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Concussions in kids

Concussions in kids are a year round issue. We know that concussions in sports are all too common, especially among kids and teenagers. Whether it’s football, basketball, skiing, soccer, ice skating, hockey, random falls off the couch or car accidents, anyone can get a concussion at any time. Doing something where you might hit your head? WEAR A HELMET! Help to keep your brain safe. You need your brain for the rest of your life. Protect your child’s brain and your own brain. Get that helmet on!

What exactly is a concussion?

A concussion occurs when you bang your head so hard, that your brain sort of jiggles inside, and bangs against the opposite end of your skull that was bashed. The back and forth motion is no good. Jello jiggler anyone? This trauma causes your brain to release chemicals, and can damage cells in the brain. Oftentimes after a blow to the head, we don’t realize that there is an issue until days later when some symptoms may arise. It’s important to take any blow to the head seriously and watch for symptoms closely.

What are symptoms of concussion?

The first concussion symptoms we often see are headache, fatigue, irritability, memory loss and confusion. (A little worse than your typical teenager’s behavior?) Some people will feel dizzy, dazed or overly emotional. They can experience headaches, vomiting, nausea or blurred vision. 

Go directly to the ER if you had a bad accident or fall, or if you are vomiting, have worsened headaches, pass out, or have a seizure. 

According to the CDC, you should call 911 or go to the Emergency Room with any of the following: 

“Dangerous Signs & Symptoms of a Concussion

  • One pupil larger than the other.
  • Drowsiness or inability to wake up.
  • A headache that gets worse and does not go away.
  • Slurred speech, weakness, numbness, or decreased coordination.
  • Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
  • Unusual behavior, increased confusion, restlessness, or agitation.
  • Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.

Dangerous Signs & Symptoms of a Concussion for Toddlers and Infants

  • Any of the signs and symptoms listed in the Danger Signs & Symptoms of a Concussion list (above)
  • Will not stop crying and cannot be consoled.
  • Will not nurse or eat”

What to do after a head injury– concussion treatment in kids

Do not let your child keep playing in that football game or take another run down the mountain! Any athlete who sustains a head injury should STOP play, take a break and be evaluated. Do not jump back in the game. This means YOU coach! Do not put your kiddo back in. Let his brain rest. Make sure she can go back in to play safely before giving the green light to return. These days, many athletic programs will do pre-concussion testing, so that if a concussion does happen an official test can be done to decide if it’s safe to go back in to play. 

It is important to be checked by a medical professional after a concussion. Your child’s doctor or nurse practitioner will provide you with recommendations to recovery and a Concussion Return to Play protocol.

Diagnosis of concussion in kids

Although post-injury testing and pre-concussion testing can be compared to help with diagnosis if a concussion is suspected, there is no actual definitive test to diagnose a concussion. Your kid’s concussion will not show up on a head CT. So if you go to the ER, they will only be doing imaging of your child’s head to rule out anything more serious, such as a fracture or brain bleed. This is why we need you to take care of that brain! If this seems like it is “just” a concussion, then imaging is likely unnecessary. Let your provider decide. You can always chat with us if you are unsure about what to do or are concerned about a concussion in your kids. 

Treatment of concussion in kids

There is no medication treatment for concussion. Instead, treatment focuses on supportive and preventative care. 

The CDC outlines 4 steps to recovery post-concussion. 

  1. REST: Resting your brain is the most important part of recovery. 

Take it easy for the first few days after injury to really let your brain heal. According to the CDC, these are the best ways to rest your body in the first fews days after injury. 

  • Early on, limit physical and thinking/remembering activities to avoid symptoms getting worse.
  • Avoid activities that put your child at risk for another injury to the head and brain.
  • Get a good night’s sleep and take naps during the day as needed.

