With cold and flu season upon us, it’s more important than ever to employ good practices to control the spread of infections and avoid illness. This is especially important for child safety.

“We need to be proactive not only to keep ourselves healthy, but to avoid transmitting illness if we’re sick,” said Eileen Finerty, RN, MS, CIC (certified in infection-control), nursing director for infection control and occupational health at Hospital for Special Surgery (HSS) in Manhattan.

Hospital for Special Surgery has one of the lowest infection rates of any hospital in the country and was recently commended by the New York State Department of Health for its low infection rate in patients undergoing hip replacement. The overall infection rate refers to all infections acquired by patients in the hospital, not only viruses such as those that cause the flu.

Infection control in the health care setting is critical. Nationwide, hospital-acquired infections result in 100,000 deaths each year.

“We emphasize infection control as a best practice,” said Thomas P. Sculco, M.D., surgeon-in-chief at HSS, “and strive to maintain it at every level of patient care from washing hands to a clean and safe environment for our patients in the operating room and the entire hospital.”

HSS employs a combination of infection-control measures, according to Ms. Finerty. Some are highly sophisticated and others are basic good practices.

Strategies used by the hospital to keep germs in check can be adapted for use at home and in everyday life, according to Ms. Finerty. These practices include:
1 - Good hand hygiene using sanitizers.
Hospital: Hand sanitizers located all around the hospital have a sensor that dispenses foam without the need to touch it. The sensor detects hand motion and automatically releases foam.
What everyone can do: Sanitize hands frequently using an alcohol-based liquid hand cleaner. Use about a tablespoon, rub it into your hands and let it dry. Do not wipe it off. Ms. Finerty carries a hand sanitizer in her purse at all times.
2 - Frequent hand-washing.
Hospital: Hospital staff are instructed to wash their hands often. Signs around the hospital say: “Good Hand Hygiene Saves Lives.”
What everyone can do: Wash your hands for at least 15 seconds. You can sing “Happy Birthday” to get an idea of how long it should take. Work up a good lather and rub your hands together.
3 - Good ventilation.
Hospital: Clean air in operating rooms and the use of special panels to direct air flow to maintain the most sterile environment possible for the patient.
What everyone can do: Open the windows and let in some fresh air to ensure adequate ventilation. A stagnant, stuffy environment causes germs to re-circulate around the house.
4 - Controlling the spread of germs.
Hospital: The entire staff is trained in infection-control measures, such as coughing into a tissue and not into one’s hand. Boxes of tissues are located throughout the hospital. Staff are encouraged to stay home if they have a contagious illness.
What everyone can do: Carry tissues and dispose of them properly and immediately after coughing or sneezing. Then wash your hands or use a hand sanitizer. You can also cough into your sleeve to avoid getting germs on your hand that can later be spread.
In general, when you’re outside or at work, or if you have come in contact with a sick person, avoid touching your face. Germs on your hand get you sick when they enter your body through your eyes, nose or mouth, or through a break in the skin. Don’t go to work if you’re sick.
5 - Cleaning and disinfecting.
Hospital: HSS housekeeping staff is especially diligent about cleaning. The routine entails mopping, cleaning, and disinfecting surfaces, getting into cracks and crevices where bacteria can grow.

SOURCE Hospital for Special Surgery

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Many parents grew up with medical adages or advice that have since been proven by scientists to be incorrect or outdated. Here are five common myths about children’s eye health and the medical reality behind them, prepared by the physicians at The Vision Center at Childrens Hospital Los Angeles for a guided child development.

Myth #1. Sitting too close to the TV will damage your child’s eyes.

Fact: “Sitting in front of the TV or a computer screen for four hours may hinder your child’s intellectual development but it will not damage their eyes,” notes Dr. Mark Borchert, division head of The Vision Center at Childrens Hospital Los Angeles.

Nearly half of all kids spend four hours or more per day using computers and electronic devices, according to a recent national survey. Dr. Borchert notes that children can develop blurred vision, headaches and other problems when focusing too long on one object, such as a computer screen. Long video game sessions may have adverse consequences such as reduced social interaction or less time doing homework; however, they will not permanently damage a child’s eyes.

“If a child is sitting too close to the TV or computer screen, it is probably because he needs glasses to see well. Sitting very close to the screen will not cause them to need glasses,” said Dr. Borchert.

To make your child’s computer station more comfortable, make sure the screen is at eye level. Reduce screen glare by using a desk lamp with a dimmer so there isn’t a big contrast between the brightness of the screen and the room. Make sure your child can’t see her own reflection on the screen.

Enforce the 20/20 rule. Have your child take a 20-second break for every 20 minutes of screen time, either by getting up and stretching or by looking out the window.
The concern about TV screens damaging young eyes originated in the 1960s when some early color TV sets were discovered to be emitting high amounts of X-rays. The problem was soon corrected and modern TV monitors, including older tube-type sets and new LCD models, are safe and do not emit any dangerous rays.

