Back to school – Four areas that need your attention1. Making the first day easierWhether going to a new school or just having back-to-school jitters, kids will need your help in making the change easier.

Remind your child he or she is ●

not the only child feeling uneasy the first day of school. Teachers know that students are anxious and will work hard to put kids at ease.

Point out the fun things back to ●

school brings – seeing old friends, making new friends, activities your child enjoys.

Find another child in the neigh- ●

borhood or a friend your child may ride the bus or walk with.

If it helps your child, consider ●

driving your child or walking with him or her the first day.

2. Backpack safetyWhen shopping for backpacks, ●

choose one with wide, padded shoul-der straps and a padded back.

Pack light. Organize the back- ●

pack to use all compartments. Put heavier items closest to the center of the back. � e backpack should not weigh more than 20 percent of your child’s body weight.

Always use both shoulder straps. ●

Using just one shoulder strap can cause back problems.

How about a rolling backpack? ●

If your child does not have to go up stairs, this may be a good solution.

3. School bus, bike and walking safetySchool bus

Wait for the bus to stop before ●

approaching the curb.Do not move around on the bus. ●

Always check for traffic before ●

crossing the street.Make sure the bus driver can ●

see you and you can see him or her before crossing.

Bike

Always wear a bicycle helmet, ●

even if it’s a short ride to and from school.

Ride on the right in the same ●

direction as traffic.

Fall 2008 Vol. 32, No. 3

Five tips for active

kids

2

News for Families

The Children’s MedicalCenter of Dayton

Making the best

choice for emergency

care

Making

4

Taking care when

taking pictures

Taking

6

SeasonalHealth Alert

continued on page 2…

Fall 2008 Vol. 32, No. 3

There’s no question that physical activity is good for kids. Despite kids’ full schedules these days, it’s apparent many do not include physi-cal activity in those schedules.

James Ebert, MD, a physician in Dayton Children’s lipid clinic, believes there are many ways families can work physical activity into their daily schedules.

“Maintaining a healthy weight requires lifestyle changes that include good nutrition and activ-ity,” he says. “� ese lifestyle changes aff ect the entire family.”

Dayton Children’s joins Kohl’s Department Stores in bringing you this information from the Kohl’s A Minute for Kids campaign.

Make it challenging1. Children love competition. You can make activities challenging to them by having contests. If you are watching TV, see how many sit-ups or push-ups they can do during a commer-cial. Make a game out of common tasks like cleaning up the backyard. Incorporate little fitness challenges into daily activities.

Create opportunities2. Some kids may not like team or group activities, but may excel in activities such as

active video games. Look for creative ways for your child to be active – both individually and in groups.

Get outside3. Simply getting outside and breathing fresh air is a great way to spend time with your family and become more active. Walk the dog, go to the park, take a hike or a bike ride as a family. Spend the time you do have as a family outside doing something a little out of the ordinary.

Play4. During the last days of summer, kids don’t want structure. Remember that being active doesn’t always require a structured schedule. Choose activities that your children will enjoy and that fit their interests.

Be a role model5. Parents need to lead by example. Remember, your children are always watching you. Make sure that you are also partici-pating in competition and playing with your children. If they see you having an active lifestyle they will want to do the same.

For more health and safety tips, visit the Dayton Children’s web-site. Click on Health Topics and/or Safety Tips. We also offer podcasts on key topics.

Back to schoolcontinued from page 1…

FREE e-news

Sign up for Dayton Children’s e-newsletter FamilyWise to receive FREE health and safety information. Join hundreds of other parents receiving this monthly news-letter by e-mail. Go to www. childrensdayton.org; click on “E-newsletter.” If you prefer, call 937-641-3620.

Growing Together is published quarterly for parents and families in the Miami Valley area by The Children’s Medical Center of Dayton, One Children’s Plaza, Dayton, Ohio, 45404-1815.

Visit our web- site at www. childrensdayton.org – your online source of child health and safety information.

2

Five tips for active kids

Use correct hand signals so driv- ●

ers know what you are doing.Wear bright clothing so drivers ●

can see you.Follow the rules of the road. ●

Walking to school

Make sure your child’s walk to ●

school is a safe route. Well-trained adult crossing guards should be pres-ent at every intersection.

Know your child’s skills. Young ●

children can be impulsive and unaware of traffic dangers. Be sure your child is mature enough to walk to school alone. Talk to your child’s doctor if you’re not sure.

Bright-colored clothing will help ●

drivers see your child.

