HOT TOPICS:

1)Holiday Safety Tips

2)Medicaid patients: you may need to reapply even if you still qualify. Please double check that your children are actively insured. 

3) Sick Visits at CAHC during cold/flu season

4)Flu Shots,  Covid Boosters and RSV immunization

5)Ticks

ENJOY A SAFE HOLIDAY SEASON

(Adapted from NSC website) From late November to mid-January, when families and friends travel and gather, we encourage you to keep everyone’s safety in mind.

CAR TRAVEL:. Traveling by car during the holidays has the highest fatality rate of any major form of transportation based on fatalities per passenger mile. Hundreds of people die every year in crashes on New Year's Day, Thanksgiving Day and the other winter holidays. 

● Prepare your car for winter and keep an emergency kit with you ● Get a good night’s sleep before departing and avoid drowsy driving ● Leave early, planning ahead for heavy traffic ● Make sure every person in the vehicle is properly buckled up no matter how long or short the distance traveled (SEE CAR SEAT TIPS BELOW!) ● Put that cell phone away; many distractions occur while driving, but cell phones are the main culprit ● Practice defensive driving ● Designate a sober driver to ensure guests make it home safely after a holiday party; alcohol or over-the-counter, prescription and illegal drugs can cause impairment

Decorations: Decorating is one of the best ways to get in a holiday mood, but emergency rooms see thousands of injuries involving holiday decorating every season.

When decorating follow these tips from the U.S. Consumer Product Safety Commission:

● Keep potentially poisonous plants – mistletoe, holly berries, Jerusalem cherry and amaryllis – away from children ● If using an artificial tree, check that it is labeled “fire resistant” ● If using a live tree, cut off about 2 inches of the trunk to expose fresh wood for better water absorption, remember to water it, and remove it from your home when it is dry ● Place your tree at least 3 feet away from fireplaces, radiators and other heat sources, making certain not to block doorways ● Avoid placing breakable ornaments or ones with small, detachable parts on lower tree branches where small children can reach them ● Only use indoor lights indoors and outdoor lights outdoors, and choose the right ladder for the task when hanging lights ● Replace light sets that have broken or cracked sockets, frayed or bare wires, or loose connections ● Follow the package directions on the number of light sets that can be plugged into one socket ● Never nail, tack or stress wiring when hanging lights and keep plugs off the ground away from puddles and snow ● Turn off all lights and decorations when you go to bed or leave the house

Fire Safety: Candles and Fireplaces Use of candles and fireplaces, combined with an increase in the amount of combustible, seasonal decorations in many homes during the holidays, means more risk for fire. The National Fire Protection Association reports that one-third of home decoration fires are started by candles and that two of every five decoration fires happen because the decorations are placed too close to a heat source.

● Place candles where they cannot be knocked down or blown over and out of reach of children ● Keep matches and lighters up high and out of reach of children in a locked cabinet ● Use flameless, rather than lighted, candles near flammable objects ● Don't burn trees, wreaths or wrapping paper in the fireplace ● Use a screen on the fireplace at all times when a fire is burning ● Never leave candles or fireplaces burning unattended or when you are asleep ● Check and clean the chimney and fireplace area at least once a year

Turkey Fryers Be alert to the dangers if you're thinking of celebrating the holidays by frying a turkey. The Consumer Product Safety Commission reports there have been hundreds turkey-fryer related fires, burns or other injuries, and millions of dollars in property damage losses from these incidents. NSC discourages the use of turkey fryers at home and urges those who prefer fried turkey to seek out professional establishments or consider using an oil-less turkey fryer. If you must fry your own turkey, follow all U.S. Fire Administration turkey fryer guidelines.

Food Poisoning: Keep your holidays happy by handling food safely. The foodsafety.gov website from the U.S. Department of Health and Human Services provides some valuable holiday food safety tips:  

● Wash your hands frequently when handling food ● Keep raw meat away from fresh produce ● Use separate cutting boards, plates and utensils for uncooked and cooked meats to avoid cross-contamination ● Use a food thermometer to make sure meat is cooked to a safe temperature ● Refrigerate hot or cold leftover food within two hours of being served ● When storing turkey, cut the leftovers in small pieces so they will chill quickly ● Thanksgiving leftovers are safe for three to four days when properly refrigerated

Watch this holiday food safety video for more information.

