just kids | spring 2012

JustKidsSpring 2012ChildrensOmaha.org

CHOKING HAZARDSKeep Your Child Safe 4

MENINGITISGet the Facts 6

URGENT CARE CENTERSTwo Convenient Locations 7

Do Your Kids get Enough

ZZZ’s? p5

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Twitter.com/ChildrensOmaha JustKids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2012. All rights reserved. Printed in U.S.A.

➍ Choking Hazards: Keep Your Child Safe

➎ Lack of Sleep Can Harm a Child’s Health

➏ Meningitis: Act Fast!

➐ Pediatric Urgent Care

➑ Your Infant’s Teeth

➒ Pediatric Dental Care Offered at Children’s

➓ Peanut Allergy Is Serious Business

Children’s Transport Team Marks Milestone

Contents

ChildrensOmaha.org JustKids Gary A. Perkins President and CEO Martin W. Beerman Vice President, Marketing

and Community Relations David G.J. Kaufman, MD Medical Advisor Dannee Schroeder Senior Editor

Learn more about this season’s merchandise at www.kohls corporation.com/communityrelations/Community02.htm. Or just use your smartphone to scan this Microsoft Tag. Visit www.ChildrensOmaha.org/2DCode to learn how to use tags.

On The WeB

Unintentional and preventable injuries are the leading causes of death for children younger than the age of 14. Many people are unaware that 80 percent of car seats are not properly installed, nor do they realize that fastening a seat belt or wearing a bike helmet can be the difference between life or death for a child.

Children’s Hospital & Medical Center is committed to the health and well-being of all children. The Kohl’s Keeps Kids Safe program, a partnership between Children’s and Kohl’s department stores, is dedicated to reducing the number of accidental injuries in children. Kohl’s Cares® earmarks net profits from the sale of its $5 books and plush toys for initiatives such as injury prevention, immunizations and education programs for diabetes, asthma and childhood obesity, among others. Since 2000, Kohl’s has raised more than $150 million to support children’s health and education initiatives nationwide.

Kohl’s has donated more than $1.2 million to Children’s Hospital & Medical Center in support of child injury prevention programs. Every time you purchase a plush toy and accompanying book offered at Kohl’s Department Stores in the Omaha area, Kohl’s shares the sales proceeds from this merchandise with Children’s Hospital & Medical Center.

Children’s and Kohl’s Committed to injury prevention

2 To find a physician, call 1-800-833-3100

What’snew?Children’s experts Offer helpful Tips with Free Parenting U ClassesWith the arrival of a child, there are some things you learn automatically, like how little sleep an adult actually needs to function, the importance of sippy cups, and that polar bears may be hiding in your closets. For other lessons—including the skills to get through those all-important first years—there’s Parenting U from Children’s Hospital & Medical Center. These are FREE classes given by professionals known for their knowledge of children. Along with a new topic each week, we’ll provide food, child care and prizes.

Free PArenTinG ClASSeS Call 800-833-3100, or log onto ChildrensOmaha.org/ParentingU to register today.

Parenting U Upcoming DatesEach session will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Call 800-833-3100, or log onto ChildrensOmaha.org/parentingU to register today.

Tuesday, June 26preparing For Your newbornRachel McCann, M.D., F.A.A.P., Children’s Physicians

Tuesday, September 11preparing For Your newbornSteven Sindelar, M.D., F.A.A.P., Children’s Physicians

Tuesday, September 18Baby’s First YearsMichelle Mogenson, D.O., F.A.A.P., Children’s Physicians

Tuesday, September 25Effective Time-Out TechniquesAshley Harlow, Ph.D., N.C.S.P.Children’s Behavioral Health

Tuesday, October 2Mastering potty TrainingKatie Anglim, M.D., F.A.A.P.Children’s Physicians

Tuesday, October 23Childhood Obesity prevention & ManagementCristina Fernandez, M.D., F.A.A.P., Children’s Weight Management ClinicJennica Cornine, M.P.A.S., P.A.-C., Children’s Weight Management Clinic

ChildrensOmaha.org 3

Christopher Columbus used a compass, but

babies have other means of exploration—like

their mouths. Young children ages 6 months to

3 years often put objects in their mouths, and

sometimes they swallow odd things. Fortunately,

there are some things parents can do to lower

their child’s risk of choking.

identify Choking hazardsTo prevent your child from inhaling or

swallowing potentially dangerous items,

follow these steps:

• Place small items, such as toys with tiny

removable parts or common household

objects, in places that toddlers can’t access.

