Tuesday, December 11, 2012

Tis the Season for Generosity

Recently, we experienced an unexpected but wonderful act of generosity in one of our clinics and wanted to share the story with our followers!

One of our therapists was in the lobby with her patient and the patient's caregiver discussing how well she did in therapy playing with a play kitchen set.  When the therapist asked if the patient had a play kitchen at home, the caregiver told the therapist that she did not.  The grandmother of another patient who happened to be in the lobby at that time overheard the conversation.  This was the first day that this grandmother had ever been to our facility as her granddaughter is usually brought to therapy by her mom.  She and her granddaughter left after therapy, only to return a short time later with a brand new kitchen play set to be donated to our patient!  This grandmother bought a little girl who she knew nothing about a new kitchen play set simply because she overheard the therapist saying how well she did with it.  What a beautiful act of kindness!

It's easy to get caught up in the day to day routine and to forget what this season is about.  The holidays are about kindness, generosity, and sharing good will with one another.  Here at MedCare, we participate in various volunteer activities during the holidays and throughout the year and we encourage you to do the same!  Giving back to those in need doesn't have to be time consuming or expensive.  Little acts of kindness go a long way!  Below, we've included some suggestions on ways you can make a difference during the Holidays and all year round!

Feed the Hungry

In 2011, 50.1 million Americans lived in food insecure households, 33.5 million adults and 16.7 million children.  Consider donating food items or serving food to those in need as a way to give back to your community.  

The Houston Food Bank:  The Houston Food Bank is the nation’s largest size Feeding America food bank and source of food for hunger relief charities in 18 southeast Texas counties. They have been named one of 10 Top-Notch Charities across the nation by Charity Navigator. A network of 500 food pantries, soup kitchens, senior centers and other agencies, feeding a total of 137,000 people each week, provides 50 million nutritious meals annually. Fresh produce, meat and nonperishables are distributed from the new warehouse at 535 Portwall, and hot meals are prepared and distributed from Keegan Center, a 15,000 square-foot industrial kitchen. Additional community services range from nutrition education to assistance with food stamp applications and hands-on job training. Red Barrels offer a convenient way for grocery shoppers to donate nonperishables for their neighbors in need.  For more information, visit http://www.houstonfoodbank.org/default.aspx

The Star of Hope:  The Star of Hope is a Christ-centered community dedicated to meeting the needs of homeless men, women and their children. Positive life changes are encouraged through structured programs which focus on spiritual growth, education, employment, life management and recovery from substance abuse.  We serve three meals a day, 365 days each year, at all three facilities. What an opportunity to encourage and uplift as you hand a meal tray to our clients. This can be scheduled for an individual volunteer on a regular basis or for a small group of 10 on a regular or one-time basis. Volunteers help set-up, serve and clean-up. Lunch and dinner shifts available throughout the week. Snacks & Goodnight is another program for volunteers of all ages; this project has become a tremendous hit! Thanks to the snacks you provide, our clients end the day with a delicious blessing. At TLC, volunteers arrive at 7:45 p.m. to set-up. Clients are invited to come by for a snack beginning at 8:00. Snack time is over at 8:30. Volunteers sweep up and are out the door.  For more information, visit http://www.sohmission.org/NetCommunity/home

Loaves and Fishes Soup Kitchen:  For the past 35 years, the soup kitchen has provided both spiritual and material sustenance to its clients.  Loaves and Fishes exists to give hope, to light a candle in the darkness of the streets of Houston.  We provide a hot meal and a warm welcome to those in danger of losing their sense of human dignity.  For more information, visit http://www.magnificathouse.org/LoavesFishes.htm

Spend Time with Children in Need

The Boys and Girls Club of Houston:  Boys & Girls Clubs of Greater Houston provides these youth a safe haven in the midst of chaotic, dangerous neighborhoods and family contexts and delivers high-quality programming that builds character; enhances academic performance; improves physical health and fitness; expands life skills; develops leadership potential; promotes civic engagement; and equips youth for pursuing rigorous postsecondary educational opportunities and productive careers.  For more information, visit http://www.bgclubs-houston.org/index.php

