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Hospitals

Cardon Children’s Medical Center Car Seat Safety Tips and email contact information for parents with questions

Phoenix Children’s Hospital Injury Prevention features the Car Seat Helper App; also more on their Kids Ride Safe program

AAA Arizona offers assistance from certified car seat technicians. Contact the AAA Traffic Safety Educator to schedule an appointment

National Highway and Traffic Safety Association (NHTSA) car seat safety inspection stations in the Greater Phoenix area

Valley Fire Departments: Links to individual station web site pages on car seat inspection and safety checks. Call first to make sure a certified technician will be on site:

Avondale Fire Department

Chandler Fire Department

Gilbert Fire Department

Mesa Fire Department

Peoria Fire Department

Phoenix Fire Department

Scottsdale Fire Department

Surprise Fire Department

Tolleson Fire Department

National Highway Traffic and Safety Association has the latest car seat recommendations for kids and updates on state-by-state laws

Safe Kids USA features research on car seats and placement and motor vehicle safety facts sheets.

That makes it the second leading cause of unintentional injury death in this age group.

But not every drowning results in fatality. Some children survive a drowning…but doesn’t always mean a full recovery for the victim.

Lesia Crawford, of Phoenix, tells the story of how her younger brother, Andrew Hill, survived after falling in to a swimming pool- and what his life is like now, many years later.

For every pediatric drowning death, another two children are hospitalized after nonfatal drowning injuries.

And in Arizona, warm weather, long summers, and thousands of residential swimming pools that do not need to be drained in winter contribute to tragic water-related accidents among young children.

But there is good news.

Research results that will be released in the February 2012 issue of Pediatrics (published online Jan. 16), found rates of pediatric hospitalizations associated with drowning actually declined 49 percent during the study period, from 4.7 hospitalizations per 100,000, to 2.4 per 100,000.

The hospitalization rate for boys remained consistently higher than the rate for girls, though rates declined for all age groups and for both males and females.

Hospitalization rates decreased across all geographic regions of the U.S., with the greatest decline occurring in southern states.

The American Association of Pediatrics (check out their re-designed website) says that the study offers benchmarks that can be used to judge future efforts in drowning prevention and to target interventions to high-risk areas.

They do it on tight budgets and under rigid guidelines to meet nutritional requirements. It’s not easy. Everyone has a story about their own school cafeteria experience, likely involving “mystery meat” or watery spaghetti sauce that topped over-cooked pasta.

Things became even worse when over time, schools stopped doing any real “cooking” at all.

Instead, they used pre-packaged foods that merely required re-heating or defrosting, leaving them now with mostly ovens just to heat-and-serve with, says Michelle Dudash, local registered dietician and chef consultant.

Salad bars are becoming more common in schools.

But these days, schools are making an effort to do more scratch cooking, as they used to do way back when the idea of serving children a hot lunch at school began.

“This is a gradual process,” says Dudash, “because it takes more labor and a little more variety of equipment.”

Valley school cafeteria managers are challenged to meet the new MyPlate.com USDA guidelines. Parents are challenged, too, as they try to provide good nutrition to their children in a world where sugary drinks, snacks and cereals, as well as fast foods, are heavily marketed to kids.

Dudash says that many people, including parents, tend to get caught up in focusing on one single nutrient in a food, but forget to take in account the total nutrient-richness.

For example, she says that though flavored milk has added sugar, it contributes just 3% of added sugars to kids’ diets while delivering 9 essential nutrients. Soda and many fruity drinks deliver little, if any beneficial nutrients, which makes them “empty-calorie drinks.”

Pairing a soda with a meal has become commonplace, says Dudash, but it should not be this way.

Soda can be enjoyed as a treat, but not offered on the everyday menu. “Kids should be drinking milk (lowfat dairy or fortified non-dairy alternative if needed) first, water throughout the day, and up to 4 to 8 ounces (for younger and older children, respectively) 100% fruit juice per day if they choose.”

The single-focus approach on one ingredient that many people take, says Dudash, can cause people to overlook particular foods like nuts or avocados. Parents say, “Oh, it’s high in fat!”

