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When a sudden illness or injury occurs, the emergency room (ER) provides immediate medical attention to those in need. Understanding the top reasons for visiting the ER can help people make informed decisions about seeking emergency care. Here are the five most common reasons people in Nevada visited an ER in 2023. 1. Abdominal pain  One of the top reasons people visit the ER is abdominal pain. The abdomen has many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. Significant pain in this area can be a cause of concern.  Warning signs of a serious problem include abdominal pain with fever, vomiting, and not being able to move or perform everyday tasks due to pain. Seeking medical attention when experiencing these symptoms is essential. Emergency physicians can perform abdominal exams, assess the condition and rule out significant threats.    2. Fever  High fevers that do not get better with medicine and are accompanied by other symptoms can cause concern. This can indicate that the body is fighting off an infection or illness.  Fever with symptoms like vomiting, pain, altered mental status, shortness of breath or inability to perform daily functions are warning signs to watch out for. Adults and children should visit an ER, where the team can assess the causes of the fever.   3. Chest pain and shortness of breath  Chest pain and discomfort, or pain in the upper body can suggest warning signs of a heart attack. If a person is experiencing signs of a heart attack, call 911 immediately to ensure timely treatment or assessment by a medical professional. Heart attack symptoms include:  Chest pain, including pain that can be described as chest pressure, heaviness or squeezing   Discomfort in the chest, arms, back, neck, shoulders and jaw  Difficulty breathing   Sweating with any of the above symptoms   When visiting a Renown ER for chest pain, a trained medical professional will promptly perform an Electrocardiogram (EKG) in an area where preliminary assessments, also known as triage, take place. Individuals experiencing shortness of breath or trouble breathing, whether from a respiratory infection, asthma complications or other pre-existing conditions should not ignore symptoms as these can signify more serious issues.  Warning signs of respiratory distress may include:  A significant change in breathing rate A significant change in the amount of energy used to inhale or exhale when breathing Changing of the skin color to blue, gray or paleness, which can indicate a lack of oxygen Nasal flaring  Chest retractions, which can suggest difficulty bringing air into the lungs What this looks like: the chest sinking in just below the neck, breastbone or rib cage while breathing 4. Neurological symptoms  Sudden and severe headaches or seizures may prompt individuals to visit the ER if symptoms are extremely disorientating or debilitating. These symptoms could be indicative of various conditions, including strokes or neurological disorders that require prompt evaluation.  If a person is experiencing signs of stroke, call 911 immediately to ensure timely treatment.  Stroke symptoms include:  Numbness, weakness or loss of movement in the face, leg or arm, especially on one side Confusion, including trouble speaking or understanding Trouble with vision or loss of balance  When choosing emergency care for signs and symptoms of stroke, a Comprehensive Stroke Center can provide patients with immediate intervention, including evaluation, treatment and education. 5. Cough/flu-like symptoms  Emergency departments are staffed by medical professionals trained to prioritize and treat emergency and trauma situations. Receiving care at an ER should be reserved for severe symptoms and life-threatening conditions. It’s best to schedule a visit with a primary care physician for mild cold and flu symptoms. Most urgent care locations are equipped with rapid testing options, including RSV, COVID-19, influenza, mononucleosis, urinary issues and strep throat. It is critical to distinguish between common respiratory infections and more severe cases, such as pneumonia or complications from the flu.   Symptoms that may warrant a visit to the ER include:  Rapid decline in the ability to perform regular daily activities  Coughing or throwing up blood  Severe dehydration and inability to drink fluids High fever not responsive to medication  Understanding top ER visits in Nevada  While these ER complaints are common reasons for emergency room visits in Nevada, it's important to remember that emergency care is available for all immediate medical needs. Do not hesitate to seek help at an emergency room if someone experiences a sudden or severe health concern. Quick and appropriate action can make a significant difference in keeping you and your loved ones healthy.  Renown Health is the largest locally governed, not-for-profit healthcare network in northern Nevada, providing leading emergency and trauma care by board-certified emergency physicians 24/7 at three locations, including the region’s only pediatric emergency department. Renown Health emergency rooms prioritize swift assessments, advanced diagnostic tools and compassionate care, providing leading emergency and trauma care. Trust Renown ER for not just emergency care but exceptional care. Learn more at renown.org/ER.

