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What You Should Know About Car Surfing

by Whitney Henry
Child Advocacy Specialist

Father handing son car keysAs a parent, you talk to your teenagers about safe driving all the time. You remind them to wear their seat belt, tell them not to use their cell phone, and make sure they know the rules of the road. But there is one danger of teenage driving that you may not be talking to your teens about: car surfing.

Car surfing is a thrill-seeking activity where a person rides on the exterior of the vehicle while it is being driven by another person. This is often done by a person standing on the hood or trunk of the car, or being pulled behind on a sofa, skateboard or sled. Your teenager may have seen videos of this dangerous activity on YouTube, popular video games or television.

Car surfing can turn deadly with just one wrong move on the driver’s or rider’s part. A 2008 study by the Centers for Disease Control and Prevention found 58 car surfing deaths and 41 non-fatal injuries from 1990 through August 2008 with the majority of the victims between the ages of 15 and 19 years old. Seventy five percent of the deaths were caused by a bump or blow to the head and even those who did not die sustained serious, life-long injuries.

Even at speeds as slow as 5 mph, someone thrown from a moving vehicle can be seriously injured or killed, but incidents have also been recorded with teens going up to 80 miles per hour. Most injuries are caused by unanticipated movement of the car such as swerving or hard braking.

The good news is that there is something you can do. Talk to your teens today about the hazards of car surfing. Remind them that they are responsible for their own safety and the safety of their friends whether they are the driver or the passenger. Tell them that it’s okay to speak up if they feel that an activity is unsafe. It could save a life. It’s also a good idea to talk to the parents of your teen’s friends to make sure they know about car surfing so they can talk to their teens about it. With a little bit of time and some communication you can help your teen stay safe while they are away from home.

The Don’t Drive Stupid Website has tips for talking to your teen about safe driving and information about Graduated Driver Licensing Laws that can help you keep your kids safe on the road.

Whitney-HenrieWhitney has a degree in Health Promotion from Weber State University. She has been working in the Child Advocacy Department at Primary Children’s for almost 2 years. She is a certified Child Passenger Safety Technician, and loves the opportunity she has to help educate others about injury prevention. Whitney loves to read, travel, and spend time with her family.
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4 Ways to Help Kids Develop Heart Healthy Habits

valentineby Sara Bybee, LCSW
Center for Safe & Healthy Families

With Valentine’s Day around the corner, you’ve probably been helping your kids cut out heart-shaped valentines or decorate heart-shaped cookies for school. No doubt you’ll even be seeing heart shapes in your dreams by the time Valentine’s rolls around! But how can you make sure that your kids actually care for their hearts? Below are some ways you and your children can make small changes in everyday routines to foster a healthy heart, both physically and emotionally.

1. Encourage healthy eating

  • Model healthy eating, maintaining an appropriate weight and portion control. Kids learn from watching their parents so it’s important to practice what you preach.
  • Offer praise when kids reach for healthier, less sugary snacks and when they make healthy choices.

2. Encourage daily activity, even if it is small such as taking the stairs instead of the elevator

  • Take walks together as a family or suggest another physical activity instead of watching TV. Physical activity is not only good for the physical health of your heart, but can also release dopamine which causes us to feel happier. In addition, doing physical activity as a family stresses the importance of exercise and also encourages more emotional bonding.
  • Encourage and support your child’s interest in sports and other physical activities such as dancing, karate, skating, etc. Kids will be more apt to stick with an activity if they enjoy it, so be sure to praise their interests and encourage them to practice!

3. Discourage the use of nicotine and tobacco products

  • If you use these substances as a parent, now’s the time to quit! Kids learn by watching their parents model behavior so try to show them the choices you’d like them to make in the future.

4. Encourage emotional well-being

  • Show empathy to your children to model sensitivity, good listening, etc.
  • Be sure to talk to your children about feelings and work through difficult emotions they may feel such as rejection or grief.
  • Let your children know that it’s healthy and normal to experience a range of emotions and praise them for sharing their feelings.
  • Encourage your children to reach out to friends or family in need to offer their support.
  • Consider volunteering as a family for a cause you feel connected to; this will help your child learn the value of kindness and generosity.