Remember to hide the usual suspects—pins,

needles, coins, latex balloons, pen caps,

marbles and tiny balls. Also, don’t forget

atypical items like high-powered magnets;

these small magnets are fun stress relievers

for adults to keep on their desk, but can also

be choking hazards for young children or

even teens who use them to mimic piercings.

• Avoid giving young children foods that

can cause choking. Keep little ones younger

than age 4 away from seeds and nuts; sticky,

gummy or hard candy; peanut butter chunks;

popcorn; hot dogs; whole grapes; big chunks

of cheese or meat; raw veggies and raisins.

• Monitor children closely when they play

and eat.

• Get down on your hands and knees and

experience your house like a baby does.

Look for unsafe objects your child might

find, and baby proof the house accordingly.

Button Batteries Pose extra riskIn addition to being a choking hazard, round

button batteries, when swallowed, can cause

dangerous internal chemical burns in children.

Damage can occur in as little as two hours after

ingesting. According to the U.S. Consumer

Product Safety Commission (CPSC), children

most often gain access to button batteries directly

from games, toys, calculators, remote controls

and other common household items.

The CPSC recommends the following

steps to prevent battery ingestion:

• Discard button batteries carefully.

• Do not allow children to play with

button batteries.

• Keep remotes and other electronics out

of the reach of children if the battery

compartment does not have a screw to

secure it. Use tape to help secure the

battery compartment.

• If a button battery is ingested,

immediately seek medical attention.

if Your Child Swallows SomethingWhile most swallowed objects, other than

batteries, pass through a little one’s

digestive system symptom-free, it may take

up to one month for the item to pass.

Parents should check their child’s stools to

ensure that the item has been expelled.

Objects that get inhaled and lodge in the

windpipe can put your child’s life at risk.

Swallowed items may also get caught in the

digestive track or obstruct the esophagus.

Here are the symptoms to look for:

• Constant coughing with no obvious cause

• Chest or stomach pain

• Hoarseness or drooling

• Vomiting

• Pain or difficulty when swallowing

If your child has any of the above

symptoms, seek prompt medical attention.

If your child suddenly starts to choke,

wheeze or has trouble breathing after

swallowing, handle it as a medical

emergency. Perform the Heimlich

maneuver, and immediately call 911 or

your local emergency number.

CHOKING HAZARDS: Take Steps to Keep Your Child Safe

PrOTeCT YOUr ChilD FrOM ChOKinGTo learn more, enter the search term “choking hazard” at our website at HealthLibrary.ChildrensOmaha.org.


SUSPeCT A SleeP PrOBleM?Are you concerned that your child isn’t getting proper rest? If so, talk with your child’s primary care provider. To find a physician for your child, call the Children’s Find-A-Doctor service at 1-800-833-3100.

When children are young, we tuck them in

at night and see them off to school in the

morning. As they turn into teenagers, though,

it gets harder to track how much time they

actually spend asleep. Now a growing body

of research shows we need to watch children’s

shut-eye at every age.

Sleep’s Deep effects on ChildrenThe average child sleeps 13 months during

the first two years of life. All this sleep helps

a baby’s brain develop. As children grow older,

they need fewer hours of sleep: 10 to 12 hours

a night for preschoolers, at least nine for

school-age children and teens. But the

importance of sleep doesn’t diminish.

Sleep helps us solve problems, react quickly,

form memories and learn. Inadequate sleep

affects how well children do in school. It also

impacts a child’s physical well-being. The

body releases hormones during sleep that

aid growth, build muscles and repair cells

and tissues.

Lack of Sleep Can Harm a Child’s HealthA study in Pediatrics found that childhood

sleep deficiencies may be linked to future

problems, too. Among them: decreases in

mental functioning that begin as early as

adolescence. Increasing evidence also suggests

that poor sleep contributes to major health

problems, such as obesity.

help Cultivate Your Teen’s DreamsResearchers say children’s sleep problems

shouldn’t be ignored. While parents are often

involved in the sleep schedules of young

children, they tend to step back in high

school. Because sleep is so critical, however,

you should stay involved.

