Energy drinks and the facts ma'am

Emergency Department Visits Involving Energy Drinks

 From the Dawn Report: November 2011
Trend data show a sharp increase in the number of emergency department (ED) visits involving energy drinks between 2005 (1,128 visits) and 2008 and 2009 (16,053 and 13,114 visits, respectively), representing about a tenfold increase between 2005 and 2009

Approximately half of the energy drink-related ED visits (52 percent) made by patients aged 18 to 25 involved combinations of energy drinks with alcohol or other drugs

Overall, more ED visits involving energy drinks were made by males (64 percent) than by females (36 percent), and visits by males were more likely than visits by females to involve energy drinks in combination with alcohol (20 vs. 10 percent) or illicit drugs (12 vs. 5 percent); visits made by females were more likely to involve energy drinks in combination with pharmaceuticals than visits by males (35 vs. 23 percent)

When examined by the reason for the ED visit, more than two thirds (67 percent) of visits involving energy drinks were classified as adverse reactions

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Energy drinks are flavored beverages containing high amounts of caffeine and typically other additives, such as vitamins, taurine, herbal supplements, creatine, sugars, and guarana, a plant product containing concentrated caffeine. These drinks are sold in cans and bottles and are readily available in grocery stores, vending machines, convenience stores, and bars and other venues where alcohol is sold. These beverages provide high doses of caffeine that act as a stimulant upon the central nervous system and cardiovascular system. The total amount of caffeine in a can or bottle of an energy drink varies from about 80 to more than 500 milligrams (mg) of caffeine, compared with about 100 mg in a 5-ounce cup of coffee or 50 mg in a 12-ounce cola.¹ Research suggests that certain additives may compound the stimulant effects of caffeine. Some types of energy drinks may also contain alcohol, producing a hazardous combination; however, this report focuses only on the dangerous effects of energy drinks that do not have alcohol.

Although consumed by a range of age groups, energy drinks are marketed to appeal to youth and are consumed by 30 to 50 percent of children, adolescents, and young adults.² Of the several hundred brands of energy drinks on the market, the most popular brands of energy drinks that account for the majority of the market share are Red Bull, Monster, Rockstar, Full Throttle, and Amp. Marketing for energy drinks often targets young people, suggesting benefits such as increased energy and stamina, weight loss, and enhanced physical and/or mental performance.² Emphasizing thrill seeking with names such as "Cocaine" and "Venom," energy drink companies use innovative media to reach their audiences, such as advertisements in video games and at sports events, and solicit market research feedback from consumers via social media to help identify new packaging designs.³ The popularity of these drinks has increased markedly in recent years, with energy drink sales increasing 240 percent from 2004 to 2009.⁴

Consumption of energy drinks is a rising public health problem because medical and behavioral consequences can result from excessive caffeine intake. A growing body of scientific evidence documents harmful effects, particularly for children, adolescents, and young adults.² Among college students, associations have been established between energy drink consumption and problematic behaviors such as marijuana use, sexual risk taking, fighting, smoking, drinking, and prescription drug misuse.^5,6 In one study, bar patrons who consumed alcohol mixed with energy drinks were 3 times more likely to leave a bar highly intoxicated and were 4 times more likely to intend to drive while intoxicated than those who did not consume alcohol mixed with energy drinks.⁶ This latter finding may be because the high levels of caffeine found in energy drinks can mask the symptoms associated with being intoxicated (e.g., feeling lethargic). Individuals, especially youthful drinkers, may incorrectly believe that consumption of caffeine can "undo" the effects of alcohol intake and make it safe to drive after drinking. The popularity of energy drinks—coupled with the burgeoning literature suggesting the risks involved with their use—underscore the importance of gaining additional information about these beverages.

The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related emergency department (ED) visits in the United States and can be used as a source of information for assessing the more negative medical consequences associated with consuming energy drinks. To be a DAWN case, the ED visit must involve a drug, either as the direct cause of the visit or as a contributing factor. Such a visit is referred to as a "drug-related visit." Drugs include alcohol; illegal drugs, such as cocaine, heroin, and marijuana; pharmaceuticals (e.g., over-the-counter medicines and prescription medications); and nutraceuticals, such as nutritional supplements, vitamins, and caffeine products. This issue of The DAWN Report highlights trend data for energy drinks from 2005 to 2009, as well as describes characteristics associated with energy drink-related visits using combined data from 2004 to 2009.

Trends and Overview of ED Visits Involving Energy Drinks

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Trend data show a sharp increase in the number of ED visits involving energy drinks between 2005 (1,128 visits) and 2008 and 2009 (16,053 and 13,114 visits, respectively) (Figure 1).⁷ This represents about a tenfold increase between 2005 and 2009.

Figure 1. Energy Drink-Related Emergency Department (ED) Visits, by Year: 2005 to 2009*

Figure 1 Table. Energy Drink-Related Emergency Department (ED) Visits, by Year: 2005 to 2009*

ED Visits	2005	2006	2007	2008	2009
Energy Drink-Related ED Visits	1,128	3,126**	10,052**	16,053**	13,114**

* Although the remainder of the report includes combined data between 2004 and 2009, the number of visits in 2004 only was suppressed because of low statistical precision. Thus, only data between 2005 and 2009 are included in Figure 1. ** The difference between the number of visits in 2005 and subsequent years was statistically significant at the .05 level. Source: 2005 to 2009 SAMHSA Drug Abuse Warning Network (DAWN).

 

Combined 2004 to 2009 data indicate that the majority of ED visits involving energy drinks were made by patients aged 18 to 39, with 45 percent of visits made by young adults aged 18 to 25 and 32 percent made by persons aged 26 to 39. The two remaining age groups—adolescents aged 12 to 17 and adults aged 40 or older—each accounted for about 11 percent of visits. Males made up 64 percent of ED visits involving energy drinks.

