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Caring for Baby Teeth Means Healthier “Grown-Up” Teeth

Baby teeth are referred to as many things such as; deciduous, milk teeth, temporary or primary teeth. These teeth are the first set of teeth that a child develops. They develop in the womb and become noticeable in the mouth during the infant years. Permanent teeth are those which replace the baby teeth when they fall out.

healthy baby teethDeciduous dentition consists of central incisors, lateral incisors, canines, first and secondary molars. The lower, two front teeth are the first teeth to go, followed by the upper two front teeth, moving on to the teeth on either side of the front teeth. The primary teeth may continue to fall out until the age of 12-13. The ages are general guide lines. Different children, even in the same families, vary in age ranges

Many times we are asked how to tell the difference between a baby tooth and an adult tooth. Primary teeth start to exfoliate between the ages of 4-6 years. Primary teeth tend to be whiter and smaller then the permanent teeth. The permanent teeth are 1.5 times the size of the baby teeth.

Care of baby teeth is just as significant as caring for permanent teeth. While the truth of the matter is that baby teeth only spend a short period of time in a child’s mouth, they play a fundamental role for the permanent teeth that come later:

  • They not only save space for their permanent tooth replacement but they also give the face a normal look.
  • They assist in clear pronunciation of words, help manage good nutrition for the body and help protect the permanent teeth.
  • When a primary tooth is decaying or infected, it can also damage the permanent teeth underneath the gum line.

Care for baby teeth starts before they breakthrough the gums. Start getting in the habit of wiping your baby’s guns with a soft, wet washcloth or gauze during bath time. Toothpaste is not necessary at this stage. You can wrap the cloth around your finger and gently wipe over the gums. This also helps your baby get used to having his or her teeth cleaned as part of their regular routine.

After your child’s teeth start to show around 6 months of age or so, purchase a baby toothbrush with small bristles. Don’t get worried if your child hasn’t cut any teeth by the end of their first year, for some kids this doesn’t happen until 18 months of age. If you are cleaning your baby’s teeth regularly at this stage, toothpaste is still not necessary just yet. Brush gently on both sides of the teeth twice a day. You can brush your baby’s tongue gently to remove bacteria.

It’s always important to replace any toothbrush when it looks worn or the bristles start to spread out. Remember to start forming good brushing habits with your kids at a young age. Call your dentist with questions or concerns you may have with your child’s teeth. There is never a silly question for your dentist; we understand the importance of your child’s health.

The Last Time I Checked My Child’s Allergy Supplies Was…. ???

As summer approaches and families begin making plans for long-postponed vacations, for our family, it means beginning a summer check up for our allergy needs. Especially since vacation time can also make us forget about other details, summer is a yearly reminder to clean out, update and refill.

Inhaler clean-out - smallCleaning Out A few months ago, something prompted me to check my son’s asthma inhaler. Upon examination, I was horrified. At some point, the inhaler must have discharged while it was enclosed in the holder and had “grown new friends”- yuck! Worse yet, I realized that my son had used the inhaler recently (which means all of what was hanging out in his inhaler was also having a party inside of his lungs too). In times of being a normal mom who worries about her son’s asthma, I was fast forwarded into dry-heave mode quickly followed by recycling the old case and getting a brand new one altogether. I sent the stretchy outer case through the washing machine and let it completely air dry.

The food allergy mom in me sent an email to the wonderful people at the Allergy & Asthma Network. With a tinge of embarrassment for feeling like I was the world’s worst allergy mom, I sent a picture and asked if they had any words of wisdom for me as well as to others on how to prevent a dirty inhaler from entering our lives again. They quickly responded with some helpful information from their Understanding Asthma Guide:“Clean your inhaler following the manufacturer’s instructions, usually once per week. Clean the actuator — not the metal canister — with warm water and leave time for it to air dry before another dose is needed. Holding chambers also need to be washed, especially when the unit becomes cloudy or filmy inside. Replace disposable parts as recommended to avoid bacterial growth. Talk with your doctor if there’s any uncertainty about cleaning your inhaler or holding chamber.”

UpdatingDuring my frantic summer allergy cleaning binge, I also noticed my son’s emergency contact paperwork was faded and torn. This is something that I consider to be an extension of safety for him in the event that he is unable to speak for himself. It contains a copy of my son’s Allergy Action Plan. I also updated his picture because, gosh, don’t all children seem to change overnight?! This is also helpful when your child is with people they normally aren’t around (such as a substitute teacher) so that they have immediate confirmation that the person with the food allergy pack matches up with the listed allergens and contact information. Never assume, always overdue. Nobody ever died from too much information, only not enough.

