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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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Car seat mistakes can have very serious consequences. Misuse of a car seat can injure your child, or fail to keep them safe in the event of a crash. A lot goes into finding the right car seat for your child. With so many factors to consider (including age, weight and height of the child, type and brand of a car seat, cost of the car seat, etc.) it can be easy to forget critical factors. Here are two common mistakes that certified technicians often find when speaking with parents. Mistake #1: Getting a used car seat without knowing its history Why: A used or secondhand car seat can pose several factors that can compromise its safety in a crash. First, car seats expire six to ten years after their date of manufacture, so refer to the car seat's manual for recommended car seat longevity. The safety mechanisms can be compromised if a car seat has been in a crash. So it's crucial to replace your car seat following a collision. Solution: Only use a car seat if you know its history. A new car seat is your best bet, as they are up to date on the latest safety guidelines, and safety mechanisms are up to standard. However, if you are considering a used car seat for your child, please ensure the following: The car seat has never been in a car crash. The car seat isn't expired or outside the manufacturer's recommended longevity. It comes with the car seat manual and has all safety labels, including manufacture date, model number, and use instructions and restrictions. The car seat or any of its parts have not been recalled. The overall state and integrity of the car seat and its parts are undamaged. The carseat or any of its parts have not been recalled and are present and in working order.

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While the appearance of a winter wonderland in your yard can be a welcome one, an accompanying aspect is not: the idea of clearing your driveway and sidewalks. The sometimes-daunting task of snow shoveling is a repetitive activity that can cause muscle strain to the lower back and shoulders. However, by following the tips below, you will spend more time appreciating your winter wonderland -- when your sidewalk and driveway are all clear, that is. But, we all know that injuries happen, and if you do find yourself with back pain that does not resolve in a few days, contact your primary healthcare provider, or visit a Renown Urgent Care. Another way to avoid injury during strenuous activity, or help heal an injury that won't go away, is to work with a physical therapist who can offer at-home exercises to keep your body strong. 6 Tips for Safe Snow Shoveling Following these tips from the American Physical Therapy Association can help you avoid injuries: Lift smaller loads of snow, rather than heavy shovelfuls. Be sure to bend your knees and lift with your legs, rather than your back. Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier. Step in the direction where you are throwing the snow to prevent the low back from twisting to help prevent “next-day back fatigue.”  Avoid excessive twisting because the spine cannot tolerate this motion. Bend your knees and keep your back as straight as possible so that you are lifting with your legs. Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back. Backward bending exercises while standing will help reverse the excessive forward bending of shoveling. Stand straight and tall, place your hands toward the back of your hips and bend slightly backward for several seconds. When in doubt, ask for help. The Reno community is a generous one and you can typically find snow shovelers for hire on local message boards like Nextdoor and Facebook. Or, if you have a kid in your neighborhood, they might be looking to make some extra money on a snow day.

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Although the exact cause of Sudden Infant Death Syndrome is unknown, there are steps parents and caregivers can take to reduce the risk. Here's what every parent needs to know. SIDS is the leading cause of death in the country in infants in their first year of life. However, the exact cause of SIDS still remains a mystery, though it is often attributed to unsafe sleeping practices. Karen Wagner, a Pediatric Nurse Practitioner at Renown Health answers some of the most commonly asked SIDS questions. Protecting Babies from SIDS: Always place babies on their backs when putting them to sleep for naps and at night. Use a firm sleep surface, such as a mattress in a safety-approved crib, covered by a fitted sheet. Share your room – not your bed – with your baby. Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you, or with anyone else. Keep soft objects, such as pillows and loose bedding, out of your baby's sleep area. Do not smoke during pregnancy or around the baby; these are strong risk factors for SIDS. The risk of SIDS is even greater when a baby shares a bed with a smoker. To reduce risk, do not smoke during pregnancy, and do not smoke or allow smoking around your baby. Your SIDS Questions Answered:  Who's most at risk? Three out of five SIDS victims are boys. African American and Native American infants are twice as prone to the syndrome. Other groups at increased risk include preemies, low-birthweight babies, and infants exposed to cigarette smoke. Is putting my baby down on their back really that important? It's vital. Back-sleeping increases a baby's access to fresh air and makes her less likely to get overheated (another factor linked to SIDS). I put my child to sleep on their back at night, but can I let this rule slide for a short nap? It's not worth the risk. Babies who normally sleep on their back are 18 times more likely to die of SIDS when placed down on their tummy for a snooze. Is side-sleeping safe? No. Studies show that putting a baby down on her side rather than on her back doubles the SIDS risk. It's easier for an infant to roll onto her tummy from her side than from her back. I'm worried about my baby getting cold. Is it safe to cover them with a blanket? Wait until their first birthday. Blankets, pillows, comforters and stuffed toys can hinder your child's breathing; even soft or improperly fitting mattresses can be dangerous. If you're worried that your little one may get chilly, swaddle them in a receiving blanket or use a sleep sack.