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Alcohol and Drug Involvement

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ED visits involving energy drinks can be divided into two groups: those that involve energy drinks only and those that involve energy drinks in combination with pharmaceuticals, alcohol, and/or illicit drugs (hereafter referred to as "energy drink combinations"). An estimated 56 percent of visits involved energy drinks only (Table 1). About one quarter (27 percent) of visits involved energy drinks in combination with pharmaceuticals, 16 percent involved combinations with alcohol, and 10 percent involved combinations with illicit drugs. Central nervous system stimulants (e.g., Ritalin^®) were involved in 10 percent of ED visits related to energy drinks in combination with pharmaceuticals.

Drug Combination	Number of ED Visits	Percentage of ED Visits*
Total ED Visits	7,301	100%
Energy Drinks Only	4,059	56%
Energy Drinks in Combination	3,242	44%
Any Pharmaceutical Combination	1,985	27%
Central Nervous System (CNS) Medications	1,158	16%
CNS Stimulants	696	10%
Pain Relievers	312	4%
Narcotic Pain Relievers	107	1%
Drugs That Treat Anxiety or Insomnia	143	2%
Benzodiazepines	98	1%
Any Alcohol Combination	1,174	16%
Any Illicit Drug Combination	699	10%
Marijuana	344	5%
Cocaine	251	3%

* Because multiple drugs may be involved in each visit, estimates of visits by drug may add to more than the total number of visits, and percentages may add to more than 100 percent.
Source: 2004 to 2009 SAMHSA Drug Abuse Warning Network (DAWN).

Alcohol and Drug Combinations by Demographic Groups

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Approximately half of the energy drink-related ED visits (52 percent) by patients aged 18 to 25 involved combinations of energy drinks with alcohol or other drugs, whereas 44 percent of visits made by patients aged 26 to 39 involved such combinations. Approximately 3 in 10 visits by patients aged 12 to 17 and those aged 40 or older involved energy drink combinations (28 and 30 percent, respectively).
When ED visits involving energy drink combinations were examined by drug type, pharmaceuticals were commonly combined with energy drinks across each age group (Figure 2). Specifically, combinations of energy drinks and pharmaceuticals were involved in 20 percent of energy drink-related ED visits among patients aged 12 to 17, 30 percent of such ED visits among those aged 18 to 25, 28 percent of such ED visits among those aged 26 to 39, and 21 percent of such ED visits among those 40 or older. Energy drinks in combination with alcohol were involved in 20 percent of energy drink-related ED visits made by patients aged 18 to 25, 17 percent of such ED visits among patients aged 26 to 39, and 10 percent of such ED visits among those 40 or older.
By gender, energy drink-related ED visits made by males were more likely than visits made by females to involve energy drinks in combination with alcohol (20 vs. 10 percent) or illicit drugs (12 vs. 5 percent) (Figure 3). However, ED visits made by females were more likely to involve energy drinks in combination with pharmaceuticals than ED visits made by males (35 vs. 23 percent).

Alcohol and Drug Combinations by Reason for Visit

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When examined by the reason for the ED visit, more than two thirds (67 percent) of ED visits involving energy drinks were classified as adverse reactions, and approximately one third (34 percent) involved misuse or abuse of drugs (Figure 4).^8,9 Among visits involving energy drinks only, the majority (92 percent) were classified as adverse reactions, and 8 percent involved misuse or abuse. More than half (57 percent) of visits involving energy drink combinations were classified as misuse or abuse and less than one third (30 percent) involved adverse reactions.

Figure 4. Reason for Emergency Department (ED) Visits Involving Energy Drinks Only or in Combination with Other Drugs*: 2004 to 2009

Figure 4 Table. Reason for Emergency Department (ED) Visits Involving Energy Drinks Only or in Combination with Other Drugs*: 2004 to 2009

Reason for ED Visit	All	Energy Drinks Only	Energy Drink Combinations
Adverse Reactions	67%	92%	30%
Misuse or Abuse	34%	8%	57%