Change doesn’t have to be drastic; by including some small changes in your child’s daily routines, you can help encourage him/her to maintain heart healthy habits for life!

Sara graduated with her Master’s in Social Work from Portland State University and moved to Salt Lake City in 2012. Since then, she has been working with Safe & Healthy Families and has been enjoying all that the Southwest has to offer. In her free time, she loves hiking, biking, running, taking her dogs to the park, speaking Spanish, learning about other cultures, cooking, and baking.
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Measles: Prevention, Symptoms, & Recent Outbreaks

vaccineMeasles has been in the news again recently, as cases identified in California continue to increase and a third Utah County resident tested positive for measles in mid-January.

Measles, also called rubeola, is a highly contagious respiratory infection caused by a virus. While it is best known for its typical skin rash, it also brings about flu-like symptoms, including fever, cough, and a runny nose.

Measles is very rare, and a child who is properly vaccinated is extremely unlikely to contract the disease. Because as many as 30-50% of people who get measles are hospitalized for complications, it’s important for public health officials to contain an outbreak.

For more information about the current outbreak, visit: health.utah.gov/measles.

Recent Outbreaks

According to the CDC, From January 1-23, 2015, 68 people from 11 states were reported to have measles. Most of these cases are part of a large, ongoing outbreak that originated in an amusement park in California. In 2008, 2011, 2013 and 2014, there were more reported measles cases compared with previous years. CDC experts attribute this to more measles cases than usual in some countries, such as in Europe, where Americans travel more often, and the spread of measles in U.S. communities with pockets of unvaccinated people. The CDC web site also details all major outbreaks of measles over the past few years.

Signs and Symptoms

While measles is probably best known for its full-body rash, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes. A characteristic marker of measles are small red spots with blue-white centers that appear inside the mouth.

The measles rash typically has a red or reddish brown blotchy appearance, and first usually shows up on the forehead, then spreads downward over the face, neck, and body, then down to the arms and feet.

Measles is highly contagious — 90% of people who haven’t been vaccinated for measles will get it if they live in the same household as an infected person. Measles is spread when someone comes in direct contact with infected droplets or when someone with measles sneezes or coughs and spreads virus droplets through the air.

A person with measles is contagious from 1 to 2 days before symptoms start until about 4 days after the rash appears.


Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations.

For most kids, the measles vaccine is part of the measles-mumps-rubella immunization (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age.

Measles vaccine is not usually given to infants younger than 12 months old. But if there’s a measles outbreak, or a child will be traveling outside the United States, the vaccine may be given when a child is 6-11 months old, followed by the usual MMR immunization at 12-15 months and 4-6 years.

As with all immunization schedules, there are important exceptions and special circumstances. Your doctor will have the most current information regarding recommendations about the measles immunization.

The measles vaccine should not be given to these at-risk groups:

  • pregnant women
  • kids with untreated tuberculosis, leukemia, or other cancers
  • people whose immune systems are suppressed for any reason
  • kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they are at risk for serious reactions

During a measles outbreak, an injection of measles antibodies called immune globulin can help protect people who have not been immunized (especially those at risk of serious infection, such as pregnant women, infants, or kids with weakened immune systems) if it’s given within 6 days of exposure. These antibodies can either prevent measles or make symptoms less severe.

For women who are not pregnant and people not in one of the other at-risk groups mentioned above, the measles vaccine may offer some protection if given within 72 hours of measles exposure.

Vaccine Side Effects

The measles vaccine occasionally causes side effects in kids who don’t have underlying health problems. The most common reactions are fever 6-12 days after vaccination (in about 5%-15% of kids vaccinated) and a measles-like rash, which isn’t contagious and fades on its own (in about about 5% of vaccinated kids).


There is no specific medical treatment for measles. To help manage symptoms, which usually last for about 2 weeks, give your child plenty of fluids and encourage extra rest. If fever is making your child uncomfortable, you may want to give a non-aspirin fever medication such as acetaminophen or ibuprofen. Remember, you should never give aspirin to a child who has a viral illness since the use of aspirin in such cases has been associated with the development of Reye syndrome.

