Friday, November 20, 2009

November is ending on a healthier note...


It is extremely nice to see the closing of November ending with a huge decline in absentee's. At this time I am happy to state our absenteeism is 1-2% in the BREC which is a far cry from what we began the month with. This should make us all feel a sigh of relief. Clearly the students are doing what we asked of them in regards to hand washing, coughing into their arm and utilizing the paper cups as opposed to drinking straight from the fountains. From what I have heard Black River has had far less absenteeism than many of the surrounding school districts, so parents you should all be proud of the proactive measures this school has taken since the beginning of the school year.


With this said; I want you to be aware that we are still seeing a few cases of Influenza A, head lice and most recently a few cases of scabies (rash caused by a mite). Please pay attention to your children's complaints regardless of what they might be. One never knows when a complaint may just be an early warning sign of what's to come.


For now there is not much else to report health wise, so I will close wishing everyone a very happy Thanksgiving and a healthy Christmas Season to all.


Nurse Donna

Monday, November 2, 2009

November-Absenteeism on the Rise

As the new month begins I note an increase in student absenteeism. Especially on the Elementary School side of the BREC. Having said this, I will continue to preach the need for parents and teachers to work together to promote and monitor for excellent hand washing techniques and proper respiratory etiquette with ALL children.

We are still seeing the occasional case of Chicken Pox but nothing I am concerned about (less than 1/2 dozen cases in total since the beginning of the school year). The Flu viruses and Strep Throat seem most prevalent at this time. Having said this; Do note that our rate of absenteeism on its worse day has NOT been any where near high enough to warrant parents wondering why we have not closed the schools. Folks, the numbers just are not there! Yes, we are seeing more illnesses than norm for this time of year, but then again so are all the other school districts near and far.

My belief is if we continue to work together promoting good hygiene habits here at Black River School District, we will see far less illnesses over the winter months ahead. Not allowing drinking from the water fountains, hand sanitizers in all the classrooms, teachers/students wiping down desks regularly are ALL excellent preventative measures be taken daily here at Black River.

Wishing everyone a safe and healthy holiday season....

Nurse Donna

Thursday, October 1, 2009

New month...how about an update?

In an effort to keep parents current on what we are seeing health-wise in school I will share monthly the variety of illness's coming through the clinic.

As usual as it is we have had several students with Chicken Pox during the month of September. We have also seen strep throat (Scarlet fever if rash presents) on the elementary side as well. Some have had a stomach virus and yes a couple cases of influenza A for which the children were treated per H1N1 protocol by their physicians since they are only testing for H1N1 if the person become hospitalized.

It is important that we all understand and educate ourselves in regards to the huge media hype on the H1N1 influenza virus. Such information is readily available through your county health department website and/or by googling the CDC web page. H1N1 is being treated the same as the yearly influenza virus and the best defense is still proper eating, good hand washing techniques and last respiratory etiquette. Teaching your children to cough into the arm rather than their hands will prevent that hand to hand contact of any virus.

Remember children need to get plenty of rest, set a specific bedtime and adhere to it. Students need at least 8 hrs of sleep per night to function at their best. And parents certainly need a bit of adult time after each workday as well.

With the cold weather creeping in, please make sure your child is dressed appropriately for the weather. Coats, hats, gloves, boots, etc. Weather and temperatures permitting our students do go outside for a bit of fresh air and the opportunity to play and release a bit of bottled up energy. They need to be dressed for such!

Well, this is it for now. Know that Black River School District continues to do its part in preventative measures towards keeping all your children healthy and safe. Together we can make this district one of the healthiest in this area. But it does take a joint effort.

To your families health,

Nurse Donna

Wednesday, September 2, 2009

Welcome back...FYI- How We Are Preparing for Flu Season

Welcome back. I hope everyone enjoyed their summer break. I know I did!

Keeping you current.

With the abundance of information circulating in regards to the upcoming flu season and the continued spread of the "Swine" or H1N1 flu virus I thought I should share with you the
steps that we are taking at Black River Local School District this year.

All students will be sent home if they present to the clinic with a fever of 99 degrees or higher. They may not return till they have been fever-free for 24 hrs without the assistance of fever reducing medication.

Though to some this may sound a bit harsh, it is our responsibility to recognize and remove ill students from the school setting. It is our main defense in providing the highest medical protection to our student & staff population.

Tips we are utilizing to educate the students at school:

Proper hand hygiene (frequent hand washing vigorously for 15-20 seconds with soap) As we tell the children, singing Happy Birthday to yourself twice is the preferred time we are striving for.

Respiratory Etiquette "coughing/sneezing into your forearm/elbow area.

