It's About Children - Fall 2004 Issue by East Tennessee Children's Hospital
 

It's About Children - Fall 2004 Issue by East Tennessee Children's Hospital

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See more at: http://www.etch.com/about_us/its_about_children.aspx

See more at: http://www.etch.com/about_us/its_about_children.aspx

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It's About Children - Fall 2004 Issue by East Tennessee Children's Hospital It's About Children - Fall 2004 Issue by East Tennessee Children's Hospital Presentation Transcript

  • ChildrenÕs Hospital 2018 Clinch Ave. ¥ P.O. Box 15010 Knoxville, Tennessee 37901-5010 We always try to stay current with friends of the hospital. If for any reason you should receive a duplicate issue, please notify the hospital at (865) 541-8257. NON-PROFIT ORGANIZATION U.S. POSTAGE PA I D PERMIT 433 KNOXVILLE, TN 22nd Annual Telethon raises more than $2.1 million resonance imaging (MRI) scanner along with other radiology and ultrasound equipment, operating room equipment, various equipment used in the NICU, and Lifeline vehicles, which are mobile intensive care units to provide neonatal and pediatric transport. This equipment and technology enables the hospital to continue providing the best available pediatric health care to children throughout East Tennessee. In 1983, ChildrenÕs Hospital became one of the 22 charter hospitals participating in the first CMN telethon. In 22 years, the local telethon has raised more than $20 million, all of which has remained at ChildrenÕs Hospital for the direct benefit of the hospital and its patients. ChildrenÕs Hospital would like to thank everyone who generously gave their time The 22nd annual ChildrenÕs Miracle Network Telethon was a tremendous success again this year, raising more than $2.1 million for ChildrenÕs Hospital. The live, two-day broadcast aired on WBIR-TV Channel 10 June 5-6. The money raised on-air by this yearÕs telethon will purchase Giraffe Omnibed units for the hospitalÕs Neonatal Intensive Care Unit (NICU). These beds offer premature infants the specialized treatment they need in the best possible environment to support them during a critical growth period. The Giraffe Omnibed helps control light, sound and unnecessary touch to the baby while offering ideal warmth. Funds raised by previous telethons have been used to purchase a magnetic and money to make the 2004 CMN telethon so successful. ChildrenÕs Hospital extends its gratitude to many area companies, including GoodyÕs, Wal-Mart and SamÕs Club, which presented the hospital with substantial donations they raised throughout the year. Additionally, the East Tennessee community raised $262,476 through telephone pledges during the 22-hour broadcast, made possible by the more than 500 volunteers who gave part of their weekend to answer phones during the telethon. ChildrenÕs Hospital is indebted to the news team and production crew of WBIR- TV Channel 10 for being a vital part of the telethon for each of the past 22 years. They once again demonstrated their extraordinary support for ChildrenÕs Hospital and the children of this region. by Rupal Mehta, student intern Fall 2004Fall 2004
  • Board of Directors James S. Bush Chairman Robert Madigan, M.D. Vice Chairman Robert M. Goodfriend Secretary/Treasurer Michael Crabtree Dawn Ford Peyton Hairston Jeffory Jennings, M.D. Bob Koppel Donald E. Larmee, M.D. Dugan McLaughlin Chris Miller, M.D. Alvin Nance Dennis Ragsdale J. Finbarr Saunders, Jr. William F. Searle III Bill Terry, M.D. Laurens Tullock Danni Varlan Medical Staff Chris Miller, M.D. Chief of Staff Lewis Harris, M.D. Vice Chief of Staff David Nickels, M.D. Secretary Chiefs of Services Lise Christensen, M.D. Chief of Medicine Cameron Sears, M.D. Chief of Surgery David Birdwell, M.D. Chief of Pathology Clifford J. Meservy, M.D. Chief of Radiology Mike Mysinger, D.D.S. Chief of Dentistry Mark Cramolini, M.D. Chief of Anesthesiology Administration Bob Koppel President Paul Bates Vice President for Human Resources Joe Childs, M.D. Vice President for Medical Services Rudy McKinley Vice President for Operations Jim Pruitt Vice President for Finance Beckie Thomas, R.N. Vice President for Patient Care A quarterly publication of East Tennessee Children’s Hospital, It’s About Children is designed to inform the East Tennessee community about the hospital and the patients we serve. Children’s Hospital is a private, independent, not-for-profit pediatric medical center that has served the East Tennessee region for more than 65 years and is certified by the state of Tennessee as a Comprehensive Regional Pediatric Center. Ellen Liston Director of Community Relations David Rule Director of Development Wendy Hames Editor Neil Crosby Cover/Contributing Photographer “Because Children are Special…” ...they deserve the best possible health care given in a positive, child/family-centered atmosphere of friendliness, cooperation, and support - regardless of race, religion, or ability to pay.” ...their medical needs are closely related to their emotional and informational needs; therefore, the total child must be considered in treating any illness or injury.” ...their health care requires family involvement, special understanding, special equipment, and specially trained personnel who recognize that children are not miniature adults.” ...their health care can best be provided by a facility with a well-trained medical and hospital staff whose only interests and concerns are with the total health and well-being of infants, children, and adolescents.” Statement of Philosophy East Tennessee Children’s Hospital www.etch.com The Bottom LineArtwork by some of Children’s Hospital’s special patients 2 Mauricesa Lauren Sarah 3 Dear Bob Koppel, CEO, I would like to comment on a couple of your employees. My daughter Kaitlyn E. Reed was seen in the Emergency Department on December 18, 2003. The doctor who saw her was Ameeta Lall. I wanted to show my appreciation for her. I have never seen such a caring doctor in an Emergency Department before. She truly cares for her patients. My daughter was having a reaction to some of her medication. We were concerned, but that wasnÕt all; Ameeta shared this concern and never made me feel uncomfortable. She was honest and spent a lot of time making sure we were OK and comfortable. My daughter improved with the Benedryl she was given, and I have never seen a doctor so relieved and happy as Dr. Lall was. I wish all doctors could have that bedside manner, but they are few and far between. My daughter and I will definitely remember her for years to come. The second wonderful experience we had was the following day, December 19, in the lab. Kaitlyn had to have some blood drawn for some tests. The gentleman who took her blood, Ryan Hillis, was just as wonderful as Dr. Lall. We were in the lab around 12 p.m. that day. Kaitlyn has a hard time with being stuck, even at her own doctorÕs office. He managed to stick her twice, and she did not fight back once. After the experiences with her and the lab work, it had to be his personality and mannerisms. I hope he knows he was very much appreciated. My daughter left both visits with lots of stickers and happiness. Thank you for having these two people on your staff. They are definitely assets to ChildrenÕs Hospital in my eyes. Thank you, Donna Reed Knoxville Dear ChildrenÕs Hospital, Thank you so much. My daughter MacKenna Allen was seen inyour Emergency Department on June 7. Your staff couldnÕthave been more caring or compassionate. I cannot believe thelevel of commitment that your staff shows to children. I have been to my local hospital before, but I drove an hour toChildrenÕs, because MacKenna broke her arm and was soscared. I was so heartbroken for her. She was met with smilesand kind words from everyone. When it was time for her armto be put in a splint, two of the friendliest nurses came in tohelp. Everyone explained everything to her. I was so impressedhow they made sure that she understood what was happening,in terms she knew. When the staff came in, they told her whathad happened, not just me; they didnÕt talk down to her likeshe was a child. Please let everyone in the ED know that it really does make adifference. When a total stranger shows such compassion andlove to your child, it touches you more that I can express.Thank you from