Lately I have tried to keep current regarding the COVID 19 outbreak, which is virtually the only thing on our minds. A great concern for pediatricians has been a marked increase in “accidental” injuries, driven mainly by 2 factors: normal routines disrupted, allowing greater opportunity for errors affecting safe practices previously built into daily schedules; and increased at home time for children resulting in more potential for harmful incidents.

Everyone  now focuses on cleanliness: clean hands, all surfaces constantly scrubbed.  Be careful! These agents are all caustic and poisonous. We pediatricians have been warning about the risk of household cleansers left out inadvertently. This was a concern before Mr. Trump’s unfortunate public comments about their use (at least hypothetically) as some form of treatment.  Whatever one’s politics, that certainly was not helpful in this regard.  Hand sanitizing agents are all high in ethyl and isopropyl alcohol, which also can cause serious toxicity when swallowed  or in one’s eyes.  We all must be vigilant in handling these materials.  Keep them high up, out of reach of all young children(<10 at least);  BE SURE to assess if older children are intellectually and emotionally equipped to use properly. Wherever possible, direct parental supervision is best.

Keep ALL medicines in original, properly labelled bottles, replace  in medicine cabinets immediately after taking the prescribed dose–DO NOT leave them on the counter where they may be discovered by children when unsupervised, even momentarily.  Don’t leave batteries, lighters, coins, jewelry around for toddlers–everything in boxes,  drawers up out of reach.

A special word about FIREARMS if you keep them in your home: both the weapon AND the ammunition should be stored in locked containers, SEPARATELY, away from all minors.  Children should NOT have access to the keys. It is always more dangerous to keep loaded weapons at home.  That is even truer now–children are home more!

Regarding emergency rooms: most pediatric ER’s are closed due to low volume with all care now shunted to the main ER.  I have previously advised against overuse of ER’s for more trivial, non-emergent matters.  Now, it seems, the opposite may be occurring.  Local pediatric ER physicians and surgeons report that the incidence of appendicitis diagnosis has shifted.  The ratio of early to perforated (later, more serious) diagnosis –previously 70/30 in favor of early, safer identification is more recently exactly the opposite– 70% of appendicitis diagnosis currently have already perforated and the children are much sicker. Likely this is due to an understandable, but in this instance misplaced, fear of being exposed to COVID.

That is just one statistic that reminds us that we must balance our legitimate worries with what we see in front of us at the time with a potentially sick child. I remind all of my patients that I am in my office and available by phone almost every day(where am I going to go?–I’m locked down too!) Please do not avoid addressing your child’s health concern.  Call me–we can discuss it, I can see them in the office, the PARKING LOT, and we are set  up for televisits as well.  I can call ahead to the ER to streamline your visit if we both agree it’s necessary.

Thanks for following.

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