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Patient Engagement: The Medically Engaged Teenager

by Sahar Ameri and Debbie Bemeldoctorteen
Pediatric Education Services

As parents, we encourage our teens to take on more personal responsibilities, including engagement in their own healthcare. This is just as important for those with medical issues as it is for otherwise healthy teenagers.

During adolescence, children undergo emotional and physical changes at a time when they are dealing with increased life stress. All of these things can affect a child’s emotional and physical health. Parents can help their children understand and assume more responsibility for their health needs. Some teens may find it difficult to openly communicate about their feelings, but it is important that they know how to speak to their doctors.

Here are some tips to help you and your teen:

  1. Encourage your child to communicate openly with their physician.
  2. Allow them privacy when they meet with their physician. Yes, Mom and Dad–that means you might leave the room!
  3. Assure your child of their privacy rights as outlined by physician-patient confidentiality laws.
  4. Help your teen become familiar with their physical and healthcare issues. They should have a sound understanding of any chronic illness and treatments.
  5. Have them maintain a list of their medications they are taking and ensure they understand what each medication is for.
  6. Allow them the freedom to contact their healthcare provider independent of you.
  7. Encourage independent health care management and follow up.
  8. Let them know you are supportive of their health, healthcare, and any decisions they wish to make (within reason of course!)
  9. If you fear they are not compliant with their medical plan, have an open and frank discussion with them about the ramifications of non-compliance.
  10. If they are non-complaint, set clear expectations and limits, then make sure you hold them to these limits.

The Age of Information

Most adolescents gain knowledge from their peers or the internet. While the internet may be a useful tool, it can also have incorrect information. The best way for your teen to understand their medical needs is to visit a doctor with whom they have a rapport and have frank and private discussions. Teens should know that they can communicate any issues they are facing to their physician and that they will not be judged or punished. Their doctor is there to address any concerns they may have.

Here are some possible questions to have your teen ask their doctor:

  • Will the information I give to you be private? What, if anything, will you tell my parents?
  • What will the prescribed medication do? Why am I taking it and what are the side effects?
  • How can I prevent illness?
  • If I do not improve, when should I call to reschedule an appointment?

Age and Consent in Healthcare

For those 18 and Over

Anyone 18 years or older is in control of their own medical care. This means several things:

  • They will need to sign consents for treatments and procedures unless they have been declared incompetent or are incapacitated.
  • They are not required to share their healthcare information with their parents.
  • Anyone 18 years of older will be asked if they have an Advanced Directive when being admitted to the hospital. Find out more about Advanced Directives.

Minors and Medical Information

Children under the age of 18 will require parental consent for procedures or treatments. In some circumstances, a minor may receive medical care without parental consent. In these cases, the minor may then control the medical information.

These situations include:

  • Minors who are married or in the armed forces may seek medical care without the consent of their parents. Minors then control their medical information.
  • Minors who are pregnant or who is a parent with custody of a minor child may receive certain authorized medical services for themselves or their child without parental consent.
  • Minors may request and receive medical care or services related to a sexually transmitted disease without parental consent and are then in control of their medical information.
  • Minors age 16 or older may be emancipated by a juvenile court order in Utah. Emancipated minors may obtain healthcare services without parental consent and are then in control of their medical information. Legal documentation must be obtained before recognizing the minor as emancipated.

For more information,  see the State of Utah Department of Health Confidentiality Policy for Minors.

Additional Resources for Teens:

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Child Passenger Safety Week

seat-belt-buckleby Whitney Henrie
Child Advocacy Specialist

In my line of work I hear a lot of stories about how in the past, cars didn’t have seat belts and car seats were rarely used, if at all. The question I usually here at the end of one of these stories is something like, “Well I survived without all that stuff and so did my kids. So why is it so important?”

September 15-20 is National Child Passenger Safety Week and we want to make sure everyone knows why car seats and seat belts are important.

Did you know that car seats have saved the lives of an estimated 9,600 children age 4 and younger between 1975 and 2010? That’s just those under the age of 4. Think how many more were saved by their booster seat or seat belt. That’s 9,600 more children who went on to have full lives. That’s a lot of families that were saved the heartache and grief of losing a child. In 2012 alone, an estimated 284 lives were saved by child restraints and an additional 58 children could have lived if car seat use was 100 percent.

It is estimated that every 34 seconds a child under 13 is involved in a crash and motor vehicle crashes remain the leading cause of death for kids 1-13. Unfortunately car seats and seat belts, now a prevalent part of our society, are not being used to their full advantage. In 2012, over one third of children killed in car crashes were not in car seats, booster seats, or seat belts.