Once you are feeling a little better, then you can add back some very light activity

  1. Light Activity: As your child starts to feel better, gradually return to regular (non-strenuous) activities.
  • Find relaxing activities at home. Avoid activities that put your child at risk for another injury to the head and brain.
  • Return to school gradually. If symptoms do not worsen during an activity, then this activity is OK for your child. If symptoms worsen, cut back on that activity until it is tolerated.
  • Get maximum nighttime sleep. (Avoid screen time and loud music before bed, sleep in a dark room, and keep to a fixed bedtime and wake up schedule.)
  • Reduce daytime naps or return to a regular daytime nap schedule (as appropriate for their age).
  1. Moderate Activity: When symptoms are mild and nearly gone, your child can return to most regular activities.
  • Help your child take breaks only if concussion symptoms worsen.
  • Return to a regular school schedule.
  1. Back to Regular Activity: Recovery from a concussion is when your child is able to do all of their regular activities without experiencing any symptoms

You may receive a Return to Play Protocol. There is a specific protocol for returning to play. You must REST your brain before going back to any physical activity and be able to be symptom free as you progress to full play. Your provider will outline this for you and give you strict guidelines for returning to play,

Baseline testing for athletes can help diagnose a future concussion in kids

Some medical offices can provide some baseline testing for kids at higher risk for concussion. Call your PCP or ask your sports coach if they have this available for your child. This testing allows the patient to get their brain function tested BEFORE a head injury occurs. This information, including memory, concentration and attention skills can be compared to brain function after an injury occurs. It can help determine if there was a concussion and how severe it is. This must be done by a medical professional who is trained in concussion management. They then can use this information to help guide return to play protocols and recovery needs for your child. 

Long term concerns following concussion

Some concussion symptoms can last weeks to months. It is important to keep your child’s brain rested and avoid any further brain injury. Repeated injury to the brain can cause worsened damage.Repeated concussions become harder and harder to recover from. Do your brain a favor and protect it! If you sustain a concussion, don’t bash your head against the wall again and surely don’t jump back into football practice again just yet! Let that brain REST and recover. 

Make sure to really question your child after ANY head injury. Don’t let them fool you into thinking they can jump back into the game. Make an effort to be sure they have no symptoms of concussion, and have them checked out after a head injury. I say this all the time, you need your brain forever! Take care of it! No sport or game is worth forever damage to your brain. When in doubt, pull them out. Missing a few games is worth it when it comes to your brain and health. 

– Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like how should parents approach screen time for toddlers? Do I have a cold sore or a canker, and is it contagious?  How to take a temperature to see if my child has a fever? Do antibiotics work on viral and bacterial infections?  Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Screen time for toddlers and babies– how much is too much?

According to the National Institutes of Health (NIH), screen time usage in children increases from 53 minutes for babies at age 12 months to more than 150 minutes for toddlers at 3 years old. Screen time (TV, computer, smartphone, tablet, laptop, etc…) for toddlers and babies can be very confusing. Is it good? Bad? How much screen time is too much? 

Parents often feel guilty for letting their young children watch TV or play video games. For some parents, it is the only way for them to get a break during a long day of activity. But what parent doesn’t have a kid who becomes a zombie once they are in front of the TV too long, or one that becomes a complete maniac when they have to end their screen time? Is screen time for kids a good or bad thing? What is the correct thing to do when these kiddos ask for screen time? 

The answer isn’t simple. There are lots of actions patents can take to make screen time in babies, toddlers, and older kids a positive experience. It is important for parents to set screen time limits and create rules around screen time that best fit their family. 

In general, the less screen time the better! Children under 2 years of age really shouldn’t be having any screen time. Toddlers over the age of 2 should be limited to no more than 1 hour of screen time a day! 

Screen time guidelines and recommendations

Here are the American Academy of Pediatrics’ recommendations for screen time: 

  • “For children younger than 18 months, avoid use of screen media other than video-chatting. 
  • Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they’re seeing.
  • For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
  • For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health. 
  • Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.
  • Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.”

One comment about the AAP’s screen time recommendations for babies and toddlers under 18 months. This age group needs stimulation from YOU, the parent. Not from a screen! It may seem like they are learning something, but turns out they really are not. They need to see your face, your facial expressions, and all the great, diverse words you are saying to really learn well.

Can screen time increase learning in babies and toddlers?

Some say that screen time, when done properly, can increase learning in children this age. In a world filled with screens, we would expect that screen time usage will increase for our children compared to years ago when technology wasn’t as advanced. Now, there are screens everywhere, and of course the kids want in on the fun too! Children will need to be able to use screens to function in today’s society. It is inevitable that they will be exposed to screens. The question is, how can we make screen time beneficial? 

