Pediatrics


Safety in the Family Chiropractic Practice
Pediatrics
Written by Jeanne Ohm, D.C.   
Wednesday, 18 October 2006 15:56

I am frequently asked, “What are the safety concerns for children in the chiropractic practice?”

Having spoken with several chiropractic malpractice insurance carriers, the real issue of safety in the care of children comes outside the scope of care itself but, rather, in office equipment accidents. With that in mind, I will address some key safety standards for the office and adjusting room pertinent to the care of kids.

General:

1. Plants are wonderful.  Make sure the ones you have are not poisonous. Even if they may be “out of the reach of children,” leaves may drop on to the floor.
2. All unused electrical outlets should have child safety covers.
3. The entire office should be examined for frayed wires.
4. All cabinets within children’s reach must have safety latches (regardless of what they contain).
5. Check all shelves, desktops, and windowsills for objects that hang down within a child’s grasp. If something is within their arm’s reach, they will pull on it. If it attaches to something that can get pulled down, they will pull it down.
6. Bulletin boards with tacks frequently “shed” tacks on to the floor. Be continuously vigilant of this, or use staples to secure your papers to the board. (This includes tacks for posters on the wall as well.)
7. Children’s play areas may have toys left behind that do not meet the “non-choke” standards. The toy room should be checked daily for these and other hazardous objects left behind.
8. All stairs accessible to children should have a child safety gate at each landing
9. You should not even consider having the “heated” water dispensers in your office near to public accessibility.
10.Bathroom cleaners need to be stored in an out of way place.
11.Chairs (or other climbable furniture) should be away from any unsecured, operable windows.
12.Make sure all bookshelves and other tall pieces of furniture are balanced and secured and cannot topple over if a child tries to climb up.
13.Coffee/magazine tables with extendable sides pinch little fingers.
14.X-ray darkrooms need to be locked from the outside so film chemicals are never accessible to a wandering child.
15.Important emergency numbers should be posted at the CA booth and a CPR/choking chart is equally important and well.

Specific to the adjusting room:

1. All hi-lo adjusting tables must have safety stop features.
2. With drop tables, when adjusting a parent or sibling and a child is standing close by to watch, be sure that their fingers are not anywhere near the table before you make the drop.
3. Warning signs about the potential dangers of children touching equipment allow parents to be aware of the potential hazards of your equipment.
4. As a general rule, children should never be left to wander into unsupervised adjusting rooms.
5. Never leave a child on a table unattended. Even infants who have never rolled over will find the most inappropriate times to take their first roll.
6. Older children should be assisted off the table so they do not loose their balance. Children will frequently make unexpected and erratic moves.  Be prepared.
7. When using the infant toggle headpiece, especially if the child is seated, before you make the “drop,” be sure their little fingers are not reaching up and feeling for the headpiece as it is touching their ear.
8. Do not leave the headpiece on a counter with the strap hanging over the edge. It is very tempting for a child to pull it down onto their head.
9. Keep the headpiece out of reach. The knob on it unscrews and 3-7-year old boys love to explore this mechanism and unscrew it. The hazard comes with the tiny ball and spring that can fall out after the screw is taken out. If dropped on the floor, these become treasures for crawling infants who are also at the stage of putting everything into their mouths.

Although this list may not be complete for every office, it is a good start. If you have additional suggestions, please e-mail them to me: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr. Jeanne Ohm instructs internationally on the topic “Chiropractic Care for Pregnant Women and Children.”  She is executive coordinator of the International Chiropractic Pediatric Association and can be reached via their website at www.icpa4kids.com.

Information about the upcoming Pangea 2006 Conference, Oct. 26-28, can be found on the ICPA website: www.icpa4kids.com.

 
Essentials of the Case History for Children
Pediatrics
Written by Jeanne Ohm, D.C.   
Friday, 29 September 2006 00:04

When taking a case history on a child, especially an infant, the questions we are asking are a bit varied from those we ask the adult patient. Questions that address the birth process and the potential interventions that may have occurred are essential toward proper assessment. Additionally, postural and behavioral considerations, specific to the infant, must be addressed.

The following list of questions is derived from Dr. Heiner Biedermann’s work.1 The information gathered from these questions will offer you valuable insight in determining the need for specific spinal adjustments in the infant or child.  

