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How can you ensure you’re giving your children safe doses of over-the-counter medications? The safest bet: Confirming dosages and recommendations with your doctor. With that in mind, here are a few answers to basic questions about OTC medications and children. It’s cold and flu season in Northern Nevada. This means you’ll find parents in the aisles of practically every drug store, wondering what will and will not work for their sick children. Over-the-counter (OTC) medications — and their dosages, side effects, interactions and more — can inspire abundant anxiety for parents. At the outset, the U.S. Food and Drug Administration offers the following warning about use of medicines for cough and colds in children:   The FDA doesn’t recommend over-the-counter medicines for cough and cold symptoms in children younger than 2 years old. Prescription cough medicines containing codeine or hydrocodone are not indicated for use in children younger than 18 years old. Codeine and hydrocodone are opioids that are available in combination with other medicines, such as antihistamines and decongestants, in prescription medicines to treat cough and symptoms associated with allergies or the common cold for adults. Caregivers should also read labels on OTC cough and cold products, because some might contain codeine. So how can you feel comfortable administering any OTC medication to your children? The short answer is: Check with a doctor first. And with that in mind, here are a few common questions and answers from Kristin L. Wilson, MD, of Renown Pediatrics about children and OTC medications. Please talk about the importance of correct dosage of pediatric medications. Pediatric dosing is weight-based and unique to each medicine (and sometimes even the circumstance you are treating.) Therefore, there are no standardizations of “safe” amounts that apply to all medications. What are signs of an overdose of pediatric medications? Signs of intoxication/overdose are also unique to each medication and supplement. And to make it more confusing, mixing current prescriptions with various supplements or over-the-counter medications can cause significant adverse effects as well. Is there an age at which children take adult over-the-counter medications? Infants through adolescents can take medications that are also prescribed to adults, but only under a healthcare provider’s careful guidance. Dosing is determined by various factors dependent on child’s age and also medical history, as above. What is the takeaway about administering medications to children? When in doubt, ask a healthcare professional whether a medication or supplement is safe for your child based on his/her age and medical history as well as recommended dosing based on recent weights and other vital signs.

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Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."

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In the state of Nevada, all-terrain vehicles (ATVs) are one of the pediatric population's top three mechanisms of injury. Kids under 16 are the leading victims of ATV incidents and fatalities because they cannot reach controls, cannot activate controls and they have a restricted field of vision. Tips to Safely Utilize ATVs ATVs are off-road vehicles used for activities such as off-roading and farm work. In the state of Nevada, it is legal for teens to ride them, even without a driver's license. However, even though it is legal for teens to ride these vehicles, it is not always safe. Here are a couple of tips and tricks to stay safe while using ATVs: Be at least 16 years old. Health and safety experts strongly discourage ATV use by anyone younger than 16. Operating an ATV demands that drivers be skilled at making quick adjustments, such as speeding up, slowing down and shifting their weight to help turn the vehicle. People under 16 are less likely to have the physical strength and decision-making experience necessary to drive an ATV safely. Get safety certified. Before you ride an ATV on a trail, learn how to do it safely in a controlled setting. Visit the ATV Safety Institute's website for course information. Ride an ATV that's right for your size and age. Full-size ATVs can weigh more than 600 pounds and be very difficult to handle. Select an ATV designed for you or your child's age group. This sizing can be found on the manufacturer's warning label right on the vehicle. Always wear an approved helmet and eye protection. The best helmets for ATV use have a full-face shield and meet Department of Transportation safety standards. Many helmets have flip-down visors for eye protection. If yours doesn't, be sure to wear shatterproof goggles and not just sunglasses. Wear long pants, long sleeves, gloves and over-the-ankle boots. ATVs have a high center of gravity and no safety cages, roll bars or seatbelts. If they tip, you can fall off. Protective clothing will help prevent scrapes and cuts if you get thrown from an ATV. Always ride at a safe speed on a trail meant for ATV use. When ATVs get going fast, they become less stable and more likely to tip. ATV tires are not meant for pavement or high speeds. Both factors can make turning an ATV difficult and dangerous.