Myth #2. Eating lots of carrots will improve a child’s eyesight.

Fact: Carrots do contain Vitamin A, which is a key ingredient in good overall nutrition; however, eating a lot of them will not improve your eyesight. Recent research findings have found that eating foods rich in Lutein, a plant nutrient, may help prevent age-related macular degeneration, one of the most common causes of blindness in older adults. Lutein is a carotenoid, natural pigment, found in dark green leafy vegetables such as spinach, plus various fruits and corn.

“The research is very preliminary, but it does suggest that Lutein can help protect against adults developing macular degeneration. Eating a balanced diet with plenty of green vegetables should be sufficient for most families,” said Dr. Borchert.
Carrots’ reputation as eyesight enhancers is partially due to the fact that Vitamin A sources are helpful in treating night blindness, also called nyctalopia, which can be caused by Vitamin A deficiency.

Myth #3. Only adults can wear contact lenses safely.

Fact: Children of all ages, even infants, can wear contact lenses safely if the correct procedures are followed. Under the age of 10, an adult will need to insert, remove and clean the lens. Many children over 10 can handle the contact lenses (wearing and cleaning) themselves.

According to Dr. Borchert, ophthalmologists may prescribe contact lenses for infants and very young children to enhance vision development when the eyes have very different prescriptions after cataract surgery, corneal scarring or diseases like Retinopathy of Prematurity.

Dr. Borchert said older children could manage their own contact lens care if they are mature and responsible. “If they make their own bed and shower on their own, they can probably safely handle their contact lens.”

He noted that it is not a good idea for elementary school children to wear contact lenses just for cosmetic reasons. Also, all contact lenses should be obtained through a physician, either an ophthalmologist (M.D.) or a doctor of optometry (O.D.).

Myth #4. Running with scissors is the leading cause of eye injury in children.
Fact. A recent national survey found that approximately 59% of pediatric eye injuries occur during sport and recreational events. The National Eye Institute also states that baseball is the sport responsible for the greatest number of eye injuries in children aged 14 and younger. However, basketball is the leading cause of eye injuries in those aged 15 to 24.

According to Prevent Blindness America, 72 percent of all sports-related eye injuries are to those aged 25 and younger. Yet, only 15 percent of children wear eye protection. Children should be encouraged to wear the appropriate safety eyewear, such as goggles or face masks, for every sport in which they participate.

“We need a cultural change in this country. Children who play contact sports such as basketball and baseball should be wearing eye protection — most do not. Twenty years ago, very few children wore bicycle helmets; now a parent would be considered irresponsible if she sent her child out riding without a helmet. We need the same sense of concern when children play sports,” said Dr. Borchert.

Myth #5. It is impossible to get young children to wear sunglasses.
Fact. “It is very important that young children wear sunglasses and the newer products with strap-on frames are easy for them to wear,” said Dr. Borchert.
The lens of a child allows 70% more UV rays to reach the delicate retina than in an adult. Most parents are aware of the critical need to protect their children’s skin from UV exposure with sun block, yet few insist their children wear sunglasses.
“If it is bright enough outdoors for you to be wearing sunglasses, your child should also be wearing them,” said Dr. Borchert.

New, colorful sunglasses with Velcro straps, designed for infants and toddlers are available in stores and via the Internet. They are comfortable and provide excellent protection from UV rays and foreign objects. Most young children adapt to them easily.

SOURCE Childrens Hospital Los Angeles

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The Children’s Hospital of Eastern Ontario in Ottawa, Canada have released research findings pointing to the possibility of reducing wheezing and hospitalization through a combination of epinephrine and dexamethasone. Even if these meds sound complicated, they are actually commonly used.

“Until this point, we’ve had no good treatment options for bronchiolitis, except for supplemental oxygen and extra fluids. In this study, we looked at two medications that have been used to treat bronchiolitis without great benefit when used separately. But, combining the two resulted in a reduction of hospitalizations,” says study author Dr. Amy Plint, a pediatric emergency physician at Children’s Hospital of Eastern Ontario in Ottawa, Canada.

Wheezing, known as bronchiolitis in medical circles, is a common sickness for children which is triggered by a virus. 800 infants were used for the study. Between ages six weeks to twelve months, these babies were given controlled treatments of nebulized epinephrine and six oral doses of corticosteroid dexamethasone. Wheezing stopped quicker in subjects with the combination treatment.

The editorial authors wrote that, “Given the small effect size of the study — 11 infants would have to be treated to prevent one hospital admission — it does not seem practical to apply the treatment, especially considering the potential effects of high-dose corticosteroids on brain and lung development in such young children.”

However, Plint said the treatment was well-tolerated, and there’s no evidence in this age group that there are any neurodevelopmental effects from a short course of steroids. So fears about child safety should be doused a bit.

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