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If you or someone you know is experiencing a medical emergency, it's essential to seek immediate attention by calling 9-1-1 or visiting the ER for a thorough evaluation by a trained medical professional and timely intervention. Access to a convenient and trusted emergency room (ER) is critical to any person’s healthcare needs, including medical emergencies related to women’s health. We explored some common scenarios and warning signs prompting women to seek immediate medical attention with Aiden Gould, Board-Certified Emergency Physician at Renown Health. When your medical emergency can’t wait, Renown ER is here to provide you with the region’s leading emergency care to diagnose and treat your condition or illness.  Understanding Common Reasons Women Visit the Emergency Room Gynecological Emergencies: One of the most common reasons women may seek emergency care is due to gynecological emergencies such as severe pelvic pain, abnormal bleeding or complications related to pregnancy. These issues can be alarming and warrant immediate medical attention if the issue persists or is out of the ordinary for you.  Emotional and Physical Well-Being: For those facing diverse medical or mental health emergencies, seeking prompt assistance is crucial for a thorough assessment and safe, timely intervention. Renown ER teams are equipped with trained professionals who provide compassionate care for individuals seeking help in the following situations: Suicide risk assessment and intervention Substance abuse assessment Assault and trauma care Crisis support and intervention Resources for ongoing care and well-being support Severe Abdominal Pain: Unexplained and severe abdominal pain that is substantially different than what is normal for you is a symptom you should never ignore as it can indicate underlying issues. Warning signs of an acute medical situation include fever, vomiting or a rapid change in motor function and inability to move due to pain. Respiratory Distress: Difficulty breathing, persistent coughing and other respiratory issues can be especially concerning. Women with pre-existing respiratory conditions like asthma or those experiencing sudden respiratory distress should seek immediate care from a medical professional. Warning signs of respiratory distress may include a significant change in one’s breathing rate, changing of the skin color to blue, gray or paleness due to lack of oxygen, nose flaring and chest retractions. Cardiovascular Emergencies: Heart-related issues are not exclusive to men. Women can also experience cardiovascular emergencies that often go undiagnosed because symptoms differ from men. Symptoms like chest pain, extreme fatigue, vomiting or pain in the abdomen, shortness of breath or palpitations should be evaluated by an emergency medical professional as timely intervention is critical in such cases. Renown leads the region in cardiology care with our technological expertise and patient-centered approach. Our comprehensive team diagnoses heart disease and other cardiac conditions, offering personalized treatment plans.  Neurological Symptoms: Sudden and severe headaches, seizures or other neurological symptoms may prompt women to visit the ER if symptoms are extremely disorientating or debilitating. These symptoms could be indicative of various conditions from mild to severe, including strokes or neurological disorders that require prompt evaluation.  Renown Regional Medical Center is a Comprehensive Stroke Center, providing primary stroke care including evaluation, treatment and education to patients who arrive at a Renown facility with the signs and symptoms of a stroke. Compassionate Care in Times of Need At Renown Health, we understand that your time is valuable, especially in emergency situations. That's why we strive to provide patients with exceptional care, compassion and respect. Plan ahead and make informed decisions about seeking medical care by viewing your estimated triage wait time at a Renown ER.

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Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

Read More About What is Polycystic Ovary Syndrome (PCOS)?

Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

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Access to a trusted and efficient emergency room (ER) in times of unexpected medical emergencies is crucial. Renown Health’s emergency and trauma care is available at three ER locations, including the region’s only level II trauma center and ER designed for pediatric patients to provide you and your family with prompt, high-quality and specialized care by board-certified emergency physicians when you need it. Dr. John Hardwick, board-certified emergency physician at Renown Health, describes a guide to emergency care at Renown Health below. Timely and Compassionate Care: Renown ER is committed to delivering timely and compassionate care. Experienced medical professionals at Renown will communicate openly with you, involving you in the decision-making process and addressing any concerns you may have. Upon arrival, you can expect to be promptly assessed by a team of skilled medical professionals who will prioritize your needs based on the severity of your illness or condition. Click here to learn more about the emergency care process, from check-in to discharge. Expert Medical Team: With advanced technology and experienced specialists from Northern Nevada Emergency Physicians, all patients are in good hands for emergency care at Renown Health. Our pediatric and adult emergency physicians have completed fellowship training in specialty areas such as sports medicine, ultrasound and emergency medical services. Team members in the emergency department will ensure you are informed and as comfortable as possible during your visit to minimize any pain or discomfort you may feel. Efficient Triage Process: Renown ER utilizes an efficient triage process to prioritize patients based on the urgency of their medical condition. This ensures that those with more critical conditions receive immediate attention, while still providing timely care for others. Tests such as labs or diagnostic services will often be completed while you wait to see a physician to expedite the process. Comprehensive Diagnostic Services: The ERs at Renown offer comprehensive diagnostic services to quickly identify your symptoms. This may include X-rays, laboratory tests, CT scans and other imaging studies, helping emergency physicians make informed decisions about your treatment plan.   Specialty Care and Collaboration with the Renown Health Network: We offer the area's largest network of specialized providers and services to help ensure you receive industry-leading, personalized care during and after your emergency room visit. This collaboration means you’ll have access to more specialists and a wide range of expertise to continue your care without leaving the Renown Health network. State-of-the-Art Facilities: Renown Health invests in state-of-the-art facilities and equipment to ensure that patients receive the best possible care. Renown ERs are equipped with modern medical technology, allowing board-certified emergency physicians to diagnose and treat a wide range of medical conditions. Post-ER Visit Support and Resources: Your experience with Renown Health doesn't end when you leave the ER. Our team will address your questions and provide you with post-visit instructions, medications and follow-up recommendations to continue your care. With a commitment to timely and compassionate care and a team of expert healthcare professionals, you can trust Renown ER to provide the highest standard of emergency medical services when you need it most.