* Visits for other reasons are not shown. Because each visit may involve multiple drugs, the percentages may not add to the total. Source: 2004 to 2009 SAMHSA Drug Abuse Warning Network (DAWN). Discussion Between 2005 and 2009, there was a marked increase in the number of ED visits involving energy drinks. It is notable that visits involving energy drinks alone often caused adverse reactions, suggesting that energy drink consumption by itself can result in negative health events serious enough to require emergency care. Although there are no recommended or "safe" levels that have been experimentally established for caffeine, most researchers and clinicians consider 100 to 200 mg of caffeine per day to be moderate intake for an adult. Pediatricians recommend that children and adolescents abstain from all stimulant-containing energy drinks.2 Excessive caffeine intake from energy drinks can cause arrhythmia's, hypertension, and dehydration, in addition to sleeplessness and nervousness. Additional risks and other medical complications can arise depending on the individual's overall health status (e.g., cardiac conditions, eating disorders, diabetes, anxiety disorders) and other drugs or medications he/she may be taking (e.g., medications for attention deficit disorder). Use over time can cause dependence and withdrawal symptoms.10 Risky behavior such as drinking and driving can also be facilitated by mixing energy drinks with other substances such as alcohol; a study of college students found that more than half of them mixed energy drinks with alcohol.2 Public awareness campaigns focusing on the health effects of consumption of energy drinks are needed to educate the public about the potential risks associated with consumption, alone and in combination with alcohol and/or pharmaceuticals. On an individual level, an ED visit involving energy drinks offers medical staff an opportunity to educate the patient in the clinical setting. The fact that one in four ED visits related to energy drinks involved energy drinks in combination with pharmaceuticals, with more such visits made by males and adults aged 18 to 39 than by other demographic groups, suggests that these groups may benefit from targeted education on the dangers of energy drinks in combination with other substances. Finally, given the finding that one in six visits involved energy drinks in combination with alcohol, public health awareness campaigns could also help dispel the misguided belief that energy drinks can offset or eliminate the effects of alcohol intoxication.  ______________________________________________ End Notes 1 Food and Drug Administration. (2007). Medicines in my home: Caffeine and your body. Retrieved from http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/UCM205286.pdf 2 Seifert, S. M., Schaechter, J. L., Hershorin, E. R., & Lipshultz, S. E. (2011). Health effects of energy drinks on children, adolescents, and young adults. Pediatrics, 127(3), 511-528. 3 Butschli, J. (2011, August 25). Social media input energizes Verve Energy Drink packaging redesign. Packaging World. [Available at http://www.packworld.com/package-32243] 4 Mintel Global New Products Database. (2009, August 28). Energy drink ingredients continue down unhealthy path (Press release). Retrieved from http://www.mintel.com/press-centre/press-releases/386/energy-drink-ingredients-continue-down-unhealthy-path 5 Miller, K. E. (2008). Energy drinks, race, and problem behaviors among college students. Journal of Adolescent Health, 43(5), 490-497. 6 Thombs, D. L., O'Mara, R. J., Tsukamoto, M., Rossheim, M. E., Weiler, R. M., Merves, M. L., & Goldberger, B. A. (2010). Event-level analyses of energy drink consumption and alcohol intoxication in bar patrons. Addictive Behaviors, 35(4), 325-330. 7 Although the remainder of the report includes combined data between 2004 and 2009, the number of visits in 2004 only was suppressed because of low statistical precision. 8 Within DAWN, an ED visit is categorized as an adverse reaction when the chart documents that a prescription or over-the-counter pharmaceutical, taken as prescribed or directed, produced an adverse drug reaction, side effect, drug-drug interaction, or drug-alcohol interaction. Although energy drinks are not treated as drugs by the Food and Drug Administration, ED visits involving energy drinks were classified as adverse reactions if the chart documented them as such. If other substances are reported on the chart as involved in the visit, an energy drink is not necessarily the sole reason for the adverse reaction. 9 Misuse or abuse cases within DAWN are broadly defined to include all visits associated with illicit drugs, alcohol use in combination with other drugs, alcohol use only among those younger than 21 years old, and nonmedical use of pharmaceuticals. 10 Bernstein, G. A., Carroll, M. E., Thuras, P. D., Cosgrove, K. P., & Roth, M. E. (2002). Caffeine dependence in teenagers. Drug and Alcohol Dependency, 66(1), 1-6. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (November 22, 2011). The DAWN Report: Emergency Department Visits Involving Energy Drinks. Rockville, MD. The answer is always moderation, I love my caffeine as much as the next person but drinking to many energy drinks or adding other substances to them is just not a good choice for anyone.  Stay safe and stay alive!  ~~~ Leslie

Some Clean Nursing Humor..sorta

Friday is fun and so is being a nurse especially an ER nurse, we seem to be a special breed. ER nurses have a "special kind" of humor that you don't share with the ladies in your church group.We mean no harm, it is a coping mechanism for me to get thru the trauma of my day or night shift. When you see nothing but sickness and despair, you need a good laugh to brighten your cloudy day. So laugh on people!!


A spoof of Aerosmith's "Walk This Way" done by two Indiana Wesleyan University 2009 Nursing majors. This video is about hospital handwashing guidelines. All rights reserved by Joel Ferguson and Corey Sizelove.






The UAB ER rap was concepted and created by ER nurses for a National Nurses' Week contest and celebration. UAB nurses and other staff members are featured in the video.


A spoof of Justin Timberlake's "Sexyback" done by the University of Alberta 2010 Med class. Wenckebach is a type of cardiac arrhythmia.

And the last one Rocks!! I love this! UAB you are the bomb!!
"I ain't afraid of no Stroke!!  if I act FAST that is...

1 Four Loko is 5 beers high!

Attorneys General from 35 States Want New Limits on Four Loko

from the Fresh Story Blog

  One 23.5 ounce can = the alcohol of 5 beers!!

 Attorneys General from 35 states and the City Attorney of San Francisco have joined forces in calling for the Federal Trade Commission (FTC) to place new limits on the amount of alcohol that can be sold in a single-serving can – a request clearly aimed at Four Loko, sold by Phusion Projects LLC. Four Loko is sold in 23.5-ounce cans that contain about the same amount of alcohol as five beers.

The FTC has charged Phusion Projects with violating federal law for making false or misleading claims that a can of Four Loko can be safely consumed on a single occasion, and for failing to disclose the number of alcohol servings per can. In October, Phusion agreed to change the labels on cans to state that the drinks contain as much alcohol as four to five cans of beer. The FTC has proposed a settlement that would require the beverage company to make the containers resealable and clearly label the equivalent number of regular beers in the drink.
Iowa’s Attorney General Tom Miller and his colleagues say that’s not enough. They want the FTC to strengthen the regulations on Four Loko by limiting the amount of alcohol in a single-serve container to two servings, regardless of other requirements. “The company claims that you can safely drinking one can of Four Loko in a single occasion, which is absurd,” Miller said in a news release.
Four Loko came under fire in late 2010 for adding caffeine to its alcoholic beverages. Under pressure from state and federal officials, Phusion removed caffeine from its products and no longer markets them as “energy drinks.”
The news about Four Loko brings up the whole issue of standard drink size – and the public confusion that comes from the fact that alcohol companies are not required to list nutrition facts or serving sizes like all other food and beverages. Visit our website for more information about calories in alcohol, standard drink size and responsible alcohol use.
Sources:
“States ask FTC to limit Four Loko servings,” cleveland.com, November 17, 2011.
“Too much alcohol for one can, states say of Four Loko,” desmoinesregister.com, November 18, 2011.
“35 Attorneys General ask FTC to limit amount of alcohol in single-serving can,” drugfree.org, November 18, 2011.

Tags: alcohol, alcoholic, attorney general, beer, beverage, caffeine, calories, drink, energy drink, federal trade commission, four loko, ftc, iowa, phusion projects, regulations, responsible, san francisco, serving, size, standard, tom miller

 

 

Vote~ Kids are Dying~ Faces of The Choking Game

Every child seen here (and thousands more) DIED from 'playing' a 'game', many died within minutes!! Please TAKE A MINUTE and SAVE FUTURE Kids from the same fate. We need to win $10K in the Pepsi Refresh Everything Grant Challenge to hold a National Conference to Educate on the Dangers of the Choking Game.