TOY/GIFT Safety:  Gifts and toys should inspire joy, not cause injuries. Thousands of children are seriously injured in toy-related incidents every year. Avoid safety hazards while gifting with these tips from the U.S. Consumer Product Safety Commission:

● Toys are age-rated for safety, not for children’s intellect and physical ability, so be sure to choose toys in the correct age range especially if the child has any cognitive, motor or learning delays. 

 ● Choose toys for children under 3 that do not have small parts which could be choking hazards 

 ● For children under 10, avoid toys that must be plugged into an electrical outlet 

 ● Be cautious about toys that have button batteries or magnets, which can be harmful or fatal if swallowed 

 ● When giving scooters and other riding toys, give the gift of appropriate safety gear, too; helmets should be worn at all times and they should be sized to fit

To find out about holiday toy safety and recalls, check the U.S. Consumer Product Safety Commission website.

CAR SEAT/BOOSTER SEAT/SEATBELT SAFETY: From Safe Kids Worldwide Website www.safekids.com. Additional information on car seats can be found under "more" on the top tab of the website after closing this popup window. 

Choose the Right Direction:  Rear- or Forward-Facing •

For the best protection, keep your baby in a rear-facing car seat until 2 years old or more. You can find the exact height and weight limit on the side or back of your car seat. Kids who ride in rear-facing seats have the best protection for the head, neck and spine. It is especially important for rear-facing children to ride in a back seat away from the airbag. • When your children outgrow a rear-facing seat and are at least over age 2, move them to a forward-facing car seat. Keep the seat in the back and make sure to attach the top tether after you tighten and lock the seat belt or lower anchors (LATCH). Use the top tether at all times. Top tethers greatly reduce your car seat’s forward motion in a crash. • Kids can remain in some forward-facing car seats until they’re 65 pounds or more depending on the car seat limits. Check labels to find the exact measurements for your seat. Discontinue use of lower attachment when your child reaches the limits set by your car seat and car manufacturers. Continue to use the top tether. You must read both manuals to know about those limits. Not to worry: Once your child meets the lower anchor weight limits, you will switch to a seat belt. Seat belts are designed and tested to protect all adults as well as children in car seats and booster seats.

Check Car Seat Labels • Look at the label on your car seat to make sure it’s appropriate for your child’s age, weight and height.  • Your car seat has an expiration date. Find and double check the label to make sure it’s still safe. Discard a seat that is expired in a dark trash bag so that it cannot be pulled from the trash and reused. Know Your Car Seat’s History • Buy a used car seat only if you know its full crash history. That means you must buy it from someone you know, not from a thrift store or over the internet. Once a car seat has been in a crash, or is expired, it needs to be replaced.                                  

Register Your Car Seat • Register your new or currently used car seat, ensuring that you are promptly notified about future recalls. You can register online with your car seat manufacturer, using the information found on the label on your car seat at safercar.gov. You can also register by filling out the registration card that came with your car seat. It’s filled out with your car seat’s information. Mail the card; no postage required. 

Make Sure Your Car Seat is Installed Correctly

• Inch Test. Once your car seat is installed, give it a good tug at the base where the seat belt goes through it. Can you move it more than an inch side to side or front to back? A properly installed seat will not move more than an inch. 

• Pinch Test. Make sure the harness is tightly buckled and coming from the correct slots (check your car seat manual). With the chest clip placed at armpit level, pinch the strap at your child’s shoulder. If you are unable to pinch any excess webbing, you’re good to go. 

• For both rear- and forward-facing car seats, use either the car’s seat belt or the lower anchors and for forward-facing seats, also use the top tether to lock the car seat in place. Don’t use both the lower anchors and seat belt at the same time. They are equally safe- so pick the one that gives you the best fit. 

• If you are having even the slightest trouble, questions or concerns, certified child passenger safety technicians are able to help or even double check your work. Visit a certified technician to make sure your car seat is properly installed. Find a technician or car seat checkup event near you.

Check Your Car Seat • Seventy-three percent of car seats are not used or installed correctly, so before you hit the road, check your car seat. Here’s a quick car seat checklist to help you out. It takes only 15 minutes.  • Learn how to install your car seat for free. Safe Kids hosts car seat inspection events across the country where certified technicians can help make sure your car seat is properly installed. They also serve in fixed locations called inspection stations during specific days and times in some communities. You may find an inspection station with certified technicians at a GM dealership, a hospital or even a fire house. They will teach you so that you can always be sure your car seat is used correctly. Find a Safe Kids car seat checkup event where we use only certified technicians, near you.

