hello i'm district attorney marian ryan thank you for joining us for this episode of middlesex update the topic of our show today is going to be summer safety awareness in obviously a very appropriate topic summer is just a week away in june is also national safety month so this is a time when we can really have a candid conversation about how to keep children particularly say during this time of year this episode's important not only for the parents of young children but for older siblings babysitters caretakers and particularly grandparents who more and more often are spending lots of days caring for their grandchildren one of my responsibilities as district attorney is to respond to and investigated all other tended deaths across middlesex county including those of children and obviously the death of a child is particularly heartbreaking but one of the things that i've learned in my thirty plus years at the district attorney's office is that many of these deaths of children are preventable in can be avoided in this prevention and education campaigning are central to the public safety mission of my office and our efforts to foster safe and healthy communities later this week i'll be kicking off my countywide two thousand and fifteen summer safety campaign at the burlington mall where we'll be there to talk to customers and their children about safety and how to really avoid some of the problems that come with the joys of summer in today's show is part of this effort and happy today to have joining me three very distinguished and raul respected members of the medical and law enforcement community and training and education and pro him as such thank you all for being here today thank you thank you for and then before we get too far into the topic i'd like to give our viewers a chance to get to know you a little bit so i'm going to start with gail and just gail ask if you can tell us a little bit about yourself as well as your connection to this topic sure thank you once again thank you for having us on here i've been a nurse for over a little over thirty years now i started out mid surgeon nursing  then i kind of got into a little of the pediatrics it was over at melrose wakefield hospital i worked there for about twenty five years and then found myself across the street at a skilled nursing facility where i'm now the admissions director so i'm going from one end to the other that's right i also have been a member of the melrose board of aldermen for about eighteen years and i think i got into all the safety stuff first of all my medical  background but as an alderman the public safety is the big issue that's where you you know he hear from you constituents about certain things that are happening in their neighborhood that are safety concerns so public safety has always been a priority as a member of the board of al and as you said first and foremost for death for a child is heartbreaking and a lot of times preventable that we've found so obviously public safety is the main thrust of what we're doing here and whatever we can do to help people and make sure that they can prevent things from happening that's awful because james tell us a little bit and tell us the ticket if you've had a little international experience with these kind of issues is correct correct so i've been with program ass for about eight years  now as well as being a paramedic i'm also the director of education and training so i spend a lot of my days training other e m s providers in law enforcement and in hospital staff as well on general care and treatment of patients i have spent some time in haiti doing some international work doing some educational training down there as well where there's a huge need naturally for more advanced medical care and as well staying connected to the community i act as the explorer post advisor for a post nine one one in cambridge which covers the belmont water town cambridge area so we're training young folks in the same stuff as well i'm trying to teach them how to respond to emergencies as well as some interaction with the harvard med science program which runs partly out of our simulation lab doing some simulations with high school students and teaching again them how to assess and manage some pretty serious medical emergencies ok now gail you mentioned that you write for the melrose free press and i know in this week's edition you wrote a column focusing on safety in the hole in talking about the six most common causes of death nationwide and five of those particularly relate to children you tell us what those are sure well first of all this the motor vehicle accident this medication put poisoning falls choking drowning and fire and obviously schools coming to an end finally after this long winter in kids will be spending a lot more time at home enjoying the summer but tell us how that amount of time particularly if this them unsupervised time at home might relate to some of these issues well i think you know one of the things is the cleaning supplies that we use in the house they should be really locked up in a locked cabinet you know they have all those safety locks to to let a new cabinet i think you know don't wait for something to happen just do that the minute you have a child in the house medications keep them out of reach of children they look at a lot of our medications very colorful and you know they look like candy and so you know keep them also in a locked cabinet make sure when you if you have the safety topped on you get there click when you shut the cover of it so that children can't do it alcohol once again alcohol is now we're coming in from very pretty color of keep them out of reach up high in law cabinets windows is a big thing we hear every year we hear stories about kids falling out of windows trying not to have furniture by the windows don't put the bed up against the window in the summertime when you open up their window to let in that fresh air make sure that that screen is solid secure and not just the screen but the frame kids go up and they look out the window they get very excited about what they may see out there and they don't realize that if they lean on that screen just a wee bit you know they could be out that window now james focusing just for a minute only gayle mentioned about kids the possibility