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Renown Health welcomes you back from Burning Man. To make sure you have the support you need, here are some tips on where to get healthcare after your return from the playa. Our urgent cares see patients 365 days a year for medical concerns that are urgent but not life-threatening. This can include fractures, cuts, burns, sprains, fevers, animal bites, rashes, sore throats and fevers. Where To Get COVID-19 & Monkeypox Tests in Reno-Sparks Renown Health’s emergency rooms do not provide walk-in COVID-19 or monkeypox testing for patients. If you are experiencing symptoms related to COVID-19 or monkeypox, we recommend you make an appointment with your primary care provider or visit one of our urgent care locations. Testing for COVID-19 is also available at local pharmacies in the Reno-Sparks area. Please visit Washoe County's COVID-19 page to learn more. Labor Day Holiday Hours: Fernley and Fallon urgent care locations will be open from 9 a.m. to 3 p.m. on Monday, Sept. 5; all other Renown urgent care locations are open from 9 a.m. to 5 p.m.

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The summer is here, and it is time to take action. The heat can be dangerous for kids, so make sure that you are aware of the signs of heatstroke and know how to prevent it.  Did you know heatstroke is the leading cause of non-crash related fatalities in children? “On average, every 10 days a child dies from heatstroke in a vehicle. In more than half of these deaths, the caregiver forgot the child was in the car.” (Safe Kids Worldwide,” 2022, para.1)  Babies are at higher risk for heatstroke than adults, as they cannot regulate their body temperature as well as adults can. They also do not have the same understanding of how hot the environment is and may not be able to communicate that they need to be taken out of the car.   Here are eight simple tips to keep your baby cool in the back seat:  In hot weather, it is important to keep your baby cool and hydrated by using a car seat cover or towel over them to reflect the sun's rays. It is important to dress your baby in lightweight clothing that covers their arms and legs. Make sure that your car is well ventilated and use a towel or blanket to create an air gap between your baby and the seat. This will help with air circulation, as well as provide insulation from hot surfaces. Keep an eye on your baby's skin color. If it starts looking too red or flushed, it may be time to get somewhere cooler. Keep the temperature at a comfortable temperature for you, not for your child. Keep windows cracked open for ventilation and make sure that there is nothing blocking the flow of air from entering or exiting the vehicle. Dress your infant appropriately for their environment with appropriate head and neck coverings, keeping them cool as well as protected from sunburns. Ensure that you have enough fluids on hand to last an hour before getting out of the car or use bottled water if possible. Never leave your child unattended in a car.    If you suspect heatstroke in someone, especially a child, take the following measures:  Call 911 immediately.  Cool the victim – Get the person to a shady area, remove restrictive clothing and cover skin with sheets soaked in ice-water, and place ice packs in the arm pits and groin.  Have the victim drink cool fluids, preferably an electrolyte-containing sports drink.  Monitor body temperature with a thermometer, but stop cooling efforts after temperature has dropped to 102.   Additional Resources:  Baby Safe Class  This class helps prepare parents for emergencies that may occur in baby’s first year. Along with car seat safety and basic baby proofing, discussion will include prevention and treatment of common injuries.