the bottom of my heart! Trisha Couture Sevierville Flu shot added to children’s shot list The Centers for Disease Control and Prevention has added the influenza vaccination to the recommended immunization schedule for children. The Advisory Committee on Immunization Practices decided to expand their flu shot recommendation to include children 6-23 months old for the 2004-2005 flu season. Previously the vaccination had only been recommended for children over 2 years. Caregivers and all adults who have close contact with children, such as school personnel and church workers, are also recommended to receive the vaccination. Vaccines should be given in the fall of each year. "Recent studies show that children younger than age 2 and children with chronic conditions like diabetes, asthma and HIV have a higher risk of hospitalization for influenza and related complications, including severe pneumonia," according to a statement issued by the American Academy of Pediatrics. Young children tend to also have a higher hospitalization rate for flu-related illnesses than most healthy adults, for whom the vaccination has been recommended for many years. During the 2003-2004 flu season, ChildrenÕs Hospital treated more than 2,000 cases of flu, an overwhelming increase compared to previous years. The flu season not only affected more people, but it also began several months earlier than usual. Typically flu is more prominent in the months of January through March; last year ChildrenÕs Hospital saw the majority of its cases in November and December. For more information about when and where to obtain the flu vaccination, contact your childÕs primary care physician or the ChildrenÕs Hospital Community Relations Department at (865) 541-8165. To find our more about influenza recommendations, visit www.etch.com or www.aap.org. by Casey LaMarr, student intern On The Cover: Twins David and Tony Restaino had neurosurgery at ChildrenÕs Hospital. Read their story on pages 4-5
  • 54 Eleven-year-old twins Tony and David Restaino spend most of their days diving off springboards or swimming at the University of Tennessee Recreation Center. However, when Tony began struggling with double vision last summer, the board and the water didnÕt come into focus like before, and each dive became harder and more dangerous. He first complained to his dive coach about the problem and then to his parents, Diane and Mike. "We definitely wanted to investigate the double vision, because we knew that Tony couldnÕt dive with that problem," Diane said. "We couldnÕt understand where the problem was coming from, but we wanted to make sure that he was not only safe diving but in his every day life as well." Tony had an MRI to see if something in his brain might be causing the double vision. After meeting with pediatric neurologist Dr. Christopher Miller, the Restainos were referred to pediatric neurosurgeon Dr. Lewis Harris. When he first met Tony, Dr. Harris asked him many questions: "What are your symptoms?" "When are you experiencing these things?" "How often do they occur?" Dr. Harris wanted to do a spinal MRI on Tony, and once he learned that Tony had an identical twin brother named David, he wanted David to have an MRI as well. Once Dr. Harris saw the results, he explained to Tony and David and their parents that both boys had a Chiari malformation. A Chiari deformity or malformation is a condition in which the most inferior part of the cerebellum (part of the brain) is displaced downward through the base of the skull into the upper spine. Even though David was not experiencing the symptoms that Tony was feeling, the MRI revealed the condition was present in both twins. "The results came back on both of the boys, and they both had fluid collecting in their spines," Diane said. "At that point, Dr. Harris recommended we do surgery on both of the twins, because their brains were actually slipping out of their skulls and blocking the top of their spinal cords." TonyÕs and DavidÕs lives changed immediately at that point. Not only did Dr. Harris recommend brain surgery for both boys, but he also wanted Tony to quit diving and David to quit swimming until they had the surgery and had successfully recovered. Dr. Harris explained that not correcting the problem could have led to spinal cord damage and future problems. On June 30, 2003, Tony and David came to ChildrenÕs Hospital for surgery. Each surgery required Dr. Harris to open the back of the skull and pull the bone away from the spine and spinal cord. Each surgery lasted about four hours, with TonyÕs lasting a little longer. Even though each boy was in surgery for that amount of time, their parents were in the waiting room for over eight hours, knowing that one of their sons was undergoing major surgery. "When we were in the waiting room, they called us every hour and let us know what was happening," Diane said. "The surgery department took great care of the boys in the operating room and just as good care of us in the waiting room." Before Tony and David left the recovery room, Diane and Mike were informed that the boys would go to the Pediatric Intensive Care Unit (PICU) immediately afterward. "Before David, who was second for surgery, was even in recovery, the hospital staff came to tell us about the PICU," Diane said. "They told us where we could sleep if we wanted to stay, the cafeteria hours, and how we could enter the PICU when we visited; there were no questions left unanswered." Tony and David spent slightly more than a day in the PICU after surgery. Their entire swimming and diving teams came to visit Diane and Mike and to check on them. "The hospital was so understanding of the situation and welcomed our visitors," Diane said. "We never felt alone or removed from our world of friends and family. They were all welcome, and ChildrenÕs Hospital never made us feel like our calls, visitors or children were a bother at all." "I thought the nurses and staff in the PICU were incredible," Mike said. "Not only did we observe the great way they were taking care of Tony and David, but they also were giving such great care and attention to all of the children (in the unit). It was amazing how they continued to be positive and calm under circumstances like buzzers going off and being surrounded by very sick and injured children." The Restainos were grateful that Dr. Harris spoke with Tony and David on their level and shared the truth about exactly what the family could expect from the surgery, recovery and possible outcomes. "He was wonderful and so good with each of them," Diane said. "He came to visit the boys in the PICU and laughed, telling them he knew that he wasnÕt their favorite person anymore. He learned their senses of humor and their personalities, and he treated them like he had always known them." After spending time in the PICU, Tony and David were moved to the Second Floor Inpatient Unit until they were able to go home. While on the second floor, they were able to have visitors in their room, which included their older brother, Joe. As Tony and David focused on recovery, Joe wanted to help by picking movies from the hospital video cart and video games for them to play. During the recovery process in the hospital and after the boys came home, Joe was concerned about the pain his younger brothers were experiencing. "I was very nervous and scared that they might not be able to hang out with me again," Joe admitted. Mike and Diane noticed JoeÕs concerns. "We knew it disturbed him to see the boys be totally bed ridden and obviously in a great deal of pain," Mike said. Tony and David seem to be "frequent flyers" to childrenÕs hospitals, having been patients at the childrenÕs hospitals in Boston and Dallas for other health care needs. "We believe this is by far the best childrenÕs hospital we have ever been in, without a doubt," Mike said. Tony and David were expected to stay at the hospital for a week but were able to leave after four days and were at home on July 3, 2003. After getting home, it took the boys two weeks to begin to move around. "IÕd say the whole recovery period was six weeks, and then they didnÕt do any activity until they went back for their checkup with Dr. Harris the end of August," Diane said. That checkup proved the surgery worked the way it was supposed to. The brain had been moved away, the fluid was moving properly, and