Avoid letting your hands/fingers touch your mouth and nose area. This will decrease the spread of germs one may have touched throughout the day.

Utilizing disposable paper cups at water fountains. We have placed cup dispensers at all Elementary drinking fountains to deter mouth contact on the fountain nozzles.

Teachers are wiping down desks at the end of the class day with disinfectants. This is above and beyond the nightly custodial cleaning.

Hand sanitizer Dispensers Placed in all classrooms within reach for students to use throughout the school day.

So as you can see, we ARE taking as many precautionary measures as feasibly possible within the school buildings and are asking for your support in keeping your ill children home when symptoms present. All children need to remain home until they have been fever free for 24 hours without fever reducing medications.

Should you have any questions, please feel free to call my office at 419-736-2161, ext. 403.

Nurse Donna

Wednesday, July 8, 2009

Hope you are all enjoying Summer Break....

Just a quick note to say I am thinking of all of you and hoping your Summer Break is going well. I am keeping busy this summer as a Camp Nurse for the Society of the Handicapped at Camp Paradise in Seville. What a great camp this is!

I have met some wonderful new friends and hope you are doing the same. See you in August.

Nurse Donna

Tuesday, May 19, 2009

Summer Safety

For many Americans, summer means fun in the sun. The kids are out of school, adults are on vacation and it's time for outdoor activities like riding bikes and hosting barbecues. However, the U.S. Consumer Product Safety Commission (CPSC) warns that summer also is the time of year consumers are most likely to be injured.

So that everyone can enjoy summer activities lets keep safety in mind by brushing up on ways to avoid injury to our children.

One of the best ways to stay safe this summer is to wear a helmet and other safety gear when biking, skating and skateboarding, and when riding scooters, all-terrain vehicles, and horses. Studies on bicycle helmets have shown they can reduce the risk of head injury by as much as 85 percent.

Use layers of protection to prevent a swimming pool tragedy. This includes placing barriers completely around your pool to prevent access, using door and pool alarms, closely supervising your child and being prepared in case of an emergency.

Never bring charcoal grills indoors. Burning charcoal produces deadly carbon monoxide

When cooking outdoors with a gas grill, check the air tubes that lead into the burner for any blockage from insects, spiders, or food grease. Check grill hoses for cracking, brittleness, holes, and leaks. Make sure there are no sharp bends in the hose or tubing. If you ever detect a leak, immediately turn off the gas at the tank and don't attempt to light the grill until the leak is fixed. Newer grills and propane tanks have improved safety devices to prevent gas leaks.

Make sure your home playground is safe. Falls cause 60 percent of playground injuries, so having a safe surface is critical. Concrete, asphalt or packed dirt surfaces are too hard. Use at least 9 inches of wood chips or mulch.

Make sure your home playground is safe. Falls cause 60 percent of playground injuries, so having a safe surface is critical. Concrete, asphalt or packed dirt surfaces are too hard. Use at least 9 inches of wood chips or mulch.

Use softer-than standard baseballs, safety-release bases and batting helmets with face guards to reduce baseball-related injuries to children.

If you are a soccer mom or dad, beware that movable soccer goals can fall over and kill children. Make sure the goal is anchored securely at all times and never allow anyone to climb on the net or goal framework or hang from the cross bar. Remove nets when the goals are not in use.

To prevent serious injuries while using a trampoline, allow only one person on at a time, and do not allow somersaults. Use a shock-absorbing pad that completely covers the springs and place the trampoline away from structures and other play areas. Kids under 6-years-old should not use full-size trampolines.

Don't allow a game of hide-n-seek to become deadly. There have been many reports of numerous suffocation deaths involving children who crawled inside old cedar chests, latch-type freezers and refrigerators, iceboxes in campers, clothes dryers and picnic coolers. Childproof old appliances, warn children not to play inside them.

If summer plans include camping and you want heat inside your tent or camper, use one of the new portable heaters that are equipped with an oxygen depletion sensor (ODS). If oxygen levels start to fall inside your tent or camper, the ODS automatically shuts down the heater before it can produce deadly levels of carbon monoxide (CO). Do not attempt to use alternative sources of heat or power to warm a tent or camper. Traditional camping heaters, charcoal grills, camping lanterns, and gas generators also can cause CO poisoning.

Install window guards to prevent children from falling out of open windows. Guards should be installed in children's bedrooms, parents' bedrooms, and other rooms where young children spend time. Or, install window stops that permit windows to open no more than 4 inches. Whenever possible, open windows from the top - not the bottom. Also, keep furniture away from windows to discourage children from climbing near windows.

Summer also means yard work. When mowing, keep small children out of the yard, and turn the mower off if children enter the area. If the lawn slopes, mow across the slope with the walk-behind rotary mower, never up and down. With a riding mower, drive up and down the slope, not across it. Never carry children on a riding mower.