The good news is there is a lot that can be done. The following is a list of steps you can take to keep your kids safer today:

  • Keep your child in the right car seat for their size, not just their age. Often kids are moved from rear-facing to forward-facing, a harnessed seat to a booster seat, or prematurely to a seat belt before they are ready. Just because your child is 2-years old doesn’t automatically mean they are ready to be turned forward-facing. Check the height and weight limits on the labels and use the seat until your child reaches these limits.
  • Read your instruction manual. Reading both the instruction manual for your car seat and your vehicle can help ensure that you are installing and using the seat correctly. If you are having any trouble, or would just like to make sure you’ve installed the seat correctly, don’t hesitate to call the Certified Child Passenger Safety Technicians here at Primary Children’s (801-662-6583).
  • Keep kids under age 13 in the back seat. From 2008 to 2012 there were 1,874 kids in the 8-14 age group killed in crashes. 1/3 of those were killed while riding in the front seat. The backseat is the safest place for kids to be until they are at least 13-years old.
  • Buckle up on every ride, every time! You never know when a crash will happen, so it’s important to always have everyone in the car restrained properly, even if you are just going around the block. Making buckling up a habit on short trips will make it easier to enforce on longer ones.

Spend a little time thinking about the way your family travels this National Child Passenger Safety Week. Double check that all your kids are in the right seat and that they are installed and used correctly. Make sure you are buckling up yourself! Your kids will notice and follow your example. Let’s make sure even more lives are saved by properly buckling up.

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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Youth Suicide Prevention: Information that Can Help Save a Life

suicidepreventionby Sara Jackson, LCSW
Center for Safe & Healthy Families

Youth suicide has unfortunately become a pressing matter in the past few years. With the increased stresses that youth face, some consider suicide because they simply do not know how to ease their pain. In fact, according to the International Association for Suicide Prevention, “Every year, over 800,000 people die from suicide; this roughly corresponds to one death every 40 seconds.”

Although the numbers are heart-wrenching, you can make a difference. Just talking to someone, lending a shoulder to cry on or showing your support can save a life.

Below are some signs that someone may be at risk:

  • Withdrawing from friends, family or community
  • Seeking access to firearms, pills, or other means to harm oneself
  • Talking or writing about death, dying, or suicide
  • Feeling hopeless
  • Acting angry or seeking revenge
  • Acting reckless or engaging in risky activities
  • Increase in alcohol or drug use
  • Seeing no reason for living or feeling no sense of purpose in life
  • Feeling anxious or agitated
  • Changes in sleep habits – with the inability to sleep or sleeping all the time
  • Talking about wanting to hurt or kill one’s self
  • Experiencing dramatic mood changes
  • Taking little interest or pleasure in doing things more than half the time

If you notice these symptoms in someone or are concerned that someone you know may be at risk of attempting suicide, don’t delay or ignore your concerns. Seek help right away.

Here are some ways to get help:

  • Call 911
  • Call or go to your nearest emergency room
  • Call your family doctor and ask for help
  • Call a crisis hotline:
    • Lifeline: 1-800-273-TALK
    • National Suicide Hope Line: 1-800-784-2433
    • NAMI Utah: 1-801-323-9900 or 1-877-230-6264
    • Para la Prevención de Suicidio: 1-888-628-9454

Remember, even just checking with someone to see how they are doing can save a life. Be proactive and voice your concerns to keep your loved ones safe and healthy.

Additional Resources:

About Teen Suicide (info for parents)

My Friend is Talking About Suicide (article for teens)

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.

Enterovirus D68 (EV-D68) and Utah: What You Need to Know

evd682The Centers for Disease Control have reported increased numbers of children being seen for respiratory illnesses that are requiring hospitalizations and some stays in the intensive care unit in ten states. They have identified Enterovirus D68 (or EV-D68) as the likely source of many of these illnesses.

In the past two weeks, Primary Children’s has seen increased numbers of children admitted to the hospital with serious respiratory disease symptoms, including pneumonia and asthma. Many are testing positive for the family of viruses that includes EV-D68, but we do not have a test that identifies the specific strain. We are waiting on confirmation from the CDC, but we suspect EV-D68 may be here in Utah.

The hospital has increased its surveillance of respiratory illness and is planning for increased numbers of children hospitalized for respiratory illness much earlier than the usual winter season. Parents should know that most children with cold symptoms are not going to get severely ill. However, if a child has difficulty breathing or is wheezing, they should see their primary care provider or seek medical attention. Children with asthma may be more at risk, and they should follow their asthma care plan. If a child with asthma has worsening symptoms, they should see their physician.