Tony and David were able to go back to doing anything they wanted to do. The family will always remember those six weeks of recovery as the longest six weeks of their lives. "We had no idea how it was going to turn out," Diane said. "When we made the decision about surgery, we had no idea if it would fix the problem, and it was a very risky surgery for both boys. We are really thankful Dr. Harris was in Knoxville to take care of Tony and David." When the Restainos first met with Dr. Harris, he told them the worst-case scenario was the possibility it would take two years for the twinsÕ problem to be fixed, but the best-case scenario was that they would recover immediately. The end result was the best-case scenario; the brain had moved away and the fluid was coming out of their spines. Tony and David are back to doing all the things that they enjoy in school, they are back swimming and diving, they have their same senses of humor, and they are bickering with one another and older brother Joe just like before the surgery. "It is hard for us to believe that our children had brain surgery just over a year ago, and today they are just like any other kids," Mike said. "It is remarkable; no one would ever know it." "As far as ChildrenÕs Hospital goes, they really do put their arms around the entire family," Mike said. "It is so obvious that when you walk in the door, you can understand that their goal is very simple; their goal is to take care of your child, and hopefully when you leave, your children are healthier than when they came in. There is no question that from the volunteers to the (clinical) staff to the doctors, ChildrenÕs HospitalÕs mission is very simple Ð to serve the children and families in the community." by Janya Marshall, Associate Director for Public Relations TonyDavidTonyDavid& The Restaino Family
  • Pediatric cardiologist developed love for medicine as a child 7 David Hill, M.D. B.A. Ð University of Tennessee, Knoxville, 1976 M.D. Ð University of Tennessee Medical School, Memphis, 1980 Internship and first year of residency (general surgery) Ð University of Texas Southwestern Medical School, Dallas, 1980-82 Residency (urology) Ð UT Memphis, 1982-85 Fellowship (pediatric urology) Ð Mayo Clinic, Rochester, Minn., 1988-89 Other education Ð spent two months working at the Great Ormond Street Hospital in London in 1985 Family Ð Wife, Carolyn; sons, Matt (deceased) and Reid (age 18) Interests Ð family, hunting, fishing, flying airplanes Always interested in working with children, David Hill, M.D., considered pursuing a specialty in pediatrics while he was in medical school. But he also knew he had a significant interest in surgery. Two of his mentors in Memphis, Drs. Butch Noe and Gerald Jerkins, were pediatric urologists who encouraged him to consider the subspecialty of pediatric urology as a means to combine his two interests. A native of Milan in West Tennessee, Dr. Hill most recently practiced in Nashville, and he joined the Children's Hospital-based practice of Drs. Preston Smith and David Riden in the spring. The busy and growing practice had a need for an additional pediatric urologist to better serve this regionÕs children. Pediatric urologists treat a broad spectrum of medical and surgical problems. Among the most common conditions are hernias and hydroceles, and pediatric urologists also frequently perform circumcisions. More complex conditions include congenital anomalies such as bladder exstrophy (a rare but very serious condition in which the bladder is outside the body), neurogenic bladder in children with spina bifida, and kidney stones. "WeÕve begun seeing more and more kidney stones in children in recent years," Dr. Hill said. Some of the conditions require extensive reconstructive surgery. Children with spina bifida, for example, may need reconstructive surgery to help them gain bowel and bladder continence. Dr. Hill is particularly interested in the treatment of hypospadias (an abnormal opening of the urethra on the penis) and kidney tumors (primarily WilmsÕ tumor). Hypospadias is one of the conditions that has been impacted greatly by the current trend toward outpatient surgery. "The move toward outpatient surgery is probably the biggest change in pediatric urology since I began practicing. When I was a resident, surgery for hypospadias required a four-day hospitalization," he said. "Now, itÕs an outpatient procedure. Vesicoureteral reflux also was a three- or four-day stay, and now itÕs usually a 23-hour inpatient stay or even an outpatient procedure." Outpatient surgery is an important improvement in the health of children for many reasons. Hospitalization is disruptive to a childÕs routine and emotional well-being, and it is clear that children recover more quickly when in the comfortable environment of their own homes. Working in concert with Drs. Smith and Riden, Dr. HillÕs presence will benefit the areaÕs children by helping to expand the availability of pediatric urological care in the East Tennessee region. Physician treats variety of urological needs 6 Yvonne A. Bremer, M.D. B.S. Ð Cornell University, Ithaca, NY, 1994 M.D. Ð State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, N.Y., 1998 Internship and residency (pediatrics) Ð Medical College of Virginia Hospitals, Virginia Commonwealth University Health System, Richmond, Va., 1998-2001 Fellowship (pediatric cardiology) Ð Medical College of Virginia Hospitals, Virginia Commonwealth University Health System, 2001-04 Family Ð Husband, Richard L. Bremer, an internal medicine physician and hospitalist who will be practicing at Baptist Hospital Interests Ð outdoor activities including skiing, canoeing, hiking, biking and kayaking Growing up, YvonneA. Bremer, M.D., knew she wanted to be a doctor. "In high school, I rotated with a pediatrician who was my mentor," she said. "I was goal-oriented early on." When she reached medical school, Dr. Bremer decided to schedule pediatrics as her last rotation because deep down she knew that was where her interests were. "I wanted to keep an open mind, but nothing else caught my interest." But she was also looking for a challenge, and she found that in cardiology. "It was very rewarding and stimulating, as well," she said. She chose to combine the two interests and completed her fellowship in pediatric cardiology in June. Anative of Buffalo, N.Y., Dr. Bremer joined the pediatric cardiology practice of Dr. Jeffory Jennings at Children's Hospital in July. She and her husband, also a physician, found the Knoxville location to be ideal because of their interest in outdoor activities, and they also fell in love with the city when they visited. "We could see living here, raising a family here and working here," she said. As a pediatric cardiologist, Dr. Bremer treats children with a wide range of heart problems, including heart murmurs, chest pain, syncopy (passing out), high blood pressure and congenital heart disease (for example, ventricular septal defects, atrial septal defects, patent ductus arteriosis and pulmonary stenosis). These problems can either correct themselves, require medication or require surgery; more complicated congenital heart conditions include hypoplastic left heart syndrome, transposition of the great arteries and Tetralogy of Fallot that may require multiple surgeries. "Pediatric cardiology has come a long way over the past 50 years," she said. "We are able to save so many more lives. But itÕs hard to tell a parent that his or her child has congenital heart disease, and itÕs even harder to tell a parent the child will need open heart surgery." Dr. Bremer also noted that pediatric cardiologists are unusual from other pediatric specialties in that theyalso treatadults who have heart problems that developed inchildhood. Adult cardiologists treat adult-onset problems, not problems that appeared in childhood. She has a special interest in echocardiography, a noninvasive way to study the heart, and is especially interested in fetal echo, which examines the heart of a fetus before birth. Dr. Bremer also is trained in transesophageal echo, which goes through the esophagus to look behind the heart. Both of these types of tests have helped to improve care for babies and children with heart problems, because the problems can be diagnosed early (in the case of fetal echo) and more thoroughly (in the case of transesophageal echo). Dr. Bremer says she especially enjoys the counseling component of her specialty. "Telling a parent, Ôhere is the problem, here is what weÕll do,Õ and being able to prepare them, sometimes even before the childÕs birth, about what to expect. ItÕs scary for the parent, but itÕs not the end of the world because there is so much we can do." Dr. Bremer is looking forward to entering into practice with Dr. Jennings at Children's Hospital and helping provide the specialized cardiology care needed by an increasing number of children in this region. Subspecialist Profiles
