PMD 1996 or “…of course I can find data…I’m a consultant…”

Last updated on March 3rd, 2018 at 12:54 pm

Gather data??? No problem…that’s what I do…and I’m pretty good at it. …or at least I thought I was. But I didn’t really know the EMS market – especially for a pediatric product…and I was soon to find out no one else did either.

I started with what I thought was a pretty good list of some very basic questions:

I.   General Market Insights:The PedREST story2

  1. Overview of stretcher market
    • Key players / competitors
    • Listing of stretcher models
      • Which stretchers are unique (independently manufactured)
      • Which are market leaders
    • Market share
    • Distribution channels
      • % VARS / Direct / Wholesale
      • Means of communication (Internet, catalogue, sales personnel, etc.)
  2. Overview of US emergency medical transport (e.g. ambulance) market
    • Ambulance company data:
      • company size (public, private & govt.) by region (if available)
        • # small (<20 ambulances)
        • # medium (21-50 ambulances)
        • # large 50+
        • how has this changed over past 5 years
      • average number of sites per company (small/medium/large)
      • average number of ambulances per site (small/medium/large)
    • Purchases (last 5 years) ambulances and stretchers

II. Pediatric “Emergencies” (1994+)

  1. Infant/pediatric ambulance (ground and air) transports
    • age distribution
    • geographic distribution (if significant)
  2. Volume of infant/pediatric transports as % of total transports conducted by various services
  3. Breakdown of call “codes” (as initially called/diagnosed)
    • % code 3: stable transport
    • % code 2: unstable or potentially unstable – not usually life threatening
    • % code 1: medical emergency – life threatening
    • Frequency of code escalation (eg. How often code 3 or 2 becomes code 1)
  4. % of infant/pediatric transports requiring “medication” administration en-route

Truth be told there were more questions on my list, but you get the idea. It seemed like this would be a good place to start. So armed with my questionnaire I started my research. Unfortunately at this point the internet was still in its infancy. While today you could type in “ambulance crash child transport” and get tens of thousands of references, back then the results barely registered.

My luck didn’t get any better by phone…I tried the American Ambulance Association and was referred to a nurse at the Walter Reed Hospital who referred me to an editor at JEMS magazine (an EMS trade publication) who referred me …and referred me…and so on. The list was endless…and no matter who I contacted no-one had the information I was looking for. What amazed me was the difficulty I was having even finding “the basics” – i.e. the number of ambulances in the US…and the number of crashes they had – forget trying to locate anything pediatric specific.

It wasn’t that the people I encountered weren’t helpful. The basic fact was the information was not available because it wasn’t being gathered. No-one was tracking the number of ambulance crashes taking place in the US primarily because no-one was reporting them. And why would they??? The only crashes required to be reported were the ones that resulted in a fatality. It would not in fact be until late 1999, with the creation of an internet site called EMS Network News that we would finally see how “big of a deal” the issue of ambulance crashes truly was. In the meantime, I was beyond frustrated – feeling like I had failed before I’d even begun. Still I had made a promise that I wasn’t quite willing to let go of… so I made a decision – a leap of faith so to speak, that this was (or would be) something that really mattered once people finally knew about it.   I hoped for the best …and jumped.       …thanks for listening…

Teaching Water Safety is Important Year Round

Last updated on September 2nd, 2015 at 11:17 pm

Now that summer is over and pools are being Jabari makes a splashclosed up for the fall and winter, water safety may no longer be at the top of many parents’ minds, but it should be. Drownings don’t only take place in the summer time in pools. Children can easily drown in a pool which has been covered for the season, in bathtubs, toilets, mop buckets, and nearly anywhere there is water. Water safety is a year-round concern. Did you know that drowning is the second leading cause of death in children ages 1-10 years of age? Did you also know that the vast majority of drowning cases might have been prevented if water safety measures had been in place and followed? So how can parents teach water safety to their kids and learn themselves how best to protect kids from water dangers? A couple of moms and entrepreneurs believe they have the answer.

Mentor, LLC, is working hard to keep kids safe in the water. Founders, Kerry Grier and Rebecca Wear Robinson are seeking to promote water safety by “working with grass roots and national organizations, we seek to bring about social change through education and information presented in a fun, memorable and relatable manner. We believe by teaching water safety to children at a young age, the basic principles will become ingrained – and through time, the number of water-related accidents and deaths will decrease. We’re donating 10% of our sales to local and global organizations in an effort to help build programs that teach water safety and swimming to at-risk kids. It’s the first step of many as we expand globally to help keep our children safe in the water.”