Is it Time for a Booster Seat? • Take the next step to a booster seat when you answer “yes” to any of these questions:

• Does your child exceed the forward-facing car seat’s height or weight limits?

• Are your child’s shoulders above the forward-facing car seat’s top harness slots?

• Are the tops of your child’s ears above the top of the car seat?

• If the forward-facing car seat with a harness still fits, and your child is within the weight or height limits, continue to use it until it is outgrown. It provides more protection than a booster seat or seat belt for a small child.

Be Wary of Toys • Toys can injure your child in a crash, so be extra careful to choose ones that are soft and will not hurt your child. Secure loose objects and toys to protect everyone in the car.

 Buckle Up • We know that when adults wear seat belts, kids wear seat belts. So be a good example and buckle up for every ride. Be sure everyone in the vehicle buckles up, too. • Buckling up the right way on every ride is the single most important thing a family can do to stay safe in the car.

Prevent Heatstroke • Never leave your child alone in a car, not even for a minute. While it may be tempting to dash out for a quick errand while your babies are sleeping in their car seats, the temperature inside your car can rise 20 degrees and cause heatstroke in the time it takes for you to run in and out of the store.  • Leaving a child alone in a car is against the law in many states.

ILLNESS PREVENTION

 We strongly recommend that all family members have updated immunizations to prevent spread of preventable illnesses during your gatherings.

Influenza vaccine is  available for all ages at our office.

COVID-19 vaccination is recommended for all over age 6months of age. There is an updated vaccine for 2023-24 winter.

RSV Immunization is available for newborns through 8 months of age. There is a very limited availability at the moment. However, pregnant parents can get a similar immunization during pregnancy which will protect your infant through their first RSV season. AND family members over age 60 can get an adult immunization for RSV to protect themselves and protect the young members of your families.

Pertussis vaccine is generally part of the TDaP vaccination adults get every 10 years. Pertussis causes “whooping cough” which can be deadly to young infants who have not yet had all of their pertussis immunizations. For adults, pertussis can cause a serious cough that can last for months.

Pneumococcal vaccine (“pneumonia shot”) is recommended for all eligible not only to protect the adults in the family but also to protect young children but also medically fragile individuals.

A reminder to please stay home and avoid gatherings if you are sick or feeling ill. COVID-19 testing is still recommended even for mild symptoms as it can still be quite variable in it’s presentation…everything from a mild scratchy throat to a mild cough to high fevers and pneumonia can all be attributed to COVID-19.

Hand washing is an excellent way to prevent spread of germs, covering coughs appropriately, cleaning high touch surfaces (door knobs, handles, etc) and not sharing utensils when sick can be helpful. Ventilation such as cracking a window or running a HEPA filter in a room during gatherings may help as well. Wearing a mask when you are sick and have to be around others is a great way to prevent sharing your illness with others.

MEDICAID PATIENTS: As the "Public Health Emergency" phase of the COVID-19 pandemic has come to an end, some Medicaid patients may need to re-apply even if they still qualify. Please be sure to check that your family or child is still eligible and that you are still active. Many people have been dropped from Medicaid coverage even if they still qualify. Please check that you and your children still maintain coverage. 

SICK VISITS

-We expect that the fall/winter will bring the usual illness we see as children return to school. If you feel that your child needs to be seen please call the office to schedule a visit. On the weekends we ask that you call in the morning as we are available for shortened hours on the weekends for urgent visits. Our physicians are on call 24/7 for urgent matters after hours and on weekends but please keep non-urgent calls (medication refills, form requests, wellness visit scheduling) to business hours. If your child is coming into the office for a sick visit, please bring all of their medications with them (inhalers, spacers, etc.) to review and please mask if your child is over the age of 2 and has cough, runny nose, congestion, fever, sore throat, vomiting, diarrhea, or pink eye. This helps to keep other patients and our staff safe. 

Fever reducer dosages are located on our main page. Close this tab and search under "more" at the top of the website. Always dose by WEIGHT, not age, when giving pain reliever/fever reducer. 

FLU SHOTS, COVID-19 Vaccine and RSV Antibody immunization 

Flu Shots:

Children who have wellness visits in the upcoming weeks may get their flu vaccine at the time of the visit. Flu clinics are up and running, you may self-schedule or call the office.  These will be done as they have been done in the past (weather-permitting) with "drive-up" stations on weekends. Both office locations will be available on different days. We strongly encourage children to be updated on their flu vaccines before the peak of flu season and before traveling/gathering for upcoming holidays. 

