Teaching First Aid to Children - A Special Christmas Gift

TO: My Readers
FROM: Occ Doc in a Box

Please enjoy this "Second Edition" of Teaching First Aid to Children (click to download). It offers fun AND education for the whole family! It gives children 15 first aid jingles they can learn and understand, with pictures to color. And, adults get 15 simple first aid lessons they can teach, while learning themselves.

It comes 20 years after I produced the "First Edition," which was a coloring book for young visitors to the emergency department. My 9-year-old son provided the original illustrations. The new edition includes those "classic" cartoons, accompanied by updated and expanded lessons for adults.

I hope it helps you and your children enjoy a safe, healthy, and injury-free 2010!

Merry Christmas from Occ Doc in a (Gift) Box!

The Perfect Gift for the Trucker on Your List

Healthy for them, free for you!

Target audience: Employers and Employees

If you're searching for the ideal stocking stuffer for your favorite trucker, you've come to the right place! Our completely unique and totally FREE Commercial Driver Health Education book is just the thing. This one-of-a-kind pamphlet is chock full of health tips every driver needs. It emphasizes practical strategies for surviving the unhealthy and stressful demands of "life on the road." We've selected tips that help drivers maintain medical certification they need under Department of Transportation rules. Topics include Fighting Fatigue, Recognizing Sleep Apnea, Exercise and Nutrition While Travelling, Visual Health, and more!

Download this PDF file from our Web site to print or distribute as you desire. And, here's a special offer for employers who have a fleet of drivers: between now and Dec. 25, we will take your order for up to 100 copies free!

Keep watching our blogspot this holiday season to see more ways I become Occ Doc in a Christmas Gift Box!

Find our Commercial Driver Health Education booklet here:
http://www.affinityhealth.org/object/services-specialty-occupational-driver-health.html

Or from the Affinity Occupational Health web page, http://www.affinityhealth.org/page/services-specialty-occupational, look in our "Health Library" at the bottom of the right hand column.

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Why do ladies extend their pinkies when holding drinks?

Target audience: Employers and Employees

You can spot a classy lady at a party by the way she holds her beverage container. Whether it’s a fancy champagne flute or a can of beer, a woman of sophistication keeps her pinkie extended straight, with only the thumb and three fingers on the glass. Puzzled by this nuance for years, I’ve finally figured out why. The sophisticated woman is showing everyone she is counting her drinks! The three fingers on the glass show she’s limiting herself to a three-drink maximum. That’s because four drinks in 24 hours, for a woman, is a binge!

If you watch a gentleman drink, you’ll find further proof of my theory. A man who holds his drinking glass with his thumb and all four fingers shows that he knows to limit himself to four servings, as five drinks in 24 hours, for a man, would be a binge!

I know that all of you blog readers are ladies and gentlemen, and understand the definition of a drinking binge: Four or more drinks for a woman, five or more drinks for a man, in 24 hours equals a binge. And you understand that a “binge” differs from a “bender.” Whereas a three-day-long drunken “bender” is accomplished only by extreme misuse of alcohol, a simple binge can occur almost accidentally. Most people who drink alcohol do so socially and in moderation. Moderate drinking is defined as one to two drinks in 24 hours, and not more than 14 in a week. But, even normally moderate drinkers could surprise themselves by reaching binge level simply by having a cocktail before dinner, a couple of glasses of wine with the meal, then an after dinner drink. Because this can happen fairly easily, ladies and gentlemen should use the pinkie up/pinkie down drink counting method I have described!

But, portion size can undo this drink counting method, just as portion size can do in dieting. When counting drinks, remember that each of these is a serving of alcohol:

• 12 ounces of beer
• 5 ounces of wine
• 1 ½ ounces of spirits

Some people find the idea of consuming four or five drinks inconceivable! To other people, that seems like nothing at all. But, it doesn’t matter how it seems. What matters is, what it does. Without a doubt, even a single binge does bad things for your health. Accidental injury risk increases, not only behind the wheel of a car, but also on a snowmobile, a motorcycle, in a boat, or on the basement stairs. Binges cause next-day blood pressure to be higher and heart rates faster. Work accident risks are greater even 24 hours after a binge. Work productivity drops for 24 hours after a binge, and the likelihood of work absence increases. That means lost production and missed opportunities for the work organization. And, that amount of alcohol equals a lot of calories, of a type which are hard for the body to metabolize. Those calories deposit directly into the liver, causing a condition with the unglamorous name of fatty liver. Repeated binges can make that progress all the way to cirrhosis.