Kids with measles should be closely watched. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhea, pneumonia, and encephalitis (a serious brain infection), which may require antibiotics or hospitalization.

In developing countries, vitamin A has been found to decrease complications and death associated with measles infections. In the U.S., vitamin A supplementation should be considered for children between 6 months and 2 years old who are hospitalized with measles and its complications.

Also, all kids over 6 months old with certain risk factors — such as vitamin A deficiency, a weakened immune system, or malnutrition — might benefit from vitamin A supplementation.

When to Call the Doctor

Call the doctor immediately if you suspect that your child has measles. It’s important to get medical care following measles exposure, especially if your child:

  • is an infant
  • is taking medicines that suppress the immune system
  • has tuberculosis, cancer, or a disease that affects the immune system

Remember that measles, a once common childhood disease, is preventable through routine childhood immunization. Additionally, please contact the Utah Department of Health if you think your child may have measles.

Additional Reading

This information is part of Primary Children’s KidsHealth website. This resource features information on a variety of health topics for you and your children.

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Why Kids Shouldn’t Wear Bulky Coats in Car Seats

carseatby Shannon England-Rice
Child Advocacy Specialist

When it’s cold outside, most of us want to bundle up to stay warm. During the winter months, I am continually telling my children to put on their coats. At times I feel like a broken record. When it is cold, there are times a coat is necessary, but generally not in your vehicle.

Why is it unsafe to wear a coat in your vehicle? In a crash, you want the seat belt or harness of a car seat to be as close to the individual as possible. Here are a few tips to remember when fitting a child in a 5 point harness:

  • The harness should be snug, comfortable, and positioned closely to the child.
  • Big, fluffy coats prevent a good fit. They create a gap between the child and the harness.
  • Winter coats can make it difficult for a parent to get the harness straps tight so they tend to leave the harness looser which is dangerous.
  • In a crash, even when the harness is tightened, if a child has a coat on, the fluff compresses and the straps are too loose for the child’s body. When harness straps are loose, injury can result and at worst, ejection from the vehicle can occur.
  • Keep in mind; this applies to children in booster seats and adults in seat belts as well.

There are many options for keeping your child warm in the vehicle without a coat on. Dress your child in layers before strapping them into his/her car seat. Undershirts, leggings and long johns work well for layering. Once the child is dressed, car seat manufactures and safety advocates recommend a sweatshirt, or a well fitted fleece coat be worn by the child in place of a bulky coat. If the car is extra cold, a blanket can be placed on top of the harness itself. Never place a blanket under the harness, because this causes the same problem – an improper fit with a gap between the child and the harness. Placing a coat on backwards after a child is buckled in is also an option. Gloves and a hat will also keep children warm and won’t interfere with the harness.

The installation of the car seat and the fitting of the child are equally important. Always follow the manufacturer’s instructions for both rear-facing and forward-facing positions. Please feel free to call one of Primary Children’s child passenger safety technicians with any fitting or installation questions. You can also call to schedule a free car seat check appointment Monday through Friday from 9:30 am – 3:00 pm by calling 801 662-6583.

Here’s to the rest of a fun, warm, and safe winter!

Shannon Rice Shannon England-Rice has a degree in Public Heath, and has been working in Primary Children’s child advocacy department for 10 years. She’s dedicated to keeping kids safe through car seats, helmets, and parental supervision. She works with the Hold On To Dear Life campaign and other outreach programs. Shannon has 6 children and loves to exercise, read, shop, and travel.
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The Air We Breathe: Protecting Our Kids During An Inversion


by Elizabeth Joy, MD, MPH, Michelle Hofmann, MD, MPH, & Steven Bergstrom

It comes as no surprise to anyone living along Utah’s Wasatch Front that our air quality is compromised for days to weeks come wintertime. Our murky air is referred to as an “inversion” as it is the reverse of a normal air pattern (i.e., cooler air above, warmer air below). During inversions, the Wasatch Front valleys and their surrounding mountains act like bowls, trapping a dense layer of cold air under a layer of warm air. The warm layer acts much like a lid, and any pollution produced during an inversion becomes trapped in the cold air near the valley floor (Figure 1). This warm inversion air layer is usually displaced when a strong storm system blows in, releasing lower polluted air, and restoring air quality to healthier levels.