Have a safe and healthy summer!!!

Nurse Donna

Wednesday, April 29, 2009

Swine Flu? Do you know what it is? If not, read on.

For those who like to follow my web page, I wish to clarify first and foremost that there have been NO CASES of Swine Flu at Black River Local School District as of this posting date. As of this posting Ohio only has one (1) confirmed case of the Swine Flu.

If you would like additional information please visit the CDC's Swine Flu website by clicking on the following link: http://www.cdc.gov/swineflu/.

Remember your best defense is proper "hand washing" which is the #1 preventative measure according to the CDC. Teach your children and family members to sing "happy birthday " twice in their heads while washing hands to afford the recommended amount of time needed for proper washing with soap and warm water.

If a family member develops any of the following symptoms by all means do seek medical attention to assure that you do not have the influenza virus. The symptoms are as follows:

Fever
Cough
Sore throat
Body aches
Headache
Chills
Fatigue

Note that some people have reported diarrhea and vomiting associated with swine flu.

Remember that the Swine flu is thought to be spread the same as all other flu viruses which are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. (Hence, why hand washing is the #1 preventative measure).

Lastly, remember if in doubt regarding sending your child to school use your parental instinct; if they are not feeling well keep them home. Do not risk others to exposure at this time. Every one's cooperation is essential as we all do our part in and out of the school setting to assist in keeping this virus at bay for our families, friends and neighboring communities.

Nurse Donna

Tuesday, April 21, 2009

Spring Health & Safety Tips

Spring time is now here. For most children, this means more outdoor activities (swimming, camping, bike riding, etc.). For all parents, this means being extra vigilant to keep your child safe and healthy.

I found an article that discusses some tips to keep your child safe and healthy this spring, including:

Avoiding and Treating Spring Allergies, which can cause your child to have a lot of sneezing, plus a clear runny or stuffy nose, itchy and watery eyes and a cough, especially when he has spent a lot of time outside.

Water Safety to protect your children when they are swimming or boating. Most importantly, always supervise your children around the water.

Sun Safety to prevent damage from too much exposure to the sun. Regular use of sunscreen in children can lower their risk of skin cancer by almost 78%. But remember that sunscreen only works if you use it correctly and it does not substitute for limiting too much sun exposure. Many parents make the mistake of using sunscreen and then allowing unlimited sun exposure.

Using Insect Repellents Safely to prevent bites from mosquitoes, etc. which can make your child miserable.

Help your child enjoy Spring by following the basic health and safety tips that are described in the rest of this article.

Spring Time Seasonal Allergies and Children

Allergic rhinitis, or hay fever, is a common problem in infants and children. The most common symptoms include a stuffy or runny nose with clear drainage, sneezing, itchy eyes and nose, sore throat, throat clearing and a cough that may be worse at night and in the morning. These symptoms usually occur during certain times of the year for people with seasonal allergies, corresponding to being exposed to outdoor allergens, such as tree pollens, grasses and weeds. Other people may have perennial allergies, with problems occurring year round from exposure to indoor allergens, such as dust mites, pets, second hand smoke and molds.

Other signs of having allergic rhinitis include the 'allergic salute,' a common habit of children which consists of rubbing their nose upward. This is usually because the nose is itchy and this practice can lead to a small crease in the skin of the lower part of the nose. Children with allergic rhinitis also commonly have 'allergic shiners,' which are dark circles under the eyes caused by nasal congestion.

Allergic rhinitis does run in certain families and are more common in children that have asthma or eczema. It is also more common in children that are exposed to second hand smoke, air pollution and pets.

Having uncontrolled allergies can put your child at risk for getting a secondary sinus infection, ear infections, and for having poor concentration at school. It can also make asthma symptoms worse.

The best treatment for allergic rhinitis is to avoid what your child is allergic to by following prevention and environmental controls. For seasonal allergies, this includes keeping windows closed in the car and at home to avoid exposure to pollens and limit outdoor activities when pollen counts are highest (early morning for tree pollen in the spring, afternoon and early evening for grasses in the summer, and midday for ragweed in the fall).

The medications that are used to control the symptoms of allergic rhinitis include decongestants, antihistamines and steroids. If symptoms are mild, you can use over the counter medications as needed. Avoid using topical decongestants (such as Afrin) for more than 3-5 days at a time or frequent use of over the counter allergy medicines with antihistamines, as they can cause drowsiness and poor performance in school.