The truth is, says Dudash, that these types of foods that contain fats that are healthy. They contain other nutrients that are essential towards a child’s development.

Portion size is key, says Dudash, for parents and kids alike.

Carb and calorie contents are now posted with selections

Dudash encourages families to take a look at the simplicity of the Myplate.gov guidelines that school cafeterias are trying to implement, and try following them at home. Parents who are confused, or have questions, should delve a little deeper in to what the recommendations are, and why they have been established.

“Go beyond simply asking your kids what they had for lunch,” says Dudash. “Take a closer look at the menu. Make an appointment to tour the cafeteria to see what really goes on — have a friendly, respectful chat with the cafeteria manager. And, maybe have lunch with your child at school.”

Serving a mid-day meal to school children dates back to the turn of the century, when young students, post Industrial Revolution, became the focus of social scientists, nutrition experts, government researchers and welfare groups, according to the Food Timeline.

Community leaders began to understand the connection between good nutrition and learning, and an awareness of the dietary needs of children grew.

The sandwich, according to food historian and reference librarian Lynn Olver, who assembles information on the site, was a mainstay. It was a convenient way to “carry foods that are to be eaten with bread,”  as referenced by a 1915 cookbook.

Sandwich ideas from a cookbook published in 1940 included meat loaf, egg and

Courtesy Smithsonian Institute

olive, cheese and onion, salami, or peanut butter. A baked apple, carrot “straws” and celery were recommended to go alongside, followed by a homemade dessert such as cookies, puddings, or tarts.  An insulated container of soup was often included. Beverages were always milk or  juice, cocoa or lemonade.

Hot lunches were served to children in the public schools of large cities from the time of World War I.

The National School Lunch Act, passed in 1946, was intended to meet the needs of students and families as well. “The educational features of a properly chosen diet served at school should not be under-emphasized,” reads a House report on the measure passed by Congress. “Not only is the child taught what a good diet consists of, but his parents and family likewise are indirectly instructed.”

USDA recommendations for what makes a healthy school lunch, and how to teach parents and kids about what a healthy diet includes, have morphed over the years. In the Valley, school districts recently began following the Myplate.gov guidelines.

The changes are subtle. Mac-n-cheese, pizza, and chicken nuggets may still make the menu- but the ingredients used for these old favorites have changed.

Michelle Dudash, local registered dietitian and author of Clean Eating for Busy Families, to be published in fall, 2012, says that districts are eager to spread the word to parents on what kids are being served.

The Mesa School District, says Dudash, has really ramped up their marketing program to communicate to parents the positive things they are doing, and what is new. Changes in Mesa Schools include:

- Chicken nuggets are baked instead of fried. There are no fryers in the school.

- Some pizzas are made with whole grain crusts and reduced-fat cheese.

- Flavored milk  selections are fat-free and contain only 31 calories more than unflavored non-fat milk.

- At least one entrée per week is made from scratch. New recipes are being tested and sampled by students. Mesa Schools plans to add more from-scratch entrees to menus next year.

Washington Elementary School District, in northwest Phoenix, has also instituted the changes, says Dudash, which includes a tweaking of ingredients as well:

-Cheese sticks are made with whole grain breading and reduced fat cheese.

From the Washington Elementary School District

- “Fruit or Vegetable of the Month” is served once per week for a month in elementary schools. Foods in the spotlight include gala apples, bell peppers, and watermelon. Kids love it, says Dudash.

- Dark green lettuces and sweet potatoes are served more often.

-Stir fry dishes are accompanied by brown, instead of white rice.

Next up: Dudash offers tips on how to cut through the confusion on what is healthy…and what is not.

The United States Department of Agriculture first published recommendations on good nutrition for Americans at the turn of the century.

The first graphic guide, “Eat this way, every day,” established food groups and recommended amounts within each group. Proper nutrition was seen as a the great protector of good health.

The most recent guide, dubbed “MyPlate,” uses a a simple image of a plate with a circle to the side for a dairy product. It’s fairly simple. If you fill your plate halfway up with fruits and veggies, then add a whole grain item plus some lean protein to the other half, you’re within the guidelines. 