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Participating in sports and physical activities is enjoyable and beneficial for our health. However, the risk of injuries comes with the fun and excitement of sports. Sports-related injuries, including sprains, traumatic brain injuries and broken bones, are more common than we realize and can land you in the emergency room. Dr. Scott Shepherd, Emergency Medicine Physician, provides a wealth of information. Traumatic Brain Injuries: The Invisible Threat Traumatic brain injuries come in many forms. From “mild” brain injuries, concussions, to major brain injuries and bleeds. Sometimes it is very difficult to tell the difference between a major injury and a minor injury because many of the symptoms are the same. Concussions Concussions are a type of “mild” traumatic brain injury resulting from a blow to the head or a violent shaking of the body that causes a transient alteration in mental function. They are particularly prevalent in contact sports such as football, soccer and boxing. A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. Typically, concussions are not life threatening and usually short lived. However, multiple concussions can lead to permanent disabilities. So, remember there is nothing “mild” about injuring your brain. Contusions The more serious brain injuries from brain contusions (actual bleeding in the brain material) and bleeding that presses on the brain are life threatening. These injuries are caused by the same blow to the head as a concussion and the symptoms are the same from memory deficits, loss of coordination to coma. Because of this, anyone who has a blow to the head and is not acting normal should be evaluated by a medical professional. Anyone suspected of having a severe head injury should seek immediate medical attention and follow a strict protocol for rest and a gradual return to play. It is important to note a person may not lose consciousness if they suffer a concussion; however, major consequences can occur if not properly managed. If you suspect you have an emergency that needs immediate medical attention, please call 911 or visit an emergency room near you. While it is impossible to prevent traumatic brain injuries altogether, the severity of the injury can be mitigated through proper helmet usage and knowing your skill level when participating in high-risk activities. The guidelines for picking a helmet for summer activities such as mountain biking, dirt biking and riding off highway vehicles are similar to those of picking a helmet for winter sports. Learn more about choosing the right helmet. Any blow to your head, neck or upper body can result in a major head injury Signs to watch for include the following: Headache Dizziness Blurred vision Difficulty with thinking, attention or memory Sensitivity to noise or light Ringing in the ears Changes in hearing Double vision Changes in behavior Balance issues Nausea/vomiting   Sprains: The Annoying Twist One of the most common sports injuries is a sprain, which occurs when ligaments that connect bones are stretched or torn. Sprains typically occur in joints, such as the ankle, knee or wrist, and are often caused by sudden twists or impacts. Symptoms may include: Pain Swelling Bruising Limited range of motion Rest, ice, compression and elevation (RICE) are the initial recommended treatment, followed by physical therapy to regain strength and mobility.