  • Children’sNews... As A Grand Event enters its 5th year this fall, a new element has been added to the Grand Legacy program that was such a success during last yearÕs event. Sponsored by ChildrenÕs Hospital and Baptist Senior Services, A Grand Event and its Grand Legacy program have an objective to bring grandparents and grandchildren together to create their history, both individually and together. It urges grandparents to commit to taking the time to record their own legacy -- not only to preserve their legacy for their grandchildren but also to bridge the generations with the importance of history and traditions. Ina Hughs, award-winning columnist for the Knoxville News Sentinel, will lead this yearÕs new Grand Legacy program Ð a creative writing workshop that will "Tell The Story Only You Can Tell," which will concentrate on family stories and beliefs that define who we are and what is important. Hughs said the session will "use specific assignments to jump-start our Ômuse,Õ and we will look back to those people and places, events, circumstances, experiences and ideas that shaped us and remain as part of our family lore." The series will begin September 7, and each assignment will include examples from other writers as a guideline. In a non- threatening environment, participants will be inspired and encouraged to begin a collection of story "pictures" and picture "stories" that will become part of a book, a gift of life, to those they love and who love them. "It is, after all, our stories that bind families together and through which its members live on in the eyes and hearts of the next generation," Hughs said. Hughs, whose career as a writer of non- fiction and family stories spans 35 years, will help participants focus on specific assignments and offer suggestions and inspiration. "DonÕt worry if you are not a Ôwriter,Õ" she says. "A writer, just remember, is a person who writes -- nothing more, nothing less. Five minutes in the room, and you will be a writer, I promise!" The final session of "Tell The Story Only You Can Tell" on September 28 will tie all the elements of each grandparentÕs special story together by uniting the written stories with photographs from each person illustrating these special life experiences. Neil Crosby, a professional photographer with Neil Studios in Knoxville, will offer tips and techniques for using photography as a way to enhance the gift of memories to children and grandchildren. Other events for this yearÕs A Grand Event will include: Walk on the Wild Side Saturday, September 11 Take a "Walk on the Wild Side" during A Grand Event, a fun-filled day at the Knoxville Zoo for seniors and their grandchildren from 8 a.m. to noon. This recreational event is a great way for grandparents to bring their grandchildren to enjoy the zoo, take advantage of seeing the animal exhibits and, most importantly, exercise. Each Baptist Senior Plus member will receive a free gift, a snack bag and a free blood pressure check, all while their grandchildren enjoy a variety of games and activities. Grandparents can sign up with BaptistÕs Senior Plus program and enjoy the zoo for just $2 if tickets are purchased in advance and $3 if bought at the event. Tickets for accompanying grandchildren 12 years and younger are also only $3 each, and any other person attending with the Senior Plus member will receive $1 off the regular admission price to the zoo (not valid with any other discount or coupon). For more information, call (865) 632-5170. Walk on the Cultural Side Tuesday, October 5 Grandparents and grandchildren can take a "Walk on the Arts Side" together during a special evening, beginning at 6p.m., at the Knoxville Museum of Art, where there will be opportunities to learn more about and experience a variety of cultural arts experiences from throughout Knoxville and East Tennessee. More information about ÒA Grand EventÓ is available on www.etch.com. A GRAND EVENT! Creative writing element introduced for 5th annual program 98 The 20th annual Fantasy of Trees to benefit ChildrenÕs Hospital is fast approaching. This year the event will take place November 24-28 at the Knoxville Convention Center and will feature the theme, "Where Your Heart Finds Christmas." Co-chairs Becky Vanzant and Karen Waldbauer, assistant co-chair Linda Redmond and dozens of volunteer leaders are planning many new activities for this yearÕs 20th anniversary show. Some of the new childrenÕs activities include holiday aprons, necklaces, wooden ornaments and tote bags, while a 20-foot- long, six-foot-tall Holiday Mosaic featuring a festive holiday scene will take shape throughout the five-day event as children add their artwork to the unique display. Adults and children alike will enjoy a nightly Christmas tree lighting ceremony as well as three new designer categories, new holiday shops and a new "Hobbies for the Holidays" area from Scripps Networks. Net funds from the 2004 Fantasy of Trees will be placed in the Open Door Endowment Fund. This fund will provide greater security to the families of East Tennessee by ensuring the hospital ALWAYS is able to provide care to children whose families cannot afford the care they need. With an endowment fund, only the income is spent, while the principal remains secure and untouched -- therefore guaranteeing that care is always available to the uninsured children of East Tennessee. Volunteers are needed to help at the five-day holiday event, and sponsors and designers are currently being recruited. For more information about the 2004 Fantasy of Trees and how to volunteer, contact the ChildrenÕs Hospital Volunteer Services and Resources Department at (865) 541-8385, send an e-mail to fot@etch.com, or visit www.etch.com/fantasy.cfm. by Suzann Hollingsworth, student intern Planning continues for 20th annual Fantasy of Trees Children’s Hospital honors volunteers The success of ChildrenÕs Hospital is due in large part to the countless hours of hard work by the hospitalÕs volunteers. Their smiling faces can be found throughout the hospital assisting with a number of duties, from helping in the Gift Shop to pushing the video and toy carts by patientsÕ rooms. Four of the hospitalÕs volunteers were recently honored for their dedication and hard work during the Volunteer Appreciation Luncheon April 17 at the Knoxville Convention Center. The Anne D. Regas Award, named in memory of the founder of the ChildrenÕs Hospital Auxiliary, was awarded to Nancy Finley for her exemplary service and commitment in volunteer service. Finley began volunteering in 1993 on the toy cart and then took on additional duties in the Hematology/Oncology Outpatient Clinic in 1997. In the past, she has served on the Auxiliary board and numerous committees and has assisted with many fund-raising efforts. She currently chairs the Board of Directors for HOPP (Hematology/Oncology Patients and Parents support group) and supports Camp EagleÕs Nest. Tom Elsea received the Edna H. Duncan Award for professional and personal excellence during his years of volunteer service. This award was named in memory of a 10-year volunteer who donated more than 25,000 hours of service to ChildrenÕs Hospital. Elsea began his volunteer service in 1993 at the Fantasy of Trees and became a volunteer at the hospital in 2000. Today you will find him at ChildrenÕs two days a week, one day greeting visitors at the Information Desk, the other day staffing the video cart. In the last four years, he has accumulated nearly 2,000 hours of service. The 24 Karat Award, given to a volunteer who illustrates enthusiastic participation, was presented to Katty Smith, who volunteers with the Information Desk. She started volunteering in 1998 with the video cart and in the Hematology/Oncology Outpatient Clinic. Smith can also