Another major message of MyPlate, says registered dietitian Michelle Dudash, is to make half of the grains on your plate whole grains, such as whole wheat bread or brown rice.

MyPlate also emphasizes drinking more water, and fewer sugary drinks, says Dudash, who is president-elect of the Arizona Dietetic Association.  Arizona already imposes limits on the amount of sugar a beverage may contain for students in kindergarten through eighth grade, she adds.

Schools that participate in the National School Lunch Program (NSLP)– schools that offer free or reduced-price meals – including public schools, some independent non-profit private or charter schools, must serve meals that meet the new MyPlate guidelines.

No doubt parents have seen some changes in school lunch menus as schools strive to meet the requirements, and, says Dudash, some are puzzled.

“Just by reading menus, says Dudash, “parents many times assume (the new recommendations) are unhealthy. Even though parents see pizza on the menu, they don’t realize that it’s on a whole grain crust and with reduced fat cheese. When they see “French fries” they assume they are fried, when in fact only 11% of all schools in the country even have deep fryers anymore.”

Although school lunches must meet the Federal nutrition requirements, decisions about what specific foods to serve, and how they are prepared, are made by local school authorities, says the NSLP.

Next up: Chicken nuggets? Mac-n-cheese? Dudash shares what some local school districts are serving up that might surprise parents.

Rob is married to my husband’s sister, Aimee. They live in Florida.

Rob is known in our family as the guy who builds things like decks and outdoor cabanas and sunrooms. With no plans or drawings. The ideas pour from his imagination, and are implemented purely from the calculations in his head.

His tools hang on the wall of his garage in perfect order. There’s a box for clean rags…and a second box for dirty rags. I’ve seen this. Rob is a perfectionist. He’s an electrician, a carpenter, a plumber. He can program remotes and trouble shoot any TV/home theatre system.

And he thrives on creating and then constructing something new for his family and friends to enjoy.

Rob's fire pit

Aimee is used to Rob’s penchant for puttering around, working on projects. She’d returned from a morning of Christmas shopping that Wednesday, and sat down to take a break. As she was channel surfing, she looked up to see Rob come in from outside.

“Will you sit with me,” Rob asked her. “I’m going to lie down. I’m not feeling very good.”

This wasn’t an unusual request. Aimee says Rob is frequently so drawn to a project that he skips breakfast. Sometimes he feels a little shaky, stops, and takes a rest.

But as she sat next to the bed, Aimee sensed something was different. “Does it feel like there’s an anvil on your chest?” she asked. No, said Rob. “Any chest pains?” No, said Rob. “Do your arms hurt?” No.

He wanted to feel for his pulse. Aimee found it to be steady and normal. What was going on? Rob switched positions, trying to get comfortable. He was sweating.

“I think I’m going to throw up. Can you get me the trash can?”

Aimee went in to the bathroom to get it. Noticing that there was trash in it, she told Rob she was going to run and get a plastic bag or something else for him to use. When she returned, she heard the sound of vomiting coming from the bathroom.

Aimee ran to her computer and Googled heart attack symptoms. She scanned down the web page and saw the some of the typical signs – chest discomfort, pain in the arms, legs or jaw.

But then she saw this, further down the list: (Symptoms) may include breaking out in a cold sweat, nausea, or light-headedness.

She returned to the bedroom where she found Rob, now back in bed. She instinctively grabbed a cold, damp towel to bring to him. As she began to place it on his head, he started making a gagging sound.

His head jerked back, his neck arched. For a nanosecond, Aimee thought he might be joking- throwing his head back in the “clear the airway” position for CPR. His arms and legs jerked unnaturally. It was all so surreal.

As his eyes rolled back and his lips turned blue, Aimee says another thought entered her mind. A co-worker had lost her husband months earlier when he suffered a massive heart attack.

She knew she had to act fast. She grabbed the phone, dialed 911, and screamed for her son, Robby, 18, down the hall in his bedroom. “Dad’s having a heart attack! I need help!”

Aimee’s a science and math teacher, and had often volunteered to be one of the required CPR certified faculty members at her school. I’ve known her since she was 14. She’s a cut-to-the chase, down-to-business kind of person.