Prescription allergy medications include the newer, non-sedating antihistamines, such as Claritin and Zyrtec (usual dose is 1-2 teaspoons or 1 pill once a day), and topical steroids, such as Nasonex, Flonase, and Nasacort Aqua (usual dose is 1-2 squirts in each nostril once each day). If your child's symptoms are well controlled, then you can decrease the dose of the nasal steroid that you are using for 1-2 weeks and then consider trying your child off of it and see how they do. Continue the antihistamine for 1-2 months or until your child's allergy season is over. Allegra is another antihistamine that is commonly used in older children because it is only available in a pill form.

To be effective, your child should be using these medications every day. They will not work as well if just used on an as needed basis. They are in general very safe with few side effects, but the nasal steroids have been associated with growth suppression when used in high doses. This is however rare, and your pediatrician will monitor your child's growth to make sure this does not happen.

If your child's symptoms are not improving with the combination of the antihistamine and steroid, then we may also use a decongestant, such as Sudafed, AH-CHEW D, or as a combination (Claritin D).

For seasonal allergies, it is best to start using these medications just before your child's season begins and then continue the medicines every day all through the season. For perennial allergies, your child may need to take these medicines year round.

Your child may also benefit from nasal irrigations using saline nose drops 1-3 times a day. This will help the sinuses drain.

If your child does not improve with these interventions, then we will consider having him see an allergy specialist for skin testing to figure out what he is allergic to and to possibly start immunotherapy injections (allergy shots).

Water Safety and your Children

To ensure that your children are safe, never leave them unsupervised around water. Here are some tips to keep your child safe around water:

Teach your child to swim, but remember that younger children shouldn't be left unsupervised around water even if they know how to swim. The AAP recommends that children under age four not be given formal swimming lessons, especially as a primary means to prevent the risk of drowning.

Always wear a safety approved life jacket when on a lake, river or ocean while boating, water skiing, jet skiing or tubing.

Warn your children about playing in canals or other fast moving water.

Do not let your child play around any water (lake, pool, ocean, etc.) without adult supervision (even if he is a good swimmer).


Don't allow running or rough play around the water.


Childproof your swimming pool with a fence around your backyard and a fence (at least 4 feet high) around the pool, with a self-closing, self-latching gate. Also consider having a phone poolside and learning CPR in case of emergencies.

Sun Safety for your Children


It is now well known that exposure to sun puts people at risk for skin cancer and premature aging and that most of that exposure comes during childhood (80% of a person's lifetime sun exposure occurs before they are 21). Regular use of sunscreen in children can lower their risk of skin cancer by almost 78%.

There are many sunscreens available for safe use in children over six months old. Pick one that offers UVA and UVB protection and that has a SPF of 15 or higher (especially if your child has light skin). Apply the sunscreen in a thick coat at least 30-45 minutes before going outside and reapply every two hours (or more often in he is swimming or perspiring heavily).

Here are some other tips to protect your child from the damaging effects of the sun.

Wear protective clothing, including a hat and long sleeve shirt and long pants. Keep in mind that most clothing only has a SPF of 5-9, so you can still get sun damage with a shirt on.

Limit exposure to the sun when it is at its strongest (10am-4pm).
Protect your child's eyes with sunglasses that protect against UVA and UVB radiation.

Use sunscreen daily, even if it is cloudy, since most of the sun's radiation penetrates clouds and can still cause sunburn.

Consider using a sunscreen with ingredients (such as zinc oxide or titanium dioxide) that physically block the sun's radiation if your child has sensitive skin.

Deet lowers the effectiveness of sunscreens, so use a higher SPF if you are using a combination product that has both a sunscreen and an insect repellant.


Insect Repellents for Children

Insects (mosquitoes, gnats, chiggers, ticks, etc.) commonly bite children and can make them miserable. There are many safe and effective insect repellents that you can use to protect your child, including those that use deet, citronella, or soybean oil. Remember to only use products that are approved for children, follow the manufacturer's instructions and wash off the insect repellents when you return indoors.

Insect repellents with deet are probably the best and most commonly used. Although it is absorbed through your child's skin, it is generally safe as long as the product has less than 10% deet. You should apply the deet product to all exposed skin, except near the eyes, mouth, open cuts or hands of small children (who may rub their eyes or put their fingers in their mouth). Deet is absorbed through the skin, so you may want to limit how much you put on younger children, wash it off as soon as possible, and apply it more to clothing than skin.

Although deet insect repellents are effective for several hours, they do wash off with water and sweat, and you may have to reapply them to be most effective (follow the product's instructions to be safe).

Other insect repellents that are generally safe in children include those made with Citronella (Avon's Skin-So-Soft) and soybean oil (Bite Blocker).

Remember that insect repellents do not protect against most stinging insects, including wasps, bees and fire ants.