One way Grier and Robinson are promoting water safety is through a new book, Jabari Makes a Splash. They say, “Through the adventures of a lovable lion cub named Jabari and his menagerie of friends, children will learn how to have fun in the water – safely.” Jabari Makes a Splash is aimed at children ages two to four. Jabari will also be featured in future water safety books and DVDs designed to entertain and educate kids up to age 10 and their parents about how to stay safe in and around water all year long.

You can find out more about the book and other resources offered by Mentor, LLC, by visiting their website at https://www.jabariofthewater.com.. You can also hear more about the program and the book by listening to Rebecca Wear Robinson’s interview on the October 18, 2010 episode of the Ask MomRN Show

Kathy Ireland Urges Funding for Down Syndrome Research

Last updated on March 3rd, 2018 at 12:55 pm

Model, actress, designer and mother Kathy IrelandKathy Ireland is now the aunt of a three-month old girl with Down Syndrome.  Kathy reminds us that one out of every 800 babies has Down Syndrome in her touching opinion piece for AOL Health.  Kathy has been advocating for Down Syndrome research, which faces budget cuts due to the economic crisis and growing healthcare costs.  Kathy urges each of us to write to your area’s legislators to urge them to support funding for research on prevention and treatment for Down Syndrome.

In the beginning, the PMD story: “Dying to Save the Lives of Kids”

Last updated on March 12th, 2018 at 10:17 am

I think it’s time…

PMD or Pediatric Medical Devices has been 15 years in the making. …or rather 15 years of my life. I kept thinking well when everything is done…when the PedREST finally comes out to the market…when we actually save a child’s life…then I’ll tell my story. But that hasn’t happened…at least not yet… and there’s no guarantee of when it will… so I think it’s time to tell this story to the best of my ability and hope someone gets to hear it…

The PedREST storyI probably should tell anyone who decides to stop by and read this that this is not “light reading” for a slow weekend. As I said at the start, it’s been 15 years. What I didn’t say was that during those 15 years, I’ve had someone close to me try and take controlling interest of the company,  licensing negotiations fall through at the eleventh hour and trusted industry professionals  “borrow” our ideas.

Truth be told it hasn’t been all bad.  Because of this journey I’ve met some wonderful, truly selfless people without whom I would have lost faith a long time ago.  And I founded this community – something I am very proud of…

But I’m getting ahead of myself.  To really tell this right I need to go back to when it all began – September of 1995 when an EMT – my little sister – invented something she believed would save the lives of kids.  I’m not going to retell her story since it’s already been told here.  What I will say is that it started with a simple concept drawing on construction paper.  Then in July of 1996 she came and asked me for my help…could I make her dream a reality?  Of course I could…or so I thought.

People will always tell you things like …never give up…  believe in your dreams and they’ll become a reality, …even “build it and they will come”.  You know the sayings…and I listened to all of them.  Bringing a new product to market is never easy…it’s also not inexpensive (as I soon discovered).  It doesn’t care that the US has gone to war, or that we’re in a recession, or even that the job that pays the bills has come to a standstill.  You just have to keep going and make tradeoffs…what will you give up this month so you can pay the attorneys, the engineers, the prototype guy?  But you can only give so much before it crushes you and at one point it almost crushed me.

I am stronger now and rebuilding my life.  And I think that’s why it feels like the right time to share this.   … maybe someone can benefit from my mistakes …maybe someone who’s going through something like I did can take courage in knowing it is possible to come out the other side.  For whatever it’s worth…my story begins here…   until next week…thanks for listening…

A Parent’s Guide to Coughs

Last updated on March 3rd, 2018 at 12:56 pm

No mom enjoys hearing a child cough, even though pediatricians often remind parents that coughing is actually a good thing — it’s the body’s way of keeping the lungs clear and preventing pneumonia. But that doesn’t make the problem any easier for you or your child, especially when your little one can’t get a good night’s sleep because of a nagging cough.

all coughs are not the sameFiguring out the cause of your child’s cough can be tricky, says Dr. Roy Benaroch, assistant clinical professor of pediatrics at Emory University in Atlanta. “The description of the cough is really just a starting point, because different people hear slightly different things,” says Benaroch. “You really need to look at the cough in context of the other symptoms.”