be found volunteering for the Fantasy of Trees, the ChildrenÕs Miracle Network Telethon, and the ChildrenÕs Hospital Invitational Golf Tournament, as well as leading preschool groups on tours of the hospital. She also serves as Program Chair of the ChildrenÕs Hospital Auxiliary. Susan Bascom received the 2004 Shining Star Award for dedication to evening and weekend service. Bascom started volunteering at ChildrenÕs Hospital in August 2002 and is an Auxiliary member. She now leads a local group of volunteers with HOPE, a national organization, who have adopted the video cart service. She is in charge of recruiting, training and scheduling HOPE volunteers to staff the cart. When she began this effort, she noticed there was a need for more volunteers on Sundays. Presently, she and the other HOPE volunteers can be found working the cart on Sunday afternoons and Monday evenings. by Suzann Hollingsworth, student intern One of the AuxiliaryÕs most popular services for patients at ChildrenÕs Hospital is undergoing a major change. The "video cart" of loaned movies will change to a new closed-circuit digital television system in the hospitalÕs new patient rooms. In anticipation of this growth and change, the Auxiliary has diligently raised funds through the last few years, and on May 18, the group presented a check for $75,000 to the hospital. According to Auxiliary President Nancy Mason, this is the largest single contribution ever made to ChildrenÕs Hospital by the Auxiliary. "The Auxiliary funded the establishment of the video lending library some 12 years ago, following a gift from a hospital supporter which placed VCRs in each patient room. We have continued to purchase videos and loan them to patients and families in the hospital for more than a decade now, all free-of-charge," Mason said. Fund-raising efforts have included the AuxiliaryÕs annual holiday greeting card sale, plant sales and other special events. With this substantial donation from the Auxiliary, ChildrenÕs Hospital will be able to offer pre-programmed movies 24 hours a day to patients, as well as provide educational programming for parents regarding care for their childÕs injury or illness. by Rupal Mehta, student intern Auxiliary gives record donation to Children’s Hospital Award Winners left to right: Tom Elsen, Katty Smith, Nancy Finley and Susan Bascom Award Winners left to right: Tom Elsen, Katty Smith, Nancy Finley and Susan Bascom
  • ChildrenÕs Hospital is in the midst of major construction as a 115,000-square- foot, seven-story patient tower is being added at the corner of Clinch Avenue and 20th Street. After working around unpredictable spring weather, the tower is now fully enclosed, and work is underway on the interior of the building. After the tower is complete, the hospital will undergo renovation on most of the existing facility. The renovation will continue until September 2005, when the entire three- year project should be complete. The hospital hopes to start moving into the following spaces in the new tower by fall 2004: ¥ New area of the Emergency Department, Neurology and Phlebotomy open in August and September ¥ New areas of Second and Third inpatient medical floors open in September and October ¥ New area of Fourth surgical patient floor opens in October ¥ New Kitchen and Dining areas open in October and a new servery area opens in December ¥ New Pediatric Intensive Care Unit opens in November ¥ New Post-Anesthesia Care Unit and Endoscopy Suite open in November. The hospital is also adding an in- house television system, more comfortable family areas and a laundry area for patient families that will be in place by November. An Expansion/Renovation Timeline is available on our website at www.etch.com/attractions.cfm. Click on "WeÕre Growing." This $31.8 million expansion and renovation of ChildrenÕs Hospital will allow more space and comfort for patients and families. Features of the expansion include 95 private patient rooms with full baths, an expanded 13- bed Pediatric Intensive Care Unit and an expanded 44-bed Neonatal Intensive Care Unit. The hospitalÕs licensed beds will increase from 122 to 152, and a larger Emergency Department will increase from 18 to 35 beds. In addition, the Surgery and Radiology departments, cafeteria, support services and storage will be expanded. by Amber Birdwell, student intern Medicine specialists, started Pediatric Analgesia and Sedation Specialists, PLLC (PASS). PASS provides the pediatric sedation service at ChildrenÕs Hospital, offering improved patient safety and a family-centered, consistent sedation practice in strict compliance with policies of ChildrenÕs Hospital and the Joint Commission for the Accreditation of Healthcare Organizations. The service is available Monday through Friday from 7 a.m. to 4 p.m. for patients undergoing certain tests in the Radiology Department (especially CT and MRI scans that require children to remain still for extended periods of time), as well as for patients in the Hematology/Oncology Outpatient Clinic and in the Gastroenterology Lab. The need for sedation depends on the age of the child, the length of the procedure and the degree of discomfort it might cause, Drs. Connors and Lembersky explained. Any child under age 5 will need sedation for an MRI because the test requires the child to remain still for about 45 minutes. An older child or teen probably can undergo an MRI without sedation but may need it for an uncomfortable procedure in the GI Lab. PASS utilizes some newer sedation medications that may be administered only by certain specialists. These drugs are more effective and safer but are administered in a different manner, making it necessary for a doctor solely responsible for sedation to be present. The drugs work quickly and wear off quickly and also can put patients into a deeper state of sedation for a shorter amount of time. This enables the child to be motionless for the test. While any sedation ensures the child doesnÕt remember the discomfort of a test, a milder level of sedation would not necessarily keep the child still enough to ensure the most accurate test results. In the past, sedation drugs were often administered by the physician performing the test, as the test was being conducted. Now, a sedated patient is under the eye of the "sedation doctor" while a second physician focuses entirely on conducting the test, ensuring a safer test for the child. Pediatric hospitals like Children's are utilizing these new services on an increasing basis to improve care for their 1110 patients. The new service also addresses a change in the Joint CommissionÕs credentialing process that requires hospitals to address sedation services. Physicians who are members of Pediatric Analgesia & Sedation Specialists, PLLC, the service offered at Children's Hospital, are: J. Michael Connors, M.D.; Robert Lembersky, M.D.; Lise Christensen, M.D.; and John Williams, M.D. These Pediatric Emergency Medicine specialists already were certified to perform sedation in the Emergency Department but now can extend their services to other areas of the hospital. They have performed more than 400 sedation procedures just since beginning the service at the start of 2004. Drs. Connors and Lembersky have communicated with and/or visited several sedation services in other areas of the country and have researched protocols to ensure that the service at Children's Hospital performs sedation in the best manner. After attending a recent conference on the subject in Denver, Dr. Connors noted,"We were delighted to see that our service at Children's Hospital is far more advanced than most other pediatric sedation services around the country." State children’s hospitals form alliance East Tennessee ChildrenÕs Hospital is one of four Comprehensive Regional Pediatric Centers in Tennessee that recently joined forces to form a new advocacy group for pediatric healthcare. Called the ChildrenÕs Hospitals Alliance of Tennessee, or CHAT, ChildrenÕs is joined in the new organization by Le Bonheur ChildrenÕs Medical Center in Memphis, TC Thompson ChildrenÕs Hospital in Chattanooga and Vanderbilt ChildrenÕs Hospital in Nashville. The goal of the alliance is to address gaps in health care for children caused by inadequate state laws and complexities in the health insurance system. Tennessee has ranked for many years near the bottom for childrenÕs health care under some criteria. But according to Jim Schmerling, CEO of Vanderbilt ChildrenÕs Hospital and chair of CHAT, TennesseeÕs new car seat legislation is one example of how that will change. Tennessee ranked 50th out of 50 states in compliance with car seat laws, but now the new law is one of the most stringent in the country. The Alliance believes promoting research, formulating new policies, and training health care professionals will allow CHAT to foster development of childrenÕs hospitals and better promote the health and well being of children in Tennessee. CHAT will work with the Tennessee Legislature on such issues as TennCare, childhood immunization, child passenger safety, healthy food vending in schools and use of lottery funds to help keep children healthy. Mary Nell Bryan has been named CHAT President and CEO. She has an extensive background in legislation and government relations and has spent 15 years lobbying with a concentration in health care and not-for-profit issues. Bryan will advocate on the state and national levels for the interests and policy positions to drive the quality of childrenÕs health care. SheÕll also develop and implement programs and services of the association. CHATÕs Board of Directors is made up of two representatives from each hospital; ChildrenÕs HospitalÕs representatives are Bob Koppel, President and CEO, and Dr. Joe Childs, Vice President for Medical Services. Koppel said the alliance will enable the four hospitals to work together and with other agencies to better address the needs of children. "Whether it relates to state or federal legislation, TennCare or legal issues, for each of us, itÕs about our young patients, their families and their quality of life," he said. All four CHAT member hospitals are certified as Comprehensive Regional Pediatric Centers, which is the highest level of certification for pediatric care in the state of Tennessee. Each of the pediatric institutions is equipped to care for seriously ill children in a unique pediatric environment separate from adult care areas. Comprehensive centers also provide training to help community hospitals meet pediatric medical requirements. by Kathryn DeNovo, student intern Relocation, construction continue at Children’s Hospital New sedation service offers greater safety, comfort to patients In early 2004, a pediatric sedation service was created at ChildrenÕs Hospital to offer greater safety and comfort for patients for medical procedures and tests when general anesthesia is not necessary. More hospitals across the country are developing pediatric sedation services due to an increasing number of children requiring sedation for painful or lengthy procedures and stricter requirements for providing sedation. At ChildrenÕs Hospital, Dr. Mick Connors and Dr. Robert Lembersky, both board certified Pediatric Emergency
  • 13 BOOMSDAY Traditionally, Journal Broadcast Group holds its Star 102.1 Boomsday celebration on Labor Day (Monday), but this year the event has been moved to Saturday, September 4. Star 102.1 Boomsday is the largest Labor Day weekend celebration in the Southeast. Over 250,000 guests are drawn annually to Neyland Drive on the banks of the Tennessee River for a day of food, entertainment and fun. After the sun sets, a spectacular fireworks show is presented from the Henley Street Bridge. Volunteers will be at the event to sell soft drinks to the thirsty crowd to benefit ChildrenÕs Hospital. Last yearÕs event raised more than $12,000. Call (865) 541-8567 to volunteer. TUNNEL THUNDER VI Tunnel Thunder VI will take place September 11 at Jaycee Park in Clinton. The ride is a poker run to the Cumberland Gap Tunnel and then back to the park. The first bike out will be at 11 a.m., and the last bike out at noon. Cost is $10 per person, and lunch will be provided at the end of the ride. The event also features a silent auction, door prizes and a $250 grand prize. The event is presented by the Volunteer Road Riders. For more information, call the Children's Hospital Development Department at (865) 541-8441. WAR OF THE WINGS This event gives the term "hot wings" a whole new meaning. The University of TennesseeÕs Kappa Delta sorority will present the 12th annual "War of the Wings" on Saturday, September 18, before the Tennessee-Florida football game. Event visitors can vote for their favorite wings prepared by local restaurants and UT fraternities. Football fans are encouraged to stop by Fiji Island any time three hours before the 8 p.m. kickoff and enjoy "All You Can Eat Wings." In 2003, the "wing fest" raised more than $3,000 for ChildrenÕs Hospital. Tickets are $5 in advance and $6 on game day. For tickets or more information, call (865) 541-8437. OAKES FARM CORN MAZE What do you get when you combine 12 acres of corn stalks, 5.3 miles of trails, over 960,000 stalks of corn, and three different mazes? Fall family fun at the Oakes Farm Corn Maze in Corryton, located at 8240 Corryton Road. And for a few weeks around Halloween when the maze becomes "haunted," Oakes Farm donates proceeds from the maze to ChildrenÕs Hospital. This year, those dates are October 6-30 (excluding Sunday nights). During the day, the maze is a fun challenge for the whole family, while at night, it becomes a haunted adventure amid the cornstalks. In addition to the maze, visitors can take a hayride, stroll through the pumpkin patch, and enjoy many other fall activities. For more information about visiting the maze, call (865) 688-6200 or visit www.oakesfarm.com. If you are interested in volunteering with the "haunted" corn maze, call (865) 541-8745. GIBBS HAUNTED FOREST Families can enjoy a safe and spooky night of fun at the Gibbs Haunted Forest in late October. The haunting begins the weekend of October 15 and continues through Halloween night, Sunday, October 31; the event opens each evening at sundown and closes at 11 p.m. on most nights. On the walking tour of the Haunted Forest, visitors will encounter a haunting collection of monsters, ghosts, goblins and ghouls. There is also a childrenÕs Halloween activity area for younger visitors to enjoy while older children and adults tour the forest. The Haunted Forest has been a tradition for Susan and Robby Taylor over the last 10 years; they help sponsor the event to raise money for ChildrenÕs Hospital in honor of their daughter Stephanie, a long-time patient. In 2003, the event raised more than $8,000 for the hospital. Admission to Gibbs Haunted Forest is $7, and children 6 and under are admitted free; all proceeds benefit ChildrenÕs Hospital. For more information on the event, call (865) 541-8437. NEILL SANDLER FORD LINCOLN MERCURY SALE If youÕre looking for a new vehicle, consider buying from Neill Sandler Ford Lincoln Mercury on the Airport Motor Mile and benefit ChildrenÕs Hospital. The auto dealership began a yearlong fund- raiser for the hospital in May and will donate $50 to the hospital after the sale of new or used vehicles through March 8, 2005. Proceeds from this program will be presented at TKÕs Breakfast for ChildrenÕs Hospital on March 12, 2005 For more information, contact Gene Wishon or Michael Borkman at Neill Sandler Ford Lincoln Mercury at (865) 970-2500 or the ChildrenÕs Hospital Development Office at (865) 541-8437. by Casey LaMarr, student intern U P C O M I N G E V E N T S T O B E N E F I T C H I L D R E N ’ S Mark your calendars now for several upcoming events to entertain families and benefit ChildrenÕs Hospital. Thanks to the generous people of East Tennessee who host and participate in these events, ChildrenÕs Hospital can continue to provide the best pediatric health care for all the children of this region. DatestoRememberUpcoming events to benefit Children’s Hospital August Karaoke in the Park August 28 Sons of Thunder Fun Ride August 28 SamÕs Club Golf Tournament At Cedar Hill in Lenoir City August 28 September Boomsday September 5 Tunnel Thunder Ride September 11 October Oakes Farm Corn Maze October 6-30 (except Sundays) Gibbs Haunted Forest October 15-31 November Todd Helton Celebrity Golf Tournament November 8 Tino Sale November 10-11 Fantasy of Trees Gala November 23 Fantasy of Trees November 24-28 For more information about any of these events, call (865) 541-8441 or visit our Web site at www.etch.com and click on “Coming Attractions.” 