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Summer is around the corner, bringing heightened risks of heatstroke, especially for children who cannot regulate their body temperature as efficiently as adults. Infants are particularly vulnerable and may not express discomfort, so never leave a child unattended in a vehicle. Top Tips for Preventing Heatstroke Reduce the number of deaths from heatstroke by remembering to ACT. Avoid heatstroke-related injury and death by never leaving a child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not inside so kids don’t get in on their own. Create reminders. Keep a stuffed animal or other memento in your child’s car seat when it’s empty, and move it to the front seat as a visual reminder when your child is in the back seat. Or place and secure your phone, briefcase or purse in the backseat when traveling with your child. Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations Keeping Your Baby Cool in the Back Seat In hot weather, it is crucial to keep your baby cool and hydrated by using a car seat cover or towel over them to reflect the sun's rays. Dress your baby in lightweight clothing that covers their arms and legs. Keep an eye on your baby's skin color. Move them to a cooler place if they look too red or flushed. Keep the temperature at a comfortable temperature for you, not for your child. Keep the windows cracked open for ventilation and ensure nothing is blocking the airflow from entering or exiting the vehicle. Dress your infant appropriately for their environment, including appropriate head and neck coverings, to keep them cool and protected from sunburns. Ensure you have enough fluids to last an hour before getting out of the car or use bottled water if possible. Never leave your child unattended in a car. Steps to Follow if You Suspect Heatstroke  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 Fahrenheit. Baby Safe Classes These classes help prepare parents for emergencies that may occur in baby’s first year. Safe Kids Worldwide 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.”

