Gary A. Emmett, M.D., F.A.A.P
The United States has a crisis in the abuse of prescription painkillers such as oxycodone and hydrocodone. The rate of newborns withdrawing from painkillers or opiates – called neonatal abstinence syndrome or NAS – in the US almost tripled from 2000 to 2009 (1.2 babies per 1000 newborns to 3.4) and has gone up even more since. The areas with the highest levels of addicted newborns are not big cities, but rural areas in states such as Kentucky and Maine, which have very limited pediatric resources to care for these sick infants. The cost of Medicaid for newborns has increased greatly because the care for NAS babies is expensive.
At the other end of the pediatric age range, the Centers for Disease Control and Prevention estimates that there are now 10,000 extra deaths yearly from prescription opiate overdose (some obtained legally, much not) and these include many adolescents and young adults. Additionally, opiate overdose deaths in the past have been heavily male-dominated, but now over one-third are female.
Many factors contribute to the increasing abuse of prescription painkillers by kids, including greater availability. For example, the number of hydrocodone and oxycodone products prescribed legally in the United States increased from about 40 million in 1991 to nearly 180 million in 2007, according to a recent study. The Philadelphia Inquirer recently reported that one man managed to obtain 380,000 tablets of Oxycodone and Xanax from one family doctor in Philadelphia in less than two years by using a small army of accomplices recruited to pose as patients in severe pain
W. Douglas Tynan, Ph.D., Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Do you think guns in the home make your children safer? It’s usually not the case. Last January, high school student Anthony Krueger locked himself in his room and shot himself under the chin twice after his mother called the police about his drug use. Stories like this highlight that one of the largest risk factors for teen suicide is the presence of a gun in the home.
In Krueger’s case, the 17-year-old from Dover, Del. survived, but faces a long slow recovery from his injuries . Without access to a gun, an emotional argument can lead to broken doors and objects, screaming, tears and even a fist fight, but rarely does it end in death. With a gun present, the circumstances change.
Krueger’s mother had bought the gun for protection, and allowed him access so he could “protect” his younger siblings while his mom was at work. His suicide attempt was featured in a Wilmington News Journal article earlier this month that looked at an adolescent suicide cluster in the state last year.
Christopher C. Chang, M.D., Ph.D, Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Recently, a 13-year-old girl in Sacramento, CA, died of anaphylaxis after ingesting a rice krispies treat coated with peanut butter, to which she was extremely allergic. In this tragic case, even though everything possible was done to save her, including the swift administration of epinephrine (Epi-pen), she went into cardiac arrest and was pronounced dead later at the hospital. Her heartbroken parents, one of whom is a physician, issued a statement imploring people to stay ever vigilant and never let their guard down when it comes to known food allergies.
Although such deadly consequences are rare, this sad story exemplifies that they do indeed occur. The victim was at a church camp, her mother was present. Food was being shared in a festive and communal atmosphere. It was dusk and visibility was low. The girl picked up a treat without realizing that it had been coated with chocolate and peanut butter. As soon as she took a bite, she recognized the taste and spit it out. But just that minimal exposure was enough to trigger anaphylaxis.
The Epi-pen (one of several available epinephrine autoinjectors on the market) is a very effective rescue medication, especially if used right away. Unfortunately in this case, it did not work. The reasons for this are purely speculative. The point is to never be cavalier about food allergies, particularly with nut and shellfish allergies. ALWAYS read labels. ALWAYS ask questions at restaurants. NEVER eat home-prepared foods unless you are certain they contain none of the potentially lethal substance. The sad truth is that the best medicine that we have failed to help this girl, the only effective “treatment” would have been avoidance.
Anna Nguyen, Healthy Kids blog Editor
With two young children, meal time prep usually involves cutting food into small pieces to avoid any potential chozing hazards. Despite my best efforts, there have been some near choking incidents – my 1-year-old stuffing too much fruit in her month at once and my 3-year-old swallowing meat that wasn’t chewed well enough. Luckily for me, coughing cleared things up.