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Taking a few minutes to prepare for your child's pediatrician visit helps ensure that all your child's medical needs are met. Knowing the right questions to ask your provider can help you get the most out of your visit and ensure you and your child feel comfortable and informed. It is essential to base your questions on your child's specific health needs, but the ten options below are a great place to start. How is my child's overall health and development progressing? Is my child meeting their developmental milestones, and are there any areas where they may need extra support? What vaccinations does my child need, and are they up to date on all required immunizations? Are there any nutritional recommendations or concerns for my child's age and stage of development? What are some strategies for promoting healthy habits and physical activity for my child? Are there any warning signs I should look out for regarding my child's health or behavior? What can I do to help prevent common childhood illnesses like colds, flu strains or ear infections? What should I do if my child gets sick, and when should I seek medical attention? Are there any changes to my child's medication or dosage that I should be aware of? Is there anything else I should know or be aware of regarding my child's health or development?

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What is the role of the child life specialist? Here are common questions and answers about how these special individuals give both parents and kids peace of mind. Let’s face it: A hospital can be an intimidating place for just about anyone. But add in being a small human with very little worldly experience — aka a child — and it’s easy to imagine how overwhelming a hospital visit can be. Enter the role of the child life specialist. Liz Winkler, a child life specialist with Renown Children’s Hospital, explains how a Renown program puts young patients and their families at ease. What does a child life specialist do? Child life specialists help young patients develop ways to cope with the anxiety, fear and separation that often accompany the hospital experience. They give special consideration to each child’s family, culture and stage of development. As professionals trained to work with children in medical settings, specialists hold a bachelor’s or master’s degree in the areas of child life, child development and special education or recreational therapy. Our child life specialists are also professionally certified and affiliated with the national Child Life Council. Child life specialists also offer tours of Renown Children’s Hospital for families whose children are scheduled to have surgery. Child life supports children and families by: Helping children cope with anxiety, fear, separation and adjustment Making doctors, needles and tests a little less scary Providing art, music and pet therapy Organizing activities Addressing your concerns Telling you what to expect Creating a therapeutic and medical plan Offering a hand to hold What else is available at the Children’s Hospital that helps ease some of the stress of a hospital visit? Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered on supporting and nurturing patients and families at our many locations. We have kid-friendly environments to help ease some of the stress of a hospital visit. These include colorful exam rooms, kid-friendly waiting and common areas, and medical equipment designed especially for children. Our children’s ER is open 24 hours a day, seven days a week. So parents and caregivers have access to emergency care tailored to little ones — anytime, day or night. We have several pediatric specialists on the Renown team in areas including diabetes, emergency medicine, neurology, pulmonology, blood diseases and cancer. How can parents start to ease their children’s mind when they know a hospital visit is in the future? As with many things in life, good preparation can help kids feel less anxious about the experience and even get through recovery faster. It’s important to provide information at your child’s level of understanding, while correcting any misunderstandings, and helping to eliminate fears and feelings of guilt. If you’re anxious and nervous, your child may reflect these feelings and behaviors. So make sure you educate yourself, feel comfortable with the process, and get your questions answered.

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When you have an ill child in the hospital, it is a stressful event. And Panda Express is helping local families support children who need special care. Their generous donation provides much-needed equipment, programs, and resources via the new Panda Cares Center of Hope, Renown Children’s Specialty Center. Their partnership directly benefits patients and their families! The ‘Panda Cares Center of Hope, Renown’s Children’s Specialty Center’ In fact, this new center provides care to not only children, but also comprehensive support to the entire family. Similarly, it creates an environment that reduces stress, promotes healing, and provides a superior patient and family experience. This facility upholds Panda Express’ mission, vision, and values and its four pillars: to directly help fund the emotional, mental, physical, and spiritual needs of children. This center, the first-ever in northern Nevada, will provide care for children who have chronic conditions. In particular, it offers ongoing treatment, health management, and specialty medical services, including: Nephrology Endocrinology Neurology Pulmonary Infectious Diseases Medical Genetics Adolescent Medicine How You Can Help! When you order from Panda Express, you can opt to round up your change, which will help support programs and services, such as the Center of Hope for Renown Children’s Hospital. Order Online A Partnership for Health & Education of Underserved Youth This partnership allows Renown Children’s Hospital to continue to strengthen regional services and increase Panda’s visibility within our growing community. Last year, 21,930 sick children received care from Renown Children’s Hospital. To date, Panda Express has raised $449,200 in financial support to assist us in providing health and education to every child, regardless of illness, injury, insurance, or ability to pay. Panda Express funds have already supported: Giraffe omni beds for the NICU Ultrasound machine for the Children’s ER Panda warmers and a hand held Accuvein machine Child Life Program to support sick patients and families Meeting room in the Children’s Specialty Center In kind donations, volunteer time and support of local events such as the University of Nevada Reno, Wolf Pack Dance Marathon