Please join us in Saving lives - we need your votes and texts! With only days left - we are extremely close to winning to grant - but we desperately need more votes to get there. YOUR Vote or Text could make the $10K difference and the difference in the life of a child!!

Every person with a cell phone and/or email and/or Facebook can place 1 Text and 2 online votes: one vote signing in with Facebook, the second signing in with Pepsi.

TEXT 109321 (message) to 73774 (recipient)
Also Vote using your Mobile or PC:
online link: http://www.refresheverything.com/chokinggame
mobile link: http://m.refresheverything.com/Idea/19586

US residents aged 13 and older are eligible to cast votes and text!

More information and education also available www.Ed4Ed4all.com 

A Nurse is an Artist with a Canvas of Caring

Inspirational quotes 

that nurses can count on to lift those spirits: 

Nurses need a little lift everyday and I hope these inspiring little messages help to paint some sunshine on your canvas today.

“Constant attention by a good nurse may be just as important as a major operation by a surgeon.”

– Dag Hammarskjold, Diplomat

“To do what nobody else will do, a way that nobody else can do, in spite of all we go through; that is to be a nurse.”

– Rawsi Williams, BSN, RN

“The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest.”

– William Osler, MD

“Panic plays no part in the training of a nurse.”

– Sister Elizabeth Kenny

“The most important practical lesson than can be given to nurses is to teach them what to observe.”

– Florence Nightingale

“Nurses may not be angels, but they are the next best thing.”

– Anonymous Patient

“Nurses dispense comfort, compassion, and caring without even a prescription.”

– Val Saintsbury

N-urturing

U-nderstanding

R-eally great

S-uper smart

E-ager to work hard!

“Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual, and an intuitive sense of ethics, and of the appropriateness of action taken.”

– Myrtle Aydelotte, PhD, RN, FAAN

“Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts.”

- Florence Nightingale

“Whether a person is a male or female, a nurse is a nurse.”

- Gary Veale, RN

“We often think of nursing as giving meds on time, checking an X-ray to see if the doctor needs to be called, or taking an admission at 2:00 a.m. with a smile on our faces. Too often, we forget all the other things that make our job what it truly is—caring and having a desire to make a difference.”

- Erin Pettengill, RN, quoted in RN Modern Medicine

“Bound by paperwork, short on hands, sleep, and energy… nurses are rarely short on caring.”

- Sharon Hudacek, RN

“Our job as nurses is to cushion the sorrow and celebrate the joy, everyday, while we are ‘just doing our jobs.’”

- Christine Belle, RN, BSN

 Have a wonderful weekend, this nurse is working her weekender duty in the ER, thank you to those of you that inspire me daily to keep doing what I do selflessly. 

Even after 32 years in healthcare I still enjoy taking care of patients and making them feel better.

Quotes found via the "Scrubs.com" website, sign up for their newsletter, its a good one. I enjoy my emails from them. 

Vintage nursing photos found all over the web, I love them. 

Little Known Danger In Your Household

Coin lithium button batteries can cause severe injuries when swallowed.

If you have spent anytime around young children you know that most things end
up in their.........mouth (or sometimes ears). So what is the big deal about swallowed objects? don't they just come out the "other end"? Depends, on the size,
the object itself and where it might get lodged.
Look at this Xray and tell me what you see:

Electronic devices are a part of daily life. And they’re getting smaller, slimmer and sleeker. But inside the battery compartment of mini remote controls, small calculators, watches, key fobs, flame-less candles, singing greeting cards and other electronics, may be a very powerful coin-sized button battery. When swallowed, these batteries can get stuck in the throat and cause severe burns. Small children often have easy access to these devices, and many parents do not know there is a risk.

Energizer is proud to be part of a new partnership addressing the safety issue of children swallowing coin-size button batteries. Swallowing a battery can cause serious health problems for your child. More than 3,400 lithium batteries were swallowed in 2010 and they can be found in many common household devices.

Learn more about lithium battery safety at http://www.thebatterycontrolled.com.


More important facts about battery safety Here 

Thank you to  Energizer and Safe Kids USA, for being committed to helping parents prevent children from swallowing coin-sized button batteries.

Please be aware of the dangers around your household, pay close attention to those little munchkins that have a fascination for all things, and keep them safe.

Take the pledge here
Secure your devices and get counted here 
Share this with your family and friends here  

Science of some designer drugs ~synthetics

The science of designer drugs: essential review October 8, 2011,  
★★★★☆ Clinical toxicology of newer recreational drugs. Hill SL, Thomas SHL Clin Toxicol 2011;49:705-719. Abstract

This essential article will probably be of most interest to chemical structure geeks (like me) and academics, but it is the best review I know that gets granular about the pharmacology of the many new designer drugs. The authors did a comprehensive review of published medical literature involving new designer drugs. (Synthetic cannabinoids, synthetic cocaine , and GHB are not covered.)
They classify these drugs into four categories:
piperazines 
phenethylamines
tryptamines 
piperidines 

Piperazines are synthetic chemicals that do no exist in nature. Included in this group is BZP, a sympathomimetic stimulant with effects similar to those of amphetamine. BZP inhibits re-uptake of dopamine and norepinephrine.
Phenethylamines include amphetamine, methamphetamine, and MDMA (ecstasy). Other examples are the synthetic cathinone mephedrone, MDPV (commonly found in “bath salts”), bromodragonFLY, and the 2C series.
Phenethylamines are predominantly sympathomimetic stimulants, but can have varying degrees of psychoactive and hallucinogenic properties created by substitutions on the basic molecule.
Tryptamines are derived from the amino acid tryptophan. Examples include psilocybin, LSD and DMT (a component used by Ayahuasca shamans). Tryptamines are primarily hallucinogenic rather than entactogenic or stimulant.
Piperidines include desoxypipradrol (2-DPMP), a component of the designer drug “whack”. It has also been found recently in products sold as “Ivory Wave” bath salts. Piperidines are stimulants that can cause prolonged psychotic effects. This classification scheme is very helpful in thinking about designer drugs, but has limited clinical usefulness.
In fact, when dealing with a patient who has been acutely exposed to a designer drug, the clinician is never certain exactly what chemical or chemicals are involved. Street products can contain a mixture of ingredients. Therefore, there are few specific recommendations regarding medical management in this paper.