But it had been six years since she had taken a CPR class. “I always heard people say CPR, oh I totally forget that. But you really don’t. It’s amazing how it comes right back.”

She thought to put the 911 dispatcher on speakerphone. “Put your ear to his mouth. Is he breathing?” He wasn’t. “She told us we had to get him off the bed, and on to the floor.”

So Robby took his dad’s shoulders, and Aimee held his ankles. Together, somehow, they got Rob, who is a robust man, down from the big four-poster bed and on to the floor.

Aimee says her hands knew exactly where to go on her husband’s chest. “You’re going to do 600 compressions,” said the operator. “I’m counting with you.”

It was a fast pace. “I was just in the moment, said Aimee. “ I knew I had to keep the heart beating. I’m a science teacher. I just knew.”

Aimee says they’d counted seventy-five compressions when the operator told her the first responders from Jacksonville Fire and Rescue Department were outside. Robby jumped up to take over. “I told him to just push right here. Just keep pushing.” Aimee hurried to unlock the door.

Four members of JFRD walked in to the bedroom. Aimee and Robby stepped aside. “They were like Supermen. They took our four poster bed and pushed it to the side like it was nothing.” It had been less than 5 minutes since Aimee had initiated the call.

They continued CPR. An ambulance arrived just two minutes later with more paramedics.

There was no breathing. And  no pulse.

Aimee and Robby looked on as paramedics placed patches connected to a defibrillator on Rob’s chest. “Clear!” They watched as his chest arched up six inches off the floor. Still no pulse.

They tried a second time. Nothing.

The angles of the house prevented paramedics from bringing in the gurney; so they picked him up and carried him hammock-style. They put him on the gurney, now in the garage next to the impeccably kept tool bench. They wheeled him to the ambulance to try again and establish an airway through intubation.

Aimee and Robby watched as the ambulance pulled away, headed to Jacksonville’s Mayo clinic, a very short drive from their home. That’s when the tears came. Aimee broke down, hugging a neighbor, on her driveway. How could all of this just happened within a span of just minutes?

Alex, 16, Aimee and Rob’s other son, had been running an errand when he got the word from Robby to come right home. They all drove to the hospital to find out what was next.

At some point, either in the ambulance or in the emergency room, success. The defibrillator had re-started Rob’s heart. Cardiologists placed a stent in Rob’s left descending anterior artery, or “the widowmaker,” as it is called. It was 100% blocked.

It was exactly same condition that had taken the life of Aimee’s coworker’s husband at the start of the school year.

Rob spent the next several days in intensive care, on a ventilator. Doctors cooled his body to a lower temperature to help enhance the healing process to his damaged heart muscle.

Still, no one could predict the outcome. Had his brain suffered a lack of oxygen? If so, for how long? Which functions might be affected? It was a waiting game.

Aimee began a bedside vigil. Her friends and relatives sent messages of support. Her parents (my in-laws) drove 16 hours straight to be with her. Rob’s parents arrived, too. More tears.

Doctors explained the technical details of what had happened, and the worse-case scenarios of what may lie ahead. Nationwide, they told Aimee, the survival rate for people with Rob’s type of heart attack — those that make it to the hospital at all –is only 8%.  Only one percent, they said, actually walk out of the hospital.

She kept talking to him, not sure if he could hear her, or if he ever would. We texted:

They began the warming process. There were setbacks. Infection and fever set in, we found, as Aimee texted family members on Friday, the day before Christmas Eve.

The news hung heavy over members of our family. I knew Aimee’s phone was her lifeline, so I texted her late in to the night Phoenix time, middle of the night Jacksonville time. I wanted her to know how I marveled at her bravery and strength.

For a while, we heard nothing. Then, a Facebook message and this text pinged in:

By Christmas Eve, Rob was sitting up in a chair. He wanted to watch the New York Giants play. Aimee put the game on, but the volume on the remote wasn’t working properly. “Hand it to me,” said Rob. “I’ll  fix it.”

He was back.

Robby, right, with Alex and Rob

A Christmas miracle

The road to recovery won’t be easy; restrictions abound. There’s talk about big lifestyle changes. New medications.