12 Estate Planning... ÒYour will, the foundation of your estate planÓ Include Children’s Hospital in your estate plans. Join the ABC Club. For more information, call (865) 541-8441. Please send the free brochure titled ÒPersonal RecordsÓ Name______________________________ Address__________________________________________ City___________________________ State_______ Zip_____________ Phone#(______)___________ r Please call me at the above phone number for a free confidential consultation concerning planned giving. r Please send me more information about deferred giving. r I have already included ChildrenÕs Hospital in my estate plan in the following way: __________________________________________________________________________ r Please send me information about the ABC Club. ChildrenÕs Hospital Development Office (865) 541-8441 Making a will is one of the most important activities you will ever undertake. It need not be difficult or unpleasant, but it is very important. A will is the only legal document that records your final wishes. Your family members will already be under a great deal of stress simply because you have passed away, and you can significantly reduce their burden by leaving a properly executed will. People have many excuses for not planning or writing a will. Some express concern over paying a lawyer to prepare their will. This should not be a consideration; the few dollars you spend on professional fees for a properly prepared will are truly miniscule compared to the expense and heartache of failing to plan. By preparing a will, you are telling those you leave behind how to care for your minor children and how to dispense of all you have accumulated during your entire lifetime. Putting your instructions in a valid will eliminates any room to speculate about your intentions. You can save time and money by focusing your efforts and "doing your homework" before visiting with your attorney. 1. Sit down with your spouse and have that difficult discussion about who should raise your children if you some time with your executor to discuss your wishes and make certain they will agree to serve. 5. Write all of this information down. 6. Select an attorney. Choose someone who has experience in estate planning, and make an appointment. Feel free to discuss fees in advance, and follow through by mailing the attorney a copy of your information well in advance. The attorney will appreciate dealing with a well-prepared client and will also be glad not to waste time serving as a "referee" between you and your spouse on important matters such as custody of children and selection of an executor. 7. After your will is finalized, sign it, give a copy to the executor and keep the original in your safe deposit box. Then sit back and enjoy the security that comes from knowing you have made all the necessary arrangements to prevent unnecessary expense and avoid family strife after you are gone. For more information on wills and estate planning, including a copy of our free planning booklet "Personal Records," please send your name and address to us via the reply form below. Or you may email David Rule, Director of Development, at dsrule@etch.com or Teresa Goddard, CFRE, Senior Development Officer, at tgoddard@etch.com, or call them at (865) 541-8441. should both die together in an accident. Then both of you should meet with the people you select to make certain they will agree to accept the responsibility. Choose an alternate in case your first choice is deceased or unable to take your children. Specify who is to manage any money left for your childrenÕs benefit and consider having someone separate involved with overseeing those funds. 2. Pull together a listing of the people to whom you will give your belongings. List their name, current address and phone number and their relationship to you Ð son, daughter, niece, nephew, grandson or granddaughter, neighbor, friend. List what you would like them to have and be specific. 3. List all of your assets: house, land, securities, retirement plans, IRA, jewelry, art, collectible items, bank accounts, vehicles and other personal property. Make a list of your favorite charities. List the location of your safe deposit box. Consider attaching a letter to the will indicating any wishes you may have for a funeral and the location of cemetery lots and information about any prepaid funeral arrangements you have made. 4. Choose an executor. It is especially important to determine which of your relatives or friends is wise and honest enough to serve as executor of your estate. This is the person whom the court will hold accountable for carrying out your wishes as listed in your will. You and your spouse should spend
  • available that will hold a child who weighs more than 100 pounds, regardless of height. Currently, there is only one booster seat that is designed for children taller than 4 feet 9 inches (it is intended for children up to 5 feet tall). It is available only at Babies R Us, and we understand the model may soon be discontinued. If your child weighs more than 100 pounds or is between 4 feet 9 inches and 5 feet tall, you need to follow the booster seat manufacturersÕ guidelines. Remember that the law was created for safety, not for punishment. So if your child is under age 9 but is above the weight and/or height guidelines for booster seats, use the following tips to ensure your child is safe if you choose not to put him or her into a booster seat: ¥ The seat belt should be positioned over the child's pelvis and across the collarbone and sternum (the child must ride in a seat with both a lap and shoulder belt). ¥ Have the child sit closer to the seat belt buckle so that the shoulder strap will not go across his or her neck. ¥ The childÕs legs should bend comfortably at the edge of the carÕs seat when he or she is sitting all the way back in the seat. If you have additional questions or concerns regarding this issue, please visit a car seat checkpoint or contact your local police department. Q : What are some common mistakes that someone should avoid with car safety restraints? A : The following common mistakes can easily be avoided by taking extra time and care in placing your children in a restraint seat: 1. Car seat is too loose in the seat. 2. The harness is too loose on the child. 3. The infant has been turned forward facing too soon. 4. The rear-facing seat has not been placed at a 45-degree angle. 5. The retainer clip is used incorrectly. 6. The harness straps are placed through the wrong slots. 7. Not using a booster seat with a child Q : Do you recommend secondhand car seats? A : Here are some things that you should consider if it is absolutely necessary to use a secondhand car seat: ¥ Is the seat more than 10 years old? Look on the label for the date it was made. If it is more than 10 years old, it should not be used. Some manufacturers recommend that car safety seats only be used for 5-6 years. Check with the manufacturer to find out the companyÕs recommendation. ¥ Was it ever in a crash? ¥ Does the seat have any visible cracks in the frame? ¥ Are there any parts missing? ¥ Has the seat been recalled? If you answered yes to any of the questions above, you should NOT use the secondhand car seat. Other questions to consider include: ¥ Does it have a label with a date of manufacture and model number? ¥ Does it have the original instructions? ¥ Is it less than 1 year old? If these questions are not clearly answered, I would recommend getting a new seat. If you have questions or concerns, visit a Safety Seat Checkpoint or call the local law enforcement agency in your area to have the seat inspected and properly installed before you begin using it. Q : What if my children donÕt like safety seats or safety belts? A : It really is not their choice. Children simply canÕt understand the risks of a motor vehicle crash and the benefits these devices provide. As an adult and parent, you must insist on children and all passengers using proper restraints for their own safety and protection. DonÕt start the car until everyone (including yourself) is buckled up. If you make it a habit and start practicing when your children are young, buckling up and getting in a booster seat will not be something "odd" or "not coolÓ; it will simply be part of the ride. Trust me, if you havenÕt seen someone injured in a motor vehicle crash, you donÕt want to. Buckle