First, recognize the signs that your teen isn’t

getting enough sleep. Two key signs: changes

in mood and a slide in motivation. Sleepy

teens have trouble waking up in the morning,

are irritable late in the day, sleep extra long

on weekends and doze off during the day.

Next, understand what’s keeping your teen

awake. Many factors may play a role, and

some—such as early school start times—

you can’t control. But some you can.

how to help Your Child Sleep WellHelp your child get a good night’s sleep with

these steps:

• Encourage a consistent sleeping and

waking schedule.

• Ban the use of computers, TVs, music

players and phones close to bedtime.

• Help your child create a good sleep

environment—a place that’s quiet

and dark.

• Limit teens’ caffeine intake, especially

energy drinks.

Sometimes, a sleep disorder is responsible

for poor rest. For example, sleep apnea causes

pauses in breathing during sleep and leads

to daytime tiredness. If you think a sleep

disorder may be affecting your child, talk

with a doctor.


Meningitis Requires Fast Action

Meningitis can strike fast and hard. Some

forms of this disease can kill a healthy child

in as little as 24 hours.

Meningitis is an inflammation of the

membranes that cover the brain and spinal

cord. A virus or a bacterium usually causes

meningitis. It’s important to try to find out as

quickly as possible what’s causing the illness.

That’s because the treatment and the severity

differ depending on the cause.

You can help by learning the signs and

symptoms of meningitis and having your

child evaluated as soon as possible. Prompt

diagnosis and treatment give your child a

better chance for complete recovery.

Bacterial meningitis—a more severe

form of the illness—can have very serious

complications, such as brain damage, hearing

loss and learning problems. Even with

treatment, there is still a risk for death.

You can prevent many forms of meningitis by

having your child vaccinated as recommended.

The Symptoms of MeningitisIf your child has any of these symptoms,

contact your doctor immediately:

• Stiff neck

• Fever

• Headache

• Nausea and vomiting

• Red or purple rash

• Fatigue or extreme sleepiness

• Seizures

• Irritability, lethargy and poor feeding,

which may be the only symptoms in infants

A physical exam and a history of symptoms

help tell a doctor if meningitis is likely. A blood

test and a spinal tap can determine whether

a virus or bacteria are causing the infection,

which determines treatment.

Viral meningitis, which isn’t as severe, usually

goes away on its own. Doctors treat bacterial

meningitis with intravenous antibiotics. Serious

cases may require intensive care.

Take Steps to Prevent MeningitisThe Centers for Disease Control and

Prevention (CDC) recommends that children

be vaccinated against bacterial meningitis.

These vaccines are safe and effective, the CDC

says. Different vaccines are given to infants

and young children, preteens and teens.

College freshmen need a second vaccination

unless they have already received two doses.

Some forms of bacterial meningitis are

contagious and can be spread through

coughing, kissing and sneezing. Anyone in the

same household, day care center or other site

who has been in close contact with someone

with these forms of the disease should receive

antibiotics to prevent infection.

There are no vaccines for viral meningitis.

However, you can reduce your risk for

infection by washing your hands thoroughly

and often. You should also avoid kissing or

sharing glasses or eating utensils with

someone who is sick.

hAve QUeSTiOnS ABOUT MeninGiTiS?To learn more about meningitis, visit HealthLibrary.ChildrensOmaha.org and enter the search term “meningitis.”


Two Locations for Children’s Urgent Care Centers

Children become sick. Teens are injured

playing sports. And, children will be

children, so sometimes accidents happen.

When your child has an illness or injury

that’s not serious enough for the

emergency room, but can’t wait until

tomorrow, visit one of the two Children’s

Hospital & Medical Center Urgent Care

locations.

When your doctor’s office is closed,

Children’s Urgent Care Centers are open.

Hours of operation are Monday through

Friday from 6 to 10 p.m., and weekends

and holidays from noon to 10 p.m.

Children’s two Urgent Care Centers

are staffed by pediatricians and pediatric

nurses from Children’s Hospital &

Medical Center. No appointment is

necessary.