Screen time in kids and toddlers, ages 2-5 years old

There is a place for screen time in kids who are 2-5 years of age. It is important to choose screen time wisely, and utilize their time online by picking educational programs. Toddlers can learn from online apps and educational shows. But it is important that the parent then introduce this information learned in the real world. The parent needs to connect what the child learns online with the real world. Otherwise the child doesn’t understand what they see, and screen time becomes just distraction time with no additional educational value. So after Johnny watches Elmo sing ABC’s… make sure to sing them together, and point out some real “A”pples! Connect with your toddler to be sure that they can see what they watched on the screen, in the real world. 

If screen time usage for your toddler must be lengthy, then it is important to utilize high quality content for the child. Shows like Mr. Rogers and Sesame Street are great choices to optimize screen time. Letting your child navigate YouTube or 10 shows of Caillou is probably not the best idea. Choose wisely. Not all ABC programs are good. Check out the programs you are letting your child watch. You may be surprised at what you see. Don’t let your child navigate YouTube or the app store! Guide their choices. Help make screen time for your kids high quality. 

Make screen time meaningful

The American Academy of Pediatrics has some great tips for screen time use. One favorite tip of ours is engagement with your child during screen time use. Use screen time as a chance to play a game, sing, dance or snuggle up and watch a show together. Get those dancing shoes ready. Bounce around the room with your child. BE there with your child. We get it, one (or two) episodes of Sesame Street isn’t horrible, but use some of the time your child is on a screen as time you can interact together. Your kiddos love you and want you to play with them. Join in the fun! Kids love to dance. And they love to dance even more with their parents! Ask your child questions about what they are seeing, hearing and feeling. These types of interactions will help make time with the screens more meaningful. “Cookie monster loves cookies, do you?” “Caillou is so whiny, isn’t he?”

That being said, according to The Journal of Pediatrics (the official publication of the American Academy of Pediatrics), responsive parent-child interactions are what makes children successful and able to complete tasks, have impulse control, regulate emotions, be creative and flexible. This is developed through unstructured social play, and not digital screen time. So it’s not the screen time that actually increases success, but the interactions they have with YOU, the parent! Make sure that your screen time doesn’t take the place of unstructured play time! Get outside, get on the floor, break out those blocks and have some fun!

When is screen time bad for toddlers?

The Journal of Pediatrics reports that overall, TV time has decreased in ages 2-5 yr olds, but is this because of the push to limit screen time? Or is it because those little buggers are taking over mom’s ipad and stealing dad’s cell phone to watch shows on YouTube? The answer seems obvious. The decrease of actual TV time has been replaced by portable screens. Screen time in general can vary, but a screen is a screen! 

Kids of all ages are impacted. What 8 year old isn’t asking for a phone? How many toddlers do you see at dinner with a tablet? In general, screen time is bad when it isn’t educational, exceeds pediatricians’ recommendations of daily usage, or replaces the opportunity for children to have healthy interactions with their parents. Moms and Dads, I urge you, make your children interact with you at dinner. Don’t bring the tablet. Make some parts of your life “screen free.” Interact with your child by looking at them and talking with them. Don’t let screens replace human interaction, sports, physical activity and the ability to communicate with others. 

Screen time in school aged children and teens

What about older kids? Screen time usage in older children and adolescents has risen, mostly because of the increase in cell phone usage. Once they have a cell phone, they have constant screens at their fingertips. Means of communication change and screen time becomes essential to communication. Make sure to teach your teen about the safety of the internet. Review their screen usage and set limits. Be sure that you teach your teen about respect, privacy and safety. Mental health illnesses are on the rise, partly due to social media use and cyberbullying. It is very important that you have a discussion and plan with your teen about social media usage given the significant risks associated with its use in this age group. 

Screens are here to stay. Make your child’s screen time usage meaningful, set limits, interact with your child during screen time and be sure to monitor what your child is looking at! Now, excuse me while I shut off Mickey Mouse!

– Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like how to choose a pediatricianDo I have a cold sore or a canker, and is it contagiousHow to take a temperature to see if my child has a fever? Do antibiotics work on viral and bacterial infectionsWell we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Fevers, and how to take a temperature

You have a fever, it’s OK!  Fever is one of those dreaded things that nobody wants. You feel cruddy when you have a fever, your kid is cranky, your body aches, and you want to curl up under a giant blanket, even if you are sweating. 🤒

Fever is your body’s way of telling you that you are fighting off an illness. Your immune system is eliciting a response from your body. The response is a fever. A fever is a good thing. Fever means your body is doing its job.

How do I know if I have a fever?

Temperatures over 100.4 degrees F are considered a true fever. 🤒 99 degrees is not a fever! If you have a temperature of 99 and you “run cold,” it’s still not a fever. But that also doesn’t mean you or your child aren’t gearing up to have one. Feeling chills, achy or warm to touch are all signs that fever is impending or that maybe your thermometer didn’t get an accurate reading.

Everyone will likely get a fever at some point in their life, some more than others. It’s ok! 

How to take a temperature

These are the main methods for checking your temperature:

  1. orally (by mouth) 🤒
  2. axillary (armpit) 💪🏼
  3. tympanic (ear) 👂🏻 
  4. Forehead 🤕
  5. rectal (butt) 🍑 

Temperature can vary depending on how you check it. In babies and some children, a rectal temperature can be a more accurate way to get a temp. 🤒

thermometer– how to take a temperatureTaking a temperature can be frustrating. You may have difficulty getting your toddler to sit still to check a temp. Your teen may have heated the thermometer on a lightbulb 💡 …There are frustrations with each type of thermometer on the market and with the various ways to take the temp. Don’t panic. 😳 As health care providers, we believe you when you tell us your child had a fever. It’s nice to know a general temp, like 103 vs 100, but the actual number isn’t as important as how long the person has been over 100.4, and what is happening along with the fever. 

Don’t go crazy buying the fanciest thermometers. The basic $4 thermometer is just as frustrating as the $99 one that also tells you your child’s heart rate and the time of their next poop. 

Getting a perfectly accurate temp is hard. Don’t add a degree. Don’t go crazy over taking temps. Just tell us how you got the temp. Let your provider figure out the rest. 😀

What is important to notice during fever

When you have a fever 🤒 we want to know what else is happening. What other symptoms are you or your child having. Does your child perk up when the fever decreases? Are they drinking? Getting up to play? Chat with us here at Nurse-1-1 and we can help you decide if you should get checked out!

Anyone with a fever who appears ill, isn’t able to drink, hasn’t peed for 6-8 hours, looks BAD 😵, or isn’t able to get up and about AT ALL needs to be seen by their doctor, an urgent care, or the ER.

If you or your child have NO symptoms other than fever 🤒 for more than 48-72 hours, then you should also be checked out

Most viruses will last about 7 days. Usually, a fever 🤒 with other symptoms that is caused by a virus will last only 4 days. ON the 4th day, the fever 🤒 should clear if this is JUST a virus. Your child’s symptoms may last a few days longer. If the fever lasts for 5 days, you should be seen to figure out why there are still ongoing fevers. Fevers lasting OVER 4 days often need to be worked up by a healthcare provider. 🏥

Remember fever means your body is doing its job. It’s easy to lose sight of this when you have a sick kiddo or you are feeling cruddy yourself! Drink lots of fluids, take a layer of clothes off, but keep cozy enough that you aren’t shivering, grab the TV remote and snuggle up on the couch 🛋 . Chat with us if you aren’t sure. Rest up and let that body work it’s magic and fight off those germy 🦠 bad guys! 

– Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like how to choose a pediatrician? Do I have a cold sore or a canker, and is it contagiousDo antibiotics work on viral and bacterial infectionsHow to stop pertussis or whooping cough in babies. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Cold sores vs canker sores

Cold sores and canker sores– what is the difference? Are they contagious?  

You wake up with a pain in your mouth and you start to panic… what IS this pain?  You notice a sore. Ouch. Is this a cold sore? Or a canker? A cold sore usually starts on your lip and develops into a blister-like sore. A canker sore is usually inside your mouth on your gums or inner cheeks. Both are a pain, literally!  Let’s talk more about each one, as they are very different. 