Safe use of alcohol is a “numbers game” as in how many drinks, what size, and how often. Here’s a great web site with online calculators and interactive tools to help ensure you and loved ones have the information you need to use alcohol wisely if you choose to drink:
http://www.rethinkingdrinking.niaaa.nih.gov/

Occ Doc in a Box encourages you to enjoy all your celebrations safely and in moderation. And ladies, keep those pinkies pointed!

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Your One-Stop Respirator Information Shop

Target audience: Employers

Respirator manufacturers and safety equipment vendors can be great sources of knowledge. But an employer who purchases their products may also want to cross-reference non-commercial resources. This is one of the many ways the National Institute for Occupational Safety and Health (NIOSH), a division of the Centers for Disease Control (CDC), assists business.

NIOSH has just released a Respirator Trusted-Source Information Page, with plenty of useful information on it in the form of text, photos, and tables. Consider this a reliable public resource to identify NIOSH-approved respirators, how to obtain products, and how to use them. The page will be dynamic, and information will be added as it becomes available. Content will address each of the sections listed below:

• Section 1: NIOSH-Approved Respirators – What are they, How can they be identified, Where can I get them? Understanding the types of respirators; Identifying NIOSH-approved products; and Outlets for purchasing products


• Section 2: Use of NIOSH-Approved Respirators - How to implement the use of respirators in the workplace and use them appropriately.


• Section 3: Ancillary Respirator Information - Commonly asked Questions and Answers (Fact Sheets), Respirator Myths, Science of Respirator Function and Performance, Respiratory Protective Devices Not Approved by NIOSH

The Respirator Trusted-Source Information Page may be viewed at:
www.cdc.gov/niosh/npptl/topics/respirators/disp_part/RespSource.html

And, a cost-saving tip today from out of the Box: when seeking the periodic medical approval that OSHA requires your employees have before using a respirator, start with a questionnaire, rather than a full exam. Your local Occupational Health Clinic should give you the money-saving option of reviewing questionnaires from your employees, and then notifying you which employees can be approved with that information alone. Only employees who need full medical evaluation would then be given an appointment. Do this by distributing the OSHA Mandatory Medical Questionnaire to your employees:

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=978

But, pre-fill it with the required information about work conditions and the respirator itself (“respirator usage.”). The place for that information is Part B of the OSHA questionnaire. It may be easier for you to complete this separately for each type of respirator-requiring job, and attach that to the questionnaire.

Please find a separate Part B section here, which you can use to do that:
http://www.affinityhealth.org/object/services-specialty-occupational-blog-respirator-form-2009-11-24.html

After employees complete their confidential health sections, they should then send them directly to the clinic.

This approach complies with the OSHA Respirator standard and protects confidentiality of health information. And, it may reduce the number of full exams you need to obtain by 50 percent.That way, both you AND your employees can be helped to breathe a little easier!

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Your Teens and Your Prescriptions

Don't Let Good Kids (or Good Meds) Go Bad!

Target Audience: Employers and Employees

You probably know of prescription pain killers such as OxyContin, Vicodin, and Percocet. You should know that these meds can be good and useful, because “life brings many painful things.” And though we doctors have “pills for ills and drugs for bugs” we often don’t have a cure for chronic pain. We commonly use medications like these to control pain whenever possible and prudent.

And you certainly know teenagers. You were one yourself. All kids are good kids, though no one is good in every way. For example, most teenage boys are about 10 minutes away from doing something stupid, if given the chance. And, among the common stupid things teens may do is “borrowing” the prescription pain meds of adults, to take in abusive ways. I’m writing to tell you how to prevent these good kids (and good meds) from going bad.

This happens commonly. Among 12th graders in Wisconsin, 22.9 percent say they have taken painkillers such as OxyContin, Percocet, or Vicodin without a doctor’s prescription. I live in Wisconsin in Outagamie County, where we have great health care, fine schools and where “all the children are above average.” Our prevalence of teen prescription abuse is even higher than the state’s average, with almost 25 percent of high school seniors admitting to it.*

High availability of health care services may make prescription abuse more likely among teens. That’s because more adults in such areas have been prescribed chronic pain meds, and probably correctly so. But that makes it easier for teens to “borrow” them, with or without the adult’s knowledge.