The first question you need to ask yourself is, “How sick is my child?” says Benaroch. For instance, sucking in the ribs with every breath, breathing fast or having trouble speaking in complete sentences are all signs of breathing difficulties that require prompt medical attention either in the physician’s office or in the emergency room, he says.

Below is a guide to deciphering and treating the most common types of cough symptoms in young children.

Cough symptom: Wet and productive or dry and hacking

  • What it probably means: It’s likely a cold or other upper respiratory infection, which are the most common causes of coughs in children, according to Benaroch. He adds that while the child’s cough may sound productive, it usually isn’t because young children generally don’t cough up phlegm.
  • How to treat it: Plenty of fluids and a vaporizer, which adds moisture to dry air, effectively ease coughs due to colds. Parents can also administer appropriate over-the-counter cough and cold medicine based on the age of their child. If the cough is accompanied by a high fever (more than 103 F), take your child to a pediatrician to rule out pneumonia. “If the fever comes on in the middle of the night, you don’t need to rush to the ER right then,” says Benaroch. “In this case, it’s usually okay to wait until the next morning.”

Cough symptom: Cough with wheezing

  • What it probably means: This is the classic chronic cough that often accompanies asthma symptoms. Oftentimes, the cough is triggered by cold air or exercise.
  • How to treat it: If you notice that your child is wheezing, call your doctor right away, as it might be a sign of a first asthma attack. If the wheezing is severe and your child has difficulty breathing (struggles for each breath, makes grunting noises with each breath, or cannot speak or cry due to difficulty breathing), call 911 immediately. Depending on the severity and frequency of asthma symptoms, your child may need to take asthma drugs to control the disease, treat the symptoms or both.

Cough symptom: Dry and tickling

  • What it probably means: A cough that’s due to environmental allergies, such as mold or ragweed, often originates in the upper airways, says Benaroch. “By the time kids are about 6 or so, I’ll often ask them to show me where the cough is coming from, and with allergy-related coughs, they’ll usually point to the upper chest,” he says. Other symptoms that accompany the cough include an itchy nose and frequent sneezing.
  • How to treat it: The best solution for managing allergies is to try to minimize exposure to known allergens. However, over-the-counter allergy medicines, such as those containing the antihistamine loratadine, can also be helpful.

Cough symptom: Barklike

  • What it probably means: If your child wakes up in the middle of the night and her cough sounds like a seal or small dog barking, the likely culprit is croup. This common childhood infection causes swelling of the larynx and trachea, which is why children also often have a hoarse voice and make a high-pitched, squeaky sound as they inhale. The cough usually lasts three or four days; it often improves during the day and then gets worse again at night.
  • How to treat it: “I tell parents it’s important to remain calm so that the child remains calm, because as children become more anxious, they tighten their throats and that just makes the cough worse,” says Benaroch. The best remedy for croup is to take your child outside if it’s cold or into a steamy bathroom if the weather’s warm. The cold or steamy air will help reduce swelling and ease the cough. Severe cases may require oral steroid medications. Children under the age of 2 are at a higher risk of developing breathing problems with croup, so be on the lookout for the signs of breathing difficulty listed above.

Cough symptom: Severe, violent and rapid coughing spasms

  • What it probably means: It could be whooping cough, a persistent bacterial infection of the lungs that has been increasingly prevalent across the U.S. “In school-age children, the infection can cause very severe bouts of coughing,” says Benaroch. “A child may not be coughing constantly throughout the day, but periodically he’ll have violent spells where he coughs so rapidly that he really doesn’t get a chance to catch his breath.” The name comes from the “whoop” sound that kids make at the end of the cough as they take a big breath to try to get air into the lungs. Although babies generally don’t cough, they’re at the greatest risk of dying if infected with the bacteria. Until the pertussis vaccine became available in the 1950s, whooping cough was a common cause of mortality in newborns, says Benaroch, “and unfortunately it seems to be making a bit of a comeback.” A big cause for the resurgence in cases, he says, is that the pertussis vaccine given to babies doesn’t offer lifelong immunity, and many preteens aren’t getting the recommended pertussis booster recommended at age 11 or 12. A booster is also suggested for adults.
  • How to treat it: Antibiotics are essential to stop the spread of the bacteria. However, antibiotics generally don’t ease symptoms or shorten the duration of the illness. If you or a family member has a persistent or severe cough, it’s a good idea to avoid close contact with infants until a doctor has ruled out whooping cough.