Canker sores

If the pain is inside your mouth, in the corner of your cheek or someplace else inside your mouth, and you notice one or two sores, it’s more likely a canker than a cold sore. Cankers are usually flat and red around the edge with a greyish or yellowish painful center. 

Now, we don’t know exactly why you got this awful canker.  Some people just get them, sometimes from trauma to the area, some irritation, or from a certain food. There is no solid research explaining why these happen

Treatment for the cankers is also not clear. But we do know they are painful! There is some thought that a poor immune response can lead to these painful lesions. So some providers suggest taking a multivitamin and vitamin B12 to support the immune system. 

Vitamins may help prevent cankers, but there are also lots of semi-helpful pain remedies! 😬😩   Putting a baking soda paste on the site may help it to heal. Swishing warm salt water (🥵) is thought to dry up the canker quicker… No pain no gain right? 😂🤣. And there are lots of over the counter remedies to treat the pain. 

Cankers can last a week to a few weeks. If you notice any of the following symptoms, get checked out by a provider or chat with us!

  • the canker sore is spreading, 
  • the canker sore is oozing, 
  • you have a mouthful of canker sores
  • you develop a fever 🤒
  • the sores persist for more than 2 weeks 

These worsening symptoms can indicate that this isn’t just a simple canker. 

Cold sores

A painful sore around your lips 👄 is more likely a cold sore, otherwise known as HSV1 (herpes simplex virus).  Now don’t panic. Herpes is a virus. It is not always sexually transmitted, and it can be just as painful as a canker. Your first outbreak of HSV (primary outbreak)  is likely to have caused a mouthful of sores, a headache 🤕 and maybe even a fever. Once this primary outbreak happens, from then on in, the virus stays in a sleeping (latent) state until you get another sore, when it “wakes up.” This is called recurrent HSV-1.  With this type of cold sore, you will find yourself getting a single sore on the outside of your mouth, or around you lips at random times. 

Usually the cold sores give you a warning ⚠️ . A tingling feeling, pain, itching or a strange sensation for a day or so before you get the sore. Then the sore develops into a blister-like lesion and crusts over, usually by day 5-8. 😩

Is a cold sore contagious?

HSV-1 is transmitted through close contact with someone who already has HSV-1. It can be transmitted through saliva, by kissing or sharing drinks 🍹,  and through oral/genital contact. 👄 🍆 🍑 You are more likely to catch a sore when the person you are in contact wit, also has a sore at that time. During the time there is a sore, the viral load is highest. You can also catch a sore from someone when they have no sore at all, but it is less likely. 

Cold sores in babies

You should be checked out if you have recurrent HSV accompanied by symptoms that worsen, if it spreads to your eyes 👀 , causes headaches, makes you feel ill or if you develop a fever. HSV can cause complications and other illnesses that need immediate medical attention.

If your baby 👶🏼 has these lesions, or was exposed to them, your little bundle  needs to be seen right away! HSV can be very dangerous for babies.

Antiviral medication can decrease cold sore symptoms, shorten the duration of the sores, and decrease the amount of virus (or viral load), making them less contagious. Decreased amounts of virus present means decreased spread of infection.  There are different options for antiviral treatment 💊. There are oral pill forms of medication options as well as topical creams and ointments. Some medications are taken for just a few days, some every day for a year and some just one day. This is an important discussion that you should make with your health care provider based on your health history and usual symptoms. 

The good news is that we can help you!  Most people suffer from mouth sores of some sort. Good oral hygiene can help prevent some sores and help them heal faster.  This along with good hand washing and keeping your germy saliva to yourself can decrease transmission of some sores. We are here for you and happy to help you to decide what to do when you get that dreaded mouth sore. 

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a nurse hotline to ask a few questions. Questions like, how to stop pertussis, or whooping cough, in babiesIs the Hep A vaccine safeHow to prevent UTIs in men? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Antibiotic use— viral vs bacterial infections

It’s just a virus…

Ok we get it. For most, it is easy when we medical professionals give you or your child a diagnosis and then an antibiotic treatment. It means that you should be feeling better within a few days, you know what monster you are dealing with, and exactly what to do for it. Nobody, including myself as a mom AND a medical provider, likes to hear, “it’s likely a virus.” This can sometimes just be, let’s be honest, annoying. When the words come out of my mouth when seeing patients, I know that I will likely be spending the next 5-10 min trying to convince the patient or parent WHY this is a good thing and why it is ok. 