I also checked expiration dates on his medications both inside his allergy pack and the extras that we keep on hand in the house and made sure our stock was full. It only took one bad asthma night with just a few counted doses available in his inhaler for me to realize that expiration dates on these life-saving medications are something that cannot be forgotten. Again, as a mom of an asthmatic child, the last thing that you want to tell your child who is gasping for breath is to not use their inhaler unless they have to because it might run out. I’m not proud of that moment but it happens to the best of us and teaches us new organization and safety techniques to avoid future repeats.

Early script refills - smallRefilling Because of the discount cards available the past few years, this is one area that is super easy and non-stressful. Both EpiPen and Auvi-Q have continued to provide copay assistance, which means one less expense. Nothing can beat refilling a prescription for twin packs of epinephrine and seeing a giant $0 on the receipt. Don’t get me wrong- my son’s safety is priceless and I would gladly pay to keep him that much safer at all times but not having to spend that money each year is a food allergy parents dream.

I do recommend discussing how to write out the prescription correctly with your child’s pediatrician or allergy specialist. This will ensure full benefit of the copay discounts, additional epinephrine to have on hand and for the next school year and ultimately, it will save you time going back and forth to the pharmacy for repeat refills. Also discuss correct dosages of medications for your child’s height, weight and age to prevent wasting a refilled prescription (ex: filling an Epipen Jr prescription and finding out after the fact that your child is now considered to be within the EpiPen adult dosage range…then what to do with the wasted medications?)

Allergies can be tricky but each year brings new techniques and better ways to come up with a strategy on what works best for your child and family. Just remember to be accepting of what might not work in the beginning, or even the year after and always give yourself more than enough time to be ready for school. The better prepared and calm that you seem, the less stressed your allergic child will begin another school year.

How Concerned Should Parents Be About Whisper?

Whisper is an anonymous app, launched almost 10 years ago, where people post things that they might not want to admit to in public. While maybe not as well known by parents as some others, it has over 900 million accounts, according to the Washington Post and many of them are teens.

According to the Whisper’s own terms and conditions, users must be at least 13, but anyone under the age of 18 may only use the app under the supervision of a parent or legal guardian who agrees to their terms of use. They indicate that anyone who does not agree with these terms should simply not access or use the service. How often do you expect that happens?

While the company calls what people post on the app, “User Content”, most people simply call them either “Whispers” or “Secrets.” I’ve used Whisper and found it to be one of the most interesting apps out there. Of course, I fully expect that most of the “user content” is fake.

Assuming that people actually use it for its intended purpose, to secretly tell things about themselves and that they probably wouldn’t tell people they know, it’s probably harmless. But that’s clearly not all that happens on the app. Below is a graph for a grading system that I devised to help parents understand the risks involved for their children using popular apps. In my most recent article on Instagram, I explain in detail what the values on the graph mean and how using an app might endanger a child, but here it is below in a nutshell:

What the Numbers Mean:

The numbers / ratings represent the likelihood that you will see the risky behavior occur within this app.

  • Rating < 5 is minimal risk and is highly unlikely to occur on the platform, but that doesn’t mean that it can’t happen.
  • A rating of 5-6 is average risk – it should concern parents, but not overly so.
  • A rating of 7 or 8 is problematic and should concern parents quite a bit.
  • A 9 or 10 rating is very troubling as that behavior is almost a certainty within this app, and involves issues that are likely of extreme concern to parents, such as sextortion and child pornography.

Catfishing (10 out of 10)

As an “anonymous” app, there is no attempt made to identify the users. The profiles, what little of it there is on the app, don’t even include the possibility of a picture be added. That makes it perfect for people who don’t wish to be identified. When posting a secret on the app, users have the ability to upload a picture for that individual post, which may be of themselves or it may be one that they took from some other source. Additionally, Whisper has a large library of images available by users and the app will suggest images based on words typed by the user that get superimposed in front of the image.

Cyberbullying (8 out of 10)

The potential for cyberbullying exists anywhere. I’ve seen it on posts/apps where I would least expect it. With Whisper, it can often come from pictures that the person posted which were meant to be silly or sexy. Body shaming is pretty common in cases like this on Whisper, assuming that the image in the post is really of the person who posted it.