Flu shot info: https://www.healthychildren.or...

COVID-19 Vaccines:

The updated COVID-19 vaccination is now available in our office for children between 6 months and 11 years of age.  Children 12 and older will need to go to a pharmacy, clinic or department of health for their vaccine. We will be allowing families who have already signed up for flu clinics during the next several weekends to add on covid vaccine if they choose. You may also register for a "flu clinic" slot if your child already had a flu shot at an earlier visit but now you would like to add COVID-19 vaccine to better protect them through the winter months. We are encouraging vaccinating all eligible children especially before the upcoming holidays, travel and visiting family. 

Covid vaccine info: https://www.healthychildren.or...

RSV Immunization:

RSV Antibody immunization is FINALLY HERE!!  We have a limited supply of this immunization in stock and we strongly recommended it for all infants up through 8 months of age during the expected RSV season (fall and winter). Newborn infants may be able to get this immunization prior to discharge from the nursery.  RSV is a respiratory virus that causes intense inflammation of the airways from the nose to the farthest areas of the lungs. It is particularly concerning for young infants and the elderly and people who may be immunocompromised. Even those who are not at high risk can have very significant respiratory infection, wheezing, labored breathing, congestion, low oxygen levels, and cough that can last for many weeks. It is one of the most common reasons young children are admitted to the hospital during the winter months and there is no effective cure for this virus. This antibody treatment promises to be quite effective in preventing these symptoms for our most vulnerable patients. 

Children who have special health conditions may be eligible for the RSV immunization through age two. If you feel your child is at high risk and may require this vaccine after 8 months of age, please talk to your child's pediatrician. 

RSV antibody information: These links also contain a video that may be helpful to determine if your child is breathing too fast or too hard which always requires a call to our office. 

Click these links for further information about RSV and the immunization now available. 

RSV: When It's More Than Just A Cold

Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold. But, some children get very sick with RSV. With RSV season starting earlier than usual again this year, here's what parents need to know.
https://www.healthychildren.or...

Immunization information specifically about the RSV immunization: 
https://www.cdc.gov/vaccines/v...

TICKS

The following PDF from the CDC contains general information about managing a tick bite. 

https://www.cdc.gov/ticks/pdfs...

Removing a tick:  https://www.cdc.gov/ticks/remo...

If you find a tick on your child, the best thing to do is remove it quickly by lifting straight up with fine-tipped tweezers. You may need to give a bit of a tug as ticks adhere to the skin quite well. The key is to get off all the parts of the tick that are at and above the surface of the skin. The ticks have barbed "antennae" that they use to hold themselves in place but the "feeding" part of the tick is not on the barbed antennae. Often there are one or two small black dots that remain after removing the tick. These may remain behind and do not cause lyme disease. The body will work them out like a small sliver over the next few days. Digging out these antennae can increase the risk of skin infection. It is best to leave them alone.

Next, clean the area off with soap and water. 

If the tick was possibly imbedded in the skin and feeding it will be engorged (full) of blood. Ticks that carry Lyme disease need to be actively feeding for at least 24-48hours to transmit lyme disease to a person. If a tick was found on your body and was removed within that time frame, the risk of getting lyme disease is extremely low.  This is why doing a very thorough tick check every night before bed is important. Ticks tend to like areas with folds or creases such as behind ears, armpits, the back of the neck, the groin, belly button, under scrotum, behind knees, etc. so check those areas particularly closely. 

**Old fashioned "tricks" for removing ticks with vaseline or a hot match actually increase the risk of transmitting lyme. The best thing to do is to remove the tick quickly with tweezers.  

If the tick was possibly attached for longer than 24-48 hours and was engorged, it is best to closely monitor the area of the bite daily for the next 3-4 weeks. There will be some pinkness and even a "bug bite" mark at the site that lasts a few days as would any insect bite. However, if an enlarging ring-like rash evolves in the area of the bite, your child should be seen in our office for evaluation. The lyme rash is generally flat, not itchy or warm and it does enlarge over several days. This would suggest early lyme disease and this rash is easily treated with a course of antibiotics. 

Other symptoms that would require a call to the office in the weeks following a tick bite would be an unexplained fever, joint pain or swelling, or severe headache. 

Additional information can be found on the Healthy Children Website:

https://www.healthychildren.or...