As a mom, when I hear one of my children has a virus, I know it means I have to suck it up for a few more days and wait for things to improve without a specific treatment or specific diagnosis (YES, even nurses like me take our kids to the pediatrician’s office to be checked). Viruses like hand foot and mouth, or fifths disease get off easy, but hearing that you have the common cold virus, or a viral sore throat, just seems a little anticlimactic. 

By getting off easy I mean illnesses with a solid name, an identification, are much easier for a patient or family to accept than “just a virus.” Getting off easy does NOT mean these illnesses are easy! If you have had HFM, you will know this already! The good thing is that it really is BETTER for you or your child to avoid antibiotics, but it does mean it may not be cut and dried on how to treat their symptoms at home. 

One silver lining that I like to mention and remember, is that this also means we don’t have to deal with the fighting about taking medicine, remembering to take it for most likely TEN days, and the diarrhea that will probably come with that bubble gum flavored bottle of torture that we will endure for the next week and a half. So there is that! But let’s really talk about why we don’t want to use antibiotics unless they are truly needed.

Antibiotic resistance

Using too many antibiotics, most especially when we actually don’t need them, allows the bacteria to become smart, to mutate and to try and figure out how they can beat those antibiotics. This is NO BUENO. This means the antibiotics can no longer do their job. This is what we call becoming antibiotic resistant. When antibiotics are used too frequently, especially for things that don’t need antibiotics in the first place, it allows the bacteria to become smarter and more likely to be unaffected by the antibiotics that once killed them. 

One of the more common types of resistant bacteria seen in the community, which you may have heard of, is MRSA (Methicillin-resistant Staphylococcus aureus). It can be scary if you are exposed to MRSA, because it can be hard to treat. As the name states, these bacteria are resistant to some of the more common antibiotics, so a more broad coverage (big gun) antibiotic is needed to treat this kind of infection. 

This common household name is just one of many resistant infections. According to the CDC’s 2019 Antibiotic Resistance threats report, more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result! This is alarming. It is up to providers and patients to decrease the use of antibiotics and work together to achieve this result.

Avoiding antibiotics can be a good thing!

So here is the thing. For the most part, having a viral infection means that your illness will get better on its own. It means that you do not need an antibiotic. It means that you just have to trust in the magic of nature, and wait for symptoms to resolve. 

Here is what is important to think about. Most common viral infections last about 7-9 days. Fevers for these viral infections almost always go away after day 4 (ALL BY THEMSELVES). IF you have something bacterial that needs antibiotic treatment, you likely have been sick for at least a few days, let’s say 4-5. (Note– people with a fever lasting more than 4 days definitely need to be seen by a provider). Antibiotics usually take 2-3 days to work, so you will likely be feeling better around day around day 7. So in reality, viral infections, and treated bacterial infections, usually make you feel lousy for around the same time. On average, you start to turn the corner around the same time. It just SEEMS like the prescription of antibiotics fixes you quicker than the natural course of most common viral illnesses… Make sense? Did you follow that? This is usually the case and might make you feel better about that diagnosis of a virus. 

It may sound confusing BUT the take home point here is that it’s ok to have a virus that gets better on its own. Bacterial infections DO usually need an antibiotic to get better, but a virus does not. Keep reading for more specifics! 

Why can’t I get an antibiotic for a virus?

Antibiotics only make some bacterial infections better and will not make any viruses better. The CDC outlines the BEST way to use antibiotics

Did you know that some sinus and ear infections will clear on their own? Most will actually go away without an antibiotic. Viruses such as the common cold and most sore throats will also clear over time. A lot of us think that antibiotics are necessary to treat bronchitis, when in actuality, (surprise!) they are not always needed. Most of the time, you really don’t need an antibiotic. You need time, rest and some self care (things a lot of us don’t think of as treatment options). But make sure to be checked out if you have a fever, if your issue is getting worse or not improving, or if you are worried! We said sometimes you don’t need an antibiotic…but sometimes you do! 