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The kids are back in school and the holidays are all but a distant memory: Now what? Karen Wagner, APRN, offers specific tips about getting kids back to their routines in the post-holiday-hustle-and-bustle. Are you finding the kids struggling with bedtime routines? Having trouble getting them to tackle homework? There’s a simple reason: The holidays messed with their mojo! Here, we talk with Nurse Practitioner Karen Wagner about what to do to get them back on the straight and narrow.  Why Routines Are Important “Holidays are a fantastic time to get together with family and friends, so our routines are usually off — and this is understandable, “Wagner says. “While the holidays are exciting, they are chaotic and can put our kids out of the routines.” So how do you get kids back into those routines they crave?  “Consistency/routines are crucial for our kids,” she says. “Most people — kids and adults —  experience a let-down feeling after the holidays, and post-holiday adjustment takes time.” So what can we do, specifically? Wagner recommends the following:  Re-establish family routines, including before- and after-school programs or child care routines. Once kids are back on the regular schedule, they’ll find that sense of familiarity as the old routine returns. But keep in mind, this won’t happen overnight.  Encourage healthy eating, as the upheaval of their schedule can be offset by a balanced diet.  Make sleep time a priority: Keep in mind that it might take up to three nights of strict bedtime to get them back on track. But enforcing normal bedtime will get their bodies back on a normal schedule.  Return to usual chores and expectations. Nothing encourages a return to routine like reminding them of the basics.  Incorporate indoor and outdoor time. They likely spent lots of time outdoors during our unseasonably warm winter break — and they even had a snow day or two! So encouraging both indoor and outdoor time will help them return to a circadian rhythm and tire them out from exposure to fresh air.  “It is never too early to encourage a love for physical activity in kids by exposing them to fun fitness activities and sports,” Wagner says. “Physical activity improves bone health, cardiorespiratory and muscular fitness, decreases levels of body fat, reduces symptoms of depression, and improves cognitive skills and the ability to concentrate.”

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It’s important to be aware of the risk of a concussion, which can have serious health implications. Susan Park, MD, discusses the effects of concussions and how they can be prevented. According to Susan Park, MD, a Renown Medical Group doctor who specializes in sports and family medicine, concussions are a serious issue — especially among children whose developing brains “are more susceptible to brain injury and long-term effects from concussions.” All parents, coaches and athletes, she points out, should be aware of the risks of concussions and take precautions to avoid them. What is a concussion and how does it occur? Dr. Park describes a concussion as a traumatic brain injury resulting from direct or indirect impact to the head or body, during which the brain shakes back and forth in the skull. This may cause some bruising of the brain. In severe cases, traumatic head injuries can cause bleeding, which if not treated quickly, can be fatal. What are the health implications of a concussion? Symptoms of drowsiness and confusion can be a sign of a concussion after a head injury. Some short-term effects may include headaches, dizziness and difficulty concentrating. Long-term concerns can further include mood disorders, sleep disturbance and problems with cognitive function-concentration, which may affect school performance. What sports carry the highest risk of suffering a concussion? Dr. Park notes participation in any impact sport can result in a head injury. But among school-age kids, she treats more concussions from football and soccer than any other sport. However, during the winter months, skiing and snowboarding injuries can be a common cause of concussions Any blow to your head, neck or upper body can result in a concussion with symptoms including, but not limited to, feeling dazed or confused, dizziness, nausea/vomiting or a headache. Initial treatment of concussions varies depending on severity. Rest, avoiding vigorous activity and a reduced school workload help young athletes recover after a concussion. Dr. Park notes that sometimes further imaging and an ER visit will be required. Otherwise, rest from activities is the main treatment, along with not returning to sports activities until further clearance from a healthcare provider.