Checklist for Choosing a Safe Day Care

Last updated on March 3rd, 2018 at 12:58 pm

Finding the right day-care center requires a balance of many practical issues: location, cost, hours of operation. And you of course also want a nurturing staff. “But bottom line, your child’s health and safety is what matters the most,” says Patricia Skinner, executive director of the Capital District Child Care Council, a resource and referral agency serving six counties in the Albany, N.Y., region. “After all, it doesn’t matter how stellar the caregiver’s interactions are if there’s broken glass on the playground,” she says.

Narrow down your choices and find a safe day care for your child by considering these four questions:

  1. Is the center licensed (or registered)?choosing a daycare
    Most states require day-care centers to comply with minimum health and safety standards, so your first step is to find out if the facility you’re considering is state-approved. In New York State, for instance, freestanding child-care centers must be licensed, while those that operate out of a home must be registered. If you opt for an in-home caregiver who looks after one or two kids, many states exempt these individuals from registration or licensing. However, some states do require in-home caregivers to complete a criminal-history check or child abuse/neglect screening; others require basic health and safety training. For more information, visit www.childcareaware.org.
  2. Is the environment safe, both indoors and out?
    Always take a tour of the facility when children are there to look for potential hazards, like heavy objects that kids could pull down on top of themselves. “It’s great to get references, but there’s really no substitute for your own observations,” says Skinner. “You learn so much more when you spend time in a center and observe.” Pay particular attention to the playground and other outside areas, which is where most day-care injuries occur. Make sure that kids are never left unattended — even if they’re sleeping. Also ask about the staff-to-child ratio. The younger your child is, the lower the ratio should be. For instance, one family-home caregiver should take care of only two infants. But 4-year-olds do well with a ratio of 1-to-10 (one adult for 10 children).
  3. Does the staff follow proper infection-control procedures?
    Do staffers wash their hands after each diaper change? Is the food-preparation area clean and orderly? How often are the communal toys disinfected? (Toys should be disinfected on a daily basis or more often if they’re visibly soiled.) You should also ask if children wash their hands before eating and after using the bathroom, since kids are exposed to most germs by touching surfaces and then putting their fingers in their mouths. Ask caregivers all these questions, but also observe to see if the staff is really doing what they say they do.
  4. What are the policies regarding sick children?
    Child-care providers should have specific criteria outlining when to send a sick child home, and it’s good to know the particulars so you can decide what requirements are important to you. Many centers follow national health and safety guidelines developed by the American Academy of Pediatrics and the American Public Health Association (APHA), but some are more stringent.An example: AAP/APHA guidelines state that a child with a fever (defined as an oral temperature above 101 F, a rectal temperature above 102 F or an armpit temperature above 100 F) who is otherwise acting normally shouldn’t be excluded from child care. However, many centers use fever alone as a reason to send a child home. “The providers can set their own exclusion criteria, and some of them are more restrictive than the guidelines,” says Jean Wiseman, a registered nurse and child-care health consultant at the Capital District Child Care Council. “That’s partly because they’ve seen what can happen when an illness that’s not treated properly runs through every child in the program and all the staff too.” So if you worry that a day-care center’s stringent rules may one day exclude your child from care when you need it most, it’s likely in everyone’s best interest that sick kids don’t mix with healthy ones.

What to Do if Your Child Is Sick

It’s the scenario every working mother dreads: Your 3-year-old wakes up coughing, sneezing and clearly out of sorts; your husband is out of town on business; you’re due at the office in three hours for an important meeting. When your little one is too sick to go to his regular day care — but not sick enough to for you to justify rescheduling your meeting and using up yet another dwindling vacation day, you may have more options than you realize. Some hospital child-care facilities operate day-care programs for mildly ill children that are open to everyone in the community. In addition, some freestanding child-care centers offer separate infirmaries for sick kids. For more information about child-care options for sick children, visit the National Association for Sick Child Daycare