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When it comes to each patient’s healthcare journey, medication is often a key chapter. After all, medication is one of the most common treatment methods to help patients on the road back to health. In 2023, 4.83 billion prescriptions were filled in the U.S., and with this number only anticipated to rise annually, having an expert pharmacy team on your side to make certain you are prescribed the ideal dosage to treat your condition, prepare your prescriptions on time and help you manage your medications responsibly is important.  Fortunately, at Renown Health, we have best-in-class inpatient and outpatient pharmacy teams to fill both prescriptions and promises for excellent care. Renown Pharmacy plays a vital role in helping us foster a health system that prioritizes patient well-being above all else. This department exemplifies the impact that a unified, expert pharmacy team can have on patient outcomes now and in the future.  The Masters of Medication Spanning three hospitals plus ambulatory locations across the health system, Renown’s growing pharmacy team – full of dedicated pharmacists, pharmacy technicians and even medical assistants – manages medications in a wide variety of patient settings, touching nearly every aspect of the healthcare continuum: Outpatient Retail Pharmacies Renown Regional Medical Center – 75 Pringle Way The Healthcare Center – 21 Locust Street Renown South Meadows Medical Center – 10101 Double R Blvd  Inpatient Pharmacies Renown Rehabilitation Hospital Renown Regional Medical Center (including Renown Children’s Hospital) Renown South Meadows Medical Center COMING SOON: Conrad Breast Center Pharmacy (in honor of Kristina Ferrari) in the Specialty Care Center at Renown South Meadows Ambulatory Pharmacies Anticoagulation Services – Institute for Heart & Vascular Health (IHVH) Pharmacotherapy Program – IHVH and Renown Medical Group Locations Congestive Heart Failure Pharmacotherapy Program – Center for Advanced Medicine B at Renown Regional Chronic Obstructive Pulmonary Disease (COPD) Pharmacotherapy Program – Renown South Meadows Endocrinology Pharmacotherapy Program – Renown South Meadows Additional Pharmacy Programs Medical Reconciliation Pharmacy Residency Clinical pharmacists at Renown bridge the gap between medicine and compassionate support, making sure each patient receives personalized care one prescription at a time.  “There are various roles pharmacists play within Renown,” said Clarissa Munoz, Clinical Pharmacist in the Renown Regional Inpatient Pharmacy. “Staff pharmacists work diligently to ensure correct medications are dispensed, and if compounded, make sure they were prepared properly. They also work hard to answer medication messages and phone calls, help verify orders and make sure ode trays/RSI kits are appropriately stocked and ready when needed. Clinical pharmacists work from satellite pharmacies on the floor and focus on reviewing patient charts and aim to provide additional interventions to the providers to optimize treatment strategies. We also serve as a resource for nursing staff and help answer medication questions.”  “My role in the pharmacy is pretty expansive,” added Chanelle Ajimura, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I maintain inventory to confirm patients can receive their medications in a timely manner both for our discharge and retail patients while balancing the Meds to Beds program, which offers medication delivery to the bedside and bedside medication counseling; collaborating with an interdisciplinary team to find the most affordable price for patients; and verifying that the dose, strength, indication, etc. is appropriate for the patient from start to finish.”  “In the pharmacy, I make sure patients are receiving appropriate drug therapy by checking for major drug interactions and ensuring appropriate dosing,” added Courtney Church, Clinical Pharmacist in the Renown Regional Outpatient Pharmacy. “I also make recommendations to providers so patients can get cost-effective therapy.”  Our pharmacy technicians work behind-the-scenes ensuring efficient medication management, making a difference in the lives of patients every day.  “A pharmacy technician is responsible for making sure the patient gets their medications on time and at the lowest price possible,” said Nate Graham, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “This is done by working with patients, insurance companies and case workers. We fill prescriptions, enter prescriptions into our system, receive and send orders for medications and maintain a clean pharmacy with an accurate inventory.”  “We do a variety of things; the task people probably know the most is counting out the medications and putting them in the amber vials,” added Rachel Vallin, Pharmacy Technician in the Renown Regional Outpatient Pharmacy. “We also help patients at the front of the pharmacy, ring out their prescriptions, answer some basic questions (deferring to a pharmacist as necessary) and billing insurance. Meds to Beds is my favorite part because I feel the most involved. I take medications to patients who are discharging up to their hospital rooms so they have it with them when they leave.”  “As a technician, I confirm that all medications of new admissions are available in our machines prior to admitting and then maintain stock during each patient’s stay,” added Tammara Axtman, Pharmacy Technician at Renown Rehabilitation Hospital. "I also assist our nurses when needed in regard to any of their questions with both EPIC and Omnicell.”  Our pharmacy team is also on the move all across our health system, thanks to our Ambulatory Pharmacy programs. For patients experiencing a serious heart, lung, or endocrine condition that requires ongoing drug therapy maintenance and guidance, our ambulatory pharmacies step in to carefully monitor how their medications impact their health and well-being.  “Our role as pharmacists in this department is non-traditional because we actually see patients in the exam rooms face-to-face,” said Cory Lankford, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We modify their medication regimens and drug recommendations under collaborative practice agreements.”  “Because our role is so unique, we have a lot of opportunities to make a positive impact on patients,” added Janeen Abe, Ambulatory Care Clinical Pharmacist for Renown’s Anticoagulation Services. “We do a lot of direct patient interaction, including counseling patients on their medications and helping them navigate through their disease state.”  “As a medical assistant in this department, we’re called the patient ‘liaisons’ to orchestrate who they should go to whether it’s a nurse, a provider or a pharmacist,” added Kiara Scruggs, Medical Assistant for Renown’s Anticoagulation Services. “We look at each patient’s medications and help with the Warfarin blood thinner monitor. We get to do a lot with patients." A key resource within the Pharmacy department and the emergency admission process, our Medical Reconciliation ("Med Rec") team stays on top of each patient's medication records. By ensuring each medication regimen is accurately reflected in each patient's chart and that patients continue to take their at-home medications while admitted to the hospital, this team provides vital insight into medications that could be a contributing factor to each patient's symptoms, including drug interactions. “Our medication reconciliation pharmacy technician team are true detectives,” said Heather Townsend, Clinical Pharmacy Supervisor. “When a patient arrives to the hospital, Med Rec works with patients, families, caregivers and outpatient pharmacies to compile a list of medications the patient has been taking a home. This list is used to make sure medications are not contributing to the patient’s symptoms and to assure medications are continued throughout the hospital stay. The addition of the medication reconciliation team has been one of the greatest advancements in medication safety.” “As a Med Rec Tech, we interview patients and family members and call pharmacies, skilled nursing facilities, etc. to obtain an accurate and complete medication list/history to outline what the patient is currently taking on a daily basis,” added Kara McGee, Medical Reconciliation Pharmacy Technician. “We make sure that we document the correct medication, dose, route, frequency and directions. This information is crucial because the nurses, pharmacists and physicians look at our work to figure out if any medications are contributing to the patient's health condition, and for the continuation of home medications on admission.” “Even though the Med Rec Tech might seem small in the hospital realm, it is very vital for patient information and beneficial to the patient's health,” added Brizza Villafan, Medical Reconciliation Pharmacy Technician. “There is never a dull moment in this work.” No matter the diagnosis, having Renown Pharmacy as an integral part of your healthcare team is a win-win situation for both you and them: you receive access to medication to help you heal, delivered to you with precision and care, and the pharmacy team has the opportunity to care for you and make a positive impact, a role they take seriously.