There’s the risk of depression in post myocardial infarction (heart attack) patients. Family members of intensive care patients run the risk of developing post traumatic stress disorder.

Rob was discharged from the hospital one week to the hour that Aimee had called 911. Encouraged by a close friend, she wanted to try to get in touch with the firefighters and paramedics that came with lightening speed to save Rob’s life, to thank them.

She reached the local fire chief, who pointed out that his team wasn’t the only reason Rob had made it. Aimee’s knowledge…and her willingness…to perform those chest compressions factored in as well. So did Robby’s ability to stay calm and step up when needed.

Many people are too afraid to dive in and help during an emergency like Rob’s, said the chief. They get upset, they freeze, or they have no experience with CPR.

Your hands can save a life: Resources and more on the new CPR

Not my sister-in-law Aimee. She’s smart. And brave. She knew where to put her hands, she stayed calm, her training served her just when she needed it most. “I did what anyone would do. I just saved my husband. I didn’t want him going anywhere.”

Related RAK stories:

Shirley Dunlap, Phoenix Fire 911 dispatcher

Phoenix Fire Battalion Chief Sheila Roberts

Because of the increase in respiratory illness seen in the community, Phoenix Children’s Hospital has implemented restrictions on young visitors effective Friday, December 30.

Respiratory viruses are the leading cause of lower respiratory tract disease in young children and the leading cause of death among low-birth-weight babies.

Read more on Respiratory Syncytial Virus, or RSV

Anyone with nasal congestion, a fever, labored breathing, coughing, or other signs of illness should refrain from visiting hospital patients.

Is it a cold or the flu?

While the restrictions are in place at Phoenix Children’s, child visitors must be at least 12 years old to visit patients. The restrictions apply to all patient care areas.

All visitors must be free from respiratory symptoms. Restrictions on visits by young children during cold and flu season are typical at most Valley hospitals; check with any medical center before you go.

But a new drug was added to the study’s coverage in 2011.

One in every nine high school seniors (11.4 percent) reported using synthetic cannabinoids, or synthetic marijuana, in the prior 12 months.

Also known as as “K2” or “spice,” the drug consists of herbs coated with chemicals that mimic the effects of THC, the active ingredient in marijuana.

As of October, at least 40 states, including Arizona, have banned the sale of synthetic cannabinoids.

Find more facts from NIDA on synthetic marijuana here.

Use of this drug is relatively new. The American Association of Poison Control Centers reported an uptick in calls related to synthetic cannabinoids during 2010.

To help educate parents, community members, law enforcement and healthcare providers, the Arizona affiliate of the Partnership for A Drug-Free America is offering a free lunchtime webinar on synthetic substances.

This free webinar takes place from noon to 1pm on Wednesday, Jan. 11 and will run for about 45 minutes with time for questions at the end.

Presenters include a medical toxicologist and representatives from the Drug Enforcement Administration.

For more information, reach the Partnership at 602-264-5700.

Participants can register by using the following link:
https://www3.gotomeeting.com/register/197247422

Visit the Smart Start Concierge at any location to receive a guest pass for the day. Guests can try out gymnasiums, treadmills or participate in a group fitness classes.

Parents are welcome to bring children as Child Watch child care will be available for those who work out.

Benefits of a full YMCA membership include:

▪ Dozens of Free Fitness Classes
▪ Free Water Fitness Classes
▪ Free Child Watch for the kids while you work out (Family Memberships)
▪ Free Senior Programs
▪ Reduced Rates on a variety of lessons, youth sports, camp and after school programs

The Valley of the Sun YMCA celebrates their 120th anniversary in 2012.
Founded in 1892, the Valley of the Sun Y was serving Arizonans twenty years before statehood.

As the oldest non-profit in Arizona, celebrating 120 years in 2012, the YMCA serves local communities in Maricopa County, Pinal County, Yuma, Flagstaff and Prescott offering over 283 programs and 26 social services at 17 locations.

Members are welcome regardless of gender, religion, ethnicity, age or ability to pay.

To find your nearest YMCA branch call 602-404-9622 or visit www.valleyymca.org for more information.