Over the last couple of years, WakeMed’s Families First publication has offered lots of great back-to-school tips for parents and kids.  In celebration of back-to-school, we have shared this timeless information with you from sleep training to vaccinations to packing your child’s lunch to how to know when your child really is too sick for school.

In the chaos of getting yourself ready for work and your child off to school, you notice your child seems a little warm. Do you keep them home for that?

Knowing when to keep your child home from school is sometimes difficult. If they’re not really sick, they miss school unnecessarily. If they are sick and you send them to school, they’re bounced between home and school when they really should be home getting rest.

As a general rule, if your child has any of the following, you should keep them home from school:

-Vomiting

-Rash

-Diarrhea

-A fever above 101

Sometimes your child exhibits these symptoms and then seems to recover quickly. So, what do you do? Trust your instinct. The vast majority of parents have good instincts when it comes to their child’s health. The best strategy is to relax and do what you think is best for your child.

Lindsay Kimbrell and Beth Eskridge are microbiologists in the WakeMed Pathology Lab.

Last month, we asked you to recommend some items for us to swab, culture and interpret.  We swabbed a ketchup bottle on a restaurant table, buffet tongs, vending machine buttons, hallway hand sanitizer pump, gym water fountain, elevator buttons, grocery cart handle, public bathroom sink handle and a door handle at a department store. 

And, we even took it one step further growing cultures on plastic daycare toy, video game controller, cell phone, microwave, stuffed animal, mom’s purse, refrigerator door handle and a lunch box. 

Encouragingly we found no significant disease-causing organisms on any of these items.  Everything had germs and there was skin flora on every single culture, but all of the organisms were things that are typically found on skin.  In fact, this good bacteria helps protect our skin from more opportunistic bugs like MRSA.

What we learn from this experiment is that there are germs on everything, but as long as we are healthy, the chance of getting sick by touching everyday items is very small.  There are exceptions, however.  So, to protect yourself make sure to wash your hands frequently using proper technique, especially after using the bathroom or handling raw meat or eggs.

Deb Laughery, vice president of Public Relations, was honored this month as one of the 2010 Triangle Business Journal (TBJ) Women In Business. The TBJ Women in Business awards recognize the Triangle’s most dynamic professional women.

For more than 13 years, Laughery has been responsible for WakeMed’s corporate communications, advertising, marketing, public relations and community relations activities. She also serves on the communications board of the Greater Raleigh Chamber of Commerce, Artsplosure Board of Directors, N.C. Coastal Pines Girl Scouts Board of Directors and the Junior League of Raleigh Community Advisory Council, while being active in numerous professional organizations. With more than 27 years of health care communications and marketing experience, Laughery contributes a vital skill set to WakeMed.

Carolina Parent N.C. Family-Friendly 50 Company
Carolina Parent magazine and the UNC-Chapel Hill Kenan-Flagler Business School have chosen WakeMed as one of their 50 N.C. Family-Friendly Companies for 2010. Organizations that are selected for this award show a commitment to family and a healthy work/life balance.  WakeMed offers family-oriented health benefits, child care benefits, tuition reimbursement, family support, work-life training and many other benefits that help employees balance their work life with their life at home.

Breastfeeding-Friendly Business Award
WakeMed received the Breastfeeding-Friendly Business Award from the North Carolina Breastfeeding Coalition (NCBC) this July.  Businesses chosen for this award take simple, cost-effective actions to support breastfeeding patrons and staff.  As an award winner, WakeMed will be listed as a Breastfeeding-Friendly Business on the NCBC website and receive a certificate to display at a prominent location within our organization.

Mary Schilder is director of internal consulting in WakeMed Information Services.

Last week, the North Carolina Hospital Association (NCHA) and The North Carolina Medical Society (NCMS) announced that WakeMed and Moses Cone are the initial beta sites to develop and launch the North Carolina Healthcare Information Exchange (NCHEX).  This is an exciting project for every health care provider and patient in North Carolina.

For years, hospitals have been submitting data to the North Carolina Hospital Emergency Surveillance System (NCHESS).  NCHESS is a system that tracks infectious diseases and works to catch potential outbreaks or pandemics in real-time so the spread of the disease can be controlled early on.  North Carolina is already a bit ahead of the national curve with state-wide data submission because 111 hospitals are already contributing data twice a day to NCHESS.