To keep your children safe from insect bites, you can also:

Make sure to keep as much of her skin covered with clothing as possible, including long sleeve shirt, long pants, socks, and a hat.

Wear light colored clothing, so as not to attract bugs.

Avoid using any scented soaps or other products on your baby, since the fragrances can also attract insects.

Apply insect repellents to clothing instead of to skin so that it won't be absorbed.
Wash off insect repellents as soon as possible.

Avoid areas with insects nest.

** Remember to always follow the instructions, including age restrictions on any insect repellent you are considering using.

Nurse Donna

Tuesday, April 7, 2009

What does Pertussis sound like?

If you have never heard "whooping cough" (Pertussis) click on the link below.

http://www.pertussis.com/hear.html

Nurse Donna

Monday, March 9, 2009

What is pertussis?

What is pertussis?
Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the bacteria Bordetella pertussis.

Who gets pertussis?

Pertussis can occur at any age. Although most of the reported cases occur in children under five years, the number of cases in adolescents and adults is increasing, probably due to waning of vaccine immunity. Adolescents and adults and those partially protected by the vaccine may have milder disease which is not diagnosed as pertussis. Pertussis is thought to account for up to 7% of cough illnesses per year in adults.

How is pertussis spread?

Pertussis is primarily spread by direct contact with the discharges from the nose and throat of infected individuals. Frequently, older siblings or other adult household members who may be harboring the bacteria in their nose and throat can bring the disease home and infect an infant in the household.

What are the symptoms of pertussis?

Pertussis begins as a mild upper respiratory infection. Initially, symptoms resemble those of a common cold, including sneezing, runny nose, low-grade fever and a mild cough. Within two weeks, the cough becomes more severe and is characterized by episodes of numerous rapid coughs followed by a crowing or high-pitched whoop. A thick, clear mucous may be discharged with the coughing. These episodes may recur for one to two months, and are more frequent at night. Young infants, adolescents, and adults do not have these typical coughing spells. Older people or partially immunized children may have milder symptoms.

How soon after infection do symptoms appear?

The incubation period is usually 7 to 10 days, with a range of 4 to 21 days.

When and for how long is a person able to spread pertussis?

A person can transmit pertussis from the onset of symptoms to three weeks after the onset of coughing episodes. The period of communicability can be reduced to five days after appropriate antibiotic therapy is begun.

Does past infection with pertussis make a person immune?

One attack usually confers immunity comparable to that provided by vaccine.

What are the complications associated with pertussis?

Young infants are at the greatest risk for complications. Serious complications of pertussis include pneumonia, seizures, encephalopathy (disorders of the brain), and death. Less serious complications include ear infections, loss of appetite, and dehydration.


*The child needs to complete 5 full days of antibiotic treatment before returning to school.

Thank you..

Nurse Donna

Friday, February 27, 2009

The Scoop on Step Throat

"It could be strep throat." Have you ever heard a doctor or your mom say that when you're sick and you have a sore throat? I think we all have at one time or another.

Strep throat is a disease caused by tiny egg-shaped bacteria (say: bak-teer-ee-uh) called Group A streptococci (say: strep-toe-kah-kye). These bacteria cause 15% to 20% of all sore throats and are found in your throat and on your skin.

If a child has strep throat, the doctor will probably give him or her medicine called antibiotics. These kill the strep bacteria. That's good news because sometimes strep throat can get worse and cause problems with other parts of a kid's body. In rare cases, untreated strep can cause arthritis (say: arth-rye-tus) or heart problems from a disease called rheumatic (say: roo-mah-tik) fever.

Most of the time children get the medicine they need and recover from strep throat very quickly. After taking the medicine for 24 hours, you will feel a lot better and will no longer be contagious. However, it is really important to take all 10 days of the medicine to make sure you have treated the infection.

How Do I Get It?

If someone in your family or at school has strep throat, there is a chance you may get it. Strep throat is spread when healthy people come into contact with people who have it. When a person with strep throat sneezes or blows his or her nose and you are close by, or if you share the same forks, spoons, or straws, the bacteria can spread to you.

If you get strep throat, you will start to feel sick within 5 days after you have been around the person who gave it to you.

What Will the Doctor Do?

Your doctor will look into your mouth to see if your throat is red and your tonsils are swollen and covered with white or yellow spots. He or she will also look for small red spots on the roof of your mouth. Most of the time, strep will give you a sore throat, headache, stomach ache, and fever. Typically strep will not give you a runny nose or cough, and occasionally it won't give you any specific symptoms.

To prove that what you have is strep throat, your doctor may do one or two tests. First he or she can do a rapid strep test to check for strep bacteria. He or she will rub a cotton swab over the back of your throat. With this test, the doctor may be able to find out in less than 1 hour if you have strep throat.