What Our Urgent Care Offers• The only pediatric urgent care centers

in the area

• Board certified pediatricians and

pediatric nurses

• Digital X-ray and lab services on site

• Treatment of cuts and lacerations

• Treatment of sports injuries, minor

injuries and illness

Life doesn’t stop after 6 p.m. NEITHER DO WE.

2 WEST ViLLagE pOinTE110 North 175th Street, Suite 1000(175th and Burke)402-955-8300

Both Children’s Urgent Care Center locations are open Monday through Friday from 6 to 10 p.m., and weekends and holidays from noon to 10 p.m. 1 VaL VErDE

9801 Giles Road, Suite 1(96th and Giles)402-955-7200


PROTECT YOUR INFANT’S TEETHBefore your infant goes off to sleep at the end

of the day, you should do more than kiss the

little one good night. Make sure your baby’s

developing teeth are not at risk from nursing

or bottle tooth decay.

That happens when juice or milk stays

in the mouth while a baby sleeps, especially

when sucking on a bottle all night. The sugars

in the mouth are metabolized by bacteria,

which produce acid that eats away the enamel

of the teeth. This results in cavities. Cavities

must be repaired before they extend into the

pulp—commonly called the nerve—of the

tooth, requiring either a root canal or the

tooth to be pulled.

When your baby is awake, saliva bathes the

teeth, removing much of the sugar from foods

and keeping the bacteria in check. But while

your baby sleeps, saliva production lessens,

and the decay rate increases.

Healthy teeth can last a lifetime. So teach children good dental care at an early

age. Even before the first teeth appear, wipe milk or juice off your baby’s gums with a clean gauze pad.

Dental Care


establish Good habits early in lifeHealthy teeth can last a lifetime. So teach

children good dental care at an early age. Even

before the first teeth appear, wipe milk or juice

off your baby’s gums with a clean gauze pad

after every feeding. When teeth do appear,

brush them with a soft toothbrush after the last

feeding before bed and again in the morning.

Start flossing your child’s teeth as soon as any

two teeth touch. Once children begin brushing

their own teeth, supervise them to make sure

they are doing a good job. Because letting food

sit on the teeth promotes tooth decay, teach

children to brush after meals.

healthy Teeth Tips for BabiesExperts recommend that by the time babies

are a year old, they should drink from a cup.

If the bottle helps a baby settle down, fill it

with plain water. Never put a baby to bed

with a bottle of milk, juice or sugary drink.

The American Dental Association (ADA)

makes these recommendations:

• Begin to clean your baby’s mouth during

the first few days after birth. Use a soft

washcloth or damp gauze and gently

wipe along the gum.

• When teeth begin to appear, the cloth

can still be useful, or use a soft-bristled

toothbrush without toothpaste.

• Talk with your pediatrician about dental

care for your baby. The ADA recommends

that children receive their first dental visit

within six months of eruption of the first

tooth and no later than 12 months of age.

Practitioners can start your child on a

lasting program of dental care.

For the first time ever, dental care is

available for children on the Children’s

Hospital & Medical Center campus.

The UNMC Pediatric Dental Clinic at

Children’s is located in the hospital’s

state-of-the-art Specialty Pediatric Center

(SPC) located at 84th and Dodge Streets.

While new to Children’s, the clinic

represents an expansion of pediatric

dental services offered by the University

of Nebraska Medical Center (UNMC)

College of Dentistry.

Better Access to Dental Care“This is an exciting collaboration with

real benefits for families. The ability

to offer this service in our Specialty

Pediatric Center improves access to

dental care, particularly for those

children who have a great need due

to a chronic condition or illness,” says

Justin Bradshaw, vice president of

ambulatory services at Children’s.

Because the pediatric dental clinic is

physically located in the Specialty Pediatric

Center, the other clinics in the facility have

a dentist on the team for the first time.

This is incredibly beneficial for those

programs that treat children with complex

conditions, as well as for the patients and

families. Take the Osteogenesis Imperfecta

(OI) Clinic, for example. Also called brittle

bone disease, OI affects a child’s bones,

including the teeth. Children treated in

the OI Clinic now benefit from a

dentist on staff to collaborate with the

multidisciplinary team to improve

treatment.