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Help us celebrate the holiday season by sharing joy with our Children’s Infusion Services team!  Thinking about blood can make any of us squeamish, and seeing it can be even more intimidating to the children in our lives. Being treated for a condition that requires blood transfusions or chemotherapy infusions is no easy feat, especially during the holiday season. This time of year, we are proud that we can offer our pediatric patients the power of proximity and excellence by having access to high level care close to home.  The Children’s Infusion Services (CIS) department at Renown Children’s Hospital is committed to bringing the gift of quality care to our community’s youngest patients. Whether they are caring for a child with a blood disorder or giving expert infusion care for a child battling cancer, no team does what they do better than these expert nurses, medical assistants, intake coordinators and physicians.  ‘Tis the Season to Bring Hope As the only pediatric oncology and hematology program in the region, the CIS department has a lot of responsibility on their shoulders. From inpatient chemotherapy to outpatient infusion services, this team treats a long list of pediatric blood conditions including:  Pediatric cancers Anemias Immune-mediated blood disorders Sickle-cell disease Bone marrow failure syndromes Bleeding disorders  “Our team provides a large variety of services from labs draws, sedations for procedures, infusions for diagnoses such as Crohn's disease, blood transfusions, as well as chemotherapy,” said Jen Torres, RN.  “Our team works extremely well together. We try to go above and beyond for our patients every day. It may be something as simple as a hug to comfort a parent or a special birthday gift for a patient.”  “My job allows me to work with several departments and providers when coordinating care for our littlest of patients,” added Jane Strawn, Intake Coordinator. “I assure proper authorizations are in place for the care that is needed, I communicate with our families when scheduling appointments, I organize End of Treatment Celebrations, as well as birthday shout outs and work closely with our Child Life team to help make the challenging appointment little easier.”  To best serve their patients, the team thrives on being expert multitaskers. Central line care, chemotherapy administration, blood transfusions, medication management, preventative injections, lab draws, lumbar punctures, biopsies, imaging – you name it, they do it. And they do it all with the utmost focus on safety and support.  “Our days have a lot of variation, as we perform a number of different services,” said Meagan Bertotti, RN. “We provide infusions for patients with chronic or acute medical conditions and chemotherapy/biotherapy treatment to patients undergoing cancer treatments. Overall, though, we work as a team to make these difficult procedures and treatments as easy as possible for the patients and families by providing engagement and support.”  “While we handle a lot of chemotherapy treatments for pediatric patients, we also do other infusions and transfusions as well such as blood and platelet transfusions, enzyme replacement therapies, different types of injections such as Rabies vaccine or Synagis for high-risk babies who need that extra protection during the RSV season, and lab draws,” said Chelsea Angues, RN. “We care for patients that get their therapies from outside hospitals, but the patient lives within the Reno area. We receive orders from those outside hospitals to care for those patients, so they can still be with their families and not have to travel.”  As members of the Children’s Oncology Group, a highly-regarded clinical trials group where over 90% of pediatric cancer patients across the U.S. receive treatment, teams like CIS in Renown Children’s Hospital deliver the highest standard of care. This partnership is a true testament to the devoted collaboration and relationship-building this team commits to on behalf of their patients every day.  "One of the biggest accomplishments of our team is the fact that we became a member of the Children’s Oncology Group, and the Children's Infusion Center and Pediatric Oncology became one unit,” said Shelby Nolte. "Instead of being a clinic on one side and an infusion center on the other, we really came together to make it a whole unit that collaborates on almost everything.”  “We've put much time into trying to understand other departments, their flow, their rationales and their processes so we can come to a solution that benefits our patients the greatest,” added Tiffany Macie, RN. “We've taken the last few years to really build our relationships with our pharmacy staff, our lab staff and our central supply resources. Our relationship building extends beyond the walls of the Renown building as well and out to the community providers too. In the past few years, we've been able to build relationships with the providers in the community where they trust they can send us their patients for treatment and lab draws. Finally, we've spent much time working on the relationships as a team. It's emotional work we do on our unit, and these families become our family. It's important to us that we take the time to be together outside of our shifts to enjoy one another and laugh!”  In the compassionate realm of pediatric healthcare, CIS knows that the complexities of a cancer or blood disorder diagnosis can take an emotional toll on their patients and families. The team firmly believes that emotional support can be as important as the physical and medical support throughout each patient’s unique care journey, striving to be a comforting presence during daunting times.  “The most important part of my day is collaborating with the Children's Infusion team to make life manageable for the families that are going through this experience,” added Shelby Nolte, Senior Medical Assistant. “We work as a team to make life easier for the blow of a cancer diagnosis.  We are there for our families in every way.  If they need a shoulder to cry on, an ear to listen or just someone to play cards with or tell a funny story too, we are there.”  “One of the things our team does extremely well to help our patients and their families with new diagnoses is to simply meet them where they are,” said Tiffany Macie. “That looks different for every family and every patient. We work in an environment where can build relationships with our patients and their families. This allows us the unique opportunity to really get to know them. We learn their fears, their joys, their worries, what their family lives are like, and we learn how to best meet them where they are.”  Transcending the conventional boundaries of care, the CIS department closely supports each patient, offering them solace tailored to the unique fabric of each family's life.