“People can help protect themselves and their children,” says Dr. Andrew Pavia, Chief of Pediatric Infectious Diseases and Primary Children’s Hospital epidemiologist. “Wash your hands frequently, avoid close contact with people who are sick, disinfect frequently-touched surfaces, and stay home if you are ill.

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Extra Life: How to Play Games and Be a Hero for Kids

familyby Randy Bradford
Father and Extra Life Enthusiast

You probably think that playing games and helping sick children have nothing to do with each other. But that’s only because you haven’t heard about Extra Life.

Extra Life is a 24-hour gaming marathon that allows kids and adults to raise funds for a children’s hospital of their choice. Participants create a fundraising page online and then invite their friends and family to sponsor their participation in the marathon. Extra Lifers can commit to playing any type of game for 24 hours–videogames, computer games, tabletop games, or card games to basketball, soccer, croquet, and more.

Everyone who participates in Extra Life does so for their own personal reason. Here’s my story of why I Extra Life:

On April 24, 2014 my beautiful baby girl, Eleanor, was born. She was perfect. Eleanor was born more than three weeks early, but at five pounds, she weighed enough that she didn’t have to go to the NICU.quote

The day after we brought her home from the hospital, my wife felt that something was not right. We called our doctor and she suggested we go to Primary Children’s Hospital. When we got there, Eleanor’s vitals were lower than they should have been. We were most concerned about her temperature. Eleanor couldn’t keep her core temperature up and the doctors weren’t sure why.

XTRALIFEFluids (i.e., blood, urine, and spinal) were drawn to see if cultures would grow over the next 36 hours. If cultures did grow, the doctors would know what she was sick with and how to treat it. Remarkably, as we waited to see, our daughter’s health began to improve. The cultures all came back negative, meaning she didn’t have any kind of infection, and we soon returned home. It’s been four months since our daughter’s scare and she is perfectly happy and healthy.

Not a day goes by that I don’t think of Primary Children’s Hospital and how grateful I am for them. The staff was, in a word, “amazing.” They were able to take a scary situation and make my wife and I feel at peace. The nurses we had are heroes in my eyes.

You never want to have to take your child to the hospital, but if the need arises, Primary Children’s is where you want to be. My family was lucky. We were only there for 48 hours. When we left the hospital, there were families whose children had much more challenging health problems to overcome. My heart goes out to these families and I want to help in any way I can. It’s for this reason that I know I have to give back. I’ve chosen to give back to Primary Children’s Hospital by participating in Extra Life.

Extra Life is all about being a hero for the kids. Do you have a Primary Children’s hero? Perhaps it’s a really brave family member or friend who has been a patient there. Or maybe it’s the hospital staff that cared for your loved one during his/her hospital stay. Extra Life is your chance to honor those heroes by helping to raise funds for hospital programs that support Primary Children’s patients and their families.

The National Game Day will begin at 8 a.m. central time on Saturday, October 25th, and ends at 8 a.m. on Sunday, October 26th. However you can participate whenever it’s convenient for you. Some folks break the 24 hours into multiple segments. Be a hero! Register to participate at Extra-Life.org.

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Kids and Concussions: Q & A

concussionThe term concussion might make you think of someone knocked unconscious while playing sports. But concussions, or temporary disruptions of brain function, can happen with any head injury, often without a loss of consciousness. And while we frequently hear about head injuries in athletes, most concussions occur off the playing field—in car and bicycle accidents, fights, and even minor falls.

How serious is a concussion?

Concussions are common and are often treated lightly. Healthcare providers call concussions mild traumatic brain injury. It is misleading to refer to these injuries as mild. Concussions are usually not life-threatening, but they can have serious long-lasting side effects.

How does a concussion happen?

A concussion can happen from a bump, blow or jolt to the head. The brain floats inside the skull and moves quickly back and forth inside the skull. The brain tissue can be bruised or start bleeding.

What are the common signs?

Sometimes your child may pass out or “black out” for a short time. Right after the concussion happens, your child might feel confused or dazed, dizzy, sick to the stomach, or have a headache. These symptoms usually go away in a few days or weeks. Sometimes the symptoms don’t get better. Following up with a doctor is important.

Should your child see a doctor?

Your child should see a doctor if they have had a concussion. Read more about concussions to learn when you should take your child to the emergency room right away. A doctor can help make sure your child is safe to go back to their regular activities and can watch them for long-lasting side effects.

If your child has had a concussion and they are experiencing difficulty with school, getting along with others or having personality changes, talk to your doctor and the school about getting help.

Additional Reading

Mild Traumatic Brain Injury


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