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When the sudden need for emergency or critical care arises, the level of a trauma center is an important designation that helps explain the types of resources available. Renown Regional Medical Center is proud to be the only Level II Trauma Center in our region, which is a critical service to provide. We spoke with Bret Frey, MD, an emergency care physician, to discuss what this means for our community.  Requirements for Designation as a Level II Trauma Center To be a designated Level II Trauma Center, a hospital must have 24-hour immediate coverage by general surgeons and multiple specialties, such as orthopedic surgery, neurosurgery, emergency medicine and more. In addition, this hospital must provide trauma prevention and ongoing education for its teams and incorporate a comprehensive quality assessment program.  “What it means for this community is nothing short of amazing,” said Dr. Frey, who explained that Renown has over 20 specialty physicians on-call and ready to provide trauma care. According to Dr. Frey, many communities of the same or larger size have fewer specialists ready and available to provide this level of care.  Renown Regional Medical Center is located near downtown Reno. The Emergency Department has several helipads and ambulance banks to intake patients requiring emergency care. Patients can also receive emergency walk-in care. On the same campus is Renown Children’s Hospital, which is home to the only pediatric Emergency Room dedicated solely to pediatric patients.  Emergency and trauma care is just one area in which Renown Health is the regional leader. When patients or families choose Renown during an emergency, they will have access to all the resources provided through the entire health network. This means access to the many specialists available to consult on different conditions or care situations, inpatient care if needed, referrals to other areas of the network and medications to go.  “I’m very happy and proud to be a part of building something very special in this community,” said Frey.

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As families spend more time outdoors to enjoy the summer temperatures, it's important to be aware of potential hazards that can lead to burns – be it sunburns, burns sustained while grilling or navigating the hot surfaces often found around pool decks and parks. All these burn types are not only painful but can also cause severe damage to the skin and require immediate medical attention.   Ross Albright, MD, an emergency care physician, explores effective preventive measures to avoid burns during the summer and discusses when it's essential to seek medical care.  Stay Sun Safe While soaking up the sun is a favorite summer pastime for many, it's important to protect your skin from harmful ultraviolet (UV) rays. Sunburns not only damage the skin but also increase the risk of more severe burns.  Follow these tips for staying safe in the sun:  Apply broad-spectrum sunscreen with a minimum SPF of 30 before heading outdoors and reapply every two hours.  Seek shade during peak hours of sun intensity, typically between 10 a.m. and 4 p.m.  Wear protective clothing, such as wide-brimmed hats, sunglasses and lightweight, long-sleeved garments.  Fire and Hot Object Safety Summer is full of fun outdoor activities like BBQs, campfires and fireworks, all of which can pose a fire hazard if not handled carefully.   To prevent burns caused by fires:  Maintain a safe distance from open flames and grills and always use oven mitts or potholders when handling hot objects.  Keep a fire extinguisher and a first aid kit readily available.  Keep children away from hot objects and fireworks and educate them about the dangers of touching or playing with them.  Hot Surface Safety  Asphalt, metal slides and surfaces around the pool retain heat and are likely to be significantly hotter than other materials such as a wooden picnic table to grassy pathway (these can still be hot too!). So, it's crucial to be cautious around these materials to prevent burns:  Use caution when near hot surfaces surrounding water sources, such as pool decks or metal slides.  Always wear shoes when walking on hot surfaces such as asphalt, concrete and even sand.  Ensure that playground equipment such as slides and swings are cool to the touch before your kiddos start climbing around.   Recognizing Severity of Burns and Seeking Care  Despite our best efforts, burns can still occur. It's essential to know when a burn requires medical attention:  First-degree burns, characterized by redness, pain and minor swelling, can typically be treated at home with cool water and over-the-counter pain relievers such as ibuprofen (Advil or Motrin) or acetaminophen (Tylenol).  Second-degree burns, which may cause blistering and more intense pain, should be evaluated by a healthcare professional. Third-degree burns, indicated by charring or blackened skin, deep tissue damage or burns that cover a large area, require immediate emergency care.  Preventing burns during the summer is paramount to enjoying a safe and enjoyable season. By following these tips, you can significantly reduce the risk of burns and ensure prompt medical attention when necessary. Stay informed, stay safe and have a burn-free summer!  If you or someone you know experiences a burn, it's important to seek immediate medical care.

