Pediatric Emergency Contact Notifications

For the head of the trauma department at one of America's top pediatric facilities, Chicago's Children's Memorial Hospital, having to notifying parents that their children have been the victims of trauma or identify pediatric Jane Does, is an every day occurrence. But just because they look like they're handling it well, doesn't mean that it ever becomes routine.
When a child comes into the ED without a parent, it's usually the result of an accident or traumatic event. Even though their first priority is to tend to the child's medical needs, their next priority is to identify the child. They need to get his parents or guardian down to the hospital, to give consent for his treatment, provide vital medical history and most importantly, to be at their child's side when he needs them most.
You'd be surprised how often a child is brought into Children's Memorial without anything pointing to his or her identity. Many times it's the result of a car accident, where the parents are injured as well as the child, and are taken to another hospital, while the child is brought to Children's for specialized pediatric treatment. Since children don't have driver's licenses or checkbooks, identifying a child can be challenging.
Just the other day, three children ranging from 8 months to 3 years were brought into the ED after a serious automobile accident.
Their parents, who were in bad shape, were taken to another hospital and the paramedics had no clue about their names, ages or medical history. The trauma team began their medical evaluation and as they always do when dealing with an unidentified child, opened a trauma pack for each, using a patient number to identify them. We estimated their ages, did a full physical description including any identifying marks and clothing, then ordered a full set of x-rays, which helps to identify any conditions or injuries that aren't readily apparent.
The team's biggest asset in this situation was the solid relationships that they've built with police, fire department, and other local hospitals - as they work together to get the children identified as quickly as possible. After a major accident like this, the police and fire department were already in the ED coordinating efforts. With their special emergency landline system they're instantly linked by phone with any local hospital they need to reach. As the team began calling to find out where the children's parents were taken, hospitals began to call them, to say, "I know you're looking for the mom and dad of the accident victims. They're not here," saving them precious time. In this case, we found the hospital relatively quickly and found out that even though the children's parents had been seriously injured, the children's caregiver who had also been in the accident, was fine. The hospital sent her over to Children's and she - and later on the parents - were able to give them all the information they needed to identify and treat the children.
In the case of a completely unidentified child, especially babies, they depend on our procedures. Usually the fire department, police or DCFS dropped the child off, so they are already aware of the situation and have already begun going through the child's clothing and personal effects to gather evidence and identify the child. The trauma team will send the police or paramedics right back to the scene to gather additional information, medicine bottles, names, and to canvass the area. There is almost always someone who saw something. Someone from pastoral care automatically comes down and a social worker will get involved if it looks like any abuse was involved. Together, they take care of figuring out where to go from here, while the team takes care of the child medically.
If these steps don't elicit any clues to the child's identity, the hospital will get media affairs involved. Children's will never show the face or reveal the name of any child. Instead, they photograph the child's clothing and personal effects and release it to the media along with the child's estimated age, description and the vicinity in which she was found. They work closely with detectives and DCFS to give them all the details they need to chase down any leads they get from the public. Many times just calling DCFS or the police will locate parents or bring about an identification. In the case of severe trauma, abuse or inflicted injury, Children's always balances treating the child, with carefully gathering as much evidence as possible, to help the eventual police investigation. They had a young girl a few years ago, whose brutal attacker was convicted mainly on the evidence gathered and catalogued in the trauma room.
When it comes to providing emergency contact information, kids aren't always the best source. They have seven or eight year old kids come in everyday, who I'm sure are sophisticated in every other way. But get them in a trauma situation and ask them what their mom's name is and they'll say it's "mom". In this case, the first thing they'll do is look at whatever they brought in with them. School-age kids almost always have a backpack. If they don't find anything there, they'll check our records to see if the child is in the system and begin to gently probe the child for information. They ask them where their house is, what their school looks like, information about their friend's houses, maybe a familiar landmark on the corner like a 7/11 or the name of a park. If you can't find their contact information right away, try to find the name of their school. Their books will probably have the name of their school stamped inside.
Schools are also a great source for emergency contact information. They'll often even list alternate people to call in an emergency if the parents are at work or hard to reach. In an emergency, schools will usually send someone directly down to the hospital with the child's emergency card and emergency consent forms. If the injury occurs at school, most schools will send someone from the school along with the child to the hospital, while someone else is calling the parent. For parents, I would suggest that every parent name someone else on the child's emergency card, who knows the child well and would be able to step in to help out during an emergency if the parents can't get there right away.
So once you identify a child, how do you know if the person who comes to the hospital is really his parent or relative? It's not always easy. Remember that the parents didn't expect to have to come to the hospital today, and probably won't be carrying three forms of ID and their child's birth certificate. For people that come in and say they're related to a child who's been in the media, they get as much ID as they can, be it a driver's license, pictures or other proof. With kids, the biggest test is to watch their response when that person goes in the room. Usually you'll here a resounding "Mom!" or "Daddy!" and you know you've got the right person. If there's no response from the kid, or if they're not sure of the adult, it's probably not the right person. Or worse, the child might recoil from the adult, which could indicate an abusive situation.
Treating kids also means caring for their parents. When Children's has to make a notification call they'll begin by telling the person on the phone who they are and ask them how they are related to the child. If it's the mom or dad, they'll tell them that their child has been brought to Children's Memorial Hospital. Of course the parent will immediately ask how the child is. This is always the hardest part of the call. If the child is clearly fine, they'll say "Don't worry, they're fine, we just need you to come down here."
But if there is a more serious injury, or if the child hasn't survived, they say that the child has been in an accident, that they need to come down, and if necessary, that they need to get their medical history. If they refuse to get off the phone until they find out what's wrong, the trauma coordinator will say that they're very concerned about their child's health and that they need to come down right away. They'll always try to calm the person down as much as they can - tell them to go and get a pencil and paper to take down the address of the hospital, to take down the hospital's name and the nurses' direct number. They tell them to ask for them right away when they get here so they don't have to waste any time at the desk and then try to make sure they have someone to drive them over. And they finish by reminding them that they need to drive carefully and slowly and to make sure that they get there in one piece!
At Children's the top priority is the restoration of the health of every child who comes through our door, no matter who they are and where they come from.