As another example, in a recent posting, a woman announced that her boyfriend had revealed online that they were engaged before she wanted it publicly known. Within just a few hours, there were well over 300 replies, many saying that she should be happy that he was excited to be engaged. In fact, the overwhelming majority of the replies were critical of the original post and a few were not polite about it, to say the least.

Language (8 out of 10)

There is virtually no filter on what people say on social media platforms and Whisper is no exception. On social media apps that are popular with kids, they may choose to intentionally spell words incorrectly, but close enough that the reader understands the message. For example, they may use “$” instead of “S” or “!” instead of “I.” Most likely, they are trying to avoid filters that search for specific keywords but considering how often I’ve seen posts on Whisper that have foul/inappropriate words on them, it seems likely that they have little to be concerned about in this area.

Nudity (8 out of 10)

This is a little bit of a gray area. Overall, I have seen very little, if any actual nudity on Whisper, but many images certainly push the boundaries. I have observed images showing both boys and girls in images that their parents would probably object to them using/seeing. As Whisper does allow people to send private messages between users, there may be cases where nudity is involved there, but I can’t say that for sure.

Privacy (6 out of 10)

As an anonymous app, this app has the advantage of not giving others easy access to users’ personal information. Facebook, for example, provides lots of opportunities for people to publicly share where they work, who they’re married to and more. So long as users practice common sense, there’s not too much risk of privacy being lost here. The risk with Whisper is how much personal information people are willing to share within their posts and through private messages. Let’s just hope that common sense prevails.

Sexting (8 out of 10)

This is a huge issue on the app. From what I can see, the majority of posts seem to have at least some sexual connotation to them. The rating would be higher than this based simply on the sheer volume of sexual content (explicit and implicit) on the app, however it is tempered somewhat by the anonymous nature of the app. It clearly has the potential for a higher rating, especially for an app that hosts groups with names such as Sexual Confessions, Horny People, etc.

Sextortion (6 out of 10)

Any app/site that has the potential for sexting also has the potential for sextortion – the act of forcing others to perform acts of a sexual nature online. This typically requires sending images or videos, which the recipient can then use against them to force them to send even more images or do just about anything else they want to avoid the images being made public.

It gets worse if the target provides their profile names for other sites/apps, which is common on Whisper. Unfortunately, it is very common to see people post their Snapchat or Instagram name on the account, (assuming that they’re providing their own information and not intentionally setting someone else up for online harassment).

Stalking (8 out of 10)

I recommend minors not use Whisper and that anyone who does use it disable the ability for the app to know their location. I say that because the app has a feature that will automatically include the location of where the picture was posted from. Other users then have the ability to search for posts made close to their current location.

A little over three years ago, a story made the news about a young girl who met a man on Whisper. She was only 14 but claimed to be 15-17 (Whisper uses age brackets). At some point, the man suggested that they switch over to a different app. At that point, he requested that she send him naked pictures of herself and she acquiesced. Eventually, they met in person, where he provided her with marijuana and eventually, sexually assaulted the young girl, according to authorities.

This was all possible because the predator was able to search geographically on the app to find potential targets. Online predators are very skilled at finding and recruiting, as I’ve written here on Pediatric Safety.

Another feature on Whisper is to find posts that were made recently. This lets predators hopefully find people before they have signed off and can engage them in a conversation. In theory, a good idea, but it is too easy for predators to exploit.

Viruses (3 out of 10)

Sending viruses via Whisper is all but impossible, from what I’ve seen. When entered as part of a secret, the words are there, but it has been converted to an image, not an active link. However, anyone who wished to send a virus could easily do so by placing it into a direct message to someone.

If they, in turn, copy/paste it into a browser, the virus could take effect. The tease of seeing naked pictures might entice someone to do that and with URL shorteners, it wouldn’t even look like a potential risky site.

Bottom Line

Whisper is riskier than it might appear were we to average the nine potential areas of concern. That is, an average would treat each of the concerns equally, but as parents, we may be more concerned with the areas of cyberbullying and sextortion than the risk of a virus. When it comes to using Whisper as safely as possible, there are some basic principles that all users, but especially kids, should follow:

  1. It may be cynical, however, assume that nobody is who they claim to be on Whisper.Trust, but verify doesn’t apply here because everyone is hiding behind a veil of anonymity.
  2. Assume that whatever you post on the app will be seen by everyone, not just the people who have access to seeing your posts. When taking the geographic search feature into account, it is very possible that people within your own community can see what you post on Whisper.
  3. Never, under any circumstances, post a picture of yourself, or anyone else for that matter, that you might regret later. It’s better to think of it not being a question of IF someone you know will see what you post, but WHEN will they see it. That includes parents, teachers, siblings, co-workers, etc.