4. BullyingWhen one child repeatedly picks on another, this is bullying. Help your child respond to a bully.

Tell your child to look the bully ●

in the eye.Stand tall and stay calm. ●

Walk away. ●

Teach your child to say ●

“I don’t like what you are • doing.”

“Please do not talk to me like • that.”Teach your child when and how ●

to ask for help.Encourage your child to make ●

friends with other children.Support activities that interest ●

your child. � is will strengthen his or her self-esteem.

Let school officials know if there ●

is a problem.

These tips were provided by the American Academy of Pediatrics and approved by the experts at Dayton Children’s.

For more health and safety tips, including seasonal health alerts, visit our website at www.childrensdayton.org. Go to Health Topics and Safety Tips.

Join FamilyWise to receive monthly health and safety tips by e-mail.

Six rules for bunk beds

Is your house paint safe?

healthbeat

3

When children share your bikeBefore heading for the bike path with your youngster riding tandem, be aware of the safety concerns about this practice.

A young passenger on an adult’s bike makes the bike unstable and increases braking time. And that increases the risk of an accident. The American Academy of Pediatrics recommends young children ride in a bicycle-towed child trailer.

Remember –Only adult cyclists should carry young passengers. ●

Ride with passengers on bike paths, in parks or on quiet ●

streets. Avoid busy streets and bad weather.

Infants younger than 12 months are too young to sit in ●

a rear bike seat and should not be carried on the bicycle. Do not carry infants in backpack or front packs while riding a bike.

Children who are old enough ●

(12 months to 4 years) and sit well unsupported can be carried in a child trailer or rear-mounted seat if they are wearing a light-weight helmet. These small Styrofoam helmets that meet Consumer Product Safety Commission stan-dards are readily available.

Strap the child into a ●

rear-mounted seat with a sturdy harness.

Kids love bunk beds, but if your child is using one, Dayton Children’s joins the Consumer Product Safety Commission in improving bunk-bed safety.

Six bunk-bed safety tipsKeep kids younger than 6 years 1.

in the bottom bunk.Always use two side guardrails on 2.

the upper bunk – even when your child gets older.

Teach children to use the ladder 3. to climb into bunks, not chairs or other furniture. Never allow chil-dren to jump from the top bunk.

Consider a nightlight or flashlight 4. to help your child see when getting out of the bunk during the night.

Keep bunks away from ceiling 5. fans or light fixtures.

Dayton Children’s Regional Pedi-atric Emergency and Trauma Center treated 45 children last year for

bunk-bed injuries. Nationally, 572,580 children and adoles-cents were treated for injuries from bunk beds.

How are kids injured?

Head and neck injuries ●

are the most common injuries in all age groups.

Most – 72.5 per- ●

cent – of injuries were caused by falling out of bunk beds.

During the summer and fall, many families are making home improve-ments. One of these may be painting your house. Whether you do it your-self or hire a professional, be aware of the following dangers:

Houses built before 1978 may ●

have paint that contains lead. Chip-ping and peeling paint may be swal-lowed by young children. If you rent, let your landlord know about peeling and chipping paint.

Clean up paint chips immediately. ●

If removing lead-based paint from ●

your house:Keep everyone away from work •

areas. Change your sleeping, cooking and living areas if work is being done there.

Seal off work areas with plastic • so dust does not go throughout the house.

Keep pets safe too. � ey can • also be aff ected by lead.

Have the workers use a separate • pathway to the work area.

Turn off forced air heating or • air conditioning while work is being done.

Talk to your child’s doctor if you live in an older home. He or she may suggest your child should be tested for lead poisoning. A special blood test is the only way to know for sure. � e laboratory at Dayton Children’s off ers lead testing.

93.5 percent of injuries occurred at ●

home.Incidents outside the home occur in ●

dorms and other public facilities. Half of those injuries involved individuals 18 – 21 years old.

Half of all bunk-bed injuries happen ●

to children younger than 6 years old.

Visit Dayton Children’s website for more information on bunk bed safety. Go to Safety Tips.

4

Angie Davidson

of Hamilton with

daughter Kadie,

who is recover-

ing from a head

injury after a fall

from bed.

Five reasons to choose Dayton Children’s ED

1. Specially trained and experienced staff

2. Life-saving equipment to fi t children of all ages and sizes

3. We are the Regional Pediatric Trauma Center.

4. Access to pedi-atric specialists

5. Child life specialists help put kids at ease

What do parents need to think about?