If the first test doesn't prove anything, then your doctor may do a longer test called a throat culture. A swab from your throat will then be rubbed on a special dish and the dish will be left to sit for two nights. If you have strep throat, streptococci bacteria will usually grow in the dish within the next 1 to 2 days.

How Can I Get Better?

If you have strep throat, your doctor will give you an antibiotic (say: an-tye-bye-ah-tik), a medicine that kills bacteria. Usually the antibiotic used for strep throat is a form of penicillin (say: peh-nuh-sih-lun). You will take penicillin as a pill, a liquid, or a shot.

To make sure the bacteria go away completely and don't spread to other parts of your body, you must finish all of the medicine. Your doctor will have you take the pills or liquid for about a week.
Your mom or dad may give you acetaminophen (say: uh-see-tuh-mih-nuh-fun) to get rid of aches, pains, and fever. You'll want to have soothing drinks, like tea and warm chicken soup. It's best to avoid spicy and acidic foods, such as orange juice, because they could irritate your tender throat.

Your doctor will tell you to stay home from school until you have been taking the antibiotic for at least 24 hours. This way, you won't spread the bacteria to others.

How Can I Prevent Strep Throat?

If someone in your house has strep throat, you might get it. But you can take these steps to prevent it:

* Make sure the person with strep throat covers his or her mouth when sneezing and coughing.
* Don't handle used tissues or other germy items.
* Wash your hands regularly, especially before cooking and eating.
* Wash dishes, drinking glasses, knives, forks, and spoons in hot, soapy water.
* Keep sores and cuts clean because strep can get in there and cause problems, too.
* Strep throat is no fun, but after feeling sick for 2 or 3 days, most kids start feeling better. In other words, they feel less streppy and more peppy!


Nurse Donna

Monday, February 23, 2009

Hello Parents....

Someone sent a comment over the weekend in which they shared a website with us that our younger children might find of interest. If it prevents the kids from passing thier germs from child to child it may be worth our taking a moment to check it out.

Thank you Maggie Brown.

http://www.germywormy.com/

Nurse Donna

Thursday, February 19, 2009

The Importance of Establishing a Bedtime Routine

With more and more activities competing for your child’s waking hours, it is not surprising to hear that most kids are sleep deprived. A recent estimated that 62 percent of kids ages 9-13 do not get enough sleep and 70 percent wish that they could get more sleep. Of those children who are sleep-deficient, most required an additional hour or more of sleep per night to meet the recommended amount for children their age.

Experts recommend that school-age children receive 9.5 to 10.5 hours of sleep each night.What can parents do to make a difference in their child’s sleep habits? There is strong evidence in support of establishing a bedtime routine. Kids who reported having a bedtime routine were:

•more likely to get the recommended amount of sleep.
•less likely to be tired at school.
•less likely to wish for “much more sleep” than they usually get.

Part of establishing a bedtime routine is setting a time for your child to go to bed. Take the lead in setting your child’s bedtime: Children who reported that their parent “decides what time to go to bed” were more likely to get an adequate amount of sleep. In fact, they averaged 45 minutes more sleep nightly than children who chose their own bedtime.“One of the most troubling things in recurrent sleep deprivation is the effect on the immune status,” explains Kate Cronan, M.D., pediatrician and medical editor for KidsHealth. “One or two nights of poor sleep is not the issue— it is those children who repeatedly receive too little sleep.

What many parents do not realize is that without proper sleep, kids’ bodies are not able to fight infection as effectively. In addition to forsaking their physical health, sleep deprivation can also affect their outlook on life. “A tired adult understands why they may have a tough day when they are sleepy— and they soldier on,” she continues. “We cannot expect the same from our children. Parents need to help their children get the proper amount of sleep. In the end, it really will make a huge difference for the whole family.”

Tips for Establishing a Bedtime Routine:

Is it too late to start a bedtime routine if my child is elementary age? Not at all. KidsHealth.org, the most-visited Web site about children’s health, shares simple tips for establishing (or re-establishing) a bedtime routine with your child.

•Bedtime: Set a bedtime for school nights and stick to it.
•Prioritize: Make sure homework (or any other task your child needs to finish for the next day) gets done first to ensure your child can get to bed on time.
•Wrap it up: Thirty minutes before bedtime, encourage your child to finish any projects or activities, and begin the bedtime routine (wash face and hands, brush teeth, etc.).
•Unwind: Include activities in the routine that will help your child slow down and relax (like taking a shower or reading a book).
•Time together: Spend a few minutes recapping the day together. Not only is this a great chance to catch up with your child, but your voice and presence will help your child to relax.
•Good night: Say good night and remind your child to stay quiet and in bed.