Frequent Fallers" One Disabled Perspective

Since 1992, when ADA ~ Americans with Disabilities Act ~ took effect, we have witnessed an astronomical increase in community awareness. Vast numbers of handicapped persons who had rarely ventured out have come into public view. The sick have been assisted. Many broken have been made mobile. Physically unfortunates have been empowered.
As Machiavelli said, "Power corrupts." Some of we disabled have come to expect everyone else to make way for us. I fear, the pendulum has swung from equal access rights ~ to special privilege civil liberties ~ which too many of us have come to expect. Errant expectation undermines appropriate appreciation.
Beneath our somewhat successful surfaces, some of us were tyrants to begin with. We demanded instead of requesting. Rather than even ask, we answered with action! Our arrogance could masquerade as confidence.
Pride comes before the fall if fall hard we must. Some of us "Frequent Fallers" routinely blame others for our shortcomings. But, when we no longer have control over our own bodies, we are frighteningly forced to revisit our selfish realities. After all, it's in our own best interest. Just because I am stubborn, I can ill afford to remain an ass.
We that are blessed to abide in a nation that has mandated heretofore unheralded access to activities and services, making it unlawful to discriminate against us because of our "Special needs," should be grateful for the lack of restrictions we now enjoy. Not that we deserve such liberty. We ought to recognize our acceptance as gifts from the benevolent, able~bodied who pay for our extended benefits.
Please, do not misunderstand, nor find offense at my musings. I am grateful to those "Early swimmers," who recognized the desperation of handicapped individuals and broke new passages through which our citizenship now navigates. Whether motivated by humanity or purely personal gain, I am appreciative of their meeting a noble need for Equal Access. It is better now than it ever was. Access will yet improve. I hope that we who most benefit can develop a "Have-a-little-patience" perspective too.
Often, the goodhearted & charitable only hope that we have paid a price, either through contributing in some fashion within our own lives, or that by our encouraging of others, we will extend like kindness where we can. That we learn to love better, if only because we can :))
With "Equal Access," we can Leap~out, Limp~out, or Lash~out!
For some of us who are disabled, we are just fortunate to get what we have coming, instead of having to take what, by our wanton actions, we might really deserve.

Beginner's Guide To Fitness

So you are finally ready to turn from your couch potato ways, and trade your T.V. remote in for a dumbbell! Congratulations, and welcome to the wonderful world of fitness! I commend you on your resolve to lose weight and get into shape! Now where do you begin? These days there sure is a lot of talk about diet and fitness, whether it is a new diet pill or piece of exercise equipment. It is enough to make your head spin, and certainly enough to confuse the beginner. Take a deep breath, and follow these simple tips to go from being a fitness beginner to a pro!
TIP #1: GET MOVING
The first thing you need to do, as a fitness beginner, is to start moving! I mean this literally. Get up, and walk out your front door. Now walk down the street. Now turn the corner. Keep going! Do you get the picture? Start introducing your body to fitness by going on walks. These walks will probably start out slow and short, but before you know it they will be brisk and long. Try to work up a sweat as you tour the neighborhood. Make it a habit to wake up early to go on your walk, or consistently go on a walk before you go to bed. These walks will get you to start burning calories each day, and will also begin to build your cardiovascular endurance.
TIP #2: STRETCH
Once you become a pro at walking, you will need to add something new to your routine. Stretch before and after your walks. Start by reaching down to touch your toes and holding it for 30 seconds. You will feel tightness on the backs of your legs, in your hamstrings. Now place your palm against a wall at chest level and turn your body away from it. As you hold this for 30 seconds you will feel a stretch in your chest. Most inactive people have tight hamstring and chest muscles due to prolonged sitting, so it should be your priority to stretch these muscles out. You will be pleasantly surprised at what this will do for your posture!
TIP #3: CLEAN YOUR DIET
Fitness professionals like to claim that 80% of what your body looks like is directly related to what you eat. In other words, if you are eating burgers and fries and visiting the gym everyday, you are still going to look like you are eating burgers and fries! It is time to clean up your diet, so you can continue on your fast track to fitness.
· Rule #1: No more fast food. Fast food is cheap, available, and quick, but it is far from healthy. You are better off avoiding it completely.
· Rule #2: Eat 5 servings of fresh fruits and vegetables everyday. Your body needs the nutrients found in these foods, and they will fill you up without empty calories.
· Rule #3: Eat 4-5 small meals a day, rather than 2 large ones. This will keep your metabolism high all day, and turn you into a calorie-burning machine!
TIP#4: JOIN A GYM
After you have mastered walking, stretching, and have started to clean up your diet, you are ready to join a gym. Don't be intimidated or scared of this concept, the gym is a friendly place where people go to burn calories and build muscle! Find a local gym that has a convenient location near your home or work place. The key to making your gym membership worth its monthly dues is to use it consistently. Go to the gym no less than three times a week. While you are there begin a resistance training program as well as a cardiovascular program.
TIP #5: FIND A BUDDY
There is no better motivator to get you to the gym than knowing that someone is there waiting for you. If you find yourself slacking off in your workouts, or skipping the gym, a workout buddy might be just what you need. Find a friend with whom you share similar fitness goals, and become workout buddies. Agree to meet three times a week at the gym, and encourage each other throughout your workout. You will find that this makes workouts motivating and fun.
There you have it, all you need to know to get yourself up off the coach and into a healthy, fit lifestyle! Making the decision to get into shape will be the best one you make in your life, and I wish you all the best. To your health!