Delivery
Long or short duration of delivery?
Presentation at birth?
Twin?
Forceps or vacuum delivery?
Cesarean delivery?

Visible Immediately after Birth or Later
Lateral curvature of the cervical spine?
Rotation of the cervical spine?
Looks only to one side?
Moves only one arm/leg?
Face appears smaller on one side?
Back of the head flattened on one side?
Has a bald spot on the back of the head?

The First Months
Sleeping difficulties during first months, six to twelve months, or later?
Did/does the child often wake up at night?
Fixed sleeping pattern?
Arching of the spine?
Hypersensitivity of the neck region?
Orofacial hypotonus?
Persistent crying?  How often?
Problems with breast-feeding on one side or latching on?
Signs of poor digestion and elimination?
General Health
Headaches?
Mouth is often open?
Postural adaptations?
Aberrant movement?
Cranial and structural asymmetry?
Sensorimotor development slower than expected?
Delayed language development?
Decreased ability for concentration?
Questionable social integration?1

Answers to the above questions assist the doctor of chiropractic in assessing aberrant spinal biomechanics and less than optimal nerve system function in the infant and/or child. Combined with a specific spinal exam including segmental motion and muscle palpation and, possibly, X-ray, the doctor of chiropractic will have significant indicators to determine the appropriate care.

Dr. Jeanne Ohm instructs internationally on the topic “Chiropractic Care for Pregnant Women and Children.”  She is executive coordinator of the International Chiropractic Pediatric Association and can be reached via their website at www.icpa4kids.com.

Information about the upcoming Pangea 2006 Conference, Oct. 26-28, can be found on the ICPA website: www.icpa4kids.com.

References
1. Biedermann, H., Manual Therapy in Children, Journal of Manipulative and Physiological Therapeutics, Vol. 28, No. 3, 211.e9.


 
Functional Chiropractic Collaborations
Pediatrics
Written by Jeanne Ohm, D.C.   
Monday, 28 August 2006 21:47

This fall, the International Chiropractic Pediatric Association is pleased to announce its collaboration with Pangea, a holistic practitioner conference for pediatric wellness. From their conference overview, they distinctly recognize that, “Professionals who care for children and are involved in today’s healthcare system will need to rely upon supportive, collaborative relationships for the purpose of healing the child.”

On behalf of its members and the chiropractic profession, the ICPA is actively involved in this collaboration. We will be presenting research, participating in a round table discussion and, of course, have a booth. We encourage those doctors of chiropractic who are interested in fostering collaborations to attend this and other similar conferences on behalf of chiropractic. It is through these types of events we can offer practitioners of like minds the importance chiropractic plays in the family wellness movement.

I wholeheartedly support the need for collaboration in the healing arts and I recognize effective collaboration will only happen between groups of like minds and philosophies. There is much talk about the importance of chiropractic’s acceptance in the medical community. In our attempts to accomplish this, however, we have sometimes compromised the basis of our empirical core and have leaned toward mechanistic modes of practice and research for this validation. It is imperative that, in our efforts to collaborate, we remain consistent with our core empirical foundation by choosing practitioners that share our vitalistic approach to health.

The medical profession, itself, is experiencing an identity crisis. There is the traditional mechanistic sector that continues to treat conditions and diseases with suppressive, short-term treatments. There is also a strong emergence of a vitalistc sector, those practitioners who recognize and respect the process of healing from a non-invasive, ongoing, supportive manner. It is these practitioners who understand the basic principles of chiropractic, are not threatened by it, and who are interested in collaborating in practice and advanced care for their patients.

In the past few years, the ICPA has formed wonderful alliances with midwives, natural birth and parenting practitioners, psychologists, homeopaths, acupuncturists, osteopaths and holistic pediatricians. Coming from the common ground of empiricism, collaboration is easy and fruitful. The ICPA will continue to foster these important alliances on behalf of our practitioners and the whole chiropractic profession. We see that the public is becoming aware of the distinct differences between mechanistic and vitalistc care and are actively choosing more holistic practices for their families. As chiropractors, this is our opportunity to offer the empirical core values and services of chiropractic in cooperation with practitioners of like minds and services.

Dr. Jeanne Ohm instructs internationally on the topic “Chiropractic Care for Pregnant Women and Children.”  She is executive coordinator of the International Chiropractic Pediatric Association and can be reached via their website at www.icpa4kids.com.