Like most apps, Whisper can be fun to use, but it comes with risk and those risks need to be considered. As I mentioned earlier, I have already done a similar article here on Instagram and will be doing more apps in the future, so I recommend that you check back here for more articles on popular apps. You can also check out my other articles here on Pediatric Safety by visiting my profile and complete list of articles.

Another Ear Infection…What Can I Do – Part II??

Since we now understand how ear infections occur (see Ear Infections – Part I), it’s time to deal with the child who seems to get repeated ear infections. Ear infections, particularly the middle ear type, are responsible for providers ordering more prescription antibiotics than any other childhood disease.

There are a certain number of children who just seem to get an outer ear infection (otitis externa) every time they get their ears under water, usually during the warmer months of the year. There are even some who get this when they do not get their ears under water, but usually these episodes are also in the warmer months. I spoke about the treatment of the sudden or acute ear infection, but what to do about the repeated episodes. The best answer to this is using either a prescription medication or better yet, one not costing you anything at all. Mix ½ to ½ mixture of white vinegar and rubbing alcohol and place a couple drops of this into your child’s ear as soon as they get out of the pool or lake or ocean and try to limit the time those ears remain submerged. This has a way of drying out the external ear canal and helping to change the acid content of the eardrum. Ear plugs may be effective under certain circumstances but in general if you force a plug into the ear it may just irritate the skin which is exactly what we wish to avoid.

Middle ear infections (otitis media) are a different matter entirely. Remember that these are primarily due to a blockage in the normal valve system of your middle ear, with resultant pressure, fluid and infectious results. (Please refer back to part I if this is confusing). These changes happen in a progression that can occur suddenly or can develop over time.

While the obvious answer would be to use a “cold medicine” early on in the process this does not seem to influence the course of events as outlined, when looked at in controlled studies. The other end of the spectrum for treating the occurrence of multiple recurrent middle ear infections is to alter the normal anatomy in such a way as to prevent buildup of pressure in that small space which can then lead to fluid accumulation and bacterial secondary infection. This is accomplished through the use of very small tubes that can be surgically inserted through the eardrum and will serve to equalize the pressure on both sides of the eardrum. The system will calm down and the incidence of new infections will drop tremendously.

But that is a surgical procedure under some type of anesthesia, and even with tubes in the proper place, there can still be fluid production which then drains out of the ear chronically. Also, the mere act of making a hole in the eardrum through which a tube can be put in place, can slightly damage and scar that eardrum. Depending on the type of tube implanted in the eardrum, it usually comes out by itself after six to twelve months and the eardrum heals. Occasionally, the ear drum fails to heal completely and there is a perforation that might need to be surgically repaired in the future.

We treat middle ear infections for one of several reasons: to control the pain, to prevent any further extension of the infection into sensitive areas, and to preserve speech and hearing in your child.

Fortunately there are other approaches to the treatment of recurrent middle ear infections. Each significant ear infection should recognized and treated appropriately and the fluid buildup behind the eardrum monitored for resolution.

  • Fluid constantly in touch with the ear drum will dampen the usual vibrations and dull the hearing while it is there. Hearing testing can be run routinely to follow any changes in hearing.
  • All types of medications have been tried at one time or another: preventative doses of antibiotics have and still are being used for several weeks to months in an effort to prevent the bacterial infections, but the increasing number of bacteria becoming resistant to common antibiotics have caused physicians to re –think the use of long term medication.
  • Cortisone preparations by mouth have been tried to help with the middle ear inflammation, with varying results.
  • Occasionally, when all forms of treatment fail it is up to the ENT surgeon to place those tubes and let the middle ear system calm down.

So, there are many things to consider in finding a course of action for your child with recurrent ear infections and your Doctor will be familiar with each of the methods and can discuss them with you.

“My Body Belongs to Me” Children’s Book: Prevent The Unthinkable

Last updated on May 4th, 2020 at 11:49 am

As a former prosecutor of child abuse and sex crimes in New York City for 22 years, I often encountered My Body Belongs to Me-small2children who were sexually abused for lengthy periods of time and suffered in silence. One case in particular had a profound impact on me and compelled me to write a children’s book called My Body Belongs to Me.

