision.
• Learning CPR is a must. The moment a child stops breathing there is a small window of time in which resuscitation may occur. But only if someone knows what to do. Even if you’re not a parent, it’s important to learn CPR. These techniques are easy to learn and they can mean the difference between life and death. It is also critical to have a phone nearby and immediately call 911.

For more on  child safety issues, see the library of articles by Daytona Beach child injury attorney.

The warming comes as a less concentrated form of this popular medication arrives on store shelves. Giving an incorrect dose of acetaminophen can cause the medication not to work if too little is given or it can cause serious side effects and even death if too much is given.

An April 2011 report from FDA’s Center for Drug Evaluation and Research found that confusion over the different liquid concentrations for infants and children was leading to overdoses that caused some infants to be seriously ill, and some to die from liver failure.

To prevent these dosing errors, some manufacturers have voluntarily changed the liquid acetaminophen marketed for infants from 80 mg per 0.8mL or 80 mg per 1 mL to be the same concentration marketed for children, which is 160 mg per 5mL. This less concentrated  acetaminophen marketed for infants now has new dosing instructions and may even have a new dosing device in the box, such as an oral syringe.

Until now, liquid acetaminophen for infants has only been available in a stronger concentration that doesn’t call for giving as much liquid with each dose.

But both concentrations of liquid acetaminophen are now in circulation. Before giving the medication to children, parents and caregivers should check to see which version they have. The FDA is concerned that infants could be given too little or too much of acetaminophen if the different concentrations of the medication are confused.

“Be very careful when you’re giving your infant acetaminophen” said Carol Holquist, director of FDA’s Division of Medical Error Prevention and Analysis, in a news release.

Parents and caregivers should follow this advice from FDA:

• Read the Drug Facts label on the package to identify the concentration of the liquid acetaminophen, the correct dosage, and directions for use.
• Do not depend on a package banner proclaiming the product is “new.” Some medicines with the old concentration also use this headline on packaging.
• Use only the dosing device that comes with the purchased product so that you can  measure the correct amount of liquid acetaminophen.
• Consult your pediatrician before administering this medication to make sure you’re both talking about the same concentration.

If a pediatrician prescribes a 5 mL dose of the less concentrated acetaminophen, but the parents give a 5 mL dose of the more concentrated version, the child can receive a potentially fatal overdose, said Holquist.
Likewise, if a physician prescribes a dose based on the more concentrated acetaminophen and the less concentrated medication is used, the child might not get enough medication to fight a fever, she says.

Adding to this confusion is the fact that the box and bottle may look much the same for old and new versions of the medication, Holquist says.

Read the Drug Facts label on the medication to determine the difference between the two liquid acetaminophen products:

• Look for the “Active ingredient” section of the Drug Facts label usually printed on the back of the medication package.
• If the package says “160 mg per 5 mL” or “160 mg (in each 5 mL)”, this is the less concentrated acetaminophen. This medication should come with an oral syringe to help you measure the liquid dose.
• If the package says “80 mg per 0.8 mL” or “80 mg per 1 mL,” this is the more concentrated version. This product may come with a dropper.

If the dosing instructions provided by your pediatrician or healthcare provider are different from what is on the label, check with them or another healthcare professional before giving the medication. Do not rely on dosing information from other sources such as family members, old dosing charts or the Internet.

Parents and caregivers should also realize there is no dosing amount specified for children under 2. If your infant or child is 2 years old or younger, always get dosing instructions from your healthcare provider. Acetaminophen is marketed for infants under brand names such as Pedia Care Fever Reducer Pain Reliever, Little Fevers Infant Fever/Pain Reliever,  and Triaminic Infants’ Syrup Fever Reducer Pain Reliever. Store brands are also available on shelves.

For more on child safety issues,  see the library of articles by Daytona Beach child accident attorney.