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Chronic pain can be one of the most distressing feelings someone may encounter – and more likely than not, you know someone who is managing their pain as a part of their healthcare journey. In fact, according to the Centers for Disease Control and Prevention, about 1 in 5 U.S. adults have experienced chronic pain in recent years. One of the most common methods of treating pain is through prescription pain medications; however, with the rise of the opioid epidemic across the country, leveraging other interventions to help patients manage their chronic pain has become increasingly more important. What if there was a way to treat pain directly without the automatic need for pain medication? Luckily for patients in northern Nevada, our Special Procedures department at Renown Rehabilitation Hospital specializes in exactly that: interventional pain mitigation sans painkillers. With nearly 95% of their patients who come in with pain-related mobility issues being able to physically walk out of the hospital after their treatment, much-needed relief is clearly in store. Tight-knit and forever-caring, the Special Procedures team knows how to transform the purpose of pain management. A Penchant for Pain Alleviation Renown's Special Procedures team offers a wide variety of pain management solutions that are uniquely tailored to each individual patient’s needs. With the help of a team of 14 attentive nurses, interventional radiology technologists and a surgical technician – plus a dedicated patient access representative ensuring everything goes smoothly behind-the-scenes – these lifechanging interventions include: Epidurals (including steroid epidurals) Nerve blocks Ablations Tenotomies Spinal cord stimulator trials Peripheral nerve stimulator trials The nurses on this specialized team guide patients before, during and after their procedures, making sure they are at ease throughout the entire process. Each nurse emulates both expertise and empathy to help light the path towards healing.  “Before each procedure, we get the patient’s vitals, health history and work with the doctor to answer any questions they may have about what is going to happen in the procedure room,” said Michon Edgington, RN. “After they’re all done, they come back to me, and I make sure they are ready to go home by educating them on their discharge. Our goal is to get them back to their families very quickly.”  “In the actual procedure room, we perform safety checks, do charting, prepare the sterile tray for the doctor and give medication for conscious sedations, all while consistently monitoring the patient and helping the doctor out along the way to help the procedure go well,” added Shannon Boelow, RN.  This team’s dedicated imaging professionals harness expertise that goes beyond capturing images. Their skillful utilization of X-ray technology serves as a guide for doctors administering treatments for pain – and according to our own physicians, our imaging technologists are some of the best in the business.  “Our X-ray skills here are specialized,” said Julie Smith, Imaging Lead. “Visually, the doctor needs to see what’s going on inside the body so they can accurately place needles and steroids. We all work together collectively and work with each doctor to accommodate their preferences, helping the treatments go much faster and minimizing the patient’s exposure to radiation.”  Serving as the ideal representation of both precision and support, the surgical technician on this team is an important collaborator in the procedure room, helping to ensure the success of every interventional procedure with a meticulous eye for detail.  “As the Special Procedures surgical technician, I get the room ready with all the necessary instruments, including making sure everything is sterile,” said Carrie Crow, Surgical Technician. “I enjoy keeping the team organized.”  Overseeing it all are the physicians, who are eternally grateful for the team for the life-changing interventions they offer every day.  “Our physicians are so phenomenal,” said Brittney Summerfield, Manager of Nursing. “They are very supportive and collaborative, and they always do the right thing. They have total confidence in us.”  Seeing patients walk out of the hospital happy and healthy is a driving motivator for this team. Whether they had significant experience in pain management or were ready for a completely new challenge, each team member comes to work every day inspired to move mountains.  “I had worked in pain management in other facilities, and I was extremely excited to come here and solely focus on pain,” said Jodi Eldridge, Supervisor of Special Procedures. “I enjoy seeing the patients so happy when they leave no longer in pain. I feel immediate gratification, because you truly feel like you’re doing something big for the patient. It’s very rewarding.”  “I decided to come work here because I worked in the inpatient setting for a long time, and I was ready to see a different side of healthcare and provide a different type of care to our community; plus, my coworkers are the best,” added Lisa Dunnivant, RN.  There’s no question that the realm of pain management is a delicate one – and there is no team better suited to take on that challenge than Special Procedures, working harmoniously to bring relief and a renewed sense of livelihood for every patient they serve.  “Some people believe pain management is just all about pills, and that is simply not true,” said Carrie Crow. “Our procedures are yet another way to help them manage their pain and find relief.”