I prosecuted the case of a 9-year-old girl who had been raped by her stepfather since she was 6. She told no one. One day, the girl saw an episode of “The Oprah Winfrey Show” about children who were physically abused. The episode, “Tortured Children,” empowered the girl with this simple message: If you are being abused, tell your parents. If you can’t tell your parents, go to school and tell your teacher. The girl got the message and the very next day went to school and told her teacher. I prosecuted the case for the District Attorney’s office. The defendant was convicted and is now serving a lengthy prison sentence.

I have thought often of that very sweet, very brave 9-year-old girl. It occurred to me that after three painful years, all it took to end her nightmare was a TV program encouraging her to “tell a teacher.” I wrote My Body Belongs to Me to continue that message. It endeavors to teach children that they don’t have to endure abuse in silence. Parents and educators can use it as a tool to facilitate an open dialogue with youngsters.

The story is a simple scenario involving a gender neutral child who is inappropriately touched by an uncle’s friend. The powerful message really comes through when the youngster tells on the offender and the parents praise the child’s bravery. The last page shows a proud, smiling child doing a “strong arm” pose. The text assures them that it wasn’t their fault and by speaking out the child will continue to grow big and strong. It is a compelling and uplifting message.

The “Suggestions for the Storyteller” section is an important, interactive feature that facilitates the discussion to follow. It will make any caregiver feel more comfortable talking about this important subject, thereby helping to PREVENT the unthinkable from happening to their child. Research tells us that child sexual abuse does not discriminate. It is a problem that affects everyone.

  • In the United States, approx. 1 of 4 girls and 1 of 6 boys is sexually abused before the age of 18.
  • 47% of child sexual abuse victims wait 5 years or more to speak up, if they ever do.
  • 93% of child sexual abuse victims are abused by someone they already know.

It is my sincere hope that by educating girls and boys about this taboo subject, My Body Belongs to Me will prevent them from becoming victims in the first place.

Editor’s Note: This powerful book is now available in bilingual English – Spanish; just in time for April’s Child Abuse Prevention Month. My Body Belongs to Me/Mi cuerpo me pertenece

HEALTHFUL HINTS:

  • To keep your children safe:
    1. No secrets. Period. Encourage your children to tell you about things that happen to them that make them feel scared, sad or uncomfortable. If children have an open line of communication, they will be more inclined to alert you to something suspicious before it becomes a problem. The way I effectuate this rule is as follows: If someone, even a grandparent, were to say something to my child such as “I’ll get you an ice cream later, but it will be our secret”, I firmly, but politely say “We don’t do secrets in our family.” Then I say to my child “Right? We don’t do secrets. We can tell each other everything.”
    2. Teach your child the correct terms for their body parts. This will make them more at ease if they need to tell you about a touch that made them feel uncomfortable.
    3. Teach your child to tell a safe person if someone touches them in an inappropriate way. Discuss with children the importance of telling a parent, teacher or other trusted adult right away.
    4. Let children decide for themselves how they want to express affection. Children should not be forced to hug or kiss if they are uncomfortable. Even if they are your favorite aunt, uncle or cousin, your child should not be forced to be demonstrative in their affection. While this may displease you, by doing this, you will empower your child to say no to inappropriate touching.
  • If you choose to use My Body Belongs to Me as a tool for teaching your family about body safety, here are some suggestions:
    1. Read the book at least once for enjoyment before using it to get into a serious discussion.
    2. After reading the book, help lead an open-ended discussion by asking questions such as the following: What are your parts that are private, Why did the child get scared, What did the uncle’s friend do, What did he tell the little child, If someone touches your private parts, should it be a secret, Why did the uncle’s friend put his finger up to his lips, What did the child do when he did that, Were the mom and dad happy when the child told them what had happened, What did they do, If the child did not tell the parents, who else could be told, How does the child feel in the picture at the end?
    3. Find teachable moments with your child to reinforce the lessons learned in the book.

Finally – A Step Towards Safe Transport for Kids in Ambulances!