up and be safe. LetÕs all work to lower the high mortality on Tennessee roads. Parents should start the trend of seat belt wearing by setting an example for the entire family, friends, and neighbors. Make it a routine for everyone in the car to be properly restrained and use car seats, booster seats and lap shoulder belts. Make sure you use them properly. If you donÕt make sure your child is safe when riding in a car or van, unfortunately your next trip with your child might be to a hospital emergency department. Compiled by Janya Marshall, Associate Director for Public Relations 14 15 Parents, grandparents and child care professionals place children in cars, vans and other vehicles every day. Where in the car should children of different ages ride? Should children be in car seats, booster seats or seat belts? Many caregivers have had training in the appropriate way to install a car seat or a booster seat, while others try to follow the instructions on the box, and others remain unclear on these issues. Not only do many people not understand the proper way to restrain a child, nor the importance of doing so for a childÕs safety, but caregivers of children should also know that the current state of Tennessee law on child restraints is changing. Dr. Mick Connors, Emergency Department physician at East Tennessee ChildrenÕs Hospital, offers the following information on the proper installation and importance of using a child passenger safety seat and the new Tennessee law on this important child safety issue. Q : Why is the current law changing? A : The old law was outdated and not accurate to current safety standards. The state of Tennessee and its lawmakers are working hard to keep our children safer. The current changes basically followed the child passenger safety recommendations of the National Highway Traffic Safety Administration. Q : What are the dangers of not placing a child in a car or booster seat correctly or in a restraint completely? A : More children in the United States are killed and injured in car crashes than from any other cause of injury, and traffic crashes are the number one killer of children ages 1-5. Even with current legislation related to car seats, more than 1,000 infants and toddlers die and another 40, 000 are seriously injured each year because they aren't properly restrained, according to the National Safety Council. Shockingly, TennesseeÕs fatality rate is 50 percent higher than the national average. To me and other Seatbelts,boosterseatsandcar seats: Doyou knowthelaw? who is age 4-8 and less than 5 feet tall (regardless of weight). 8. Using a seat that has been recalled or is outdated. 9. A child under the age of 12 riding in the front seat. 10. The belts positioned incorrectly on the child; remember "belts over bones." If you still have questions about proper installation, consider going to a safety seat checkpoint. Q : How can a caregiver find a safety seat checkpoint? A : Checkpoints, which are free, are organized twice a month by the SAFE KIDS Coalition of the Greater Knox Area and the Knoxville Police Department. They are staffed by NHTSA-trained and AAA-certified child passenger safety technicians who will check the installation of your seat(s) and teach you proper installation techniques. Checkpoints are offered the FIRST Saturday of each month at Rodgers Cadillac at 8360 Kingston Pike in Knoxville. Hours are 9 a.m. to noon. Remaining dates for 2004 are July 3, August 7, September 4, October 2, November 6 and December 4. Checkpoints are offered the SECOND Saturday of each month at Rusty Wallace Honda on Callahan Road in Knoxville. Hours are 10 a.m. to 1 p.m., and remaining dates for 2004 are July 10, August 14, September 11, October 9, November 13 and December 11. For additional information, call the SAFE KIDS office at (865) 215-5175 or the Knoxville Police Department at (865) 215- 8633. If you live outside the Knoxville area, check with your local police department for assistance. Q : ArenÕt car restraint systems expensive? A : The cost of a new child restraint device varies according to type, model and place of purchase. The least expensive devices are the nonconvertible infant restraint devices and the harness restraint device. In general, the more features a device has, the more it will cost, although a higher price does not necessarily mean a safer device. I would recommend a car seat with a five-point restraint. These generally range from $40 to $100. Booster seats needed for children ages 4-8 can range in price from $15 to $50 and are available at most area retailers such as Wal-Mart, Babies R Us and Toys R Us. Visit the American Academy of Pediatrics' Car Safety Seats Guide at www.aap.org/family/carseatguide.htm for a detailed explanation about seats and a list of available seats, including type, price and weight/height the seat will accomodate (scroll down the page to find the list). These costs are tiny compared to the medical costs and the pain and suffering of a child who is improperly restrained and who suffers an injury in a motor vehicle crash. pediatricians, it is very simple: putting a child properly in a car or booster seat can be the difference between life and death if the child is involved in a wreck. Q : What are the specific changes to the child passenger restraint law in Tennessee? A : Here are the law's provisions: ¥ Any child under 1 year old (even if he or she weighs more than 20 pounds) or any older child weighing 20 pounds or less must be in a rear-facing car seat and should be placed in the back seat, if available. ¥ Children should be in car seats until they are 4 years old and weigh 40 pounds. Again, they should sit in the back seat. ¥ All children ages 12 and under should ride in the back seat (when available). ¥ Children ages 4-8 who are less than 5 feet tall, regardless of weight, are required to ride in a belt-positioning booster seat, located in the rear seat (if available). Previously, children ages 4 and older were not required to be in a booster seat. ¥ Every child and teenager under age 18 must use a seat belt. ¥ If you need to take the child out of the restraint, you must stop the vehicle. ¥ The driver of the car is responsible for ensuring children under age 16 are properly restrained. If a childÕs parent or guardian is in the car but is not the driver, the parent or guardian is responsible, rather than the driver. Fines are issued for violation of the laws. Q : What are the basic types of child restraint devices? A : There are four types of child restraint seats: ¥ Infant seats Ð These should be used from birth until 12 months to reduce the risk of cervical spine injury in the event of a crash. Any child under 1 year old (even if he or she weighs more than 20 pounds) or any child weighing 20 pounds or less must be in a rear-facing car seat. ¥ Convertible seats Ð These seats can be used from birth until about age 4, or a weight of about 40 pounds. Infants ride backward; later the seat can be converted into a forward-facing seat for toddlers. ¥ Toddler seats Ð This type of seat is used for children 20-40 pounds who are able to sit without support. The childÕs size should be such that the ears are below the top of the seat and shoulders are below the seat strap slots. ¥ Booster seats Ð These seats are used when a child has outgrown a toddler or convertible seat but is still too small to fit properly in a vehicle safety seat. All of these seats are required by law in Tennessee as of July 1, 2004. Q : Why booster seats? Are they really so important that the state made their use a law? A : Absolutely. The reason for booster seats is simply to better position the child in his/her seat belt. Children less than 5 feet tall, when wearing their seat belt, will typically have the shoulder portion across their neck and the lap portion of the belt over their belly button area. If the belt is in this position in a crash, the child could suffer severe neck injuries and internal abdominal and spine injuries. This common injury is called "lap belt syndrome." By using a booster, the shoulder strap will go across the chest and the lap belt will be over the child's bony pelvis, thus preventing these serious injuries. Q : What if I canÕt find a booster seat that will accommodate my larger child? A : This is a concern for many parents. Unfortunately, there is NO booster seat Dr. Mick Conners