The authors’ approach can be summed up by their last sentence: The management of users with acute toxic effects is pragmatic and, in general, as for poisoning with longer established stimulant or hallucinogenic drugs such as amphetamines and MDMA. With 169 references through 2011, this article should be in the files of anyone with more than a passing interest in the science of designer drugs.

The key to these synthetic drugs is the that they are just that synthetics, and they are mixed with other ingredients often, so you have no idea what the heck you are getting. Make a choice.......and die , that sums it up pretty much, we have body bags in all sizes, just hate to tell your momma that you made a stupid choice ;(

Leslie RN ~ don't let me catch you in the ER not being safe ;)

Scary statistics on Halloween~~ Boo!

Halloween is one of the most anticipated nights of the year for children, but our first-of-its kind Halloween report shows some scary statistics!

Please take time to read this report, it is shocking what Halloween dangers are out there, keep your kids safe please!!
http://www.safekids.org/our-work/research/reports/halloween-research-report.pdf

Top tips to keep your kids safe on Halloween from Safe Kids USA

For parents and children:

• Children under 12 should trick-or-treat and cross streets with an adult.

• Always walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the left as possible.

• Cross the street at corners, using traffic signals and crosswalks. Parents should remind children to watch for cars that are turning or backing up.

• Look left, right and left again when crossing and keep looking as you cross. Walk, don't run, across the street.

For drivers:

• Slow down and be especially alert in residential neighborhoods. Children are excited on Halloween and may move in unpredictable ways.

• Anticipate heavy pedestrian traffic and turn your headlights on earlier in the day so you can spot children from greater distances.

• Remember that costumes can limit children's visibility and they may not be able to see your vehicle.

• Reduce any distractions inside your car so you can concentrate on the road and your surroundings.

Costumes and Treats

• Decorate costumes and bags with reflective tape or stickers and choose light colored costumes to improve visibility.

• Choose face paint and make-up instead of masks, which can obstruct a child's vision. Look for non-toxic designations when choosing Halloween makeup.

• Avoid carrying sticks, swords, or other sharp objects.

• Have kids carry glow sticks or flashlights in order to see better, as well as to be seen by drivers.

• Liquid in glow sticks is hazardous, so parents should remind children not to chew on or break them.

• Check treats for signs of tampering before children are allowed to eat them. Candy should be thrown away if the wrapper is faded or torn, or if the candy is unwrapped.

More About Pedestrian Safety

• Pedestrian Safety Resources
• Halloween Research Report
• Halloween Safety Tip Sheet
• Photos Showing Safe Behavior 

Thank you for reading and keeping our kids safe!

Leslie Ernursescare editor 

Telling Amy's Story of Domestic Violence

Share Amy’s Story

By sharing the film and web site with others, you are taking a step towards raising awareness and preventing domestic violence.

We are connected to many people even beyond our family and close friends. Share Amy’s story with your email list, your human resources representative, your church congregation, your hairdresser, your hunting buddies, your doctor, or the parents at your play dates and schools.
How do you share this important info? Go to the website posted and get ideas for facebook and Twitter posts, and the link to YouTube for the embed code to the videos
http://telling.psu.edu/share/index.html
 Did you know that about ¼ of all women in the U.S. report that they have experienced domestic violence? Support the fight to end domestic violence! Watch Telling Amy’s Story and share the film and web site with others. http://www.telling.psu.edu/

                 

•  
•  
• Please retweet to increase awareness against domestic violence. Share Amy’s Story! #tellingamy  http://bit.ly/9dI4MY
• Retweet if you are against domestic violence. Share, Discuss and Refer! Share Amy’s story! #tellingamy  http://bit.ly/9dI4MY
• Join Telling Amy’s Story FB page to get updates, news and information and to help fight domestic violence #tellingamy  http://bit.ly/bVaGY0
• We are proud partners of the Telling Amy’s Story project. Share the film and web site with others. http://bit.ly/bRDqiy 

• Did you know that about ¼ of all women in the U.S. report that they have experienced domestic violence? Support the fight to end domestic violence! Watch Telling Amy’s Story and share the film and web site with others. http://www.telling.psu.edu/
• Have you heard Amy’s story? Learn more about Telling Amy’s Story, a documentary that follows the timeline of a domestic violence homicide. Hosted by actress and advocate Mariska Hargitay. Play the trailer at: http://www.telling.psu.edu/
• Take a step towards raising awareness and preventing domestic violence! Support Telling Amy’s Story at http://www.facebook.com/tellingamysstory
• Domestic Violence it’s not ok! Copy and paste this to your wall to help raise awareness of domestic violence. http://www.facebook.com/tellingamysstory
• [YOUR ORGANIZATION NAME HERE] is proud to be a partner of the Telling Amy's Story - Raising Awareness of Domestic Violence project! Check out http://www.facebook.com/tellingamysstory and get updates on the film's broadcast schedule at http://www.telling.psu.edu/ 

      
Facebook Users:
From your profile, Attach » Link and copy/paste the following url: http://www.youtube.com/watch?v=9pt0qoqFV6g
Bloggers:
Visit http://www.youtube.com/watch?v=9pt0qoqFV6g and select ‹embed› for embed code.

 Referrals:

You should enlist the assistance of a professional advocate to connect with domestic violence services or to explore other ways that you can help in the fight to end domestic violence.

Domestic violence advocates are trained to help you in a way that is best for your situation. Advocates can help you make safety plans, negotiate law enforcement issues, arrange for shelter, contact local resources, and set up counseling.
Advocates can also help you find volunteer opportunities or initiatives that help support victims of domestic violence.
National numbers and hotlines

National Domestic Violence Hotline (NDVH)

www.ndvh.org
NDVH 24-hour Hotline: 800-799-7233

National Domestic Violence Hotline advocates are available for victims and anyone calling on their behalf to provide crisis intervention, safety planning, and information and referrals to agencies in all 50 states, Puerto Rico, and the U.S. Virgin Islands.