of kids ingesting something like a household cleaner us of medication or alcohol obviously if that happens the first calls the first thing to do should be a call to nine one one but things that a parent or caretaker should be doing in the meantime while they were in those interminable minutes that it seems like while they're waiting for a nine one one to come absolutely in what you mention first is key in calling nine one one and oftentimes we find that parents will hold the call to nine one one thinking they may be able to manage this on their own because oftentimes these chemicals don't immediately present with medical complaints to the child so they'll either call poison control or try some home remedies and it's important that they make that initial call but then it's important for us in for the hospital that they get a good accounting for the child actually ingested oftentimes to walk into these scenes and there's multiple bottles on the floor multiple liquids that are open and naturally the parent will have a better account of what was in them to start with and how much they've used and what the actual chemical chemicals are and not that it's recommended but unfortunately sometimes these chemicals are shifted into secondary bottles and aren't made to hold them so we're not even quite short the chemicals are so the best thing they can do for us is to get a good accounting for the child may have ingested how much they may have ingested and then just be prepared for the child to become sick they may start to vomit which is ok just making sure that they're protecting their airway and that they're sitting forward in that that form it's coming out so they don't breathe that in and become sick or just trying to trying to keep the child calm can be very helpful as well if they do want to make that call to poison control that should be done after they call nine one one which is perfectly acceptable and oftentimes we'll call poison control as well just to try to see if there's anything we may be able to do in route to the hospital to treat the child but the most important thing is to start getting first responder absolutely absolutely in many times that call is unfortunately held until the child becomes ill and at that point point it may be too late to treat them appropriately chief mentioned as well that falls from the windows and i know you know as we have seen every year as soon as the weather gets warm we start to see some small children coming out of those windows and gail mentioned a couple of things checking the screen that sort of thing any other eye tips that you have about preventing that and then also thinking about what to do maybe even outside in terms of minimizing dangers obviously it's i always try and say it's common sense look around assess things that you can do obviously as well keeping the furniture away from the window anything their toys you know having the kids play in the middle of the room versus on the side by the windows and things but in today's market you can go to home depot you can go to your local hardware store they have these little window walks that you can open the window but it set only for a certain height if you want to get air in a lot of people open from the and that way there then the child doesn't have an access out but again like they say you know just do a good quick assessment and that's all it takes but make sure he is monitoring the children as much as you can read in james similar to that last question we just talked about in the terrible event that it does fall out obviously a colleague of first responders what should people be doing in the meantime unfortunately and in the same for us in the mess is not a whole lot that can be done but the most important thing they should do is try to keep the child still don't allow them to get up and walk around don't feel like we should pick them up and move them in the home if there is some weather outside keeping them warm keeping them covered could be great but if you move that child you can actually worsen spinal injuries so really trying to keep them still can be great  keeping them calm can be very helpful as well moving around flailing around can potentially exacerbate a spinal injury as well so in this will be our goal in a mass as well try to get them to the hospital without moving them around as little as possible in for the parents trying to just stay calm and so to collect some information that we might need and nine one one will also give them some tips on what to do securing pets and making sure that we're able to get in and help them so getting to getting some of those things together the nine one will instruct them will be helpful as well so parents really need to resist that first impulse which is going to be to pick the child check them and hold them in all of those things that you don't want them to be doing absolutely now is you're going out if you get it you get a call for that terrible scenario where the child's come out a window and you're responding and you're making that kind of game play and if you just mentioned maybe calling ahead and doing those things what are the what tend to be the most common kind of injuries you mentioned the spinal injury but what are the kind of injuries to see so we typically see head injuries especially in very small children very small children have proportionally larger heads than adults so if they fall they typically fall head first so we expect to see some head injuries as children get a little bit older and we see this in teenagers as well they would tend to fall and actually write themselves after just about a story and a half so from a second story fall we would expect to see some significant lower leg injuries as well spinal injuries and with with all of those falls we expect to see what can be some particularly gruesome injuries as far as lacerations to the scalp in to the extremities as well and i think that's what makes it difficult for parents sometimes to deal with these when you see your child very sick and you have that tendency but we're going there really expecting to see unfortunately what can be some very serious injuries to to a young child anything people can do in terms of even the outside of their house obviously you don't want your child falling out the window but anything to be