Eyes On The Road {infographic}

                      Source: zautos.com via NCDOT on Pinterest

Know For Sure, don't just think you do!

Just gotta do it? or do you......

This picture is pretty self explanatory, so I should not have to say more.........


Be safe and put down that phone while driving!! or die!

Leslie

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

Have a safe and Happy Memorial Day!!

A long weekend and celebrations should never end in tragedy, take a minute to remember these tips from the great people at "Safe Kids USA" before heading out for your festivities or family fun today.
http://www.safekids.org/have-a-safe-memorial-day-week.html


If you plan to be at the pool or on the beach over the holiday weekend, check out our water safety page for drowning prevention tips, and make sure to read: "Five Truths About Children Who Drown."
If you are planning a pool party, make sure to always have an adult serve as a water watcher. Print out the Water Watcher card.


Before you put the burgers on the grill, follow a few simple tips to avoid grilling injuries.
Make sure to also visit our fire, burn and scald prevention page for more tips.





Before letting your kids out the door to go play with friends, siblings and cousins, remind them about how to stay safe around traffic, on the playground and on their bikes.
Make sure to check out our sports and recreation safety tips, our pedestrian and driver safety tips for summer and our falls prevention tips.





Just another reminder to NEVER leave your child alone in a car even for a second. If you see someone's child or pet left alone in a car, call 911 immediately!

For related safety tip on kids in around cars, visit: "Car Seats, Boosters and Seat Belt Safety."


Thank you to Safe Kids for the above information on keeping our kids safe, happy and back home again after your holiday fun.

Leslie RN (ernursescare)

Should I turn him around or not? that is the question

Lets talk about car seats, yes you should leave those kiddos rear facing as long as possible, recommended up to 2 yrs old now. Read your car seat's recommendations and refer to your vehicle's owners manual always for installation guidance. Arrive alive! and make your ER nurse's happy!

Parents Shouldn’t Ignore Changes in Car Seat Recommendations

Great advice from "The Kid's Doctor" website and Twitter page
by Sue Hubbard, M.DI have been surprised at the number of parents I have seen lately, who are either unaware or choose to ignore the changes in car seat recommendations for children under the age of two. I try to discuss car seat safety at each check-up appointment, and have always been especially mindful of doing this at the one-year check up.
Previous to the newest recommendations (established in 2009), I had discussed turning the car seat to a forward facing position if the child had reached 12 months and 20 pounds. Then in April, an article was published (Inj Prev. 2007;13:398-402), which was the first U.S. data to substantiate the benefits of toddlers riding rear facing until they are two years of age. This study showed that children under the age of two are 75 percent less likely to die or experience a serious injury when they are riding in a rear-facing. That is a fairly compelling statistic to keep that car seat rear-facing for another year!
Studies have shown that rear-facing seats are more likely to support the back, neck, head and pelvis because the force of a crash is distributed evenly over the entire body. Toddlers between the ages of 12 and 23 months who ride rear facing are more than five times safer than toddlers in that same age group who ride forward-facing in a car seat. There has also been concern that rear-facing toddlers whose feet reach the back of the seat are more likely to suffer injuries to the lower extremities in a car accident. But a commentary written by Dr. Marilyn Bull in Pediatrics (2008;121:619-620) dispelled the myth with documentation that lower extremity injuries were rare with rear-facing seats.
So, it has now been over one year since this data was published and recommended, and parents continue to say, “I just turned the seat around any way” or “I didn’t know.” I did go look at car-seats the other day and I noted that the labeling on the boxes had all been changed to recommend rear facing until two years or until a toddler reaches the maximum height and weight recommendations for the model. I take this to mean that some “small” toddlers could even rear face longer as they do in some European countries.
For safety sake, rather than convenience, keep that car seat in the rear facing position. I wonder if they will begin putting DVD players and cup holders facing toward these toddlers, as that seemed to be a concern of many parents. Maybe this will make it “okay” to listen to music or talk while in the car rather than watching TV, at least until a child is older!!
 

If you need references on car seats go to http://www.nhtsa.dot.gov or http://www.seatcheck.org. http://www.buckleupnc.org/ (for NC)  http://www.safekids.org/
Drive and Live Safe!!

Car Seat Safety Week Celebrated

This is some wonderful information I found on the CentralfoothillsMommies.com blog about car seat safety, kudos to Jaime for posting it.
By Sarah on High Country Mom Squad • on September 10, 2009

I remember when my first daughter was born prematurely, we didn’t get to put her in the carseat for the drive home right away. She was six weeks early, when I had severe preeclampsia, but thankfully, she did not have to go to the NICU (just a level 2 nursery), she didn’t have severe problems, and we went home after 12 days.
Before we took her home, we had to go through a “car seat test” where they set HipChick in her car seat for 30 minutes and monitored her oxygen saturation. Well, she failed the test, meaning that sitting up in her carseat made her chest compress so she couldn't breathe well. I had never heard of a “Car Bed,” but that’s what we took her home in! (I’ll try to find a picture today)
But speaking of carseat safety, I spent some time this week on a conference call with Amy Lupold Bair (Resourceful Mommy) and representatives the National Highway Transportation Safety Administration (NHTSA) about Child Passenger Safety Week, September 12-18.

I learned tons of new information on that call, and I’ve been carting kids around for eight years! They talked about the LATCH system, which stands for Lower Anchors and Tethers for Children. Out of eight years of carseats, I have never realized that I needed to use a tether or lower anchors!


NHTSA has put together tons of information for parents regarding Child Seat Safety, and the LATCH system, so thanks to modern technology and social media, we can be fully informed and armed with the information we need! Here are some websites where you can see information, videos, downloadable instructions, and more:

http://childcarsafety.adcouncil.org/ – Child Passenger Safety Landing Page

Here you can download fact sheets, diagrams, and instructions, and link to all the places Child Passenger Safety can be found on the web.

Facebook: http://www.facebook.com/pages/Child-Passenger-Safety/144641660131
Child Passenger Safety: www.nhtsa.gov/cps
Twitter: http://twitter.com/childseatsafety
Inspection Station locator: http://www.nhtsa.gov/cps/cpsfitting/index.cfm
According to NHTSA, “According to a NHTSA study, 3 out of 4 kids are not as secure in the car as they should be because their car seats are not being used correctly. The LATCH system (Lower Anchors and Tethers for Children) was developed to make it easier to correctly install car seats.”

So here are some quick facts from NHTSA:

Do I need to buy a new carseat? Is LATCH safer than using the seat belts for installation? Not necessarily. A carseat PROPERLY installed with a seat belt should be as safe as one properly installed with LATCH. LATCH should make it easier to get a proper installation.

Where do I get a tether anchor for my vehicle? Contact your local dealer or your manufacturer to see if a kit specific to your vehicle exists. Some dealers will install an anchor for free.

Can I use a tether on my convertible seat when it is rear-facing? NO, unless it is specifically stated in the manual. Britax and Sunshine Kids allow this on some of their models.

Click here to find a Car Seat Safety checkpoint near you! It definitely helps to have someone there to show you how to safely buckle in your car seat. I spoke with Appalachian Regional Health Care and Healthy Carolinians, and they are planning to do a Car Seat Safety Checkpoint this fall, probably in October. We’ll have more info on that soon.
Click here for all the places you can connect with NHTSA and receive valuable tips and updates!

Check out this handy widget with a video and lots of tips! You can share it on your blog, Facebook Page, email, or anywhere you can inset HTML code!



Stay safe and always buckle up!!
~~Leslie~~