Centre County Women’s Resource Center (CCWRC)

www.ccwrc.org

The Centre County Women’s Resource Center (CCWRC) provides free and confidential services for people who have experienced domestic abuse, sexual violence, and stalking. Counselor/advocates are available to help 24 hours a day.

The National Network to End Domestic Violence (NNEDV)

www.nnedv.org
202-453-5566

Celebrating its 15th anniversary, the National Network to End Domestic Violence is a leading voice for domestic violence victims and their allies. NNEDV represents and provides resources to the 56 statewide and territorial coalitions against domestic violence, which serve nearly 2,000 local domestic violence programs across the country.

Joyful Heart Foundation

www.joyfulheartfoundation.org
New York 212-475-2026
Hawaii 808-331-8000

The mission of the Joyful Heart Foundation is to heal, educate, and empower survivors of sexual assault, domestic violence, and child abuse shed by shedding light into the darkness that surrounds these issues.

Casa de Esperanza

www.casadeesperanza.org
Administrative Office 651-646-5553

Casa de Esperanza is a Latina organization whose mission is to mobilize Latinas and Latino communities to end domestic violence.

Hopeline

aboutus.vzw.com/communityservice/hopeLine.html
Partnership Opportunities 908-559-7512

The Verizon Wireless HopeLine program collects used wireless phones, batteries, and accessories from any wireless service provider. These unused wireless phones are then distributed to victims of domestic violence to not only help them feel safer and less isolated, but also provide them with a way to call emergency or support services, employers, family, and friends.

Family Violence Prevention Fund

www.endabuse.org
415-252-8900

Everyone has the right to live free of violence. The Family Violence Prevention Fund works to prevent violence within the home, and in the community, to help those whose lives are devastated by violence.

Family Justice Center Alliance

www.familyjusticecenter.org
888-511-FJCA (3522)

The Family Justice Center Alliance aims to create a network of national and international Family Justice Centers and other models of co-located, multi-agency service centers for victims of family violence and their children with close working relationships, shared training and technical assistance, collaborative learning processes, and coordinated funding assistance.

Corporate Alliance to End Partner Violence (CAEPV)

www.caepv.org
309-664-0667

The Corporate Alliance to End Partner Violence is a national nonprofit organization dedicated to reducing the costs and consequences of partner violence at work—and eliminating it altogether. From policies and programs to legal issues and legislation, CAEPV is a credible source of information, materials, and advice.

National Coalition Against Domestic Violence (NCADV)

www.ncadv.org
303-839-1852

The mission of the National Coalition Against Domestic Violence is to organize for collective power by advancing the transformative work and leadership of communities and individuals working to end domestic violence.

Dress for Success

www.dressforsuccess.org
212-684-9563

Dress for Success promoted economic independence for disadvantaged women by providing professional attire, a network of support, and career development tools to help women thrive in work and in life.

Joe Torre Safe at Home Foundation

www.joetorre.org
877-878-4JOE (toll-free)

The Joe Torre Safe at Home Foundation aims to educate children about violence so that children understand they are not alone and that there is hope.

A Call to Men

www.acalltomen.com
917-922-6738

A Call to Men challenges men to reconsider their long-held beliefs about women, in an effort to create a more just society. They achieve this by encouraging men to change their behaviors through re-education and training that promote healthy manhood.

Institute on Domestic Violence in the African American Community

www.idvaac.org/
1-877-NIDVAAC

The Institute on Domestic Violence in the African American Community (IDVAAC) is an organization focused on the unique circumstances of African Americans as they face issues related to domestic violence—including intimate partner violence, child abuse, elder maltreatment, and community violence. IDVAAC’s mission is to enhance society’s understanding of and ability to end violence in the African American community.

Please stay safe and make October your month of change!

                                                                                 

National Domestic Violence Hotline number!

I just had to add this video from the National Domestic Violence Hotline:

October is National Domestic Violence

Since October is National Domestic Violence Month I felt it extremely important to direct some serious attention to the matter of abuse, whether it be domestic, dating, elderly, or child abuse, it is all wrong and needs to stop. Partner violence is a complex mental game that is grueling for the victim to overcome. I state this from personal experience, I dealt with an abusive relationship as a young woman involved with a boyfriend that seemed to take his low self esteem out on me. He made me feel like it was always my fault, that I deserved the mental, verbal and physical abuse he would deal out each weekend we were dating. 
The terms "following the wrong crowd" was my demise as a teenager, drugs, alcohol and promiscuity was the normal for my friends daily. 
As a parent now of a son and 2 young daughters, my eyes will be ever open to the paths they take and the friends they choose. My teenage son and I have had several long discussions about my past and I have shamefully disclosed many of the stupid and careless acts that I did, the drugs that have taken many a brain cell, the alcohol abuse that many times left me unconscious and vulnerable to anyone, my teen pregnancy that could have been avoided and much more. I truly think that telling my kids the truth about  my mistakes may keep them from making the same ones. Now I know that they do have to make choices themselves as they get older, but at least I can give them the tools to work with. 
Now back to domestic violence: I found this awesome post and had to share it - Credit due to this website : http://www.downstate.edu/eap/october.html Please Please promise me that if you are being abused by someone close to you, seek out help, go to your nearest Emergency Department and tell the nurse(she will help you) call 911 and just put the phone down while on if you have to( if your abuser is in the room or house) somebody will show up and ask what is going on, they GIS system via your phone will tell the 911 dispatcher where you are.

If you have been abused once, IT WILL HAPPEN AGAIN!!!  and next time he may very well kill you! This is nothing to play around with. As an ER nurse for many years I have seen this happen many times!!

AN ACT OF DOMESTIC ABUSE OCCURS EVERY 12 SECONDS IN THE U.S.

According to former Attorney General Janet Reno, “Too many American women live in fear of the very people upon whom they depend for love and affection. Instead of providing refuge, the walls of many homes serve as prison bars.”