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Abdominal pain is one of the most common complaints that brings individuals to the emergency room. We spoke with emergency physician Bret Frey, MD, to ask about when and where to seek care for abdominal pain.   Dr. Frey advises that any time you feel something is developing inside your body that is substantially different from what is normal for you, understand that something is wrong. He further explains that warning signs of an acute medical situation include fever, vomiting or a rapid change in function and ability to move due to pain. These symptoms indicate that one needs to be evaluated by a medical professional.   This evaluation will include the care team conducting an examination and asking a series of questions to determine if additional diagnostics, such as lab work or imaging, are needed. Be prepared to discuss where the pain is and what it feels like, in addition to how long it’s been bothering you and if it’s constant or intermittent.  While appendicitis often comes to mind when thinking about abdominal pain, Dr. Frey says that this is not the bulk of cases that the Emergency Department sees. In fact, often the pain does not have a specific diagnosis, but our team of board-certified emergency physicians are experienced in assessing and caring for those experiencing the acute symptoms he described.   “We often don’t come away with an answer about exactly what it is, but we substantially rule out life threats in a very methodical and systematic way,” said Frey.  The abdomen includes many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. In addition, pain stemming from your chest, pelvis or back may be felt in the abdominal area.  If you are experiencing abdominal issues that are persistent but not an emergency, talk to your primary care doctor about what you are experiencing, and be prepared to review the history of this pain, medications, allergies and diet. He or she will be a good partner to review conditions such as gas, heartburn, constipation, diarrhea, inflammation or menstrual and ovulation pain. Drinking plenty of water is always an important part of supporting your health.

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In today's fast-paced society, it is understandable for parents to want to take shortcuts in caring for their little ones. A s a result, It is tempting to leave a sleeping infant in a car seat or swing after a long day of errands or when you need a moment to catch your breath. But, as convenient as these devices may be, they pose a serious risk to your child's safety. Why Car Seats and Swings Pose Risks for Infant Sleep Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The American Academy of Pediatrics (AAP) states that “infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical.” If a parent must use a car seat or other sitting device, they should only do so for a short period of time and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The American Academy of Pediatrics (AAP) warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. This is because infants can easily slump over or become entangled in the straps, blocking their airway, and causing suffocation. Car seats, swings, and bouncers are quick and convenient ways to feed, hold, and sleep an infant. Not out of malice or discontent, but again from the need for quick and easy access to baby care in an already busy lifestyle. However, the risks outweigh the benefits. The AAP states: Infants should be moved to a crib, bassinet, or play yard for sleeping as soon as is practical. If a parent must use a car seat or other sitting device, they should only do so for a short period and never as a substitute for a proper sleeping environment. Leaving a sleeping infant in a sitting device, such as a car seat or swing, can create unsafe sleeping conditions. The AAP warns that doing so increases the risk of sudden infant death syndrome (SIDS) and positional asphyxia. In addition, infants can easily slump over or become entangled in the straps, blocking their airways and causing suffocation.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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Most babies weigh just one pound and are roughly the size of an eggplant when they reach 24 weeks of development inside the womb. It is a crucial stage when internal organs begin functioning, and the babies' respiratory and central nervous systems are still developing.     So, in November 2021 when Kallie Johnson experienced a premature rupture of amniotic fluid around this point in her pregnancy, her care team in Winnemucca decided to transport her via Care Flight to Renown Regional Medical Center. The team at Renown Children’s Hospital immediately began discussing the risks of delivering at 24 weeks with the Johnson family.  Moving Forward with Hope Knowing the stakes, Kallie remembers never feeling rushed to decide about delivering her baby preterm. “I felt educated and supported by my care team at Renown throughout our entire stay, starting with the education they provided about what it meant to deliver my baby early,” Kallie said. “The team really helped me make the best decision for myself and my family.”    Together, Renown employees and the Johnson family moved forward with a healthy set of nerves and a powerful feeling of hope.  Weighing in at one pound 11 ounces, Sloan entered the world on Nov. 19, 2021, via emergency Cesarean section. Her birth was classified as a micro preemie because she was born before week 26 of pregnancy and so small that she fit inside the palm of her father Sterling’s hand. A full-term pregnancy is classified as reaching 39 weeks.   A Fighting Chance  Called a fighter by many Renown Children’s Hospital care team members, Sloan spent over five months in the neonatal intensive care unit (NICU). She was placed on a ventilator, fed through a feeding tube and monitored 24/7, overcoming daily challenges with the Renown team and her family.  As a result of being born prematurely, Sloan developed a grade one brain bleed and a congenital heart defect called patent ductus arteriosus, a persistent opening between two major blood vessels, causing too much blood to flow to the lungs and heart.   To meet the oxygen needs of her tiny lungs, Sloan was intubated and developed a severe oral aversion and high-arched palate as a result. The effects would lead to difficult developmental and physical challenges that she still conquers today. Yet, with the help of her care team – including physical, occupational and speech therapists, dieticians and doctors – Sloan continues to make progress every day.

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