Break Point!

As healthcare professionals, we are trained in the art of taking a history and physical exam. We ask the usual questions and really don't give it much thought. H&P's are pretty standard, we ask the same questions of each patient in exactly the same order. Much like reading off the ingredients from a recipe. To truly care for the patient we must encompass the whole patient, which includes their lives in and out of the hospital setting. Our patients are a product of themselves and their surroundings.

In Illinois alone, 132,000 children will enter the healthcare setting. At Loyola, there were 10,481 children treated. When completing their history and physical exams, we need to keep injury prevention in mind. The illness is a primary concern, but what about how they will get home from the hospital? Can we fix the broken leg or treat the asthma attack and then send them home in a vehicle without a car seat or to a home without a working smoke detector? It is up to the healthcare professionals caring for the patient to assess the child's risk for injury as part of the contract for any health care issues.

When taking a history and physical exam it doesn't hurt to ask the parents about some of the following injury related issues:

• Does the child ride in a car seat? Is the car seat appropriate for the child's height and weight?
• If the child is under one, does the child ride rear facing?
• If the child is over 40 pounds, do they ride in a booster seat
• Are seat belts worn for children (over 60 pounds) and adults?
• Is there a car seat in the other vehicles the child may ride in?
• Is the home childproof? Does it have smoke alarms?
• Do the parents know what to do in case of an emergency? Has there been any CPR training or first aid training?
• Do they wear bicycle helmets?
• Do they cross the street alone if they are under eight?

Obtaining such information can be a useful tool in determining whether the child is at risk for injury at home. Our job as caregivers is to provide care and to teach our patients. Getting the right information can make our jobs easier by giving us the knowledge we need to educate and care for the patients we serve.

Young children love to put everything in their mouths. This is a child's way of learning about their environment. Too often, children can't tell the difference between a "goodie" and a toxic material. Our households are filled with poisonous products. Even items that can be helpful for our bodies can be lethal when taken in large doses. Children can not distinguish blue Koolaid from Windex, medications from candy or household cleaners from juice. It is our job as caregivers to see that poisonous materials are safely out of the reach of children and to teach children a safer way to explore their environment. Most poisonings occur in children younger than 6 and almost half involve those under the age of 4. In a time when many parents work and children are in some form of daycare it is important that children are supervised closely and make sure the areas where are children play and learn are safe.

Some common examples poisonous products are:

Medications - Aspirin, tranquilizers, sleeping pills, iron tablets and antacids

Household products- Mothballs, furniture polish, drain cleaners, weed killers, insect or rat poisons, lye, paint thinners, bleach and cosmetics.

Many household products can be poisonous if swallowed, if in contact with the skin or eyes, or inhaled.

Following some of the safety rules will help keep your child safe from unintentional injury:

• Keep harmful products out of the reach of children. Install locks or child-resistant latches.
• Keep all products and medications in their original containers. Children think that anything in a cup, soft drink bottle or glass is safe to eat or drink.
• Do not assume that a child-resistant cap is "child proof". Children have the patience adult's lack when trying to work a cap off of a child-resistant bottle. Tightly close caps after each use.
• Check your home frequently for old or out dated medications. They may not be effective medically, but they can still be poisonous to children.
• As children grow, their capabilities change and may be able to get at objects they were once too small to reach.
• Never tell a child that medication is "candy" or " just like candy".
• Never leave alcohol within a child's reach. Watch children carefully at parties where alcohol is served. Children tend to imitate adults and finish drinks left unattended.
• Keep the poison control center phone number by your phone. The area Poison Control Center number is 1-800-924-5969
• Every household should have at least one bottle of syrup of Ipecac on hand for possible use in poisoning emergencies. It can be purchaced without a prescription.

• Stay calm and keep the child calm.
• Identify the nature of the poison. Read the label on the bottle to identify what steps are to be taken.
• Look in the child's mouth and remove any remaining pills, pieces of substances, etc.
• Take the child and the poison to the phone. Be prepared to give the child's age, weight, the product name and the amount swallowed.
• Do not wait for symptoms to occur. Many poisonings can be treated at home with the quick notification of the poison control center and fast action by the caregiver.
• Follow the instructions given by the poison control center. Do not give the child anything (even Ipecac) without first calling the poison control center.
• If you are unsure the child ingested a poison still call the poison control center unless you are completely sure.

• National Child Abuse Prevention Month
• National Sports Safety Month
• Public Health Week (4/5-11)
• Drive Safely to Work Week