Because a woman’s birth canal is curved and only a little wider than a fetus’s head, a baby must proceed through the canal in a specific sequence of moves. A failure during the process, such as a head turned the wrong way at the wrong time, can result in difficult labor or dystocia.

Using the new software, called PREDIBIRTH, Dr. Olivier Ami and a team of researchers from the Department of Radiology at Antoine Béclères Hospital, Université Paris Sud, France, processed MR images of 24 pregnant women. The result was a three-dimensional (3-D) reconstruction of both the fetus and pelvis along with 72 possible trajectories of the baby’s head through the birth canal. The program scored each mothers likelihood of a normal birth based on these simulations.

“The mechanics of the human birth canal make for a very complicated delivery process compared to other mammals,” said Dr. Ami in a news release. “We now have computer-simulated childbirth to identify potential problems. The software simulates the properties of potential deliveries.”

For this study, the PREDIBIRTH scores were computed retrospectively and measured against delivery outcomes for the 24 women. Thirteen women had normal deliveries, which had been  scored as highly favorable by the simulator. Three women who had elective cesarean-section (C-section) were scored at high risk for dystocia.

Of the five women who had emergency C-sections, two involved heart rhythm abnormalities and had simulator scores of mildly favorable and favorable. Three involved obstructed labor, all of whom scored at high risk of dystocia. Three women delivered with vacuum extraction and had mildly favorable simulator scores.

Researchers say the results in predicting dystocia were highly accurate and are a notable improvement over pelvimetry, which measures the pelvis manually or by imaging to determine its adequacy for childbirth. While pelvimetry is commonly used, Dr. Ami said it’s not entirely reliable.

“A small pelvis may be able to deliver without problems, and a big pelvis might require mechanical help during childbirth,” he said. “This uncertainty raises the rate of C-sections.”

In the U.S., C-sections account for approximately one-third of all births. In France, the rate of mechanical problems is 30 percent, two-thirds of which are emergency procedures.

“An emergency C-section has six to seven times more morbidity and mortality than a planned C-section,” Dr. Ami said. “With this virtual childbirth software, the majority of C-sections could be planned rather than emergency, and difficult instrumental extractions might disappear in the near future.”

For more on  child safety issues, see the library of articles by Daytona Beach child injury attorney.

All of the child safety seats and booster seats tested in this study properly restrained the children across a varied weight range. Almost 1,000 children ages 1 to 8 who were involved in vehicle crashes were included in this study conducted by The Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention.

Researchers say the results of this study show that the current range of child safety seats accommodates a wide range of children’s body sizes, including those who are heavier.

Considering that car crashes are the leading cause of death and injury for all children and that almost 32 percent of kids in the United States are categorized as obese or overweight, researchers wanted to explore the interaction between these two threats to children’s health, said Dr. Mark Zonfrillo, an attending emergency physician at The Children’s Hospital of Philadelphia.

Zonfrillos said the results of the study should help parents to see that their main  concern need only be following the American Academy of Pediatrics most recent car seat guidelines.

Current AAP guidelines call for children remaining rear-facing until at least the age of 2 or until they reach the height and weight limit for the rear-facing car seat.

Once they are moved to a forward-facing seat, children should be secured in a five-point harness until they reach the weight and  height limit set by the seat manufacturer. After that, children should then move up to a belt-positioning booster seat, which is the type of seat they should have until they are 4′9″ tall, a height usually reached  between ages 8 and 12.

Researchers say a good time to re-evaluate child safety seats is right after your children’s annual medical visits.

“Compare your child’s weight and height measurements to the manufacturer’s acceptable ranges on the seat’s labels or instructions,” says Zonfrillo, the father of a toddler. “There’s no ‘one-size-fits-all.’ If your older child moved to a booster seat at age 5, don’t necessarily assume it will be the same for his or her younger siblings.”