In addition, dentists will coordinate

with other pediatric specialists and do

general dental work on a patient while

the child is under general anesthesia

for another medical procedure.

All Children Are WelcomeWhile the pediatric dental clinic is a

benefit for children with complex

medical conditions, it treats all children,

including those with no other medical

condition, or those who do not have other

medical conditions treated at Children’s.

John Reinhardt, dean of the UNMC

College of Dentistry, sees this clinic as a

great step forward for UNMC, the Omaha

community and the college. “Having a new,

modern postgraduate pediatric dentistry

clinic located at the Children’s Specialty

Pediatric Center, surrounded by pediatric

medical specialists, is definitely good for

all. Our clinical service and educational

programs will rise to an even higher level

of excellence through this opportunity.”

DenTAl CliniC hOUrSThe dental clinic is open during weekdays from 7:30 a.m. to 4 p.m. it is closed on weekends. For more information, call 800-833-3100.

Pediatric Dental Care Offered at Children’s

To learn more about caring for your infant’s teeth, visit HealthLibrary. ChildrensOmaha.org and enter the search term “baby teeth.”

MOrE BaBY TEETH TipS!


feature story

A party at school turned into a life-threatening situation for 7-year-old

Max Roseland. Celebrating a movie and snack day, the kids were

encouraged to bring their favorite stuffed animal to school, wear

pajamas and bring snacks to share with the class. While this seems

like harmless fun, things took a serious turn when Max took a bite

of a peanut butter chocolate chip granola bar.

You see, Max has a severe peanut allergy. And that little bite started

a series of events that led to Max fighting for his life in a pediatric

intensive care hospital bed.

Peanut Allergies CommonPeanut allergy is the most common type of food allergy among

school-aged children, and reactions can often be severe. While some

children may only experience hives or vomiting, others experience

life-threatening throat swelling, difficulty breathing and other serious

complications. In addition, reactions tend to worsen over time.

Max had suffered reactions twice before. The first as an infant, which

prompted his parents to have him tested, and the second a year and a

half ago. That time, he was rushed to the emergency department and

immediately given epinephrine. This time was a little different.

“I got the phone call from Max’s teacher a little after noon,” says

Amy Roseland, Max’s mom. “I sent a snack with Max that day, and his

teacher had me come in that morning. I approved two snacks for Max

to eat. One was mini marshmallows and one was a bag of Vic’s

caramel popcorn.”

But somehow, in the dark classroom things got mixed up. The granola

bar had unknowingly come out of someone’s lunch. Max asked his teacher

if he could eat the granola bar and was told everything was safe for him to

eat. After one bite, his tongue immediately felt itchy. He went to the school

nurse, who gave him a dose of Benadryl and monitored his vitals. Things

seemed fine by the time Amy got to the nurse’s office. Max was breathing

and hadn’t broken out in hives.

PEANUT ALLERGY IS SERIOUS BUSINESSChildren’s state-of-the-art care saves boy’s life


As Amy and Max left the school, however, Max started crying hysterically

and saying that his stomach hurt. Amy called Max’s pediatrician, who

instructed them to head straight to Children’s Hospital & Medical Center.

While in the Emergency Department, Max broke out in hives on the back of

his neck, face and down his body. He started coughing and wheezing. Soon,

he couldn’t breathe. Max was experiencing a delayed allergic reaction.

“They gave him two shots of epinephrine and three vials of prednisone,

and then they started doing breathing treatments,” says Amy. “But he was

so far gone that nothing was working. Max was begging that he couldn’t

breathe. They sedated him to insert a tube down his throat, but when

they went to insert the tube, his heart stopped.”

Staff at Children’s immediately started CPR. After a minute of chest

compressions, his heart rate went back up. They intubated him, then

rushed him upstairs to Children’s Pediatric Intensive Care Unit (PICU).

The Children’s DifferenceChildren’s PICU is the only pediatric intensive care unit in the region to

offer 24/7 in-hospital coverage by board-certified physicians trained in

pediatric critical care. The PICU is also continuously staffed by nurses

and respiratory therapists trained in the care of critically ill and injured

children. It’s also the only hospital in the area that provides ECMO

(extracorporeal membrane oxygenation) support for all patients, from

newborns to adults. ECMO is a potentially life-saving procedure that

provides mechanical oxygenation and cardiac support for patients in

cardiac, pulmonary or cardiopulmonary failure.

