It's About Children - Fall 2004 Issue by East Tennessee Children's 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.
PA I D
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
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
Robert Madigan, M.D.
Robert M. Goodfriend
Jeffory Jennings, M.D.
Donald E. Larmee, M.D.
Chris Miller, M.D.
J. Finbarr Saunders, Jr.
William F. Searle III
Bill Terry, M.D.
Chris Miller, M.D.
Chief of Staff
Lewis Harris, M.D.
Vice Chief of Staff
David Nickels, M.D.
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
Vice President for Human Resources
Joe Childs, M.D.
Vice President for Medical Services
Vice President for Operations
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.
Director of Community Relations
Director of Development
“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
...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
The Bottom LineArtwork by some of Children’s Hospital’s special patients
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.
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!
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
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
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
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
"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
"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
"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
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
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,"
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
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
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
"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
by Janya Marshall, Associate Director for
The Restaino Family
Pediatric cardiologist developed love for medicine as a child
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
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.
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
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
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
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
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
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
firstname.lastname@example.org, or visit
by Suzann Hollingsworth, student intern
Planning continues for 20th annual Fantasy of Trees
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
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
¥ 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
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
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
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
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
State children’s hospitals
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
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
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
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
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
At ChildrenÕs Hospital, Dr. Mick
Connors and Dr. Robert Lembersky, both
board certified Pediatric Emergency
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,
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
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
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
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,
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
Karaoke in the Park
Sons of Thunder Fun Ride
SamÕs Club Golf Tournament
At Cedar Hill in Lenoir City
Tunnel Thunder Ride
Oakes Farm Corn Maze
October 6-30 (except Sundays)
Gibbs Haunted Forest
Todd Helton Celebrity Golf Tournament
Fantasy of Trees Gala
Fantasy of Trees
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.”
ÒYour will, the foundation of your estate planÓ
in your estate plans.
Join the ABC Club.
For more information,
call (865) 541-8441.
Please send the free brochure titled ÒPersonal RecordsÓ
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
You can save time and money by
focusing your efforts and "doing your
homework" before visiting with your
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
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
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 email@example.com
or Teresa Goddard, CFRE, Senior
Development Officer, at
firstname.lastname@example.org, 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
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
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
¥ 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
Q : What are some common mistakes
that someone should avoid with car
A : The following common mistakes can
easily be avoided by taking extra time
and care in placing your children in a
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
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
¥ Was it ever in a crash?
¥ Does the seat have any visible cracks in
¥ 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
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
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
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
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
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
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-
If you live outside the Knoxville area,
check with your local police department
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
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
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
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
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
¥ Children should be in car seats until
they are 4 years old and weigh 40
pounds. Again, they should sit in the
¥ 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
¥ 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
A : There are four types of child restraint
¥ 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
¥ 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
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
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