Pediatricians and family physicians also  play an important role in making sure children are well protected  as they ride in vehicles, the study’s authors say. When the children’s height and weight are evaluated during checkups, physicians should counsel the parents to evaluate their child’s measurements against their safety seat. Those with more complex questions should be referred to certified passenger safety technicians.

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

“Respiratory hygiene education and the regular use of hand sanitizer can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children,” said study author Dr. Samuel Stebbins of the University of Pittsburgh.

In the recent study, five Pittsburgh elementary schools were assigned to receive five-step training “cough etiquette and hand hygiene” program. In the program, called “WHACK the Flu,” children were taught:

• (W)ash or sanitize your hands often.
• (H)ome is where you stay when you are sick.
• (A)void touching your eyes, nose, and mouth.
• (C)over your coughs and sneezes.
• (K)eep your distance from sick people.

Five other schools did not received any special hygiene training. During the school year, children who developed a flu-like illness were tested to see if they had influenza, and whether the cause was influenza A or B virus.

A total of 279 children with flu-like illness were tested but 104 confirmed cases of the flu were identified.

The program was a hit in getting kids to use hand sanitizer regularly. On average, students used hand sanitizer 2.4 times per day, compared to the previous four suggested times (on arrival at school, before and after lunch, and when leaving school).

Schools assigned to “WHACK the Flu” had a significant 52 percent drop in the rate of confirmed illness caused by influenza A. However, there was no major difference in the overall rate of laboratory-confirmed influenza, or in the rate of illness caused by influenza B.

Along with the decrease in influenza A, there was a 26 percent reduction in total school absences. The hygiene program was also linked to possible improvements in other school attendance measures, including a lower absentee rate during the flu season.

School-age kids are a significant source of influenza transmission, and were heavily affected by the 2009-10 influenza A H1N1 pandemic. Previous reports suggested using hand sanitizer can reduce absences and some causes of infectious diseases

While the “WHACK the Flu” program didn’t lower the overall influenza rate, it did achieve about a one-half reduction in influenza A and a one-fourth reduction in school absences.

The researchers aren’t sure why there was no decrease in influenza B — possibly because of “basic differences in the biology or epidemiology” of influenza B, or because it occurred later in the flu season and mainly in younger children.

The results show that a hygiene education program including hand sanitizer “can be implemented successfully on a large scale within urban schools to reduce absenteeism and the incidence of influenza A,” Dr Stebbins and coauthors write.

Researchers say their study supports current recommendations for respiratory hygiene — including hand sanitizer — during any type of flu outbreak, and as part of an overall influenza prevention strategy in schools.

For more on medical safety issues, see the library of articles by Daytona Beach child injury attorney.

These traumatic brain injuries (TBI) can affect a child’s ability to communicate with others and take care of day to day tasks, leading to a long-term reduction in the their quality of life.

The study’s findings show the need for prevention, said Dr. Frederick Rivara, author of this study and professor of pediatrics at the University of Washington School of Public Health in Seattle.

Parents can help prevent many of these head injuries, Rivara says, by using gates on all stairways and by making sure that children use bicycle helmets when riding and that they use seatbelts in vehicles. He said schools should also consider adopting different rules for football.

Rivara and colleagues conducted  a study of 729 children younger than 18 who were treated for a TBI at emergency rooms in Philadelphia and Seattle between March 1, 2007, and Sept. 30, 2008. The majority of the injuries resulted from falls and car crashes, the study’s authors noted. Few were related to assault or abuse.

Researchers also made comparisons to a separate group of 197 children who had visited the same emergency rooms with arm injuries during the same time.

Researchers looked at the resulting disability in health-related quality of life, adaptive skills, and participation in community and social activities at three months, one year and two years after the injury compared with their functioning prior to injury.

The children’s levels of  functioning prior to injury were determined through telephone interviews with parents in most cases. Researchers looked at whether the children had trouble concentrating or remembering, whether they were depressed and teased, how they played or interacted with others, and if they could do the things that other children do.