Traveling Fitness

Whether you travel for business or pleasure, being on the road usually leads to one thing: weight gain. From missed workouts to large restaurant meals, travel days often become high calorie days. Next time that you go on the road keep the following tips in mind, and come home leaner than when you left!
TIP #1: STICK WITH CIRCUITS
When you find yourself in a poorly equipped hotel exercise room, make the best of it. You are not going to be able to get in a normal workout like you would at your local health club, so you will have to make do with the available equipment. A great way of doing this is to workout in a circuit. Most hotel exercise rooms will have at least one piece of equipment for each body part, and they are usually as empty as a ghost town, so a circuit will work well. Do one set on each body part, and then hop on a bike or treadmill for 10 minutes. Repeat this two more times, and you will find yourself sweating up a storm.
TIP #2: BURN CALORIES EVERYDAY
If your travels keep you too busy for a workout, or if your hotel does not have an exercise room, make a conscious effort to burn calories everyday. There are many different ways to fit some calorie burning into your day. Go on a brisk walk after your day's activities. This is a great way to see a new city, and also a great way to burn off the rich dinner you just ate! Take the stairs instead of elevator in your hotel and any other buildings you visit. Go on a short jog in the mornings or evenings of your stay. If your hotel has a pool, swim a few laps each morning or evening.
TIP#3: WATCH PORTION SIZE
Eating out is a must when traveling. Whether you are visiting 5 star restaurants or fast food diners, you are faced with the same problem: large portions. While the easiest thing to do with a large portioned meal is to simply eat it all, that isn't the easiest on your waist! When you order your meal ask the waiter or waitress to bring you a to-go box with your meal. This way you can take half of the meal and place it safely into the box before you even begin to eat. You will have no choice but to eat a healthy portion, and you have your next meal taken care of. If you would rather not carry around a to-go box then ask that your entrée be made into a smaller portion. If it is dinnertime ask for the lunch-sized entrée.
TIP #4: AVOID FRIED FOODS
While fast food restaurants are definitely convenient, with their low prices and quick service, this convenience is not worth the inevitable weight gain brought on by the burgers and fries. When you travel, keep this in mind: avoid fried foods. While this is always good advice to follow, it is even more important to abide by while traveling.
While traveling you are most likely to be burning less calories each day than you would normally burn at home, and you are consuming more calories due to your schedule of eating out. You are walking a fine line, and eating fried foods would throw you right over the edge of weight gain. A gram of fat contains 9 calories as compared to the 4 calories that proteins and carbohydrates carry, so you can see that consuming fried foods will drastically increase your calorie intake. If I still haven't convinced you to pass on the French fries, keep in mind that heartburn and indigestion are never fun, but how about experiencing them on an airplane, bus, or train ride!
TIP #5: BODY WEIGHT ROUTINE
When your hotel doesn't have an exercise room, and you still want to get in some type of workout, try this body weight routine right in your hotel room:
· 20 Jumping Jacks: you remember these from grade school! Start jumping!
· 20 Push Ups: Get on the floor, keep your back flat, and push!
· 20 Jumping Jacks
· 20 Crunches: Keep your hands behind your head and breathe out as you crunch up.
· 20 Jumping Jacks
· 20 Triceps Dip: Place your palms on the edge of a chair, bend at your elbows and push yourself back up!
· 20 Squats: Stand in place, with your knees shoulder width apart, squat down!
· 20 Jumping Jacks
· 20 Lunges: Keep your hands on your waist, step forward keeping a 90degree bend in your knee, and press yourself back up!
Next time your work or pleasure takes you away from home, keep these tips in mind and be pleasantly surprised with your results! Have a great trip!