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With more than 3 million cases in the United States each year, human papillomavirus (HPV) is a common sexually transmitted disease and can lead to the risk of several cancer diagnoses. Fortunately, a vaccine can prevent more than 90% of HPV cancers when given at the recommended ages. We talked to Renown Pediatrician Vanessa Slots, M.D., to learn more about HPV and the importance of getting your child fully vaccinated.   What is HPV?   Talking about sexually transmitted infections can be uncomfortable, but learning how HPV is spread is important for prevention. HPVs are spread via skin-to-skin contact. According to the National Cancer Institute, there are low/medium-risk HPVs that can cause warts and cervical dysplasia (abnormal cells on the cervix), and there are high-risk HPVs that can cause various cancers. HPV is perhaps most known for causing cervical cancer. Other cancers related to HPV are anal, vaginal, vulvar, penile and oropharyngeal cancers. In fact, men are four times more likely than women to suffer from HPV-associated oropharyngeal (mouth and throat) cancer. HPV is so common that nearly all sexually active people will be exposed at some point in their lifetime, with around half of infections being a high-risk virus.  Benefits of the HPV vaccine   Immunizations are safe and effective and have successfully reduced the transmission of many deadly diseases. The CDC (Centers for Disease Control and Prevention) states the HPV vaccine protects against infections that can lead to HPV related cancers and abnormal cells that can lead to cancer (precancers), as well as genital warts.   The recommended HPV vaccine schedule   The American Cancer Society states that the HPV vaccine is most effective when two doses are given to girls and boys between the ages of 9 to 12. There should be at least 6 months between the first and second dose. “You might be asking why your child needs to get the HPV vaccine at this young age when they are not sexually active,” says Dr. Slots. “Research shows that people have a better immune response to the vaccine when younger than in their late teens and early 20s.”   For teens and young adults ages 13 through 26 who have not been vaccinated, getting the HPV vaccine is still highly effective in preventing cancers and genital warts.   CDC recommended HPV vaccination suggestions:  2-dose schedule for people who get their first dose before their 15th birthday.  3-dose schedule for people who get their first dose on or after their 15th birthday.   “By following the recommended HPV vaccine schedule and getting your child the correct number of doses, this will ensure they have adequate protection against HPV associated diseases including cancer,” says Dr. Slots.

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With the help of Aaron Bertalmio, MD of Renown Urgent Care, we're sharing nine essential must-have items for your hiking emergency kit. 9 Essential Items For Your Hiking Emergency Kit With more than 300 days of sunshine in Reno-Tahoe and plenty of trails to explore, you'll want to keep these essential items in your kit. 1. Water Surprisingly, this no-brainer, however, is often overlooked. Bring enough water to last for the entire adventure. This amount of water can be heavy depending on the distance, altitude or intensity. With this in mind, the next best bet is to filter or purify water from a lake or stream. Here's how: You can do this with iodine or chlorine dioxide tablets, charcoal or an ultraviolet light wand. Tip: Look for water that is moving or rushing over rocks. Having enough water or filtration cannot be underestimated. "If you become injured and need to wait for help, you can only last about three days without water," Dr. Bertalmio says. 2. Food Meals-Ready-to-Eat (MREs) or dehydrated food pouches are essential, ensuring you have plenty to eat if you're outdoors longer than expected. 3. Maps Bring a printed map, compass or GPS. You can't always rely on your smartphone, so this is the perfect backup plan. 4. First-Aid Supplies Your hiking first-aid kit should change based on the type of hiking. As a basic rule, keep the following items in your pack: Fever/pain reliever Sewing kit with safety pins Tweezers Bandages and moleskin Antibiotic ointment Duct or medical tape Whistle 5. Light Source Wear or pack a small headlamp to illuminate the way if you get caught outside after sunset or in a poorly lit area. Headlamps are also great in emergencies because they are hands-free. 6. Emergency Shelter Even if you're only going out for the day, pack a low-weight emergency blanket for the trip. In other words, if the day trip turns into an overnight adventure, the blanket will keep you warm and alive in the event of cold temperatures. 7. Fire Starter Pack small tools in your hiking emergency kit to ensure an easy fire start. Waterproof matches, a knife, a lighter, or a strike fire starter are great options. Tip: Bring a multi-tool, including a knife and scissors that can be used for first-aid. 8. Layers of Clothing Mother Nature likes to change her mind in northern Nevada, and temperatures vary significantly within 24 hours. Therefore, pack a compact, lightweight waterproof and windproof jacket. This will protect you from being uncomfortably chilly and experiencing hypothermia. "Hypothermia is when your body temperature drops to a dangerously low level. You want to avoid this completely by keeping body temperature regulated outdoors and avoiding cold water immersion," says Dr. Bertalmio. 9. Sun Protection Certainly, sun protection should be part of your daily routine and an essential in your hiking emergency kit. You'll want to bring enough sunblock to reapply in direct sunlight and layers to cover exposed skin every two hours. Dr. Bertalmio reminds everyone the sun is intense in northern Nevada. "The higher altitude means an increased risk of sun-induced skin damage," he explains. "Some trails can reach above 10,000 feet, and at that altitude, UV radiation could be 35 to 45 percent more intense than at sea level."

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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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If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

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