WHAT IS DOMESTIC ABUSE?

Domestic abuse, or “battering”, is a pattern of abuse by one partner against the other, for the purpose of maintaining power and control. Domestic abuse often includes (but NOT ALWAYS) physical abuse. Forms of domestic abuse can include:

—	physical abuse
—	sexual abuse
—	verbal abuse
—	threats and intimidation
—	isolation or restriction from friends, family and other support systems
—	destruction of property
—	financial exploitation
—	jealousy and possessiveness
—	stalking or monitoring of behavior

Physical battering: The abuser’s attacks or aggressive behavior can range from bruising to murder. It often begins with what is excused as trivial contacts which escalate into more frequent and serious attacks (this can include the abuse of household pets).

Sexual abuse: Physical attack by the abuser is often accompanied by, or culminates in, sexual abuse where the woman is forced to have sexual intercourse with her abuser, or to engage in unwanted sexual activity.

Psychological battering: The abuser’s psychological or mental abuse can include constant verbal abuse, harassment, excessive possessiveness, fault-finding, isolating the woman from friends and family, deprivation of physical and economic resources, and destruction of personal property.

BATTERING ESCALATES. It often begins with behaviors like threats, name calling, abuse in your presence (such as punching a fist through a wall) and/or damage to objects or pets. It may escalate to restraining, pushing, kicking, slapping, pinching, tripping, biting, throwing, or grabbing. Finally, it may become life-threatening with serious behaviors such as choking, breaking bones, or the use of deadly weapons. (Remember, ANY household item can be used as a dangerous weapon!)



SOME FACTS ABOUT DOMESTIC ABUSE

	Adult domestic violence is one of the most serious public health and criminal justice issues facing women today. Most victims of domestic violence are women. Between 91-95% of all documented domestic violence cases are women being abused by male partners. About 1-2% is physical abuse of men by their female partners, and 3-8% of the total number of reported domestic violence cases involve same-sex relationship abuse.
	Every woman is at risk for becoming a victim of domestic violence. Domestic violence has no regard for socio-economic status, race, ethnicity, religion, employment status, physical ableness, age, education, marital status, or sexual orientation. In fact, being FEMALE is the only significant risk factor for being a victim of domestic violence.
	Batterers use emotional, psychological, economic and physical abuse as ways of controlling their victims. Abuse is NOT caused by stress, anger, or alcohol or other drug involvement. Many people find it difficult to understand why people batter their partners. This may be why, when we hear excuses like, “he had a bad day”, “she lost her temper”, or “he was drunk and out of control”, we often accept them as viable reasons why the attack occurred. But battering has more to do with the batterer’s attitudes, beliefs, and relationships to others than it has to do with these common excuses. Many men believe that they have the right to control their spouses, and to enforce their will on those around them, particularly females. Many men believe that it is the man’s duty to control his wife, regardless of the methods used. Some men even believe that women “need” to be “disciplined”. These beliefs and attitudes, coupled with society’s tolerance of domestic violence, makes it one of the most difficult problems for our society to overcome. Children in families where there is  domestic violence suffer negative consequences even if they are not the targets of the abuse