Before an emergency comes up, 1. choose an emergency department (ED) that is child-friendly. Dayton Children’s has the doctors, nurses and other staff who know how to treat, comfort and reassure children and their families. � e ED at Day-ton Children’s has life-saving equip-ment in diff erent sizes and our staff can quickly talk to other pediatric specialists in order to give your child the best care possible. � is makes a diff erence in an emergency.

Call your child’s doctor. He or 2. she can tell you whether to go to the hospital or urgent care right away or if you can wait for an office visit. � e doctor can also help you treat your child at home.

Understand what services your 3. insurance plan will cover. Your plan may ask that you call your child’s doctor first in order for services to be covered.

Choosing emergency care for your child is not a decision to make during an emergency. Instead, the experts at � e Children’s Medical Center of Dayton recommend you learn about your options before an emergency occurs.

When Angie David-son’s infant daughter Kadie fell off the bed during a diaper

change, she fi rst headed for the family doctor. After an examination, the Hamilton, Ohio mother and child were sent to Dayton Children’s Specialty Care Center in Middle-town for x-rays.

Images revealed a skull fracture, and the Davidson’s were sent to the hospital’s Regional Pediatric Trauma and Emergency Center where a CT scan revealed a blood clot on Kadie’s brain. Laurence Kleiner, MD, a pediatric neurosurgeon at Dayton Children’s, performed surgery to remove the clot.

“With a 5-month-old, it’s hard to tell something is wrong,” Angie recalls. “Kadie seemed fi ne to me.”

“Children respond diff erently to illness, injury and treatment than adults,” says Tom Krzmarzick, MD, medical director of Dayton Children’s Regional Trauma and Emergency Center. “� e closest emergency care may not always be most appropriate for children.”

Families who are a signifi cant distance from a pediatric hospital are advised to go to the nearest emer-gency department. � e staff there can stabilize their child and have Dayton Children’s transport team take the child to Dayton Children’s.

When your child needs emergency care:

best choiceMaking the

5D

aytonChildren’sfo

cus

Know the fastest route to the ED. 4. It is difficult to think clearly in an emergency.

Do not give your child anything 5. to eat or drink in case your child will need to be sedated or have tests done.

Leave other children at home if 6. possible. Your sick child will need your full attention.

What should I bring with me?

Your insurance card.1.

Money. Your cell phone may not 2. work in all areas of the hospital, so you may need to use a pay phone.

A list of your child’s medications, 3. allergies and medical history. By putting this together ahead of time, there is no delay in an emergency. � is is very important if your child has a chronic condition such as asthma or special needs.

Your child’s favorite toy, blanket 4. or game. Depending on your child’s situation, there may be a wait.

What do I do when I bring my child to the ED?

Check in. A specially trained 1. nurse (triage nurse) will talk to you about your child’s condition. It is important to give this nurse as much information as you can to determine how soon your child can be seen.

Understand that the sickest chil-2. dren are seen first. Because Dayton Children’s is a trauma center, ambu-lances and air transport will bring children in for treatment. Because they come directly to the trauma center, you will not see them arrive. If you think your child is getting sicker, please talk to a nurse right away.

If your child is very sick and 3. rooms are available, he or she will go to an exam room right away. Many times, you and your child will stay in the waiting area until called back.

� e ED staff works hard to keep 4. families together during treatment.

Generally, two people are permitted in the exam rooms with the child.

If your child needs tests, these 5. will be ordered. Depending on the time of day and tests needed, this could take awhile.

If your child needs to be admitted 6. to the hospital, the ED doctor will talk to your child’s doctor. If your child’s doctor agrees with the ED doctor, the admission process begins.

How can I help with my child’s care?

Tell the doctors and nurses every-1. thing you know about your child’s situation. � e more information you can provide, the better they can treat your child.

Ask about ways to ease your 2. child’s pain. Dayton Children’s has ways to make procedures pain-free or less painful.

Ask questions, especially about 3. continuing care at home. During your visit or before you leave be sure to ask:

What is my child’s main problem? ●

What do I need to do? ●

Why is it important that I do this? ●

Comfort your child. Let your 4. child know what is going on. Help distract your child by playing games or deep breathing. A child life spe-cialist works in the ED during busy hours. She can provide distraction therapy to kids and help them pre-pare for any procedures.

Talk to your child’s doctor after 5. the emergency visit. Your child’s doctor will want to know the diag-nosis and to put this information in your child’s medical file.

� e staff in the Regional Pediatric Trauma and Emergency Center treated more than 52,900 sick and injured children last year. � is level of experience is unmatched in our region.