Last updated on August 8th, 2019 at 07:02 pm

In 2008 the National Highway Traffic Safety Administration (NHTSA) convened a working group of representatives from the American Academy of Pediatrics, Emergency Medical Services for Children, the American Ambulance Association, and other key organizations and started a project called “Solutions to Safely Transport Children in Emergency Vehicles”. Finally a long-standing problem was being recognized and addressed: “there are no Federal standards or standard protocols among EMS and child safety professionals in the U.S. for how best to transport children safely in ground ambulances from the scene of a traffic crash or a medical emergency to a hospital or other facility. The absence of consistent national standards and protocols … complicates the work of EMS professionals and may result in the improper and unsafe restraint of highly vulnerable child passengers.”(1)

In fact a 1998 study regarding the use of child restraints in ambulances revealed that 35 States did not require patients of ANY AGE to be restrained in a ground ambulance. Of those States that did require some sort of child restraint system, requirements for an “acceptable restraint” varied significantly.(2)

It is illegal in the US to travel with an unrestrained child in an automobile. However, when a child is already sick or injured, we have been willing to transport them in a vehicle where the passenger compartment is exempt from most safety requirements, they cannot be properly restrained and they have a higher probability of an accident than an automobile. We might not if we knew the following:

  • It is estimated that up to 1,000 ambulance crashes involve pediatric patients each year.(3)
  • In a collision at 35mph, an unrestrained 15kg child is exposed to the same forces as in falling from a 4th story window.(4)

Wednesday September 19, 2012, after an intense 2 year research effort, a public meeting in August 2010 to review the findings and gather input (see Pediatric Safety Post by Sandy Schnee “A Public Meeting on Safe Transport for Kids on Ambulances“), and 2 additional years refining the results, NHTSA has released the official:

BEST PRACTICE RECOMMENDATIONS FOR THE SAFE TRANSPORT OF CHILDREN IN EMERGENCY GROUND AMBULANCESThank you NHTSA!!

The working group outlined 5 potential child transport “Situations” (see chart below) and for each described their “Ideal” solution – the best practice recommendation for safe a safe transport for each situation. They also presented an “If the Ideal is not Practical or Achievable” alternative – basically an “acceptable” backup plan.

They also came up with guidelines to assist EMS providers in selecting a child restraint system – particularly important because due to the lack of regulation and testing requirements specific to ground ambulances, many of the available child restraint devices were not designed for use in ambulances, some were tested to automotive standards and others were not tested at all.

In the end, the ultimate goal of ALL the recommendations: Prevent forward motion/ejection, secure the torso, and protect the head, neck, and spine of all children transported in emergency ground ambulances.

In short – transport these children safely.

We know that since the adoption of “mandatory use laws” in the U.S. for child safety restraints in automobiles, that thousands of children’s lives have been saved. Yet for years we have continued to allow children to be transported unrestrained on ambulances. With this report, we have finally taken a step in the right direction

It is hoped that the recommendations provided in this report will address the lack of consistent standards or protocols among EMS and child passenger safety professionals in the United States regarding how to most safely transport children in ground ambulances from the scene of a traffic crash or medical emergency to a hospital or other facility. It should be noted that the expectation is that States, localities, associations, and EMS providers will implement these recommendations to improve the safe transportation of children in emergency ground ambulances when responding to calls encountered in the course of day-to-day operations of EMS providers. In addition, it is hoped that EMS providers will be better prepared to safely transport children in emergency ground ambulances when faced with disaster and mass casualty situations”.

…. Amen to that !!

 

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Editorial Update: Quite a bit has happened since the original publication of this article. Suffice it to say that while this was a terrific step in the right direction – it was not enough to cause the system-wide level of change hoped for. According to ems.gov… unanswered questions remain, primarily due to the lack of ambulance crash testing research specific to children.To address this, in 2017 the National Association of State EMS Officials (NASEMSO) established the Safe Transport of Children Ad Hoc Committee, with the goal of improving the safety of children transported by ambulance through the creation of evidence-based standards. Pediatric Safety will continue to follow their efforts in future articles as they work to improve the national standard of care and establish consistent guidelines for the safe transport of all our children on ambulances. Every ride, every time.

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References:

1. Notice published by NHTSA of Public Meeting on August 5th, 2010 to discuss draft version Recommendations for Safe Transport of Children on Ground Ambulance Vehicles: Federal Register, July 19, 2010,

2 & 3. Working Group Best-Practice Recommendations for the Safe Transportation of Children in Emergency Ground Ambulances: NHTSA / USDOT, September 2012

4. “EMS to Your Rescue?” Int’l Forum on Traffic Records & Hwy Safety Info. Systems – Levick N, July, 2008