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Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

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

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

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Tendonitis occurs when a tendon in your body is inflamed or irritated. This painful condition can impact your day-to-day activities, but can be managed and prevented. Luis Palacio, MD, shared some insights into how to manage tendonitis. Overuse and Repetitive Motion Tendons are complex tissues in our body that connect muscles to bones, allowing us to move. Unfortunately, sometimes these tendons become inflamed, worn down or injured, a condition called tendonitis. Symptoms of tendonitis include pain or dull ache, tenderness and mild swelling at the site. While tendonitis can be caused by a sudden injury, it is more commonly seen in frequent motions, including: Repetitive motions in exercise, work or other physical activities. Awkward positions in a movement, including poor posture. Forced movements that strain your body. Sudden increase in frequency of movement or level of difficulty, including little to no recover time between new activity. Shoes without proper support or hard surfaces, such as concrete floors. Evaluation is Key If you suspect that you have tendonitis and it does not resolve on its own after a few days, you should get it evaluated by a primary care or sports medicine doctor. They can make recommendations to aid your recovery and refer you to the right sub-specialist if needed. With some intentional actions, you can help reduce the risk of tendonitis with the following suggestions: Add variety: Mixing up the type of exercise you do will help prevent repetitive motions that can result in overuse. Stretch and condition: Make sure the keep up with proper stretching and muscle strengthening to support your physical activities. Do it right: Make sure that the way you are completing exercise or work-related physical activities is correct. Seek out a professional for lessons or guidance if you are unsure.

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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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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens.   What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes.   What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting   For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.

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Grab your skis, goggles, coat – and don’t forget that helmet. Skiing and snowboarding are fun activities for all ages but come with the risk of injury. Read on for tips to make it a safe day on the mountain. Daydreaming about your next trip to the slopes? We talked to Jared Worchel, DO, about his top tips for gearing up. Get the Gear Before you head out to ski or snowboard, make sure you have all your gear ready and in good condition. Everything should fit correctly so that it keeps you as safe as possible. Wearing proper gear will also help keep you warm. Items to check on before you head out include: Boots Bindings Goggles Poles Helmet Outwear Gloves Pack water and snacks in case the drive takes longer than you except due to weather or traffic. You’ll also want to make sure that your cell phone is fully charged before you head out in case you need to contact friends of staff for help while on the mountain.  Helmet, Helmet, Helmet Having a helmet that fits correctly is the most important thing you can do to prepare for a safe day on the mountain. According to a National Ski Areas Association study, helmet use has increased over the last 15 years, with 80 percent of skiers and snowboarders using helmets. Schubert would like to see that number increase to 100 percent. “If you have a head injury it could take you out for the rest of your life,” Dr. Worchel said. “The most important things to think about when fitting a helmet are making sure that it really fits you appropriately. You want to go into a store and try on as many different helmets as they have available. I know it’s tempting to buy one online, but you’re never going to know if it fits correctly.” If you are in an accident, your helmet’s fit can help protect you. Dr. Worchel has some tips on fitting: A helmet should fit low and snug over the head. Make sure that the helmet doesn’t wiggle or feel loose. Look for a model that has adjustability in the back, which will help you make sure it fits snugly. F ind a helmet with a chin strap that will help it stay in place throughout the day.

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