Using the already successful NCHESS platform, NCHEX is going to take it one step further and create a clinical database that will enable authorized users to access a patient’s record, enabling the provider to see lab results, medications, physician interactions, diagnoses and much more. This statewide electronic medical record is going to improve the health and safety of the medical care provided across the state as well as increase efficiency of our health care system.

Over the last couple of years, WakeMed’s Families First publication has offered lots of great back-to-school tips for parents and kids.  In anticipation of back-to-school, we will share this timeless information with you from sleep training to vaccinations to packing your child’s lunch to how to know when your child really is too sick for school.

Packing your child’s lunch (and yours) is a good way to ensure they’re getting the recommended daily allowance of vitamins and minerals.

Check out these ideas from Julie Paul, MS RD LDN CDE, dietitian with the WakeMed Children’s Diabetes Program:

• Instead of the same type of bread every day, try whole grain rolls, bagels, buns, pita pockets, English muffins, flat breads or crackers.
• Try bean spreads, nut butters or vegetable strips instead of meats for a sandwich stuffer.
• Use leftovers from dinner the night before (salad, pasta salad, chicken breasts).
• Pack an assortment of raw or grilled vegetables (carrots, celery, bell pepper strips, snow peas, tomatoes, broccoli, cauliflower) with dipping sauce.
• Make kabobs with fresh fruit and vegetables.
• Try vegetable juice instead of fruit juice.
• Make your own trail mix with whole grain cereals, pretzels, raisins and nuts. To help mornings go smoother, pack lunches the night before.

With back to school just around the corner, WakeMed is participating in events for the young and a little older this weekend.

Look for us tomorrow (August 21) at Marbles Kids Museum for Kick Off to Kindergarten.  Our Children’s Asthma and Diabetes Programs will be sharing information about managing these diseases at school.

Also, tomorrow we will be participating in the Vype High School Sports Expo.  We’ll be sharing information about our Concussion Clinic and how to identify a concussion, as well as providing grip strength tests through our rehabilitation program.

Hope to see you there.

Today on NBC’s Today Show, they included a story about how adolescents are experiencing hearing loss, most likely due to exposure to loud noises and ear buds.

Visit msnbc.com for breaking news, world news, and news about the economy

Wake Specialty Physicians – ENT Audiologists Jeanne Lansing and Cameron Warren offer the following suggestions to identify hearing loss and minimize your child’s over exposure to noise.

When Is Loud Too Loud?

Noise induced hearing loss (NIHL) is a gradual, painless and cumulative loss of hearing associated with over exposure to loud sounds. There are three factors associated with NIHL:

• Loudness
• The duration of exposure to the sound
• The frequency a person is exposed to the sound
• Proximity to the sound

Safety experts use these factors in a specific mathematical equation to determine if factory workers need ear protection on the job,” says Warren.  “These measurements are difficult to obtain for personal devices.”

Tips and Technology to Prevent Hearing Loss

• Set the volume at 50 percent or less.  Many devices have volume ranges.  Set the volume at no more than 50 percent. 
• Limit exposure.  Monitor your child’s listening habits as much as possible.
• Don’t hear the music.  You should not be able to hear the music or game your child is listening to when he or she is using earbuds.
• Volume lock parental control. Many portable music devices come with volume locks.  These are great for younger children but not as effective for older children and teens, who learn how to circumvent the parental control.
• Custom earmolds.  For about $100, you can have these made for your child.  Custom earmolds limit the outside noise associated with improperly fitting earbuds so kids can turn down the volume.

So, how can you tell if the music coming through those earbuds into your child’s ears is too loud?  “The next time your child is listening to the mp3 player, stand about three feet away.  Can you hear the music he is listening to?  If so, the volume is up too high,” says Lansing.

Lansing and Warren agree:  noise induced hearing loss is 100 percent preventable.  They also agree that audiologists will begin to see more people who experience hearing loss from over exposure to noise at a younger age than in the past.  “Hearing loss is painless and happens over time,” says Warren.  “Before you realize it, you are having problems.”  If teens, and, yes, adults who “crank up the tunes” turn down the volume and exercise the right precautions, they can enjoy excellent hearing for many years to come.