Child Advocates, Inc.:  Every 8 minutes, a child in Texas experiences abuse or neglect. More than 5,000 children in the Houston area have experienced such life-threatening abuse or neglect that they had to be removed from their homes and placed in foster care. Child Advocates trains everyday people to advocate for the best interests of these children in court so they can find safe, permanent homes as quickly as possible.  Child Advocates, Inc. mobilizes court appointed volunteers to break the vicious cycle of child abuse. We speak up for abused children who are lost in the system and guide them into safe environments where they can thrive.  Child Advocates volunteers are appointed by a judge to represent the best interests of a child or sibling group in foster care.  They serve as the judge’s eyes and ears while the children are in custody, ensuring their unique needs are met until they can safely return home or are permanently placed with a loving relative or adoptive family. Unlike Child Protective Services caseworkers and court appointed attorneys who juggle overwhelming caseloads, our volunteers represent just one child or sibling group at a time. Their advocacy makes sure no child falls through the cracks of our overburdened child welfare system.  For more information, visit http://www.childadvocates.org/

Casa de Esperanza:  Casa de Esperanza de los NiƱos—the House of Hope for Children—is a safe place for children in crisis due to abuse, neglect or the effects of HIV. Casa de Esperanza provides residential, medical and psychological care according to the needs of each child. Counseling is also available to the parents in appropriate situations.  Casa de Esperanza strives to break the destructive cycle of child abuse by offering safe homes to children of families in crisis. The goal of Casa de Esperanza is to return physically and emotionally healthy children to stabilized homes where caregivers can safely provide daily care.  Children receive comprehensive assessment and intervention services while in placement. Parents receive case management and referral services while their children are safely cared for. When family reunification is not possible, Casa de Esperanza is licensed to supervise long-term foster care and adoptive placements.  For more information, visit http://www.casahope.org/

Give the Gift of Life

Donating blood is fast and easy and can be done once every 8 weeks for whole blood donations and once every 16 weeks for double red blood cell donations.  To find a location near you visit the following:

Gulf Coast Regional Blood Center:  http://www.giveblood.org/

Organize a Drive for Items in Need

Many volunteer organizations rely on donations from the community to provide supplies to the people they serve.  Consider hosting a drive for items in need with your friends and family, your neighborhood, or your co-workers!

Show Appreciation for the Soldiers

Freedom isn't free, and there are thousands of men and women who risk their lives every day overseas to ensure that our country is protected.  Consider sending words of encouragement and/or items that are needed like toiletries, magazines, and food items to soldiers stationed overseas!  The following websites allow you to “adopt” a soldier or an entire unit of military personnel and send them much needed items.

Soldier’s Angels:  http://soldiersangels.org/
Operation Gratitude:  http://www.operationgratitude.com/
A Million Thanks:  http://www.amillionthanks.org/

Friday, November 9, 2012

First Aid Guidelines

First Aid Guidelines

Almost all emergencies happen when we are in the company of our friends and family. Don’t let fear or intimidation prevent you from learning basic first aid. Even if you can’t take formal training, use these guidelines to help you know what to do in the event of an emergency.

This information was taken from the 2010 American Heart Association and American Red Cross Guidelines for First Aid, and simplified into easy to understand terms and intended to be used as a quick reference guide.

Administration of first aid must not delay activation of the emergency medical services (EMS) system or other medical assistance when required. AHA & ARC strongly believe that education in first aid should be universal: everyone can learn first aid and everyone should.

A first aid provider must be able to recognize when help is needed and how to get it. First aid providers should learn how and when to access the EMS system and how to contact the Poison Control Center.


Breathing Difficulties
·         Asthma attack – help victim take their prescribed medications and/or inhaler if needed.
o   If conditions does not improve, worsens, or if victim becomes unconscious call 911.

Allergies & Anaphylaxis
·         Allergies are relatively common, but only a small proportion of people with allergies develop anaphylactic reactions.
·         An anaphylactic reaction is a progressive series of signs and symptoms of swelling, breathing difficulty, an itching rash, and eventually shock, which, if left untreated, may lead to death.
·         Immediately administer Epi-pen if victim has one.
·         Seek medical attention immediately. Call 911 if no improvement or if worsening of condition.

·         Roll victim of their side if possible to help keep an open airway.
·         Prevent injury by removing hard & sharp objects away from victim and when possible placing pillows under the victim’s head.
·         Do NOT restrain the victim.
·         Do NOT attempt to put anything in their mouth or between the victim’s teeth.

Chest Discomfort
·         Call 911 for anyone with chest discomfort. Do not try to drive them to the hospital yourself.
·         While waiting for EMS to arrive, encourage the victim to chew 1 adult aspirin (not enteric coated) or 2 low-dose baby aspirin.