Researchers discovered that 85 percent of the children with head injuries had suffered mild trauma. While some had experienced deficits at three months,  only a few suffered lasting loss of daily life and social activities.

However, lasting effects were noted in those with mild injury who also suffered a brain hemorrhage and those who suffered a moderate or severe brain injury. Those children faced obstacles in day-to-day life, sports and school activities at the end of the two-year study observation.

The first three months after injury, there was a substantial decrease in the level of activities in which these children were able to participate. Their ability to participate in  these activities improved at 12 and 24 months but they were still significantly impaired.

Communication and day-to-day life abilities for children with severe TBI were lower at 3 months than at baseline and did not improve by 24 months. Children who met the definition of mild TBI but had an brain hemorrhage had lower quality-of-life scores at 3 months.

Researchers say those children with  problems after two years are unlikely to make significant improvement in their condition, however, data is still being collected on the children in this study.

For more on child medical issues, see the library of articles by Daytona Beach child injury attorney.

A record 31 seats have been designated Best Bets, meaning they correctly position a vehicle safety belt on a typical 4 to 8 year-old in almost any car, minivan, or SUV. Prices for these top-rated seats range from less than $15 to several hundred dollars.

In addition to the 31 Best Bets, another 5 seats are Good Bets, meaning they provide acceptable belt fit in most vehicles. Six boosters are not recommended because they don’t provide proper belt fit, and consumers are advised to avoid them.

Booster seats are for children who have outgrown forward-facing child restraints. A booster should elevate a child and route the lap and shoulder belts, which are designed for adults, in the correct position to restrain a child during a crash. Some boosters do this better than others.

The problem is that consumers can’t tell a good booster from a bad one just by comparing features or prices. The Institute’s booster seat ratings, initiated in 2008, are the only evaluations to tell parents which boosters do the best job of improving belt fit for children in the widest range of vehicles.

“A Best Bet means any of these top-rated boosters should work well in the family SUV or the babysitter’s sedan,” said Anne McCartt, the Institute’s senior vice president for research, in a news release.

Engineers evaluated 62 booster models in the latest round. Twenty-one of them show up twice in the lists. These are dual-use seats, which can work as highback or backless boosters. In the ratings, each dual-use model is considered to be 2 separate boosters for a total of 83 seats evaluated, 11 more than last year.

The biggest group of boosters falls into a middle category, designated “check fit.” These 41 seats may provide good fit for some children in some vehicles, but not as many as Good Bets or Best Bets. Parents are advised to make sure the lap belt lies flat across a child’s upper thighs and the shoulder belt crosses snugly over the middle of the shoulder. If not, a different seat is needed.

The focus of the Institute’s ratings is belt fit, not crash performance, and no crash tests are conducted as part of the evaluation. To assess belt fit, engineers use a test dummy representing an average-size 6 year-old. They measure how lap and shoulder belts fit the dummy in each booster under 4 conditions representing the range of belt configurations in real-world vehicles.

Boosters have improved a lot in recent years. In 2008 there were 10 Best Bets. That fell to 9 in 2009 but soared to 21 last year after manufacturers began using the Institute’s test protocols as they designed and updated their seats.

“Just 4 years into our ratings program, parents have a wide variety of top-rated seats to choose from,” McCartt says. “Still, boosters that don’t consistently provide good belt fit outnumber the ones that do, so consumers need to keep paying attention to this issue.”

One thing consumers need to be aware of is that most dual-use boosters have different ratings for each mode. For example, 14 dual-use boosters are Best Bets or Good Bets in highback mode but are designated check fit in backless mode. For one seat, the Evenflo Big Kid Sport, the opposite is true: It’s a Best Bet in backless mode and a check fit in highback mode.

The Harmony Dreamtime remains the only dual-use booster that’s a Best Bet in both modes, while the Combi Kobuk Air Thru is a Good Bet in both modes.

