Showing posts with label safety. Show all posts
Showing posts with label safety. Show all posts

Wednesday, September 23, 2015

If You Have Concerns About Bike Safety—Don’t Forget Trike Safety!


By: Lewis First, MD, MS; Editor-in-Chief         

          We certainly do a lot of anticipatory safety guidance when it comes to our patients riding safely on bicycles—but have you ever offered tricycle safety advice?  After reading the study being released this week by Bandzar et al. (doi:10.1542/peds.2014-3632) you may want to.  The authors report on injuries that were uploaded in emergency departments into the National Injury Surveillance System in 2012 and 2013.  
      Just the fact that more than 9000 tricycle injuries were accumulated in this database is worth your attention.  The data shared is extensive in terms of the types of injuries, ages they occur, and the seriousness of these accidents in terms of needing hospitalization or not.  Rather than describe the results, cycle through this article yourself (and you won’t have to wear a helmet while doing so).   
      Do you ask about tricycle use during toddler and pre-school visits and offer safety advice for these devices?  Share your experience with tricycle injuries with us by responding to this blog, sending us an e-letter or posting your comments on our Facebook or Twitter.

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Monday, December 1, 2014

Uncovering Some Concerning Trends in Infant Bedding Use in the US

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by Janine via Flickr
Since the onset of the “Back to Sleep” campaign for infants in the early 1990s, one would think that the use of dangerous bedding materials in cribs would be much less 20 years later—but how much less?

Shapiro-Mendoza et al. (doi: 10.1542/peds.2014-1793) elected to review almost two decades of data from the National Sleep Position Study and although the use of blankets, pillows and other dangerous bedding materials declined, they were still being used at a prevalence of over 50 percent of those surveyed in this national database as of 2010.

So why is that, and who is not complying with a safe sleep environment for their babies so as to reduce the risk of sudden infant death? The authors reveal some important demographic predictors that will allow us to better educate some populations of parents even more than we are when it comes to making sure bedding is not hazardous for babies.

This is a study that will not put you or parents of infants to sleep. And if the data as presented is not a wake-up call, then read the commentary by safe sleep experts Dr. Rachel Moon and Fern Hauck (doi: 10.1542/peds.2014-3218) also released this week.

You may want to blanket your office (rather than baby’s crib) with copies of these materials with the hope we can do even more to reduce the risk of an unintended unsafe sleeping situation.

Related Reading:

Monday, October 20, 2014

Every Eight Minutes: Young Children and Out-of-Hospital Medication Errors

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by Taki Steve via Flickr
Ever get a call from a family concerned that their child just ingested a medication that they should not have? I can’t imagine that there is a pediatrician in practice who has not received such a call weekly, if not daily. So just how common are out-of-hospital medication errors? What types of medications are usually involved, and why do these events occur?

May et al. (doi:10.1542/peds.2014-0309) extracted some interesting findings from the US National Poison Database System for US children less than 6 years old from 2002 to 2012 and discovered the magnitude of this problem is larger than you might think.

For example, did you know that every eight minutes a child experiences an out-of hospital medication error? And while the good news is that cough and cold medication ingestions have decreased over the past 10 years or so, analgesic ingestions have gone up along with a host of other medications.

To find out more about what children are ingesting in the home and what might be done about this, I’d prescribe reading a good dose of this article. Follow up by checking to make sure you or your staff have adequately counseled your patients regarding appropriate preventive steps to reduce the high rates of medication errors occurring in children in this country.

Related Reading:

Wednesday, October 15, 2014

Sofas and SIDS: A Dangerous Combination

Photo by stevepb via Pixabay
By: Lewis First, MD, MS; Editor-in-Chief 

Recently we received a manuscript from Dr. Rechtman et al. we found so worrisome that we are early-releasing the results of their study this week prior to official publication next month (doi:10.1542/peds.2014-1543).

The study uses data from a national database to look at infant deaths that occurred on sofas in 24 states from 2004 through 2012. The authors then compared demographic and environmental data from sofa deaths to other sleep-related infant deaths in other locations. The fact that sofas account for almost 13 percent of sleep-related infant deaths is concerning, and it’s worth knowing, and sharing with your infant patients’ parents, that these deaths are more apt to be labeled as suffocation or strangulation.