·         Apply firm pressure directly over the site using gauze or a clean cloth for as long as bleeding continues.
·         If it is not possible to apply continuous manual pressure while actively bleeding, apply gauze and wrap firmly with an elastic bandage.
·         In either case, if bleeding continues, do NOT remove the old gauze. Instead, add more gauze or cloth on top and apply more pressure.
·         Because of the potential adverse effects of tourniquets and difficulty in their proper application, use of a tourniquet to control bleeding of the extremities is indicated only if direct pressure is not effective or possible.

Cuts, Scrapes, and Abrasions
·         Wash with running water and soap as soon as possible. If running water is not available, use any source of clean water.
·         These types of wounds heal best and with less infection when they are covered with an antibiotic ointment and clean gauze or band-aid.

·         Immediately cool the burn by holding affected area under cool running water.
·         Continue cooling until pain is relieved. Cooling reduces pain, swelling, and how deep the burn will go.
·         Do not put ice directly on a burn.
·         After rinsing in cold water, apply cool aloe vera gel may be helpful.
·         After the burn blisters, leave the skin intact because this helps keep germs out, improves healing, and reduces pain.

Electric Injuries
·         Immediately turn off the power at its source, usually a fuse box. Do NOT touch the victim while the power is still on.
·         In case of high voltage electrocutions, immediately call 911.
·         ALL materials conduct electricity if the voltage is high enough, so do not try to touch the victim or electrical source until the power had been turned off.
·         Once power is off, assess the victim. They may need CPR and/or treatment for burns or shock.
·         All victims of electric shock require medical assessment because the extent of the injurt may not be apparent.

Spinal Injuries
·         Do not move a person if you suspect they could have a spinal injury. Also, tell them not to move.
·         The only time you should attempt to move a victim is if leaving them where they are is so dangerous that it could threaten their life. In this event, try your very best to stabilize their spine whenever possible.
·         Otherwise, only attempt to stabilize the spine if you have been trained to do so.
·         You should assume spinal injury in the following:
o   Motor vehicle accident
o   Severe ATV or bicycle crash
o   Fall from greater than standing height
o   Tingling in arms or legs
o   Pain or tenderness in the back
o   Sensory deficit or muscle weakness involving the torso or arms
o   Not fully alert or is intoxicated
o   Other painful injuries, especially of the head and neck
o   Children 2 years of age or older with evidence of head or neck trauma

Sprains and Strains
·         Apply a cold compress to the injured area. Cooling is best accomplished with a plastic bag filled with ice and water. Place a thin towel or other cloth between the bag and the skin.
·         It may helpful to apply a compression bandage to the area.
·         Rest the injured area at a comfortable elevated position.
·         Here is a helpful acronym – R.I.C.E. (Rest, Ice, Compression, Elevation).

Fractures (broken bones) 
·         Assume that any injury to an extremity (arms and legs) could be a fracture.
·         Cover open wounds with a clean dressing or cloth.
·         Do not try to straighten an injured extremity
·         Stabilize the arm or leg with a splint when possible.
·         If the injured extremity is blue or white, call 911 because this could be a medical emergency.

Human and Animal Bites
·         Immediately irrigate both human and animal bites with large amounts of water.
·         Snakebites –
o   Immediately call 911.
o   Do not apply suction. Suction removes such a small amount of venom that it is not helpful and may actually do more harm than good because it could aggravate the injury.
o   Instead, apply pressure by wrapping the bitten extremity to prevent the venom from moving further through the body. If possible, wrap the entire extremity.
o   Wrap tight enough to be snug, but allowing only one finger to be slipped under it.
·         Jellyfish Stings –
o   Immediately wash with vinegar for at least 30 seconds.
o   If vinegar is not available, a concentrated baking soda & water mixture can be used.
o   For the treatment of pain, after the nematocysts are removed or deactivated, the victim should be instructed to take a hot shower or immerse the affected part in hot water (temperature as hot as tolerated) as soon as possible, for at least 20 minutes or for as long as pain persists.

Dental Emergencies
·         Clean bleeding wound(s) with saline solution or tap water.
·         Stop bleeding by applying pressure with gauze or cotton.
·         Handle the tooth by the crown, not the root (do not handle the part that was beneath the gum).
·         Place the tooth in milk, or clean water if milk is not available.
·         Contact the patient’s dentist or take the tooth and victim to an emergency care center as quickly as possible.


Cold Emergencies
·         Hypothermia – caused by exposure to cold.
o   Begin rewarming a victim of hypothermia immediately by moving the victim to a warm environment, removing wet clothing, and wrapping all exposed body surfaces with anything at hand, such as blankets, clothing, and newspapers.
o    Seek medical attention immediately.
·         Frostbite – damage to the skin and underlying tissue caused by exposure to extreme cold.
o   Frostbite usually affects an exposed part of the body such as the extremities and nose.
o   Remove wet clothing and dry and cover the victim to prevent hypothermia.
o   Transport the victim to an advanced medical facility as rapidly as possible.
o   Do not try to rewarm the frostbite if there is any chance that it might refreeze, or if you are close to a medical facility.