A study in Pediatrics released online today captures how common non-fatal food choking incidents are for children. Almost 112,914 children from ages 0 to 14 years had a nonfatal food-related choking episode that required a trip to the emergency room from 2001 to 2009. That’s an average of 12,435 children per year or 34 children per day.
In fact, choking is a leading cause of injury among children, and can sometimes be fatal, especially in children 4 years of age or younger. The size, shape, and consistency of certain foods make them more likely to be a choking hazard for these kids. In the study, infants under the age of 1 accounted for 37.8 percent of all the choking cases.
Anna Nguyen, Healthy Kids blog Editor
For some kids, it might seem like a funny prank to make and detonate a homemade chemical bomb. Also known as MacGyver bombs, these bottle bombs are easily made by combining commonly available chemicals including toilet bowl, drain, or driveway cleaners in a container. Then the container, such as a soda bottle, is sealed and shaken to cause a chemical reaction that leads to an explosion.
But the Centers for Disease Control and Prevention warns that these bombs are hazardous and especially dangerous if detonated in public areas. In an analysis, the CDC found 134 events from 15 states involving homemade chemical bombs were reported from 2003 to 2011. Among those incidences, 21 resulted in breathing problems, and injuries like burns or skin irritation for 53 people. Two thirds of the injuries were kids, according to the report from the June 21 edition of the Morbidity and Mortality Weekly Report.
The agency wants to raise awareness about these bombs among first-responders, parents, school staff members and others who work with kids to help reduce injuries associated with these bombs. Most bomb explosions were reported in schools, mail boxes, and residential backyards.
Anna Nguyen, Healthy Kids blog Editor
In cooperation with the U.S. Consumer Product Safety Commission (CPSC), Baby Matters LLC of Berwyn, Pa., is announcing a voluntary recall of all models of its Nap Nanny and Nap Nanny Chill infant recliners and covers. This recall is announced as part of the settlement of an administrative case filed by CPSC in December 2012, which sought a mandatory recall of the Nap Nanny and Chill products.
From 2009 to the present, the Commission staff has received at least 92 incident reports involving the Nap Nanny and Nap Nanny Chill products, including five infant deaths.
For more information, go to the U.S. Consumer Product Safety Commission website.
Stephen Aronoff, M.D., M.B.A., Temple University Hospital
Planning a trip abroad for the summer? Consider potential health risks that may lurk at your destination. It’s important to check with your doctor to find out what precautions, such as vaccines or medications, can help protect your family.
Here’s why. While virtually nonexistent in the United States, measles is still a common disease in many parts of the world, including Europe, Asia, Africa, and the Pacific. This vaccine preventable disease infects about 20 million people and kills about 164,000 people per year. The majority of these deaths are among children, and more than half of these deaths occur in India. Measles can also make a pregnant woman miscarry or give birth prematurely.
What about polio? It has been decades since a case of polio has been reported in the U.S. In fact, that disease has been completely eliminated worldwide. Right? Not so. Over the past several months, cases of polio have been reported in Somalia and Kenya. This disease, which begins like many other other viral illnesses, infects the nervous system and may leave its victims paralyzed; some patients even die.
Kevin Osterhoudt, MD, MSCE, FAAP, FACMT
Today’s guest blogger is Kevin Osterhoudt, MD, MSCE, FAAP, FACMT, emergency medicine attending physician and medical director of the Poison Control Center at The Children’s Hospital of Philadelphia, and associate professor of pediatrics, Perelman School of Medicine at the University of Pennsylvania. For updates and more information, go to Poison Control Center’s Facebook page.
Ingestion of torch fuels, often used in the summertime to fuel patio torches or decorative candles, can lead to severe injury. The good news is that you can prevent this predictable summertime hazard before this year’s celebrations of the unofficial start to summer – the Memorial Day holiday weekend.
Already in May, The Poison Control Center at The Children’s Hospital of Philadelphia has taken five calls about potentially toxic exposures to these lamp oils. Two toddlers were hospitalized, one in an intensive care unit; and one adult drank some of the oil by mistake. The other two cases involved children playing with the bottle, which led to spilling or splashing the contents on the skin and face.
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