What Are the Signs of Over Exposure to Noise?

• Ringing in the ears – Temporary or constant
• Speech sounds muffled after you remove the earbuds
• If parents and teachers need to raise their voices after exposure to the noise
• Difficulty understanding someone an arm’s length away
• Ear pain can also be associated with over exposure to noise, but it is not common.

Stephen Leinenweber is a pediatric intensivist with WakeMed Children’s Hospital.

In the past, we would typically only see Methicillin-resistant Staphylococcus aureus (MRSA) infections in patients who had been in the hospital for a long period of time.  Now, we are seeing more and more community acquired infection.  In other words, we are now seeing patients who have had no history of a hospital stay present with MRSA infections to physician offices and emergency departments.

MRSA is a particular strain of Staphylococcus aureus, which is a bacteria commonly found on the skin, that has become immune to many of the antibiotics we commonly use to treat skin infections.  It is likely that MRSA became resistant to many of antibiotics due to antibiotic overuse.  Regardless of the origin, MRSA is here to stay and it is a significant problem. 

I estimate that we admit at least one pediatric patient in need of IV antibiotics or even surgery due to advanced MRSA infections per day.  Children being admitted to the hospital represent the worst of all cases, and I am certain primary care physicians, pediatricians, and emergency rooms are seeing an even higher number of less severe cases.

The majority skin infections are from non-resistant Staph or streptococcus infections. MRSA is not something to fear, but it is a good idea to know a little something about this increasingly common skin infection. 

MRSA FAQs

Does MRSA impact children as well as adults?

The short answer is yes.  However, anecdotally it also appears as if children are more susceptible to develop more serious MRSA infections, but we don’t really know why.  It might be that kids receive more antibiotics due their frequent exposure to more illnesses.

Can you prevent MRSA?

You can’t eradicate staph living on the skin.  The best prevention is just to practice good skin care.  You don’t want the skin to be too dry or too moist.  It is also a good idea to have limited contact with someone you know is being actively treated MRSA.  And, as always, wash your hands and your children’s hands frequently.  It’s a good idea to regularly wash your children’s toys and sports equipment, as well.

How can you tell it’s MRSA?

MRSA’s symptoms are the same as any other skin infection (because it really is just a certain strain of bacterial infection). Look for red streakiness of the skin, skin that is warm to touch or a painful area that might suggest an abscess or bad skin infection.  If you or your child has any of these signs, seek medical advice from a primary care physician or, if severe enough, the emergency room.

Realize too, that often physicians will not swab and culture the infection, instead choosing to treat the infection as if it were MRSA.  So, do not be surprised if the diagnosis of MRSA is never confirmed. From a medical standpoint unless the infection is severe, typing the infection does not matter.

Should I avoid people I know have been treated for MRSA?

There are a lot of social stigmas associated with MRSA, but again MRSA is everywhere.  And, yes, I have and I will continue to allow my children to go play with another child who has been treated for MRSA.  I arm them with education, so they understand the importance of good hand hygiene.

Want to learn more about MRSA?  Dr. Mark Piehl, medical director WakeMed Children’s Hospital, was quoted in a story in yesterday’s News & Observer about MRSA infecting otherwise healthy people.

This Thursday, fight back with a vengeance against bumps, bruises and bacteria at a FREE safety event just for kids!

Join WakeMed’s Injury Prevention team and Safe Kids Wake County at 7 pm, just before a showing of Monsters vs. Aliens at Koka Booth’s Movies by Moonlight.

Kids will learn about safety through fun activities featuring water safety, bike safety, seatbelt fit tests, tips on calling 911, combating germs at school and more. We’ll have tours of emergency trucks, face painters, WakeMed Children’s mascot Twinkle, Sparky the Fire Dog and other safety good guys!

Thursday, August 19

7 pm to sundown

Koka Booth Amphitheatre, Cary

Movie tickets – $3 for adults; kids 12 and under are free.

A portion of ticket sales goes to pediatric safety programs at WakeMed.