Heat Emergencies
·         Heat cramps - are painful involuntary muscle spasms that most often affect the calves, arms, abdominal muscles, and back.
o   First aid includes rest, cooling off, and drinking an electrolyte-carbohydrate mixture, such as juice, milk, or a commercial electrolyte-carbohydrate drink.
o   Stretching, icing, and massaging the painful muscles may be helpful.
o   Exercise should not be resumed until all symptoms have resolved.
·         Heat exhaustion - is caused by a combination of exercise induced heat and fluid and electrolyte loss as sweat.
o   Signs and symptoms may start suddenly and include: nausea, dizziness, muscle cramps, feeling faint, headache, fatigue, and heavy sweating.
o   Heat exhaustion is a serious condition because it can rapidly advance to the next stage, heat stroke, which can be fatal.
o   Heat exhaustion must be vigorously treated by having the victim lie down in a cool place, taking off as many clothes as possible, cooling the victim with a cool water spray, and encouraging the victim to drink cool fluids, preferably containing carbohydrates and electrolytes.
·         Heat stroke - includes all the symptoms of heat exhaustion plus signs of central nervous system involvement, including dizziness, syncope, confusion, or seizures.
o   The most important action by a first aid provider for a victim of heat stroke is to begin immediate cooling, preferably by immersing the victim up to the chin in cold water.
o   It is also important to activate the EMS system.
o   Heat stroke requires emergency treatment with intravenous fluids.
o   Do not try to force the victim to drink liquids.

Ingested Poison -
·         Immediately call the Texas Poison Control Center at 1-800-222-1222.
·         If the victim shows signs of a life threatening condition (sleepiness, seizures, difficulty breathing, vomiting) call 911 immediately.

Eye Injuries
·         By chemicals – Rinse eyes exposed to toxic substances immediately with a copious amount of water. Seek medical attention immediately.
·         By foreign objects – Do not attempt to remove an object that is stuck in the eye. If an object such as a nail is lodged in the eye, cover the eye using a gauze or clean cloth with a slit cut into it to go around the protruding object. Call 911.