Nurse Donna

* For more information about KidsHealth, please visit www.KidsHealth.org.

Wednesday, January 14, 2009

Fifth Disease IS Common in Children


Especially common in kids between the ages of 5 and 15, fifth disease typically produces a distinctive red rash on the face that makes the child appear to have a "slapped cheek." The rash then spreads to the trunk, arms, and legs. Fifth disease is actually just a viral illness that most kids recover from quickly and without complications.

Fifth disease (also called erythema infectiosum) is caused by parvovirus B19. A human virus, parvovirus B19 is not the same parvovirus that veterinarians may be concerned about in pets, especially dogs, and it cannot be passed from humans to animals or vice versa.

Studies show that although 40% to 60% of adults worldwide have laboratory evidence of a past parvovirus B19 infection, most of these adults can't remember having had symptoms of fifth disease. This leads medical experts to believe that most people with a B19 infection have either very mild symptoms or no symptoms at all.

Fifth disease occurs everywhere in the world. Outbreaks of parvovirus tend to happen in the late winter and early spring, but there may also be sporadic cases of the disease any time throughout the year.

Signs and Symptoms
Fifth disease begins with a low-grade fever, headache, and mild cold-like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone until a rash appears a few days later. The bright red rash typically begins on the face. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. The rash usually spares the palms of the hands and soles of the feet. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Kids younger than 10 years old are most likely to get the rash.

Older kids and adults sometimes complain that the rash itches, but most children with a rash caused by fifth disease do not look sick and no longer have fever. It may take 1 to 3 weeks for the rash to completely clear, and during that time it may seem to worsen until it finally fades away entirely.

Certain stimuli (including sunlight, heat, exercise, and stress) may reactivate the rash until it completely fades. Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea, and rarely, rashes that look like blisters or bruises.

In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain, often in the hands, wrists, knees, or ankles.

Contagiousness
A person with parvovirus infection is most contagious before the rash appears — either during the incubation period (the time between infection and the onset of symptoms) or during the time when he or she has only mild respiratory symptoms. Because the rash of fifth disease is due to an immune reaction (a defense response launched by the body against foreign substances like viruses) that occurs after the infection has passed, a child is usually not contagious once the rash appears.

Parvovirus B19 spreads easily from person to person in fluids from the nose, mouth, and throat of someone with the infection, especially through large droplets from coughs and sneezes.

In households where a child has fifth disease, another family member who hasn't previously had parvovirus B19 has about a 50% chance of also getting the infection. Children with fifth disease may attend childcare or school, since they are no longer contagious. Once infected with parvovirus B19, a person develops immunity to it and won't usually become infected again.

Parvovirus B19 infection during pregnancy may cause problems for the fetus. Some fetuses may develop severe anemia if the mother is infected while pregnant — especially if the infection occurs during the first half of the pregnancy. In some cases, this anemia is so severe that the fetus doesn't survive. Fortunately, about half of all pregnant women are immune from having had a previous infection with parvovirus. Serious problems occur in less than 5% of women who become infected during pregnancy.

Prevention
There is no vaccine for fifth disease, and no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent spread of the infection because the person usually isn't contagious by that time.

Practicing good hygiene, especially frequent hand washing, is always a good idea since it can help prevent the spread of many infections.

Incubation
The incubation period (the time between infection and the onset of symptoms) for fifth disease ranges from 4 to 28 days, with the average being 16 to 17 days.

Duration
The rash of fifth disease usually lasts 1 to 3 weeks. In a few cases in older kids and adults, joint swelling and pain because of fifth disease have lasted from a few months up to a few years.

Diagnosis
Doctors can usually diagnose fifth disease by the distinctive rash on the face and body. If a child or adult has no telltale rash but has been sick for a while, a doctor may perform blood tests to see if the illness could be caused by parvovirus B19.

Treatment
Fifth disease is caused by a virus, and it cannot be treated with antibiotics used to treat bacterial infections. Although antiviral medicines do exist, there are currently none available that will treat fifth disease. In most cases, this is such a mild illness that no medicine is necessary.

Usually, kids with fifth disease feel fairly well and need little home treatment other than rest. After the fever and mild cold symptoms have passed, there may be little to treat except any discomfort from the rash itself. If your child has itching from the rash of fifth disease, ask the doctor for advice about relieving discomfort. The doctor may also recommend acetaminophen for fever or joint pain.

Complications
The majority of kids with fifth disease recover with no complications. By the time the rash appears and while it's present, they usually feel well and are back to their normal activities.