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Vanessa Slots, MD, of Renown Medical Group – Pediatrics, explains why getting a flu shot each season can save lives—especially true for the very young and elderly. Why Kids Need Flu Shots The flu is not a passing cold. It is a serious illness that takes lives every year. And this year, flu activity is increasing late in the season.  And it happens like clockwork — the onset of an influenza epidemic as fall transitions into winter, and lasts into the spring months. This acute respiratory illness is caused by influenza A or B viruses with yearly outbreaks occurring worldwide. No one is immune, and everyone is susceptible to the flu. Flu Signs and Symptoms: Abrupt onset of fever Headache Body aches and fatigue along with respiratory-tract symptoms including cough Sore throat and an irritated nose Who’s at Risk? Once again: Everyone is susceptible, but children and the elderly are at greater risk of complication from influenza, specifically toddlers less than 2 years. At this age, immunities are underdeveloped. Seniors over 65 are also at increased risk because their immune systems have weakened with age. The severity of a child’s symptoms depend on age and prior exposure to the virus. And with young children, flu is more problematic, since they cannot verbalize certain symptoms like body aches and headaches. As a result, children often experience higher fevers, which can lead to seizures or convulsions. Coupled with gastrointestinal issues such as nausea, vomiting, diarrhea and poor appetite, children are at risk of dehydration and other complications from the virus that can require hospitalization. In fact, an average of 20,000 children are hospitalized from flu each year. Pre-Existing Health Issues Health conditions, including but not limited to asthma, cystic fibrosis, heart conditions, cerebral palsy, epilepsy or diabetes, can intensify flu symptoms. Still, a substantial number of children with none of these risk factors experience severe complications from the flu. How to Protect Your Child from the Flu The best way to guard against influenza is with a flu shot. Children and adults should get the flu vaccine before flu season kicks in — usually by the end of October. Shots are provided as long as flu viruses are circulating and the vaccine is in supply.