And make no mistakes about it; good meds go very bad when misused, even becoming lethal. Seizures, overdoses, and respiratory depression causing breathing to stop are real hazards of inappropriate use. And these “worst case scenarios” can happen easily, especially if other medications or alcohol are also misused.

It is so easy to misdirect prescriptions that it is becoming part of teen sub-culture. For example, a new phenomenon known as the “pharming” or “bowling” party features different kinds of prescription drugs mixed together in a bowl or a bag (also called “trail mix”). Teenage party-goers pass it, taking pills by the handful. They often don’t know what drugs they are taking or how they will affect their mind or body, nor would emergency medical responders in the event that they need to treat a teen and counteract the drug’s effect.

While these “bowling” parties are extreme examples of “getting high,” it’s interesting that, unlike with other forms of adolescent drug use, the desire to feel good or get high ranks much lower as a motivator for most prescription drug misuse. More often, teens turn to prescription drugs to help manage their daily lives—for example, to lower stress and anxiety, boost their mood or increase performance. Being a teenager is more complicated now than ever. Like adults, some teens think prescriptions will help them keep going. They may discover it’s easy and free to lift them from the home medicine cabinet. All teens need support from good role models like parents, grandparents, coaches, teachers, and their own doctors. Unfortunately many mistakenly get the message that adults solve their own problems with prescriptions, alcohol and other substances. Here are ways to be a “difference maker” and protect the teens in your lives from misusing prescription pain killers:

If you are a parent:

• Set limits and let teens know you will be disappointed. Talking to teenagers works! When important adults communicate the risks, abuse by teens declines. Parents, grandparents, relatives, adult friends, coaches, and activity leaders are all very important influencers of teen behavior.
• Model good behavior. Watch how you use medicines in front of teens. Teens learn by example. Use your own medicines responsibly. Take them EXACTLY as prescribed.
• “Denormalize” the behavior. While 1 in 5 teens abuse prescription drugs, that means 4 in 5 do not. “Everybody DOESN’T do it!”
• Debunk common myths:
  -- Prescriptions aren’t always safe. When prescription pain meds are abused, they are just as dangerous as street drugs.
  -- They can be just as addictive.
  -- It’s not okay to misuse these drugs, even “once and a while.” Experimenting with drugs is NOT a normal part of growing up!

Even if you are not a parent:

• Most people don’t keep track of their medications.
• Monitor all medications in the home—prescription and OTC medicines.
• Safely store medicines out of children’s reach and sight. Consider locking them up.
• Get rid of old or unused medicines. Returning them to a pharmacy for disposal is best.**
• Don’t take any prescription pain pill when you will be driving or on duty at work, unless and until specifically approved to do so by your doctor. Even if the doctor didn’t say you COULDN’T take it that way, don’t assume you can. You should always ask directly, “Can I take this and still go to work?” Find out first!

If you want more information (and I really hope you do!), look at the excellent Power Point review of the subject on the web page of the National Council on Patient Information and Education's (NCPIE) 24th annual observance of "Talk About Prescriptions" Month (TAP Month).
http://www.talkaboutrx.org/rxmonth2009_maximizing.jsp#article

And, I’ve included five fliers from the CDC, which give great summaries.

Talking to Your Teens About Prescription Drug Abuse
http://www.affinityhealth.org/object/services-specialty-occupational-blog-teens-PDF1.html

Maximizing Your Role as a Teen Influencer
http://www.affinityhealth.org/object/services-specialty-occupational-blog-teens-PDF2.html

Why Teens Turn to Prescription Drugs
http://www.affinityhealth.org/object/services-specialty-occupational-blog-teens-PDF3.html

Warning Signs and Symptoms of Prescription Drug Abuse
http://www.affinityhealth.org/object/services-specialty-occupational-blog-teens-PDF4.html

6 Myths About Teens and Prescription Drug Abuse
http://www.affinityhealth.org/object/services-specialty-occupational-blog-teens-PDF5.html
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*2007 Wisconsin Youth Risk Behavior Survey (YRBS)
http://dpi.wi.gov/sspw/yrbsindx.html

**Adapted from NCPIE

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Healthy Vending Machines

Target audience: Employers

Promoting good workplace nutrition – one coin at a time!