SOME MYTHS ABOUT DOMESTIC ABUSE

	MYTH: When someone is battered, he/she must have done something to deserve it. FACT: Battering is never the victim’s fault. NEVER. Batterers abuse their partners as a way to control them. Domestic violence is about control, not about punishment or discipline.
	MYTH: Battering usually ends after a couple gets married or has children. FACT: Battering usually gets WORSE over time, not better. Getting married and/or having children does not protect someone from becoming a victim. In fact, sometimes it makes the situation worse.
	MYTH: Alcohol and other drug use may cause battering. FACT: Most people who use alcohol or other drugs do not abuse their partners. And many people who never use alcohol or other drugs do abuse their partners. While it is true that perpetrators of domestic violence are sometimes under the influence of alcohol or other drugs when the episode occurs, battering and alcohol or other drug abuse are 2 separate problems – neither is caused by the other. Anyone who abuses another person while under the influence of alcohol or another drug needs help for BOTH problems.
	MYTH: If a woman wants to end the violence, she should just leave. If she doesn’t leave, it is because she either likes the abuse, or she doesn’t want to leave. FACT: Women may stay in abusive relationships due to fear, lack of resources or options, psychological damage, loss of self-esteem, depression, or other reasons. It is important to remember that LEAVING the relationship may also be dangerous – more women are killed by their partners AFTER they leave the relationship than at any other time. Women who stay in abusive relationships are not weak or stupid – they are SCARED.                                                                                          BARRIERS TO LEAVING A VIOLENT RELATIONSHIP Some reasons why women stay generally fall into three categories: Lack of resources — most women have at least one dependent child — many women are not employed outside of the home — many women have no property that is solely theirs — some women lack access to cash or bank accounts — women who leave fear being charged with desertion and losing their children or joint assets — a woman may face a decline in living standards for herself and her children Institutional responses — clergy and secular counselors are often trained to see only the goal of “saving” the marriage at all costs, rather than the goal of stopping the abuse — police officers often do not provide support to women; they sometimes treat domestic violence as a domestic “dispute” rather than a crime — police may try to discourage the abusee from pressing charges — prosecutors often are reluctant to prosecute cases, and judges rarely levy the maximum sentence upon convicted abusers — despite a restraining order, there is little to prevent a released abuser from returning and repeating the assault — despite increased public awareness of the problem of domestic violence, and the increase in available shelters, there are still not enough shelters to accommodate women and children and keep them safe from abusive persons Traditional beliefs and values — many women do not believe divorce is a viable alternative — many women believe that a single parent family is unacceptable and that even a violent father is better than no father at all — many women are socialized to believe that they are responsible for making heir marriage work; failure to maintain the marriage equals failure as a woman — many women become isolated from friends and family, either because of the possessiveness of the abuser, or because they want to hide their bruises and injuries from the outside world; this isolation contributes to the feeling that there is nowhere to turn — many women rationalize their abuser’s behavior by blaming alcohol or other drugs, anger, stress, unemployment, or other factors — many women are taught that their identity and worth come from getting and keeping a man — the abuser RARELY abuses all the time; during the non-violent periods he or she may fulfill all the needs of the partner and be a wonderful spouse; the victim believes that the abuser is basically a “good” person, and that she should hold onto a good man ARE YOU IN AN ABUSIVE RELATIONSHIP? Look over the following questions. Think about how you are being treated and how you treat your partner. Remember, when one person scares, hurts, or continually puts down the other, it’s abuse. Does your partner… _____ Embarrass or make fun of you in front of your friends or family? _____ Put down your accomplishments or goals? _____ Make you feel like you are unable to make decisions? _____ Use intimidation of threats to gain compliance? _____ Tell you that you are nothing without them? _____ Treat you roughly – grab, push, pinch, shove, or hit you? _____ Call you several times a night or show up to make sure you are where you said you are? _____ Use alcohol or other drugs as an excuse for saying or doing hurtful things to you? _____ Blame you for how they feel or act? _____ Pressure you sexually for things you aren’t ready for or don’t want to do? _____ Make you feel like there is “no way out” of the relationship? _____ Prevent you from doing things you want – like spending time with your friends and family? _____ Try to keep you from leaving after a fight or leave you somewhere after a fight? Do you… _____ Sometimes feel scared of how your partner will act? _____ Constantly make excuses to other people for your partner’s behavior? _____ Believe that you can help your partner change if you changed something about yourself? _____ Try not to do anything that would cause conflict or make your partner angry? _____ Feel like, no matter what you do, you partner is not happy with you? _____ Always do what your partner wants to do, instead of what you want to do? _____ Stay with your partner because you are afraid of what he/she will do if you broke up? If any of these are happening in your relationship, talk to someone. Without some help, the abuse will continue. GETTING HELP – WORKPLACE APPROACHES TO DEALING WITH DOMESTIC ABUSE What to do… If you are experiencing domestic violence: — You may need to notify your supervisor about the circumstances of your situation so that you can be safe in the workplace — Discuss options available to you, e.g. scheduling, safety precautions, employee/family assistance benefits — Get an order of protection if you are being physically abused — Submit a recent photo of the perpetrator to University Police/Public Safety so they may recognize the perpetrator if he/she enters the campus — Contact the EAP for confidential help and advice If you are the co-worker of someone experiencing domestic violence: — If you suspect a co-worker is suffering abuse, do NOT directly confront him/her since it is important for an individual to self-disclose, for his/her own safety, well-being, and privacy. — Express concern and a willingness to listen and be supportive, if needed. — Offer support and listening; when the individual is ready, they will confide. — Suggest that the individual contact the EAP for confidential help and advice, if there is a problem. — If you witness an incident at work, contact University Police/Public Safety immediately. Make sure the incident is documented. If you are the supervisor or manager of an employee who is experiencing domestic violence: — Be aware of unusual absences or behavior and take note of bruises or emotional distress. — Offer your support and listening; let the employee know that you are available should they decide to discuss the problem. — Suggest that the individual contact the EAP for confidential help and advice, if there is a problem. — DO NOT TRY TO DIAGNOSE OR HELP SOLVE THE PROBLEM. — If the employee has disclosed the situation to you, you may contact the EAP and/or human resources to discuss resources available, e.g. counseling, safety planning, flexible scheduling, time off, security measures, etc. — Assist the employee in documenting all incidents with the batterer which occur in the workplace. — Encourage the individual to seek help. — DO NOT DISCUSS THE SITUATION WITH ANYONE WITHOUT THE EMPLOYEE’S KNOWLEDGE AND PERMISSION. This is very important! — If the employee’s job performance is suffering as a result of a personal problem, use regular, administrative remedies to deal with those issues. Avoid “lumping” personal problems in with job performance issues. GETTING HELP – SAFETY PLANNING If you are still in the relationship: — Think of a safe place to go before an argument begins – avoid rooms with no exits (bathroom), or rooms with weapons (kitchen) — Think about and make a list of safe people to contact — Keep change with you at all times, or if possible, a cellular phone — Memorize all important phone numbers — Establish a code word or sign to alert neighbors, friends, family that you are in trouble (e.g. turning a light on or off) so they can call for help — Think about what you will say to your abuser if he/she becomes violent — Remember- you have the right to live without violence — Keep a bag packed with enough clothes for 2-3 days for yourself and your children, copies of important papers (see below), enough medication for 2-3 days (if you or your children need daily medications), account numbers, etc. (see list below) If you have left the relationship: — Change your phone number — Screen calls — Save and document all contacts, messages, injuries, or other incidents involving the batterer — Change locks if the batterer has a key — Avoid staying alone — Plan how to get away if confronted by your abuser — If you have to meet your partner, do so in a public place — Vary your routine Notify school and work contacts Call a shelter for battered women (if necessary) Do NOT go to a place where your abuser may likely find you (e.g. your mother’s home). This will put you AND the other person at risk. If you leave the relationship or are thinking of leaving, you should take important papers and documents with you to enable you to apply for benefits or take legal action. Important papers you should take include: 1. Social Security cards 2. Birth certificates for yourself and your children 3. Your marriage license 4. Leases or deeds to property 5. Your checkbook 6. Your charge cards 7. Bank statements 8. Charge account statements 9. Insurance policies 10. Proof of income, W2’s etc. 11. Immigration/citizenship papers for yourself and your children 12. Documentation of past abuses – photos, police reports, hospital/medical records, etc. REFERENCES NYS Office for the Prevention of Domestic Violence, “Domestic Violence: Finding Safety and Support”, 1997 D.L. Fontes, Psy.D., “The Hidden Side of Spousal Abuse”, Employee Assistance Report, April 1999 Janet Reno, “Facing the Problem of Domestic Violence”, The Counselor, Nov-Dec 1998 ONLINE RESOURCES National Coalition Against Domestic Violence (www.ncadv.org) AOL Keyword “domestic violence” gives you thousands of references and resources for help with this problem Google search will also give you thousands of references