Children and Those with Acute Respiratory Problems Face a Higher Risk

Figure 1

Figure 1

Poor air quality is unhealthy for everyone, but some groups are more susceptible than others. Children, especially those with asthma, are considered at high risk because they spend more time playing outdoors, their bodies are still developing, and they breathe more rapidly than adults, inhaling more air per pound of body weight. The elderly and those with acute or chronic respiratory problems, or vascular diseases such as heart disease or stroke, are also at high risk. Given that nearly one third of Utah’s population is younger than 18 or older than 65, in addition to the more than 200,000 Utahns with asthma, and 500,000 with heart disease, addressing air quality is indeed a public health imperative.


Figure 2

The primary contributor to our poor air quality and its impact on health during an inversion is fine particulate matter (PM) pollution. Often referred to as PM2.5, the 2.5 refers to the size of the particle (2.5 micrometers per cubic meter). Figure 2 provides some perspective on the size of these particles-which is 30 times smaller than a human hair!

Monitor Air Quality and Protect Your Family’s Health

A growing body of evidence suggests that even on some of Utah’s best air quality days, there are pollution sources that may be impacting health. In particular, living, working, and attending school within close proximity to major roadways results in exposure to automotive emissions that are a major source of PM2.5 and other harmful air pollutants. Considering how you can prevent or reduce exposures to vehicle exhaust is a good step everyone can take to protect themselves and their children from some of the harmful effects of air pollution. Avoid idling your vehicle, exercise outdoors away from major roadways, and for schools located near highways, schedule outdoor activities outside of peak rush hour times.

Other ways to protect ourselves and our loved ones include “reading the air.” Much like checking the temperature to know how to dress for the day, look at the current air quality conditions to know if you and your family need to use extra caution with outdoor activities that increase pollution exposures. Useful tools for monitoring air quality can be found on www.airnow.gov or www.airquality.utah.gov, or UtahAir, an app that can be downloaded onto your smart phone for real time, local air quality information. These tools also provide exposure recommendations for people with and without sensitive conditions that may be exacerbated by poor air quality. First and foremost, always listen to your body, and consider if air quality may be influencing you or your child’s health, by monitoring for symptoms like increased cough, chest tightness, wheezing, or difficulty breathing after exposures to air pollution.

Personal Responsibility in Air Quality Improvement

In addition to protecting our health, we all have a responsibility to improve air quality in Utah. Utah’s Clean Air Action Team (CAAT) published a number of recommendations aimed at improving our air quality. Some of these recommendations are aimed at policy makers such as access to lower sulfur gasoline, and investing resources to expand public transportation.

However, there are several recommendations that are actionable at an individual or household level. These include reducing both wood burning and total miles driven per person during inversion periods, and installation of ultra-low nitrogen oxide water heaters. According to the CAAT report, the emissions from heating 1 home with wood burning as the sole heating source is equivalent to emissions from 200 homes heated with natural gas in terms of fine particulate matter (PM2.5). Be a part of the solution, by doing all that you can do to reduce your own contribution to Utah’s poor air quality.

The following authors contributed to this article:

Elizabeth Joy, MD, MPH
Michelle Hofmann, MD, MPH
Steve Bergstrom
Medical Director
Clinical Outcomes Research
Intermountain Healthcare
Medical Director
Riverton Hospital Children’s Unit
Director of Sustainability
Intermountain Healthcare
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Play it Safe Outside this Winter

skiby Whitney Henrie & Tim Cosgrove
Child Advocacy Specialists

Winter sports can be a great way to make the colder months fly by and keep kids active. But when your kids are sledding, skiing or skating, you need to know how to be safe so they don’t get injured and miss all the fun.

No matter what activity you are enjoying, staying warm is important. Make sure to dress your children in layers that will keep them dry and apply sunscreen so the sunlight reflecting off the snow doesn’t cause sunburn.


