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Welcome to my blog about health, nursing, caring, kindness and positive change. Our world is full of such negative influences and bad choices, today is the day to make a positive change both physically and mentally in your life.
ERNursesCare is a blog incorporating my nearly 30 years of experience in the healthcare field with my passion for helping others, I want it to encourage others with injury prevention, healthy living, hard hitting choices, hot topics and various ramblings from my unique sense of humor. Come along and enjoy your journey......

Sunday, January 30, 2011

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!!



Saturday, January 22, 2011

Here is a clue for you: Don't drive, if you can't walk or stand up!

It amazes me the people to try to drive any vehicle after drinking alcohol, taking prescription medications that are sedating or illicit drugs that are illegal to begin with. How can you think you can drive if you can't walk or stand up. Just like the dangers of drinking and driving, drugged driving is a serious problem on the rise. Prescription drug abuse is at epidemic levels, people seem to find happiness (or not) in a little bottle of pills instead of dealing with real life. My husband and I witnessed a very drugged driver the other night on the way home from the store, he was driving a box truck and could hardly keep the truck on the road. We began following him on the interstate and watched in horror as he swerved from side to side, almost took out the exit sign and got off the exit. As we called *HP several times to ask for assistance we began to follow him, he turned off onto a local highway that was very curvy. The truck went from one side of the road to the other shoulder, we watched him nearly turn the truck over several times and almost hit 4 cars head on. We both knew we had to do something or he is going to kill himself or somebody else, we prayed that he would pull over or stall the truck. Then he slowed down and pulled into a local gas station and my husband took the opportunity to pull in beside him so he could not back out. He approached the truck and asked him to turn off the truck and surrender his keys. He noted the man was very intoxicated with something, either alcohol or drugs. With some help stopping the truck's engine the man was cooperative and gave up his keys, telling us he took some "medicine and drank some beer". We waited until the highway patrol, sheriff's dept and EMS got there to take care of him. I am really not sure how he was driving at all, he could barely talk or walk. He had just came from work he said. Sad,he has lost that job now, it was a work truck he was driving.
So to further educate those out there in blog land that might read this, info on drugged driving and to follow will be more info on some most commonly used drugs that can kill and be abused.Because I would much rather see you alive than dead in some box! And I want to keep my family safe!!

What Is Drugged Driving?  From the NIDA website Here

“Have one [drink] for the road” was once a commonly used phrase in American culture. It has only been within the past 25 years that as a Nation, we have begun to recognize the dangers associated with drunk driving. And through a multipronged and concerted effort involving many stakeholders—including educators, media, legislators, law enforcement, and community organizations such as Mothers Against Drunk Driving—the Nation has seen a decline in the numbers of people killed or injured as a result of drunk driving. But it is now time that we recognize and address the similar dangers that can occur with drugged driving.

The principal concern regarding drugged driving is that driving under the influence of any drug that acts on the brain could impair one’s motor skills, reaction time, and judgment. Drugged driving is a public health concern because it puts not only the driver at risk but also passengers and others who share the road.

However, despite the knowledge about a drug’s potentially lethal effects on driving performance and other concerns that have been acknowledged by some public health officials, policy officials, and constituent groups, drugged driving laws have lagged behind alcohol-related driving legislation, in part because of limitations in the current technology for determining drug levels and resulting impairment. For alcohol, detection of its blood concentration (BAC) is relatively simple, and concentrations greater than 0.08 percent have been shown to impair driving performance; thus, 0.08 percent is the legal limit in this country. But for illicit drugs, there is no agreed-upon limit for which impairment has been reliably demonstrated. Furthermore, determining current drug levels can be difficult, since some drugs linger in the body for a period of days or weeks after initial ingestion.

Some States (Arizona, Delaware, Georgia, Indiana, Illinois, Iowa, Michigan, Minnesota, Nevada, North Carolina, Ohio, Pennsylvania, Rhode Island, South Dakota, Utah, Virginia, and Wisconsin) have passed “per se” laws, in which it is illegal to operate a motor vehicle if there is any detectable level of a prohibited drug, or its metabolites, in the driver’s blood. Other State laws define “drugged driving” as driving when a drug “renders the driver incapable of driving safely” or “causes the driver to be impaired.”

In addition, 44 States and the District of Columbia have implemented Drug Evaluation and Classification Programs, designed to train police officers as Drug Recognition Experts. Officers learn to detect characteristics in a person’s behavior and appearance that may be associated with drug intoxication. If the officer suspects drug intoxication, a blood or urine sample is submitted to a laboratory for confirmation.


How Many People Take Drugs and Drive?

According to the National Highway Traffic Safety Administration’s (NHTSA) 2007 National Roadside Survey, more than 16 percent of weekend, nighttime drivers tested positive for illegal, prescription, or over-the-counter medications. More than 11 percent tested positive for illicit drugs.1 Another NHTSA study found that in 2009, among fatally injured drivers, 18 percent tested positive for at least one drug (e.g., illicit, prescription, or over-the-counter), an increase from 13 percent in 2005.2 Together, these indicators are a sign that continued substance abuse education, prevention, and law enforcement efforts are critical to public health and safety.