For more information on First Aid, go to www.heart.org or www.redcross.org

Tuesday, October 23, 2012

When Your Child has to go into the Hospital

When Your Child has to go into the Hospital

Be Prepared.
What should I bring to the hospital to have a smoother admission?
The more prepared you are, the better your admission experience will be. Be sure to bring a list of your child’s medications, allergies, recent surgeries, illnesses, and hospitalizations.  If your child is receiving services such as private duty nursing, therapies, or home medical equipment – bring a list of these providers’ contact numbers and what services your child receives from them. If your child gets nursing, bring a copy of the Plan of Care. You will likely be asked the same questions by more than one member of the medical team. Rather than having to repeat yourself each time, if you have everything written down it will save you time and frustration.
Good packing is another important tool to help with you & your child’s transition. Pack things that are comforting and part of your child’s normal routine as much as possible.  Many times it is more comforting for the child to wear his or her own pajamas rather than a hospital gown.  If your child has special medical supplies and equipment, bring enough backup in case the hospital doesn’t have what your child uses on hand. If they do have what you need, use their supplies and save yours since insurance quantities are limited and you don’t want to run short. Be sure to bring something comfortable for yourself as well as toiletries, snacks, and a relaxing activity to fill quiet time.
Know Your Rights.
How do I know how much say I have in my child’s care? I feel like I have no control over what’s happening.
As a parent, you have a great deal of control and influence on your child’s care while they are in the hospital. It is very important that you talk with the medical team caring for your child on a regular basis and stay informed of the treatment plan. If you don’t understand or disagree with something, tell your child’s doctor. Every time your child is hospitalized you will be given a document called “Patient Rights and Responsibilities”. It is very important that you read this and be familiar with your rights as well as your responsibilities. This could be very helpful in understanding how much control you have in your child’s care while they are in the hospital. The best survival strategy is to keep the lines of communication open. Talk to doctors, nurses, your spouse, and your child. The more information you have, the more in control you will feel.
Who’s who in the hospital?
There are so many people involved in my child’s care, how do I know who does what?
There will be many doctors and nurses involved in your child’s care. When multiple care providers are involved, it is not uncommon for them to have different ideas and opinions about your child’s treatment. This can be very confusing and frustrating for parents, and can make parents worry that “no
one knows what is going on.” It is very important that you identify the person who heads up your child’s team. Parents have also often found that keeping a list of the different medical providers, and information about how they can be contacted is helpful.
Doctors –
Attending physicians are members of the team that determine and supervise your child's medical care. Attending physicians also teach other doctors to care for children. Your child will be assigned an attending physician.
Residents and interns are physicians completing training in pediatrics. They work under the guidance of attending physicians and fellows to provide your child's care.
Specialists are physicians with advanced training in a particular specialty. It is not uncommon for the attending physician to have one or more specialists see your child while they are in the hospital. Some specialists you may see in the hospital could be Pulmonologist, Cardiologist, Endocrinologist, Surgeons, Otolaryngologist, Neurologist, etc.  Be sure to ask if you don’t know what specialty a physician practices or why they are seeing your child. 
Fellows are physicians who have completed their residency training and are now receiving advanced training in a pediatric specialty. Fellows work with an attending physician to provide your child's care. Fellows help teach interns and residents under the guidance of attending physicians.
Nurses –
Registered Nurses (RN) and Licensed Vocational Nurses (LVN) are responsible for providing the nursing care ordered by doctors, completing physical assessments, and notifying your child’s doctors of any needs, concerns, or changes regarding your child’s condition.
·   Charge nurses are responsible for overseeing the nursing care on your child's unit during a shift.
Clinical nurse specialists are registered nurses with advanced education in special areas.
Nurse practitioners are registered nurses with advanced education in special areas. These nurses are able to write orders and prescriptions under the supervision of the attending physician.
Other –
Physician Assistants (PA) practice medicine under the direction of physicians and surgeons. They are formally trained to examine patients, diagnose injuries and illnesses, and provide treatment.
·   Patient care assistants are trained to help nurses care for your child. They work under the supervision of a nurse and provide routine care activities but are unable to give medications. In most cases, this is the person taking vital signs and doing other tasks like checking blood sugar, emptying catheter bag, etc.
 Respiratory Therapist (RT) have specialized training in the respiratory system. They perform respiratory (breathing) assessments, give nebulized breathing treatments that your doctor orders, monitor and regulate oxygen use, and work to make your child’s lungs, breathing, and ventilation are controlled.
·   Child Life specialists help meet the developmental, educational, and psychological needs of your child. They plan and provide activities and support to minimize stress while in the hospital.
Nutritionists offer guidance on nutrition to help your child to grow and heal.
Radiology technologists perform X rays, ultrasounds, CAT scans, MRI scans and other tests to help the healthcare team treat your child.
Discharge Planners / Case Managers help plan for your child's discharge, make referrals to community resources if needed, coordinate insurance coverage, and work with the home care coordinator if home care services are needed.
·   Social workers provide counseling, information, referrals to community agencies and emotional support. They can help decrease stress and guide you and your family during your hospital stay.

Going Home!

I’m so relieved to be going home, but I’m nervous too. How can I be sure we are prepared?

Going home from the hospital usually brings relief to children and parents. However, many children have trouble adjusting after a procedure or hospitalization, especially if they are still recovering or experiencing pain. Such adjustment difficulties are normal, and may last anywhere from a few days to a couple of months. It is important to return to your family routines as soon as possible, and to maintain family rules and limits regarding your child’s behavior.

Before leaving the hospital, make sure you have ALL of your questions and concerns addressed. Do you feel safe taking the child home? Do you feel that he or she is stable enough to go home? Did the hospital staff teach you everything you need to know to care for your child at home? Was there something that you wanted the doctor to address that was not done. Once you have done this and are comfortable and agree that your child is ready to go home, the next step is getting things in order to go home. Have someone at home prepare your child’s room by changing their linens and freshening up their space. It is important that they come home to a clean environment. Also, have a list of follow up doctor appointments that your child will need after discharge. If the nurse didn’t make the appointments for you, do this as soon as possible and no later than the next day after discharge. Ask your child’s doctor to send any prescriptions to your pharmacy before discharge so that they will be ready for pick up when you go home. Be sure you have a list of what medications were ordered so that you can ensure you get the correct medicines at pick up. The nurse will review the Discharge Orders with you before you leave. Make sure you understand the doctor’s discharge orders, especially regarding medicines, dressing changes, diet, activity, and any home medical equipment or treatments. If you are receiving services at home, be sure to contact these providers to ensure they are prepared to resume services. If they are not, be sure to relay this information to your child’s doctor and the discharge planner/case manager working with your child.