Flying down the hill is a great feeling, but sledding can be dangerous if you’re not careful. Make sure the sled is sturdy and easy to steer. Don’t use homemade sleds like garbage can lids, plastic bags, or pool floats—you can lose control too easily. Wear gloves and boots to protect your hands and feet and consider having your child wear a bike helmet to protect their head while sledding.

Be careful when choosing the hill and make sure it isn’t too steep, near a busy road, or covered with rocks and trees. Adult supervision is very important. Make sure kids take turns sledding down the hill and that the person sledding is out of the way before the next one takes off.


Whether playing hockey or ice skating, the most important thing is to skate only on safe and sturdy ice. Indoor ice rinks are safer than outdoor ponds or lakes. Be careful when skating outdoors because even if the ice looks strong it may not be able to hold a child’s weight.

If your child plays ice hockey don’t let them step out onto the ice without proper gear. This includes padding, and most importantly, the right helmet. Use only a helmet approved for ice hockey, not a football or bike helmet.

When skating for fun, be sure your kids skate in the same direction as the rest of the crowd. If they are going to try out a new figure skating move, be sure they watch where they are going and leave themselves plenty of room.

Skiing and Snowboarding

Before getting to the slopes, make sure you have the right equipment and that it fits correctly. Don’t use equipment that is too big, as it will make it difficult for your child to stay in control. Be sure kids wear ski boots, goggles and a helmet. Snowboarders will also need knee and elbow pads.

It’s a good idea to have your child take at least one skiing or snowboarding lesson. That way you can be sure they know the basic skills needed to stay safe. It’s also important to supervise kids and make sure they stay on trails appropriate for their skill level.

No matter what activity you choose, staying active and remembering these safety tips can make your winter great! Oh, and don’t forget to have a delicious cup of hot chocolate to warm up after your fun activities!

The Child Advocacy Department at Primary Children’s Hospital embraces the concept that injuries are preventable. The HOLD ON TO DEAR LIFE© campaign is housed in the Child Advocacy Department and provides awareness and resources to parents and caregivers about unintentional injuries and how to prevent them. Tim Cosgrove and Whitney Henrie are Child Advocacy Specialists from the department that contributed to this Blog Post.
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The Risks of Avoiding or Postponing Vaccination

vaccineTwo siblings in Utah County have tested positive for measles—the first cases in Utah in several years. This incidence is part of a larger outbreak that is being investigated in California, where health officials have confirmed at least seven cases.

According to the CDC, 2014 saw a record number of measles cases, with 610 confirmed cases reported. This was the highest number of cases since measles elimination was documented in the U.S. in 2000. Although measles has been scarce in the U.S. in recent years, it is still common in other parts of the world and can spread when it reaches a community where groups of people are unvaccinated. 

Vaccines and Misinformation

When it comes to immunizing their kids, increasing numbers of parents aren’t just consulting their pediatricians for advice — they’re also paying heed to rumors and advice spread online through websites, message boards, and blogs. And conversations with other parents at dinner parties or playdates can be enough to instill doubts about vaccine safety or the necessity of giving multiple vaccines in one shot.

Even when the science or sources behind anti-immunization stances are proved unreliable or even completely discredited, it can be difficult for some parents to accept that vaccines are safe. And sometimes other personal or religious beliefs persuade parents to skip immunizations.

As a result, health officials are seeing alarming rises in preventable diseases. The Centers for Disease Control and Prevention (CDC) reported hundreds of U.S. measles cases in 2014, the largest number in many years. Most of these occurred in people who were not immunized against measles.


A Myth Debunked

Much of the controversy about vaccines stems from the now-debunked 1998 study that tried to link autism to the MMR vaccine that protects against measles, mumps, and rubella (German measles). Study after study has found no scientific evidence that autism is caused by any single vaccine, combination vaccines (like the MMR vaccine), or the mercury-containing preservative thimerosal, which was once widely used in many childhood vaccines but has since been eliminated.