According to the 2009 National Survey on Drug Use and Health (NSDUH), an estimated 10.5 million people aged 12 or older reported driving under the influence of illicit drugs during the year prior to being surveyed.3 This corresponds to 4.2 percent of the population aged 12 or older, similar to the rate in 2008 (4 percent) and not significantly different from the rate in 2002 (4.7 percent). In 2009, the rate was highest among young adults aged 18 to 25 (12.8 percent). In addition, NSDUH reported the following:

  • In 2009, an estimated 12 percent of persons aged 12 or older (30.2 million persons) drove under the influence of alcohol at least once in the past year. This percentage has dropped since 2002, when it was 14.2 percent.
  • Driving under the influence of an illicit drug or alcohol was associated with age. In 2009, an estimated 6.3 percent of youth aged 16 or 17 drove under the influence. This percentage steadily increased with age to reach a peak of 24.8 percent among young adults aged 21 to 25. Beyond the age of 25, these rates showed a general decline with increasing age.
  • Also in 2009, among persons aged 12 or older, males were more likely than females (16.9 percent versus 9.2 percent, respectively) to drive under the influence of an illicit drug or alcohol in the past year.
In recent years, more attention has been given to drugs other than alcohol that have increasingly been recognized as hazards to road traffic safety. Some of this research has been done in other countries or in specific regions within the United States, and the prevalence rates for different drugs used vary accordingly. Overall, marijuana is the most prevalent illegal drug detected in impaired drivers, fatally injured drivers, and motor vehicle crash victims. Other drugs also implicated include benzodiazepines, cocaine, opiates, and amphetamines.4
A number of studies have examined illicit drug use in drivers involved in motor vehicle crashes, reckless driving, or fatal accidents. For example—

  • One study found that about 34 percent of motor vehicle crash victims admitted to a Maryland trauma center tested positive for “drugs only;” about 16 percent tested positive for “alcohol only.” Approximately 9.9 percent (or 1 in 10) tested positive for alcohol and drugs, and within this group, 50 percent were younger than age 18.5 Although it is interesting that more people in this study tested positive for “drugs only” compared with “alcohol only,” it should be noted that this represents one geographic location, so findings cannot be generalized. In fact, the majority of studies among similar populations have found higher prevalence rates of alcohol use compared with drug use.6
  • Studies conducted in several localities have found that approximately 4 to 14 percent of drivers who sustained injury or died in traffic accidents tested positive for delta-9-tetrahydrocannabinol (THC), the active ingredient in marijuana.7
  • In a large study of almost 3,400 fatally injured drivers from three Australian states (Victoria, New South Wales, and Western Australia) between 1990 and 1999, drugs other than alcohol were present in 26.7 percent of the cases.8 These included cannabis (13.5 percent), opioids (4.9 percent), stimulants (4.1 percent), benzodiazepines (4.1 percent), and other psychotropic drugs (2.7 percent). Almost 10 percent of the cases involved both alcohol and other drugs.

Teens and Drugged Driving

According to the Centers for Disease Control and Prevention, vehicle accidents are the leading cause of death among young people aged 16 to 19.9 It is generally accepted that because teens are the least experienced drivers as a group, they have a higher risk of being involved in an accident compared with more experienced drivers. When this lack of experience is combined with the use of marijuana or other substances that impact cognitive and motor abilities, the results can be tragic.

Results from NIDA’s Monitoring the Future survey indicate that in 2007, more than 12 percent of high school seniors admitted to driving under the influence of marijuana in the 2 weeks prior to the survey.10

The 2007 State of Maryland Adolescent Survey indicates that 11.1 percent of the State’s licensed adolescent drivers reported driving under the influence of marijuana on three or more occasions, and 10 percent reported driving while using a drug other than marijuana (not including alcohol).11

Why is Drugged Driving Hazardous?

Drugs acting on the brain can alter perception, cognition, attention, balance, coordination, reaction time, and other faculties required for safe driving. The effects of specific drugs of abuse differ depending on their mechanisms of action, the amount consumed, the history of the user, and other factors.

Marijuana
THC affects areas of the brain that control the body’s movements, balance, coordination, memory, and judgment, as well as sensations. Because these effects are multifaceted, more research is required to understand marijuana’s impact on the ability of drivers to react to complex and unpredictable situations. However, we do know that—

  • A meta-analysis of approximately 60 experimental studies—including laboratory, driving simulator, and on-road experiments—found that behavioral and cognitive skills related to driving performance were impaired in a dose-dependent fashion with increasing THC blood levels.12
  • Evidence from both real and simulated driving studies indicates that marijuana can negatively affect a driver’s attentiveness, perception of time and speed, and ability to draw on information obtained from past experiences.
  • A study of over 3,000 fatally injured drivers in Australia showed that when marijuana was present in the blood of the driver, he or she was much more likely to be at fault for the accident. Additionally, the higher the THC concentration, the more likely the driver was to be culpable.13
  • Research shows that impairment increases significantly when marijuana use is combined with alcohol.14 Studies have found that many drivers who test positive for alcohol also test positive for THC, making it clear that drinking and drugged driving are often linked behaviors.
Other Drugs
Prescription drugs: Many medications (e.g., benzodiazepines and opiate analgesics) act on systems in the brain that could impair driving ability. In fact, many prescription drugs come with warnings against the operation of machinery—including motor vehicles—for a specified period of time after use. When prescription drugs are taken without medical supervision (i.e., when abused), impaired driving and other harmful reactions can also result. In short, drugged driving is a dangerous activity that puts us all at risk.
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