Finances are tight lately. Maybe your wellness budget has been shrinking. You need health promotion ideas that are low-cost, yet wide-reaching with high yield.

Consider that times are tight for employees, too. They may have less “lunch money” than in the past, and may be dining at the company vending machines more. The days of meeting at local restaurants are on hold.

Now consider the lowly food vending machine at your work place. Maybe it’s time to use it to better advantage. Does it reflect the idea that your company is committed to health and vitality? And, that working “alive, awake, alert and enthusiastic!” is helped by good nutrition?

A vending machine that displays healthy and inviting choices visibly projects your company’s culture of wellness and health. It can be a showcase for the message that your organization cares about the health of all members. These machines display their wares 24/7, not only to those who use them, but even to passers by. A “trophy case” of good nutrition choices sends a health promotion message that is low-cost, wide-reaching, yet high-yield. That’s timely considering both your budget and that of employees!

Click here for a PDF that provides step-by-step remedies for unhealthy vending machines. It comes from the CDC’s “Lean Works” initiatives, which you can browse at http://www.cdc.gov/leanworks/build/environmental.html.

If you meet with your vendor and review this guide, additional ideas will flourish. Food vendors are becoming very familiar with these requests, and they may offer surprisingly good and low-cost suggestions. One I saw was placement of all the healthy choices to the right and unhealthy to the left, with a sign challenging customers to “Make the Right Choice!” And, increasing the price of unhealthy options, to underwrite the cost of the healthier choices, almost guarantees more healthy items will be chosen.

Hey, times are tough. Everybody has to do their part. Even the snack machine!

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Fainting After Shots

Target audience: Employers and Employees

It's flu shot season! That's not necessarily anybody's favorite time of year. But, most people are happy to undergo the minor discomfort of a needle poke to be spared the misery of influenza. For some people though, any shot can be a challenge all by itself, especially for people who faint at the sight, the feel, and sometimes even just the thought of a needle! This common problem happens every day in medical offices, emergency departments, and flu shot clinics.

Doctors classify this phenomenon as "vasovagal syncope." But, it's not a disease or an abnormal condition in these situations. In fact, a normal cardiovascular reflex underlies vasovagal syncope. In certain people this reflex is simply exaggerated for unknown reasons, and can cause them to faint during medical procedures. They usually experience warning signs first, like weakness, a cold sweat, buzzing in the ears, blurred vision, and an unwell sensation. It can happen to men and women of any age, though it is probably most common among adolescent females. Among many people who have fainted with childhood shots, the tendency continues life-long. It is especially likely when shots and other medical procedures are needed in people who already feel faint from dehydration or illness.

Fortunately, there is a nearly sure-fire solution to this vexing, embarrassing, and potentially dangerous problem. It starts by telling the person who is going to give you the shot, that you fainted from a shot previously. Obviously, the right time to tell this is BEFORE they give your shot! Ask if you may lie down WHILE you receive the shot. Don't wait until you're on the verge of black out! And, elevating your legs while lying down to receive the shot nearly guarantees you won't become faint. Drinking plenty of water on the day of the shot also reduces the risk.

But, it's also important to realize that the vasovagal reaction can also happen in a delayed fashion, up to 15 minutes later. Rarely, it can even be longer. That is why the CDC’s Advisory Committee on Immunization Practices in 2006 recommended that all recipients of all vaccines be observed for 15 minutes after vaccination (MMWR 2006;55[RR15]:1-48). Even if you've never had a faint after a shot, it is a good practice to sit or lie down at the health care facility for 15 minutes after receiving the vaccine. A research study showed that fainting happens in less than five minutes in 49 percent of cases, and less than 15 minutes in 80 percent.

If shots have caused you to faint in the past, please don't be embarrassed or feel that it's your fault. It's a normal reaction which simply happens more easily to you. The important thing is to not avoid essential preventive health measures, like flu shots, for fear of fainting. The problem can be solved. But mass immunization at a flu shot clinic needs a special strategy, because your condition requires a few simple preventive steps. Speak up before you get the shot. Ask to lie down, and don't be in any hurry to leave. That's the best way for you to avoid the flu, and fainting too!

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