done in terms of outside the house you know making sure that there's not a shop or fall if you will out the  drowning as well and we know that children between the ages of one in four have the highest rate of drowning in fact they drownings account for about thirty percent of the unintended deaths of children and i know people may be thinking well we're talking about safety at home and drowning i think a lot of people think of as something that happens away from the house at the lake the pool but that unfortunately is not true is that right that's right people have outdoor pools so if you have an outdoor pool you know using fifteen inches they're going to go into it head first and a little wobbly you know what they can be right down in that bucket without being able to once again retrieve their bodies to lift up and that goes as well for some of the things that we may have outside homes when a mental thing that i mean kuwait pond fountains that people might have on their front row i don't know if they need to really be careful make sure there is nothing in the way of them tripping to fall in there but also if you have any of those ponds and you have children maybe a little fence around it just caution them to like i need to stop you know unfortunately if we know you know as well we've seen these kind of in says even with those plastic pools that people buy very small maybe  have deep but it again the same thing the kid goes baby goes forward into it and can't write themselves it's not being used for the moment empty and what else i mean that's a good suggested maybe turning it over whatever it is what are some other good safety tips in terms of kids in drownings well this is certainly drowning it features and swimming when you're you know at hotels or you know someone's yard never swim alone always make sure there's somebody with you make sure the person who is with you can swim so that if you are the only ones you know in that yard or in that pool deck that they can run in and help you make sure as i said before there's are not things in the way that they could be walking along the pool deck and fall in there teach your children about water safety teach your children how to swim it was funny i just saw her on t v the other day it was a real estate show so this is a little funny  but they were showing real estate and they were buying a condo when they were like about five or six stories up and there was a built in pool to the condo and these parents said then they had the kids were in elementary school and they were up there and they were looking out over the pool and they said whoa this is great we can see the pool right from here so we can watch the kids and i just sat there and screamed at the t v like no no you don't watch elementary school kids you know from the five play yeah right and you know so it was kind of funny and it kind of also parents themselves learning how to swim if you can swim when you have children now i don't know my husband had to swim he never knew how to swim and then he got so that he could you know tread water and whatnot he couldn't swim so he couldn't swim the olympics but you know what he could do that so it's really important now there's some laws or regulations about people having a pool on their private property in their backyard or wherever they were and there's a number you know as well as mentioned earlier the fence you have enough to and it's been mentioned a number of times point about supervision you know making sure children depend upon their kid takers to take care of them and i know one of the things and i know you know this chick one of the things we've been fortunately seen is a pool that's fenced in on three sides by the appropriate fence say but there's a deck and turns you know from the kitchen or dining room and people not being as careful right that young kids can just go through that slider and they are at the pool so the fence in no way helpful because they come from inside and i think one of the things is people have that sense that drowning always looks like the movies you know the thrashing and people yelling i'm drowning i'm drowning in we know that's not true and from you years in law enforcement respond what have you learned about just the signs of we'll drowning always look and i think it was mentioned some of the information the analogy of children usually when you think about children they're always active moving making sounds if you see a child that's quiet quiet and you better check on it because there could be a problem there not that saying every time there would be but if you see some a child in the water and there motionless you better go because it could be  situation there and that being said you know that could be just for an adult i mean that's not it doesn't take much and unfortunately it can be very quick but if they don't get the help they need we know it could be fat james in terms of a medic physiological point what is happening to people as they start to lose control of their drowning short so it's really an inability to get oxygen into the blood so as you go underwater and you're not able to get your head above you start to get water in your lungs and that will stop the ability to get oxygen from your lungs even that oxygen that's already in there into your blood and actually circulate that around to use it and we need oxygen in order to function appropriately in order to create energy as that starts to happen we're not really thinking straight and we start to struggle to try to get above water and even somebody that can't swim will start to struggle to try to get above water in that struggling requires more energy requires more oxygen and it speeds up this whole process and as the chief said drowning  silence and this process can happen very very quickly because we're not getting oxygen was struggling so we need more oxygen and people start to think inappropriately and that's why we see when in rescue situations people that had a non fatal drowning will actually start to fight and become combative with their rescuer because they're not able to get oxygen to their brain so they're not thinking straight so we see really it's an issue with being able to oxygenate well i'm mentioning that lack of oxygen to the brain what are the kind of health implications for children