However, some children with weakened immune systems (such as those with AIDS or leukemia) or with certain blood disorders (like sickle cell anemia or hemolytic anemia) may become significantly ill when infected with parvovirus B19. Parvovirus B19 can temporarily slow down or stop the body's production of the oxygen-carrying red blood cells (RBCs), causing anemia.

When a child is healthy, this slowdown of red blood cell production usually goes unnoticed because it doesn't affect overall health. But some kids who are already anemic can become sick if their RBC production is further affected by the virus. The RBC levels may drop dangerously low, affecting the supply of oxygen to the body's tissues.

When to Call the Doctor
Call the doctor if your child develops a rash, especially if the rash is widespread over the body or accompanied by other symptoms.

If you're pregnant and develop a rash or if you've been exposed to someone with fifth disease (or to anyone with an unusual rash), call your obstetrician.


Nurse Donna

Monday, January 5, 2009

Winter Safety Tips..

Sled Safely

Sledding is a great way to have fun in the snow, but being careful is essential. According to the Consumer Products Safety Commission, approximately 46,000 sledding injuries are seen in hospital emergency rooms every year. Most are children under the age of 15 with head injuries

1. Choose a hill for your children to sled on that is away from trees, rocks and other obstacles.
2. Make sure there is no street traffic or frozen water anywhere near the bottom of the sledding hill - a sled may not always come to a stop exactly where you want it to.
3. Check your child's sled to make sure it is in good condition with secure handholds and steering that works.
4. Tell your child to never ride on a sled that is being pulled by a car or snowmobile.
5. Remind your child to always sled while sitting up with his feet forward. Lying on a sled increases the chance of head injuries.
6. Have your child wear a helmet while sledding.

Prevent Winter Sports Injuries

Children should wear helmets and eye protection while skiing, snowboarding and snowmobiling.

1. Make sure your child's helmet is specifically designed for the activity he is participating in.Helmets should be well-fitted to prevent shifting or jostling of the helmet.
2. Make sure children know to stay on marked trails while skiing, snowboarding or snowmobiling.
3. Child According to recommendations from the American Pediatric Association, children under 16 years old should never operate snowmobiles. Children younger than 5 should never ride on a snowmobile, even with an adult.
4.Keep Free from Frostbite and Hypothermia
5. Children are more susceptible to frostbite and hypothermia than adults. Be aware of the symptoms and know how to treat your child if either occurs.
6. Frostbite is when soft tissue, usually in fingers or toes, freezes. There are several stages of frostbite. If severe enough, frostbite can require amputation, but most often no permanent damage will occur if skin is warmed up carefully.

Symptoms:
� Numbness
� Blisters
� Soft or frozen doughy feeling to exposed skin
� Tingling and burning of frostbitten area upon re-warming
� Aching or throbbing pain upon re-warming
� Redness, swelling upon re-warming
� Blackness

What to do: If a child complains of numbness or pain in her fingers, toes, nose, cheeks or ears while playing outdoors, check to see if her skin is blistered, hard to the touch, or glossy. If so:
� Have her come inside immediately.
� Have the child move the numb part of her body to increase blood supply.
� Do not rub the skin to warm it up, as this can cause tissue damage.
� Immerse the frozen skin in warm water. (Make sure the water is warm but never hot so the tissue isn't further damaged.
� Get medical help if the area stays numb after warming.

Hypothermia occurs when too much heat escapes from the body and body temperature drops lower than its normal 98.6 degrees F to 95 degrees F or lower. While severe hypothermia can cause internal organ damage or lead to death, it is generally not something to be concerned about unless a person is trapped outdoors or in cold water for an extended period of time without proper protection.

Symptoms:
� Shivering
� Numbness
� Muscle weakness
� Drowsiness
� Incoherence
� Lowered body temperature
� Slow pulse

What to do:

� Call 911 for help.
� Bring your child to a warm place.
� Wrap your child in blankets to retain body heat.
� Don't expose your child to any direct heat sources like hot water bottles, heating pads, radiators or fireplaces.

Why Winter Safety is Important
Winter can be a fun season for children, but hospital emergency rooms and their doctors see too many children with head injuries, broken bones and other serious winter injuries.

According to the National SAFE KIDS Campaign, in 2007 there were:
17,000 estimated injuries among children from skiing and snowboarding
24,500 estimated injuries from sledding
1,500 estimated injuries from snowmobiles and equipment
According to the U.S. Consumer Product Safety Commission:
Each year there are approximately 5,740 emergency room visits due to snow thrower-related injuries. Don't let your child be a statistic. Avoid visits to your local emergency room by helping your child stay safe while having fun during.

Please keep in mind that the text provided is for informational purposes only and is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health professional before starting any new treatment or making any changes to existing treatment.

Nurse Donna