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As our community grows, so does the need for specialized care. Thanks to a generous gift, there’s a healthier future for families in the region as a $7.5 million gift to the Renown Health Foundation is helping keep care close to home. Being in the hospital is often a stressful experience, especially for a child and their caregivers. If you add the need to travel out-of-state for care into the mix, unnecessary anxiety and financial burdens can be placed on a family that is already worried about a sick child. With our quickly growing community and close to 100,000 children under the age of 18 in Washoe County alone, the need for local specialty care is needed. The William N. Pennington Foundation recognized this need and donated $7.5 million to the Renown Health Foundation – the largest gift the health system has received – to keep care close to home and establish the William N. Pennington Fund for Advanced Pediatric Care. Thanks to this gift, Renown Children’s Hospital has hired more than 15 pediatric specialists who provide care for children in our community. Below, we introduce you to three key specialized pediatricians in northern Nevada: Joseph A. Gassen, M.D. “Having pediatric specialists in the community is invaluable,” says Joseph A. Gassen, M.D., pediatric emergency medicine. “It allows families and patients to stay in Reno and not have to travel far distances to get quality care.” Gassen, the only doctor specializing in pediatric emergency medicine in the region, moved to Reno to provide care in the emergency room at Renown Children’s Hospital. “The hospital is dedicated to improving the care of children in northern Nevada, and I wanted to be a part of this amazing vision," Dr. Gassen says. I would not have been able to relocate to Reno without the support from the hospital and the William N. Pennington gift.” Working with children and their families are what Dr. Gassen finds most rewarding. "I get to provide care for a child, which in turn makes the parent feel better,” he says. “Essentially, I get to treat the whole family, even though I only directly care for the kids.”   Colin Nguyen, M.D. Also among the first new specialists is Pediatric Neurologist Colin Nguyen, M.D., who has done extensive work with epilepsy and epilepsy surgery. “In any growing and expanding community, we need the multitude of social, financial, political and well-being services to sustain that growth and progress,” Dr. Nguyen says. “The ability to offer more breadth of medical services to our local population allows families to spend more time together and fulfill work obligations, without the need to travel long distances to obtain that specialized care.” Dr. Nguyen says he enjoys caring for children because they are honest in their emotions and reactions, as well as simple in their intentions. “It is the overall joy and unique sadness that comes in working with children, which drives many of us to continue our work -- I am no exception.” Jacob Zucker, M.D. The third pediatric specialist providing care thanks to the Pennington gift has close ties to northern Nevada. Jacob Zucker, M.D., pediatric hematologist-oncologist, was born and raised in Reno and attended medical school at the University of Nevada, Reno School of Medicine before moving to the Midwest for his residency and fellowship. Dr. Zucker feels fortunate to have been offered the opportunity to return home and give back to the community that has given so much to him. “I can say with absolute resolve that northern Nevada is an exceptional community to practice medicine in. The care offered here at home is top rate and the providers that live and practice here truly understand the purpose of community.” The addition of these three specialists and the future specialists that will be coming to our area will impact thousands of children and their families. “With a growing population, the vision of leadership at Renown, and with the generosity of the William N. Pennington Foundation, northern Nevada is in position for the first time to make local pediatric subspecialty care a reality and to keep our families at home in their community,” Dr. Zucker says.

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A well-child checkup is a great opportunity to monitor your child’s growth and development, and it's also a chance to establish a trusting relationship with your child’s pediatrician and have your questions answered. What to Expect at Each Checkup At every checkup, a comprehensive physical examination will be conducted to assess your child's growth parameters, including height, weight and head circumference. A developmental assessment will evaluate the progress of your infant or young child in achieving age-appropriate milestones, encompassing language skills, motor development, problem-solving abilities and psycho-social skills. In addition, your pediatrician will address common concerns such as feeding, sleep patterns, oral health and general infant care. Unless there are specific needs or concerns for your baby, routine laboratory tests are typically unnecessary. Your pediatrician will provide guidance on immunization schedules, post-vaccination expectations and when to seek medical attention. Furthermore, during each visit, you will receive age-specific guidance to help you anticipate your child's expected growth and development, along with essential safety precautions and illness prevention measures. Your pediatrician will discuss various topics, such as placing your baby to sleep on their back, utilizing rear-facing infant car seats until around age two, maintaining home water thermostats below 120 degrees Fahrenheit, ensuring dangerous objects and poisonous substances are out of sight and reach, emphasizing dental health and promoting the use of bike helmets, among other things. Preparing for Your Visit It is recommended that, as a parent, you write down any questions beforehand, so you don’t forget them in the moment. Most importantly, feel comfortable asking your pediatrician about anything that might seem unusual, as you are the parent, and you know best! Before leaving the pediatrician’s office, be sure that you fully understand any instructions given to you and ask for clarification if needed. From your child’s birth through young adulthood, you will be visiting your pediatrician regularly. The American Academy of Pediatrics provides what a regular schedule might look like. Well-Child Checkup Schedule Two to three days after birth and at one month Two months Four months Six months Nine months One year 15 months 18 months 24 months 30 months Three years, and yearly after

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