in a non fatal drowning short so we're going to see some potential brain injuries from that and you can develop a brain injury from lack of oxygen for too long and it doesn't take much time underwater to develop that brain injury so it will happen is their brain will go without oxygen for a period of time in cells will die and for every second war in the water thousands and thousands of brain cells are dying and as we can't get oxygen in there we start to see these brain injuries develop you also could see some long term lung damage as well getting that water which is not clean typically has some level of bacteria in it or other contaminants in it can actually damage the lung so you could have some long term respiratory as well as the brain the brain damage now gale every summer just as we see children coming out of the windows as soon as it gets warm we tend to start hearing about people leaving babies or young kids in a car i've attended and just last week there was a news story about someone in quincy leaving a one year old in the car while he got on a train being some distance away before he realized that so what you know and there shocking and yet they continue to happen so they're obviously something that people can pretty easily do and know is a big risk for the heat stroke so you know never leave children in the car alone at any time things to help you to do that and that sounds a little funny but you know what for women or even men with their briefcases are big something put in the back seat with the child because you know now children with the car seats are in the back seat so put something of your personal belongings in the back seat that you will need when you get out of that car so that you will remember that you have that specially if that or that baby is an infant and they fall asleep i mean we all live very busy lifestyle we're always raise them against that clock and you know you find that parking space you get out of the car when you just run and it's just like you know  be fast asleep in the car you forgot you've had the baby for the you know that quick second so so reverse what you do put the baby stuff in the front and i mean like the blanket or the really big or something and put your personal belongings in the backseat so that you know you have to  right to do that certainly if you find that you need to call nine one one right away i'm sure the chief can you know go into that of what you would do when you get those calls it's there tempting i think you know you baby falls asleep people into dunkin donuts or starbucks you're thinking i'm just going to run and i don't want to disturb the baby i'll get a coffee and it takes longer than you expected as you pointed out that ten minutes again if someone has that situation where they would come out and realize or like that father the unfortunate situation realizes the child's in the what should they do while the first responders are coming so first and foremost they want to make sure the child gets cool in those and it's really a heat stroke issue oftentimes if they're in there for an extended period of time you can run into dehydration issues as well but getting the child out of the car can oftentimes be helpful if it's cooler outside than in the car or simply turning the air conditioner on taking the belts off of them loosening up  restrictive clothing taking any extra clothing off of them and just allow the child to naturally cool our first tendency would be to pick that child up and hold them outside we're maybe eighty ninety degrees outside our body temperature certainly isn't helping with that so keeping them in a car seat that's designed to allow for air flow around them loosening any restrictive clothing and just turning the temperature down in the car can actually go a long way in reducing the effects of heat stroke that tea from the law enforcement perspective how do you draw the line between i ran into the store and i just forgot that i had the baby with me and the abandonment and lacked the law looks like think you know you've got to look at it from our case by case basis and really look at the  intent and the reasons why i mean obviously we've all been doing this a long time i always try and look at the big picture and then we make the decision based on that but  know we have two children ourselves and growing up having them and when i had to take care of them they would always look for things like a drive through where i want to happen yet i don't think that is at all and but those are the things you look for you know to make you don't want to leave them in the calm because again from all these things that were mentioned as far as issues and things that can happen and yes as gayle mentioned earlier not only is the issue about the heat stroke and this and that but th and you know those are the things that you've got to be aware of it's a different world that we're living in and you've got to make take steps to protect and prevent and being airing on the side of caution leaving children alone i mean there is there's no real test of whether a child can stay alone you know you know it's a common sense and what's the situation and what's with what how will that child react to being a lot right you know and just as we wrap up is there anything else that either of you want to add but just the other safety issues the safety and the sun and the importance of protecting against insect borne in tick diseases those sorts of things right for sun safety i mean sunscreen  try to stay on the middle of the road on that path you know stay in the middle as opposed to going off into the sides and getting into that tall grass and whatnot come in and take a shower immediately do it body  hear when you're out in the woods or you know along the beaches of things like that you know they have a lot of cotton long sleeve shirts now and as well of flax and chief what about things like teaching kids about the nine  at least knows enough to call nine one one as we've talked about saying you know getting the emergency services there and rolling well as always we had a great conversation and faced so many topics today i want to thank you all for joining us and hopefully you at home have found some of these tips things you want to be thinking about as we keep our kids safe so thank you for join