A notable newcomer to the Best Bet list is the BubbleBum, an inflatable seat that’s marketed for vacations, car pools, and taxis, as well as everyday use. When needed, it can be quickly inflated by blowing into a valve at the back of the seat.

Among booster manufacturers, Harmony Juvenile Products continues to be a standout. All 5 seats the Canadian company currently makes, counting the Dreamtime in both modes, are Best Bets. The company is discontinuing the dual-use Baby Armor, which was a Best Bet in highback mode but not recommended in backless mode.

Diono, which recently changed its name from Sunshine Kids, bumped an existing seat, the Monterey, from check fit to Best Bet by changing the shoulder belt guide. The new ranking applies when the dual-use seat is used in highback mode. The booster remains a “check fit” in backless mode. Consumers should look for Montereys manufactured after July 2011 to ensure they are getting the newer version.

Meanwhile, the Evenflo Symphony 65, which has been a Good Bet since 2009, now has a sister seat, the Symphony 65 e3. It has a slightly different shoulder belt guide, and that makes enough of a difference to make it a Best Bet.

“Booster manufacturers often use similar names for different seats or, in the case of the redesigned Monterey, even the same names,” McCartt says. “It’s important for consumers to look at model numbers and manufacture dates when consulting our ratings.”

For more on child safety issues, see the library of articles by Daytona Beach car accident attorney.

And that’s a big risk when you consider an estimated 40 million children between the ages of 5 and 14 could hit the trick-or-treat trails this Halloween, according to numbers form the U.S. Census Bureau. Other common Halloween injuries include eye injuries from sharp objects and burns from flammable costumes.

The nation’s emergency physicians want children and families to enjoy the holiday traditions safely and not experience any Halloween horrors that would include spending time in the emergency department. 

“

Children should be out having fun and spending time with family and friends,” said Dr. Sandra Schneider, with the American College of Emergency Physicians, in a news release. “They should not have to spend Halloween in the ER because of some injury that could have been easily prevented.”

Emergency physicians recommend that children “trick-or-treat” at organized Halloween festivities, such as local churches, shopping malls or schools. This way children are not walking in the dark and it allows constant adult supervision.

The ACEP suggests that adults follow these tips for a safe and fun Halloween:

• Make sure your child stays on the sidewalks as much as possible (off streets) and obeys all traffic signals.
• Discuss the importance of staying together in a group. Require at least one adult to serve as chaperone during trick-or-treat gatherings.
• Make sure your child knows the potential dangers from strangers. Make sure they know never to accept rides from strangers or visit unfamiliar homes or areas.
• Avoid costumes that could cause children to trip, such as baggy pants, long hems, high heels and oversized shoes.
• Avoid costumes that obstruct the child’s sight or vision.
• Avoid masks if possible. If your child must wear one, make sure it is well ventilated.
• Make sure costume fabric, wigs and beards area made of flame-resistant materials, such as nylon or polyester.
• Keep candlelit Jack-O-Lanterns away from children so they can’t get burned or set on fire.
• Make sure costumes are visible at night: avoid dark colors. Add reflective tape to costumes so your child is more visible to motor vehicles.
• Make sure you see all of the candy before your child eats it. Avoid candy that is not wrapped in its original wrapper, as well as all fruit
• Take a flashlight while trick-or-treating as visibility decreases long before it gets really dark.
• Check accessories such as swords, knives, wands and other pointed objects. Make sure they are made from flexible materials and have dulled edges.

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

The rise in exposure to prescription products has been so striking that the Centers for Disease Control and Prevention has established the PROTECT Initiative, intended to prevent unintended medication overdoses in children. According to the CDC, more than 70,000 emergency visits each year result from unintentional overdoses among children under the age of 18.

Dr. Randall Bond, an emergency medicine physician at Cincinnati Children’s Hospital Medical Center, presented his study on children and pharmaceutical poisonings at a recent PROTECT Initiative meeting in Atlanta. The study was published in September in the Journal of Pediatrics.