This blog post cannot do justice to the myriad of risk factors associated with infant deaths, so rather than try, check out the study and learn more. After reading this study, I hope you will agree that the sofa is off limits when it comes to safe sleep environments for babies!

Related Reading:

Friday, September 19, 2014

Dosing Out Knowledge on the Medications Children Commonly Ingest Unsupervised

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by Charles Williams via Flickr
We know we try hard to encourage families to secure medications, both prescription and non-prescription, from their children—but ingestions can and do occur when children are unsupervised.

Just what gets ingested most commonly forms the focus of a study by Lovegrove et al. (doi: 10.1542/peds.2014-0840) reporting on adverse drug events recorded in a national surveillance database in regard to emergency hospitalizations. The high number of hospitalizations recorded in children under 6-years-old over the five years studied will make you then want to learn the specifics of what is being ingested to cause these inpatient admissions.

While certainly opioids and benzodiazepines lead the list, the high number more specifically of buprenorphine and clonidine ingestions also got our attention and should make you think about what you are doing to specifically inquire about these medications and what can be done to prevent unsupervised access to them by infants, toddlers, and preschoolers.

If I could write a prescription to insure you read about the findings in this study, I would—but since I cannot, I hope you will just take the initiative and link to this study to learn more. It’s an important study but also a bitter pill to swallow.

Related Reading:

Tuesday, July 1, 2014

Vaccine Safety Systematically Reviewed

By: Lewis First, MD, MS
Photo by El Alvi, via Flickr

Ever wish you could get all the information reported in prior studies on vaccine safety integrated into one systematic review article? While the Institute of Medicine (IOM) has looked into vaccine safety before, additional studies have come out since then including some on newer vaccines not in the IOM report.

Thanks to Maglione et al. (doi: 10.1542/ peds.2014-1079) we are able to release this week an updated systematic review on vaccine safety using active surveillance studies with controls with strength of evidence for findings also shared. Of more than 20,000 articles identified on vaccine safety, only 67 met rigid study criteria for inclusion in this article, and as a result, some sharp points are made on vaccines and their association with complications.

While the review indicates an increased association between the MMR vaccine and febrile seizures and increased complications if the varicella vaccine is given to an immunocompromised child, there was strong evidence of no association of the MMR vaccine with autism, reaffirming the earlier IOM report findings. Despite the adverse effects identified with a few vaccines, the incidence of these effects was extremely rare and the benefits of administering these vaccines to children continue to outweigh the risks.

Additionally, we have asked infectious disease specialist Dr. Carrie Byington (doi: 10.1542/peds.2014-1494) to share her opinion on the take-aways from this important review in an accompanying commentary.

If you want to inject some hard evidence into your discussions of vaccine safety with families, this article and commentary are a must-read.

Related Reading:

Tuesday, June 10, 2014

Classifying Sudden Unexplained Infant Deaths in a Multistate Registry: A New Tool for Prevention Strategies

By: Lewis First, MD, MS

Photo by Janine via Flckr
Given the complexity of classifying a sudden unexpected infant death (SUID), such as one being due to sudden infant death syndrome or accidental sleep-related suffocation, a method of doing such classification in a clear and consistent manner could be quite beneficial—at least those are the thoughts of Shapiro-Mendoza et al. (doi: 10.1542/peds.2014-0180) who have established a system of classifying these death subtypes into groups and further help to identify with their system the highest risk groups that we might be able to intervene and potentially prevent a SUID event.

Just how useful this new system might be is further explained in a commentary associated with this special article by Moon and Byard (doi: 10.1542/peds.2014-0602), who provide historical and international context as well as analysis about the practicality and potential benefits and challenges of Shapiro-Mendoza et al.’s classifications.

If you need an update on just what the various subtypes of SUID are and what we might be able to do about them, then this article and commentary are just what the pediatrician ordered. Read them both and as you do, think about the useful applications of this classification system when it comes to prevention strategies for SUID.

Related Reading: