Cub Chat | Spring 2006

Summer 2006

Preventing Injuries........2

NICU Reunion.........4

Benefits of Active Playing........6

Volume 12, Number 2

Meet R.J. Smith—Pennsylvania’s 2006 CMN Ambassador

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heck out R.J. Smith! This energetic NASCAR fan was once in the race of his life.

R.J., of Elizabethtown, Pa., was selected as Pennsylvania’s 2006 ambassador for Children’s Miracle Network (CMN) Co-Op Network Champions Across America program.

R.J. is one of 50 children, out of 17 million pediatric patients treated at a CMN-affiliated hospital, chosen as a champion ambassador.

Remarkable care—remarkable recovery

In the summer of 2003, R.J. was a happy, carefree child with a bright future. However, that August, R.J.’s life changed. Doctors believe a virus attacked his heart and sent him into sudden ventricular tachycardia, commonly known as heart failure.

R.J. was rushed to Penn State Children’s Hospital where specialists fought to keep his fast-beating heart under control. Conventional treatment failed. He went into full cardiac arrest.

The Children’s Hospital team continued to work diligently to save young R.J.’s life. With his heart barely beating, R.J. was placed on an Extracorporeal Membrane Oxygenation (ECMO) heart/lung bypass life support system, a last resort to save his life.

The ECMO system offered the best chance to control repeated cardiac

arrest events that were damaging to R.J.’s heart. He remained on the ECMO system for nine days and was given a temporary pacemaker. The next two weeks held little hope for R.J. His lungs grew weaker and collapsed. He was moved from a conventional ventilator to the specialized Drager ventilator.

Later, R.J. was placed on hemodialysis for kidney failure. Then he faced cortical blindness; not uncommon in children dealing with a traumatic illness.

R.J. and his family are very grateful to the staff at Penn State Children’s Hospital who provided exceptional care and support for not only R.J.—but also his entire family.

R.J. and his sister Kaitlyn head out for the first day of school.

Little boy—big mission

With his future uncertain, R.J. continued to fight. Finally, he responded to treatment and gradually improved.

On his fifth week at Penn State Children’s Hospital, R.J. was removed from the ventilator. By week six he showed no signs of significant neurological damage from the prolonged and necessary treatments. The return of his eyesight was a sign of complete recovery.

Starting Out Healthy,

R.J. has thrived since August 2003.

R.J. has successfully completed first grade. He stays active as a Tiger Cub Boy Scout, and soccer and baseball player.

Not long ago, R.J. had the thrill of a lifetime—the opportunity to meet his favorite NASCAR driver, Jeff Gordon.

R.J. and his family are very grateful to the staff at Penn State Children’s Hospital who provided exceptional care continued on page 2

CMN Ambassador, continued from page 1

and support for not only R.J., but also his entire family. They have dedicated themselves to raising funds and awareness for CMN, an organization they credit with saving R.J.’s life.

The ECMO system that helped save R.J., high-tech equipment (like the Drager machine), advanced materials, hospital-based child life activities, and even R.J.’s bed were purchased with monies raised by CMN. Taking the message on the road

On R.J.’s ambassador trip he visited the Pennsylvania state capital, and was the guest of honor at a send-off party.

He received best wishes at a celebration at Children’s Hospital with many of the people who provided him with lifesaving care.

On March 13, R.J., his family, and other Champion children and their families headed to Orlando, Fla., to experience the wonder and magic of Disney’s theme parks, additional media events,

Smith family: R.J., Kaitlyn, Sue (Mom) and Bob (Dad). and a CMN Celebration Concert and Champion’s Medal Ceremony. Next, they headed to Washington, D.C., where they toured the city and participated in

various CMN media events. Each year, the Champions Across America program raises awareness for the 170 CMNaffiliated hospitals and for the children

Prevention Rules: What Parents Need to Know to Keep Kids Safe

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very year, one out of four children will be treated for an injury. Simple precautions could help avert trips to the emergency room.

“Most injuries are predictable and preventable” says Susan Rzucidlo, C.R.N.P., pediatric trauma program manager and director of the Injury Prevention Program at Penn State Children’s Hospital. As your child grows, ask for age-appropriate safety tips during visits to the doctor.

Safety pointers for parents I Use car seats or booster seats for children until 8 years of age. Children under age 13 should travel in the backseat of the car. It’s not just safety, it’s the law: Pennsylvania requires children under age 8 to ride in car or booster seats and seatbelts for those under age 18.

Make sure children use appropriate safety equipment, such as helmets and pads, when participating in activities or sports.

I Keep poisons, such as cleaning solutions and medications, out of children’s reach.

I Install safety gates and window guards to prevent falls.

I Never leave children alone around a pool, bathtub, or even a bucket of water.

I Secure choking hazards, such as toys with small parts, dangling windowblind cords, and lightweight plastic bags.

I Set your water heater to 120 degrees Fahrenheit to prevent scald burns. O I

To Learn More For more information on how to keep your child “Safe at Home; Play: and On the Way,” call the Injury Prevention Line at (717) 531-SAFE (7233).

2 Penn State Children’s Hospital, www.pennstatechildrens.com

To Learn More Learn more about preventing injuries at these sites: I

Safe Kids Worldwide: www.safekids.org

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Centers for Disease Control and Prevention: www.cdc.gov

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American Academy of Pediatrics: www.aap.org

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American College of Emergency Physicians: www.acep.org

[ health bits ] treated in CMN hospitals, including Penn State Children’s Hospital.

Champions Across America is sponsored by Co-Op Network, the nation’s largest network of credit union automated teller machines (ATMs). Co-Op Network and participating credit unions sponsor this program to honor, recognize, and celebrate the children, like R.J., who were treated at CMN hospitals.

Thanks to CMN and the care provided at Children’s Hospital, R.J.’s dream to become a NASCAR driver just may come true. O

Learn More For more information about Children’s Miracle Network, please call (717) 531-6606 or visit www.pennstatecmn.org.

New Steps May Help Block SIDS Putting babies to sleep on their backs has caused a sharp drop in sudden infant death syndrome (SIDS). Yet doctors still blame SIDS for more U.S. infant deaths than any other cause. The American Academy of Pediatrics (AAP) has revised its SIDS advice to deal with some new issues. The AAP: I No longer thinks it’s OK to put babies to sleep on their sides. Every caregiver should put a baby to sleep face up for each sleep period.

I Doesn’t recommend bed sharing during sleep. You can bring infants into your bed to nurse or comfort them, but put them back in their cribs or bassinets (perhaps in your bedroom) when you want to go back to sleep.

I Suggests you use pacifiers at nap time and bedtime through the first year of life.

Research shows a link between pacifier use and reduced SIDS risk.

The AAP also urges parents to use a firm sleep surface, keep soft objects and loose bedding out of cribs, and do not smoke during pregnancy or around the baby.

Make the Food Pyramid a Blast for Kids Plan to Save Lives How your child fares in an emergency may depend on plans you make today. With some preparation, you can be ready and save lives:

Do you and your kids need help sorting out the government’s new food pyramid? Check out “MyPyramid for Kids” at www.mypyramid.gov/kids for a kid-friendly version. “This is a fun approach to addressing the very serious problem of childhood obesity,” says U.S. Agriculture Secretary Mike Johanns. The site offers tips for parents, lesson plans for teachers, and an interactive game for kids. In the game, called MyPyramid Blast Off, a rocket needs fuel to take off. Students have to pick a healthy set of foods and physical activities to fuel their rockets.

Educate yourself with first aid and CPR classes.

I Create an emergency folder that includes: – Records of immunizations and medical conditions – Names and dosage of medications – List of allergies and drug reactions so treatment does not cause harm – Verification of insurance coverage for emergencies

Passengers Worsen Teens’ Driving

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Learn your community’s emergency phone number. Not all areas have 911.

Fried Foods Help Fuel Weight Gain

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Make your house number large and visible so emergency crews can find your home.

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Teach children how to reach and speak to emergency workers.

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Provide emergency contact numbers and your child’s medical information to those who care for your child such as grandparents or babysitters.

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Teens are more likely to tailgate and speed with other teens in the car, a study shows.

“The findings indicate that teen risky driving increases in the presence of teen passengers, particularly male teen passengers,” says Duane Alexander, M.D., director of the National Institute of Child Health and Human Development, which did the study. Researchers watched teens leave 10 high schools in suburban Washington, D.C., and pass observation points. On average, the 471 teens drove 1.3 mph faster and, at 40 mph, followed about 10 feet more closely than other drivers. Both boys and girls drove faster and followed more closely if they had a male teen passenger when compared to teens who had no passengers or had a girl in the car.

Children who eat lots of fried food are more likely to weigh too much and have poor diets, a Harvard study found. Researchers studied the eating habits of nearly 17,000 children ages 9 to 14. When their fried-food intake at restaurants rose in the course of a year, they gained more weight than you’d expect from normal growth. They also took in more calories and had less healthy diets. And overall, children’s fried-food intake rose during the three-year study. “The children more than doubled their consumption,” says study author Elsie Taveras, M.D., of Harvard Medical School. American Dietetic Association spokeswoman Sue Moores, R.D., says the study shows why families should eat at home. Few of us own a deep-fat fryer, she notes.

Penn State Children’s Hospital, www.pennstatechildrens.com 3

See You in September Attend the 2006 NICU Reunion Saturday, Sept. 16

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lot happens in three years. Children grow. Medical techniques advance. Life moves forward. To celebrate this momentum, every three years, Penn State Children’s Hospital’s Neonatal Intensive Care Unit (NICU) invites graduates back to Penn State Milton S. Hershey Medical Center for the NICU reunion.

This fall, the NICU reunion is Saturday, Sept. 16, on the front lawn of Penn State Milton S. Hershey Medical Center.

Families whose newborns spent time in the NICU come from across the region to rekindle old friendships; connect with physicians, nurses, and staff; and enjoy games, entertainment, and food. Most importantly, they come to celebrate the lives of children who are thriving thanks to the NICU care they received.

Penn State Children’s Hospital provides the highest level neonatal care in central Pennsylvania (Level IIIC) and serves as a referral center for nurseries and other NICUs. Newborn specialists provide intensive and follow-up care for newborn infants with complications due to premature birth, as well as complications from respiratory, surgical, cardiac, neurological, genetic, renal, hematological, infantile apnea, and metaTo Learn More bolic newborn diseases.

Board-certified neonatologists, nurses, and For more information about NICU staff of the NICU help children thrive every services, please visit us online at day. Celebrate this lifesaving success! O www.hmc.psu.edu/nicu/.

4 Penn State Children’s Hospital, www.pennstatechildrens.com

Save the Date!

Wednesday, August 23 is Penn State Children’s Hospital Night at the Harrisburg Senators’ baseball game on City Island, Harrisburg. First 1,500 guests will get Children’s Hospital/Harrisburg Senators’ footballs! Join us for an evening on the Island. First pitch is at 6:35 p.m.

ACT Gives Back

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he Advisory Council of Teens (ACT) is giving back. Earlier this year, teen members spent an afternoon cleaning and baking for families staying at the Ronald McDonald House, located across the street from Penn State Children’s Hospital. The fun-filled day was a way to thank CMN for its continued support of ACT. This fall, ACT’s commitment to the Ronald McDonald House continues with the second annual rolling bake sale on Monday, October 9 in the CMN room. ACT members will travel throughout the hospital and sell homemade baked goods. Proceeds will be used to purchase Ronald McDonald House wish-list items.

Get in the ACT ACT is seeking additional members. Current or previous patients between the ages of 13 and 18, who want to make a difference in the lives of Penn State Children’s Hospital patients, are encouraged to join. Members are committed to attend meetings held every other month, as well as occasional community service events. To learn more about ACT and its accomplishments and projects, visit ACT’s web site at www.hmc.psu.edu/childlife/act. O

Be Heard Not sure that you can commit to ACT, but have a suggestion? ACT would love to hear from you! Help ACT help pediatric patients at Penn State Children’s Hospital.

For more information, please call the Child Life Office at (717) 531-8366 or e-mail ACT at ACT@hmc.psu.edu.

Penn State Children’s Hospital, www.pennstatechildrens.com 5

Get Your Kids to Log Off “Screen time” cuts into physical pastimes TV and video games have robbed children of outside play for years. Now most U.S. homes have a personal computer, too, and about a third of kids ages 8 to 18 have one in their room. That has health experts casting a wary eye on PCs. The problem is not just that going online can expose youngsters to predators or cause them to waste hours in chat rooms. It’s also that rising “screen time” can cost kids the exercise they need to keep fit.

“Activity levels are waning, due to changes in [school] curricula, computer technology, and community resources,” says Carl Foster, Ph.D., president of the American College of Sports Medicine. “As a result, our kids are getting fatter and may be the first generation not to have a longer life expectancy than their parents.”

Children and teens should get at least 60 minutes a day of physical activity, according to the 2005 dietary guidelines from the U.S. Department of Agriculture, and the Department of Health and Human Services. How can you help? A lot of doctors say you should take TVs and PCs out of kids’ rooms and limit screen time to two hours a day. They also suggest that you encourage exercise.

Go for a walk with your kids a few nights a week after supper, for instance.

Shut off the Saturday cartoons to go inline skating or visit the zoo.

“While your children may complain in the short term, they will be healthier and better developed people for having a little less electronic input,” says Dr. Foster, a professor of sports science at the University of Wisconsin–LaCrosse.

“The key is to create something else for them to do outside without being overbearing about it or orchestrating the

Help Your Children Breathe Easier Pollution causes big problems for little lungs, even outside of cities

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ere’s something that can take your children’s breath away: The air they breathe.

Air pollution hurts infants and children more than adults, studies show. Kids’ lungs are still developing, they breathe faster, and they spend more time outdoors.

Problems crop up at pollution levels once thought safe, says the American Academy of Pediatrics (AAP). Trouble can start at birth or even in the womb.

Bad air can worsen asthma and cause more asthma-related hospital stays.

Studies also link air pollution with premature births, infant deaths, and slow lung growth, the AAP says. In

play. You may need to band together with other parents and organize an afterschool program to provide a safe venue.

But kids, being kids, are plenty smart enough to think up fun things to do.” O

To Learn More I

“We Can!” (National Institutes of Health): http://wecan.nhlbi.nih.gov

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PC-Turnoff Organization: www.pcturnoff.org

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American College of Sports Medicine: www.acsm.org

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National Coalition for Promoting Physical Activity: www.ncppa.org

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President’s Council on Physical Fitness and Sports: www.fitness.gov

6 Penn State Children’s Hospital, www.pennstatechildrens.com

The ABCs of Getting ZZZs Wake up to the need to help your child get enough sleep A hearty night’s sleep is as important to your child as a good breakfast.

Without enough shut-eye, children are more prone to struggle in school or on the field, have regular meltdowns and suffer depression, studies show.

Yet a whopping 69 percent of U.S. kids have one or more sleep problems a week, says Jodi Mindell, Ph.D., vice chairwoman of the National Sleep Foundation (NSF). That includes trouble getting to sleep or staying asleep.

“Kids are sleeping less today—about four hours less a week—than they did a decade ago,” she says.

This can make it tough for your child to solve problems and memorize

Keep Bad Air From Hurting Kids

fact, it may even cause asthma.

These problems don’t just occur in big cities or near industries.

“Even in suburban areas, where the region may have relatively clean air, there are studies now that show being near areas of high traffic can increase risk,” says Janice J. Kim, M.D., Ph.D., a member of AAP’s Committee on Environmental Health. In rural areas,

lessons, which can lower grades and selfesteem. Sleep-starved kids are also more easily frustrated and fidgety. A child’s sleep trouble affects the whole family, she adds. “Parents who are up coaxing a child to bed are robbed of their own valuable sleep.”

The best cure, she says, is a consistent bedtime schedule. Stick to a bedtime

the weather can blow pollution from the city into the countryside.

“You can’t totally avoid it. All of us have to breathe,” says Dr. Kim, who is also a health officer for the California Environmental Protection Agency. The most important steps you can take, she says, are to support clean air measures and help raise awareness of the problem. O

that permits your 3- to 5-year-old child to get 11 to 13 hours sleep. A school-age child needs 10 to 11 hours. If the current bedtime is too late, move it 15 minutes earlier each night. Tuck resisters back into their own beds, promptly and repeatedly, until they get the message that you expect them to get to sleep on their own.

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Restrict outdoor time on days with poor air quality for children who are asthmatic or very sensitive to air pollution. You can find local air quality listings through http://airnow.gov.

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When you or your children go for a walk or a bike ride, take a route far from heavy traffic.

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If you live near a busy road, close your doors and windows at peak travel hours. Turn your air conditioner to “recirculate.”

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Cut the idling time of your cars. Don’t let them run in the garage, which can cause carbon monoxide poisoning.

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Carpool and use mass transit when you can.

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When you drive, stay well behind trucks, buses, and other vehicles if you see smoke coming from their tailpipes.

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Urge school officials to reduce buses’ idling time.

Sound advice for sound sleep I Unplug the bedroom. Turn off TVs, computers, and cell phones. Better yet, keep such things out of the bedroom, which should be a stimulation-free zone.

I Set a wind-down routine. Start the transition to dreamland with dimmed lights and a warm bath; end with reading a book. Avoid watching TV just before bedtime.

I Go decaf. Drinking caffeine during the day affects sound sleep. Caffeine lurks not just in coffee and cola, but also in tea and chocolate.

I Reduce daytime stimulation. Overbooked kids who rush from band practice to dance class to dinner to homework may be too keyed up at bedtime to unwind. “We advise one activity per season,” says Dr. Mindell.

I Get help. If, despite these measures, your child still resists bedtime, has nighttime awakenings, or snores, talk with your doctor. You can also check the NSF’s web site: www.sleepfoundation.org. O

Penn State Children’s Hospital, www.pennstatechildrens.com 7

Children’s Hospitals Lead Abuse Treatment and Prevention Efforts

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ost parents don’t want to hurt their child intentionally. But the stress of an infant who won’t stop crying or the daily trials of caring for a child with special needs can overwhelm even the most loving mother or father. Whether you’re struggling to build positive discipline skills or have seen another parent or caretaker abuse a child but don’t know what to do, your local children’s hospital can help.

To Learn More For more on children’s hospital efforts to prevent and treat abuse and neglect, visit www.childrenshospitals.net and select “Child Advocacy.”

For more on positive parenting, contact your local children’s hospital.

Nearly 3 million cases of suspected abuse and neglect are reported in the U.S. each year. Children’s hospitals are the undisputed leaders in providing medical care to abused and neglected children. They also teach how to cope with the frustration and anger every parent feels at times. Children’s hospitals provide classes, fact sheets, and more to guide parents through child rearing, as well as support groups for parents struggling with the same frustration.

Worried that a child you know or see in a public place is being maltreated?

Children’s hospitals can help connect you to a community resource where you can anonymously report your concerns.

Some parents worry that if their child is injured by accident, not through abuse, they will be suspected of abuse at a hospital. Children’s hospitals are working on a seamless, timely, and

effective system of abuse response that helps protect innocent parents, and provides medical care and emotional healing to the most vulnerable children.

Working with children’s hospitals leaders, pediatricians, and allied groups, NACHRI developed Defining the Children’s Hospital Role in Child Maltreatment, a guide to establishing, developing, and enhancing child abuse services in children’s hospitals. These guidelines help offer the highest level of quality care possible to abused and neglected children. O

NACHRI National Association of Children’s Hospitals and Related Institutions www.childrenshospitals.net

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. ©2006 Staywell Custom Communications, 780 Township Line Road, Yardley, PA 19067, (267) 685-2800. Some images in this publication may be provided by ©2006 PhotoDisc, Inc. All models used for illustrative purposes only. Some illustrations in this publication may be provided by ©2006 The StayWell Company; all rights reserved. (206)

Cub Chat is a complimentary quarterly newsletter produced by the Office of Strategic Services at Penn State Children’s Hospital.

For questions or additional copies, please call (717) 531-8606. www.pennstatechildrens.com

A. Craig Hillemeier, M.D. Medical Director and Chairman

CHI-3726-06