“Every member of our team has special training and experience in treating infants, children and teens, whether they are a doctor, nurse, child life therapist or social worker,” says Dr. Krzmarzick. “We are here 24/7 so that children get the best emergency care available.”

Angie Davidson of Hamilton is grateful for the care Kadie received. “� is was the scariest thing in my life, but you guys did a great job.”

Other things to remember

If your child has special needs or if others will be caring for your child (relatives, for example), there are forms that will help your child get the best care in an emergency.

Go to: www.childrens-dayton.org, Patient & Visitor Info – Forms. These forms are listed in the center of the page.

Distraction techniques are just one way the staff in Dayton Children’s emergency department help kids feel more comfortable during treatment. (L-R, Elizabeth Briscoe, PCA, Olivia Balsamo, Sasha Mosel, RN, and Melissa Balsamo)

to eat or drink in case your child will need to be sedated or have tests done.

Leave other children at home if 6. possible. Your sick child will need your full attention.

What should I bring with me?

Your insurance card.1.

Money. Your cell phone may not 2. work in all areas of the hospital, so you may need to use a pay phone.

A list of your child’s medications, 3. allergies and medical history. By

On this rainy afternoon, Nathan shows off his dinosaur umbrella to the staff before turning

it into a sword and having some typical 5-year-old sword play. He is at Dayton Children’s with his mother Rachel for just one of the tests he is having this week.

Earlier in the week he had a CT scan and chest x-ray. Today, he receives an injection as part of the MIBG scan that will be done tomorrow. � is scan uses radioactive meta-iodobenzylguanidine (MIBG). � e MIBG attaches to neuroblas-toma cells after going into the blood-stream and helps doctors determine if the tumor has spread.

“Nathan has had CT scans, x-rays, MRI*, ultrasound, bone scans, nuclear medicine tests. I think he’s had every imaging procedure you have here,” Rachel says. For that reason, she is grateful that Dayton Children’s takes care to minimize radiation doses.

Taking care when taking pictures

When doing medical imaging, Dayton Children’s is

6

Nathan Ormsby of Beavercreek has undergone more imaging tests than many children his age. � e 5-year-old is a regular in the medical imaging department at Dayton Children’s since being diagnosed in August 2006 with stage IV neuroblastoma (a cancer of the peripheral nervous system that appears as a solid tumor).

Katie Lasance, nuclear medicine tech, explains a test to Nathan Ormsby and his mother Rachel.

For FAQs about medical imaging safety, visit our website at www.childrensdayton.org. Go to Services – Medical Imaging.

N A T H A N ’ S S T O R Y

Since being diagnosed with stage IV neuroblastoma in August 2004, Nathan Ormsby has been treated by Mukund Dole, MD, in Dayton Children’s hematology/oncology department.

Neuroblastoma is the most common solid tumor (besides brain tumors) in children. It is often diagnosed before a child is 1 year old. It accounts for about seven percent of childhood cancers.

Since being diagnosed, Nathan has had at least 14 rounds of chemotherapy, MIBG treatment (this procedure uses a high-dose of MIBG to treat neuroblastoma), radiation, bone marrow trans-plant and antibody treatment. Dr. Dole coordinates Nathan’s care, which has included special treatments at other facilities.

Dr. Dole says that Nathan’s disease is now stable, but he will continue with ongoing therapy as his condition is monitored.

“� e actively growing tissues in children are more sensitive to radia-tion,” says Elizabeth Ey, MD, medical director of medical imaging at Dayton Children’s. “Because a child’s life expectancy is longer compared to an older adult, the eff ects of radiation exposure last longer in a child. Doctors who image children should make sure they receive child-sized doses. More is not always better.”

Lower radiation doses is not the only reason children should be treated at a pediatric facility.

� e Ormsby’s occasionally use an adult facility for a specialized treatment.

“It’s hard for kids to be around sick adults,” says Rachel. “We notice there are not the same smiles, the patience with children or the toys. � e staff at Dayton Children’s expects kids to be kids. � at’s huge!”

She explains that the staff has let Nathan look at his scans “because he wanted to see them. � ey know kids are curious.” Nathan’s care requires that the medical imaging staff work with others in the hospital such as the lab or the hematology/oncology clinic. It’s a benefit that everyone is close by.

“� e medical imaging depart-ment is awesome. � ey are on their game. Everything is in order when we arrive and if it’s not, they make it right,” Rachel says.