“The problem of pediatric medication poisoning is getting worse, not better,” says Dr. Bond, who also is medical director of the Drug and Poison Information Center at Cincinnati Children’s, in a news release. “More children are exposed, more are seen in emergency departments, more are admitted to hospitals, and more are harmed each year.”

Bond found that exposure to prescription products accounted for most of the emergency visits (55 percent), admissions (76 percent) and significant harm (71 percent). Levels of ingestion of opioids, most often prescribed to treat pain; sedatives-hypnotics, frequently prescribed as sleep aids; and cardiovascular medications were particularly high.

“Prevention efforts at home have been insufficient,” Bond said. “We need to improve storage devices and child-resistant closures and perhaps require mechanical barriers, such as blister packs. Our efforts can’t ignore society’s problem with opioid and sedative abuse or misuse.”

Bond studied patient records from 2001 to 2008 in the National Poison Data system – an electronic database of all calls to members of the American Association of Poison Control Centers. Bond studied children 5 years old and younger exposed to a potentially toxic dose of a single pharmaceutical agent, either prescription or over-the-counter. A total of 453,559 children were included in the study.

The largest part of increasing admissions, injuries and death was due to children finding and ingesting medication on their own. Therapeutic errors at home were uncommon and increased only minimally.

The most likely explanation for these trends is a rise in the number of medications around small children, he says. A 1998-99 survey found that half of adults had taken at least one prescription medication in the preceding week and 7 percent had taken five or more. In 2006, the same surveyors found that 55 percent had taken at least one prescription medication in the preceding week and 11 percent had taken five or more.

There are 57 poison control centers in the United States. Together they provide free, 24-hour poison expertise and treatment advice by phone. All poison centers can be reached by calling the same telephone number 1-800-222-1222. Poison centers are staffed by pharmacists, physicians, nurses and poison information providers who are toxicology specialists.

For more on child medical safety issues, see the library of articles by Daytona Beach child injury attorney.

Drowning is the leading cause of unintentional death among children ages 1 to 4. And while much attention is paid to water safety during the warm months, parents and caregivers need to know that drowning risks inside the house are ever present.

In fact, bathtubs are the second leading location, after pools, where young children drown. Buckets, other containers, and even landscaping features, also can present a danger of drowning.

A new report from the Consumer Product Safety Commission related to non-pool and non-spa products indicates that from 2005 to 2009, there were 660 submersion incidents involving children younger than five years old. There were 431 fatalities, 212 injuries and 17 incidents with unknown injuries.

The majority of the victims were younger than the age of two and most of the incidents involved bath or bath related products. CPSC’s analysis of the fatalities found that 92 percent occurred in residential settings.

“Young children can drown in just a few inches of water,” said CPSC Chairman Inez Tenenbaum in a news release.  “I urge parents and caregivers to constantly supervise young children around bathtubs, bath seats and buckets. There are simple steps that every family can take to prevent drownings in the home.”

Many of the reported incidents involved a lapse in supervision, such as a parent or caregiver leaving the bathroom while the child was in the bathtub to answer the phone or door, or to retrieve a towel. In other incidents, an older sibling was left to watch a younger sibling.

CPSC’s drowning prevention safety tips include:

• Never leave young children alone near any water or tub or basin with fluid. Young children can drown in even small amounts of water.
• Always keep a young child within arm’s reach in a bathtub. If you must leave, take the child with you.
• Don’t leave a baby or young child in a bathtub under the care of another young child.
• Never leave a bucket containing even a small amount of liquid unattended. Toddlers are top heavy and they can fall headfirst into buckets and drown. After using a bucket, always empty and store it where young children cannot reach it. Don’t leave buckets outside where they can collect rainwater.
• Consider placing locks on toilet seat covers in case a young child wanders into the bathroom.
• Learn CPR (cardiopulmonary resuscitation). It can be a lifesaver when seconds count.

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.