Indeed, the journal that originally published the 1998 study retracted it and called the findings “a deliberate fraud.” And the doctor behind the study lost his license. But the study and the attention it received influenced parents worldwide and contributed to a decrease in immunization rates. Indeed, recent polls indicate that 1 in 4 parents still think vaccines are linked to autism.

Community Immunity

Some parents wonder why their kids need immunizations if many of the diseases they protect against are no longer commonly seen in the United States. But the fact is that infectious diseases that are rare or nonexistent here (because of immunization programs) are still huge problems in other parts of the world.

If immunization rates drop among U.S. kids, an outbreak could be an airplane flight away if a disease is introduced by just one unimmunized person (as in 2007 when a 12-year-old boy from Japan came to the United States for the Little League World Series and passed measles on to others).

It’s also important to understand the concept of “community immunity” (or “herd immunity”) which is when the majority of a population is immunized against a contagious disease, thus providing little opportunity for an outbreak. A single person’s chance of catching a disease is low if everyone else is immunized. But each person who isn’t immunized gives a highly contagious disease one more chance to spread.

People who can’t receive certain vaccines (such as infants, pregnant women, and those with compromised immune systems) are also protected when most of the population is immunized. So when parents decide not to vaccinate their kids, they not only put them at risk, but also others who cannot be vaccinated.

Stay On Schedule

Many parents worry about their children (especially infants) getting too many shots in one visit. They feel it might be “overwhelming” to the child’s “immature” immune system. This prompts them to request delaying or postponing some immunizations so that the shots could be more spaced out or given one at a time. A recent online survey shows that more than 1 in 10 parents use alternative immunization schedules that don’t adhere to the recommendations of health experts.

Yet, the truth is that there is no evidence to suggest that childhood vaccines can overload a baby’s immune system. On the contrary, babies are exposed to numerous bacteria and viruses on a daily basis — so much so that the added exposure from the vaccines is simply a drop in the bucket.

Similarly, giving “simultaneous” vaccines (more than one shot at the same time) or “combination” vaccines (more than one vaccine in a single shot) has not been shown to produce any different effects than giving them separately. But it does allow for immunizing kids as quickly as possible so that they are protected during the vulnerable early months of their lives. And fewer office visits can be less traumatic for a child and can save the parents both time and money.

Opinions differ on how strongly doctors should adhere to the standard vaccination schedule. Some pediatricians will try to accommodate a parent’s fears and thus go against their own best medical advice in order to keep the peace.

The Bottom Line

Immunization is the best way to protect kids from preventable diseases. A series of simple shots given from infancy to the teen years can fend off many major illnesses in millions of kids. The only time it’s safe to stop vaccinations is when a disease has been totally wiped out worldwide, as in the case of smallpox.

If you search online for health information, make sure it comes from reputable websites and legitimate sources. Keep in mind that many studies are poorly conducted and inconclusive, and often cannot be replicated by other scientists. Yet, once the information is posted online, it takes on a life of its own and is shared and quoted widely — often without a knowledgeable expert to refute false claims.

And take random opinions with a grain of salt. Some people talk about “toxins” (like mercury or aluminum) or overwhelming an infant’s immune system, and many even believe that the diseases are safer than the vaccines meant to prevent them. In truth, the risks of serious reactions to vaccinations are extremely small compared with the health risks associated with the often-serious diseases they can prevent.

So if you see, hear, or read about side effects or downsides of immunization, speak with your doctor.It’s important to get all of the facts before making a decision to delay or skip an immunization — a choice that could affect not only your kids’ health but that of others.

Have You or Your Children Been Exposed?

Individuals who came into contact with them may also have been exposed to the virus and public health officials are working to track down and notify these people.

The infected individuals in Utah County would have been contagious from December 27, 2014 through January 5, 2015 and attended several events during the infectious period. The Utah Department of Health lists their whereabouts during that time and is urging anyone who may have come in contact with them to contact the Utah Poison Control Center, which is screening individuals for potential exposure, at 1-800-456-7707, or visit the web site www.health.utah.gov/measles:

Additional Reading

This information is part of Primary Children’s KidsHealth website. This resource features information on a variety of health topics for you and your children.


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