The procedure normally involves removing blood from the body and

bypassing the heart and lungs. This allows a machine to oxygenate the

blood and rest of the heart before returning the blood back to the body. In

Max’s case, his heart was fine, but his lungs were in trouble. So, pediatric

intensivists at Children’s used a type of ECMO, called veno-venous ECMO,

to combat his failing health. The pediatric specialists at Children’s are the

only professionals in the area who perform this type of ECMO.

“The PICU staff saved his life,” says Amy. “I can’t thank them enough

for their hard work. It takes a certain type of person to do that job. We’ll

be forever grateful to them for saving our Max.”

A Community issueWhile Max’s story has a happy ending – he was off the ventilator the

next day and home soon after, his mom, Amy, wants people to know that

peanut allergies are serious business.

“I want parents to understand how important it is to not send peanut

treats to school when they’ve been warned not to, even in their own

child’s lunch,” says Amy. “You really need to pay attention to that and be

aware of and sensitive to others with food allergies. That is our vision.”

TAKe FOOD AllerGieS SeriOUSlY

To learn more about food allergies, visit us online at HealthLibrary.ChildrensOmaha.org and enter the search term “food allergy.”

Max Roseland was having fun at a school party until a peanut butter chocolate chip granola bar accidentally got mixed into his bag of treats. A delayed allergic reaction turned into an emergency situation. Fortunately, Max got the care he needed at Children’s Hospital & Medical Center.

Max

2011


Non-Profit Org.U.S. Postage

PAIDChildren’s Hospital & Medical Center

8200 Dodge StreetOmaha, NE 68114402-955-5400

881M

Children’s Hospital & Medical

Center welcomed 2012 with high

expectations for a growing

program. Children’s Critical Care

Transport Service logged a record

1,000 patient transports in 2011.

The milestone was achieved

on Saturday, Dec. 31. Children’s

Transport team went by

ambulance to northeastern

Nebraska to assist with twins

who needed additional care. The

infants were admitted to Children’s

Hospital & Medical Center.

Service Still Growing“Our transport service has

experienced tremendous growth

over the past five years. We’ve

expanded in size and in our

capability to travel, so critically

ill infants and children from

across the region have access to

specialized pediatric care,” says Rob

Chaplin, M.D., medical director of

ChildrensOmaha.org

SUBSCriBe nOW To subscribe to health-e kids, our free monthly e-newsletter, visit ChildrensOmaha.org and click on the e-newsletter icon located on the right side of the home page.

Children’s Transport Team Helps 1,000 patients

Children’s Transport Service.

Ground transportation is the top

mode of travel. Children’s dedicated

ambulance accounted for 898 of the

1,000 transports. Eighty-five trips

were made by helicopter, while the

team hopped on board fixed-wing

aircraft for 17 patient trips.

The greatest distances traveled

took Children’s to Rapid City, S.D.

and St. Louis, Mo.

“We completed more than 600

transports in 2010 and with such a

large increase last year, we know

there is a significant need for this

service,” says Dr. Chaplin. “Our

team provides crucial intervention

that can dramatically improve a

child’s outcome.”

improving CapabilitiesRecent highlights for Children’s

Transport Service include the

debut of fixed-wing aircraft in

August 2011, through a partnership

with Air Ambulance

Specialists, Inc. (AASI) and

Crow Aviation; a 2010

partnership with LifeNet, in

association with AirMethods

Corp., for helicopter travel;

and the introduction of a

customized Children’s

ambulance equipped

exclusively for pediatric patients

with American Medical Response

(AMR), in the fall of 2009.

The Children’s Critical Care

Transport Service is available

24/7. It is activated by physician

request.

Above: Children’s transport team

members load an infant into the

helicopter. Top photo: Members of

Children’s transport team pose with

the program’s fixed-wing aircraft.

enewsletterSign-Up

Children’s Hospital & Medical Center has received accreditation or recognition from the following organizations for its delivery of extraordinary healthcare to children.

just kids | spring 2012

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