Information about the upcoming Pangea 2006 Conference can be found on the ICPA website: www.icpa4kids.com.

 
Assessing the Need for Chiropractic Care in Children
Pediatrics
Written by Jeanne Ohm, D.C.   
Saturday, 24 June 2006 10:51

Many Doctors of Chiropractic become intimidated with the idea of working with children and often shy away from offering their services to this very needy population. Frequently, chiropractors do not care for children because the child cannot verbally express itself. Other doctors of chiropractic avoid caring for children because the assessment tools they use for adults are not applicable with children. The assessment of children for chiropractic care may seem to be a bit more subtle than that of the adult; however, once the skills pertinent to the care of children are mastered, the rewards are memorable and bring a whole new level of satisfaction to our practices.

The following suggestions are starters to lead you toward a successful relationship with the child, the parents and yourself, as a practitioner.

• Use an entrance form that is designed particularly for children. Pertinent questions are history of mother’s pregnancy, birth, nursing, sleeping and eating patterns.

• Make notations of physical, emotional and chemical stressors that the child has been exposed to.

• Take careful note of how the mother explains the case to you. Listen, not only to her verbal language; be conscious of her body language as well.

• If both parents are present, look for consistency in feelings and opinions.

• Ask about the whole family’s lifestyle: diet, employment, other siblings, schedules and note the stress levels of each one.

• If the child is an infant, hold it to get a good assessment of its sensitivity to touch, resistance to movements, fussiness and discomforts.

• Observe spinal tension, torsion, arching or fixed deviations to determine dural stress.

• Incorporate postural assessments in your exam relevant to the child’s age and development.

• Utilize specific motion and muscle palpation of the infant’s spinal segments to allow you to locate key areas of segmental spinal stress.

• Incorporate cranial examinations for asymmetry and distortions.

Providing quality care for children is a rewarding experience. I encourage all chiropractors to seriously consider caring for more children in their practices.

Dr. Jeanne Ohm instructs internationally on the topic "Chiropractic Care for Pregnant Women and Children." She is executive coordinator of the International Chiropractic Pediatric Association and can be reached via their website at www.icpa4kids.com.

 
Making an Informed Choice
Pediatrics
Written by Jeanne Ohm, D.C.   
Saturday, 27 May 2006 04:01

In the Western world, we pride ourselves on our freedom and ability to make choices in our lives.  We can carefully evaluate many options in our lives and choose accordingly. Perhaps our greatest freedom (although not exercised by many) is our freedom to make choices that will affect our lives and our families’ lives for years to come.

As early as preconception, the choices we make for our own health and well being affect the future lives and health of our children. The physical, emotional and chemical stresses we are subjected to have their effects on a cellular level and may very well impair normal function. It is our responsibility, from the moment we are given these options, to make choices that lead us toward a more balanced lifestyle.

Parents face the right and responsibility to find out the many options available when it comes to choosing providers. They can solicit supportive health care providers who seek to give them valuable information and who empower them with the knowledge to make informed health care choices for their families.

In my twenty-eight years in chiropractic, I have discovered that, unlike practitioners in any other profession, Doctors of Chiropractic are an incredible resource of information for family wellness care. Had it not been for an amazing support team of chiropractors, I may have never known or chosen natural options for my pregnancies, my births and my on-going children’s well being.

In chiropractic, I discovered very basic, vitalistic principles and I learned to trust the body’s ability to function. I also learned that I could make choices to enhance my ability to function better. This knowledge gave me the strength, as a parent, to make decisions that supported my children’s potential to be well.

As Doctors of Chiropractic, we have the information that parents are seeking to make natural living choices for their families. Offering our services and knowledge to the families in our communities enhances their freedom and right to choose wisely. As more and more parents seek viable options for their families’ health, we, as chiropractors, can successfully fill this need.

As you begin to help more families in this way, you will realize the profound impact your knowledge and resources will have on the decisions parents make for their families. Along with your chiropractic adjustment, the education you offer provides a much-needed service that no other family provider is fulfilling. Truly, chiropractic care offers a unique and valuable role in the Family Practice realm.

Dr. Jeanne Ohm instructs internationally on the topic “Chiropractic Care for Pregnant Women and Children.”  She is executive coordinator of the International Chiropractic Pediatric Association and can be reached via their website at www.icpa4kids.com.

 
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