While Nathan and Rachel wait for today’s test, Nathan finds two trucks to play with, pours his own apple juice and agrees to share a piece of advice for other kids coming to Dayton Children’s.

“Don’t be afraid,” he says. “� e doctors and nurses are nice and there are lots of things to play with.”* Note: MRI does not use radia-tion, so it is a good alternative to discuss with your child’s doctor if imaging tests are needed.

DaytonC

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Community child health needs Every three years, Dayton Children’s conducts a community health assessment to determine the child health needs in our area. The 2008 study, funded by the Dayton Children’s Foundation Board, shows great strides in the area of safety as a result of some strong awareness and education programs. However, it also points to some continuing areas of concern about the health of the region’s children:

Almost 1 in 4 children are over- ●

weight – caused by a lack of proper nutrition and physical activity.

Allergies or asthma continue to ●

affect almost 1 in 5 area children; over 1 in 10 children have been diagnosed with developmental delays/learning disabilities.

Nearly 1 in 10 children ages 6 to ●

14 has not had a dental visit within the past year.

For complete findings, visit our website. Click on Advocacy.

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newsbriefs

Growing Together is published quar-terly for parents and families in the Miami Valley area by The Children’s Medical Center of Dayton. The purpose of Growing Together is to show how Dayton Children’s and families are working together to keep all children healthy and safe. Additional copies of Growing Together are available by writing to Dayton Children’s, c/o Marketing Com-munications, One Children’s Plaza, Day-ton, Ohio, 45404-1815 or by calling 937-641-3666. Your suggestions and comments are also appreciated.

David Kinsaul, FACHEPresident and Chief Executive Officer

Vicki GiambroneVice President, Marketing and External Relations

Susan A. BrockmanEditor

Tom SuttmanPhotographer

8 Technology protects new-borns’ brains Dayton Children’s is one of just 28 hospitals in the country off ering the Olympic Cool-Cap Sys-tem to prevent or reduce the severity of neurological injury in newborns.

Until now, there were few options for treating the results of reduced blood flow and oxygen to the brain.

“Selective head cooling with Cool-Cap is a welcome innovation to the Regional Newborn Intensive Care Unit at Dayton Children’s,” says M. David Yohannan, MD, medical director of newborn medicine. Go to

our website – Media Center – Media

Releases – for more information.

Pain Busters helps children cope A program to reduce pain dur-ing procedures will be started soon at Dayton Children’s. Pain Busters is the result of a multidisciplinary team examining best practices in pain relief during procedures.

“At Dayton Children’s we believe no child should suff er when his or her pain can be relieved,” says Amit Vohra, MD, critical care medicine. “If a child has a good experience with a proce-dure, he or she will be less anxious if future procedures are needed.”

Best practices include distraction during uncomfortable procedures and

positions of comfort – proven ways of holding a child that will reduce pain and anxiety.

Sedation and topical medications are also important options. Staff will continue to use a pain scale to help children identify their level of pain.

New specialists join staff Paul S. Potter, MD, has joined the department of anesthesiology at Day-ton Children’s.

Dr. Potter is board certifi ed in anes-thesiology. He received his anesthesiol-ogy training from the United States Naval Hospital and Harvard Medical School. Dr. Potter has been in practice for 18 years.

Patrick A. Sobande, MD, joined the department of pulmonary medicine after completing a fellowship in pedi-atric pulmonary medicine. He is board certifi ed in pediatrics and was recently selected to the Consumers’ Research Council of America’s top pediatricians. One of his special interests is asthma treatment.

Mark Warren, DO, joined the medical imaging department after completing his fellowship in pediatric radiology. He is board certifi ed in diagnostic radiology and has a certifi cate of added qualifi cation in pediatric radiology. Dr. Warren has a special interest in interventional radiology.

Coming to your neighborhood Dayton Children’s will be opening new locations in Vandalia and Springboro.

Outpatient Care Center – Springboro will open in the fall of 2008. The center will be located just off the future Austin Road exit from I-75 on West Tech Road near the Dayton General Air-port. Urgent care, lab, medical imaging and rehabilitative services will be offered. The hospital is seek-ing LEED (Leadership in Energy and Environmental Design) certification from the U.S. Green Building Council for this building. This is one more way we are working to promote the health and well-being of children and families. Watch us grow – visit www.childrensdayton.org/springboro.

Outpatient Testing Center – Vandalia will open in late 2008 for the convenience of families north of Dayton. This center will offer lab and medical imaging services. The center will be located just off I-75 at the Northwoods Boulevard exit.