Common bacterial illnesses requiring antibiotics 

There are a few common bacterial illnesses that will need an antibiotic. If you have Urinary tract infection, or whooping cough, then you will need an antibiotic for sure. Same goes if you have a positive strep test (strep throat). Then you will need an antibiotic to treat the strep throat. If you have a negative strep test, meaning the sore throat is caused by a virus, then the antibiotic will do NOTHING for the illness you have. If you take an antibiotic for a virus, it will do more harm than good. Antibiotics have a place, and are VERY important. You can read about sore throats or chat with us and decide if you should head in to see you provider or not. 

If you have an illness that seems to be getting worse, you aren’t feeling better, you have had a fever for more than 4 days, or you are concerned about your or your child’s health, it’s important to get checked out. You can also chat with us to help you to decide the right plan for you. 

We are just coming off world antibiotics week (yes it’s a thing). So there is a lot of great info out there on antibiotic use right now.

The Center for Disease Control has amazing helpful tips in helping you to protect yourself from these nasty antibiotic resistant bacteria:

  1. Tell your healthcare professional you are concerned about antibiotic resistance.
  2. Ask your healthcare professional if there are steps you can take to feel better and get symptomatic relief without using antibiotics.
  3. Take the prescribed antibiotic exactly as your healthcare professional tells you.
  4. Safely throw away leftover medication.
  5. Ask your healthcare professional about vaccines recommended for you and your family to prevent infections that may require an antibiotic.
  6. Never skip doses.
  7. Never take an antibiotic for a viral infection like a cold or the flu.
  8. Never pressure your healthcare professional to prescribe an antibiotic.
  9. Never save antibiotics for the next time you get sick.
  10. Never take antibiotics prescribed for someone else.

Antibiotics were considered to be a miracle drug in the first half of the 20th century. Penicillin, the first antibiotic for commercial use, was discovered in 1928. It saved countless lives, particularly during World War II, and is one of the most important medical discoveries of the last 100 years. However, overuse in recent years has led to an increase in diseases that are resistant to antibiotics. You can play a big part in reversing this trend by following the tips in this article. Take control of your health. Ask questions. Work with your health care provider to make the right decisions together. And always feel free to chat with us if you have questions. 

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a nurse hotline to ask a few questions. Questions like, how to stop pertussis, or whooping cough, in babiesIs the Hep A vaccine safeHow to prevent UTIs in men? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

The Holiday Season for the Uninsured and Underinsured

This holiday season, we may buy gifts for others, we may wish to spend time with those we love, we may even reflect on how we lived over the past year. The winter season is a special time that hopefully allows us to slow down, and take stock of life. What we are thankful for? How can we be more grateful for what we have rather than fixate on what we don’t have? 

One thing you should definitely be grateful for is having good health insurance. That is, if you have it, and it’s actually comprehensive. If by some unfortunate chance you or a loved one gets sick, thankfully you are lucky enough to access help without stressing (too much) about how you will pay the bill. 

Sadly, so many Americans today are entering this holiday season one bad health break away from bankruptcy, or even worse, serious illness because they can’t afford healthcare. The number of uninsured in America increased in 2018 to 27.8 million 😱. Instead of worrying about which in-laws to visit, these people are worried about which illnesses they can care for at home, because a visit to urgent care or the ER may very well leave them broke for the holidays. 

This doesn’t even take into account the number of underinsured Americans, which climbed to 29% of all U.S. adults in 2018, according to a study from The Commonwealth Fund. This means these individuals are on high-deductible health plans and their out-of-pocket costs are above an acceptable portion of their annual income, causing them to potentially forgeo necessary care or spend precious money on healthcare that was needed elsewhere. The crazy part, a majority of those underinsured are actually on employer health plans. 🤢

The holidays should be a time spent with family, remembering what matters in life. It shouldn’t be a time to worry whether your paycheck should go towards holiday dinners or healthcare bills 😳. When we started building Nurse-1-1, we never thought it would become a go-to for uninsured and underinsured individuals. Sure, we had a hunch, but not to this degree. Every single day Nurse-1-1 helps a multitude of patients all struggling with the same tough decision —  “I’m sick, but what should I do if I don’t have (adequate) health insurance or the money for out-of-pocket costs.”

Nurse-1-1’s Health Experts empower these patients with trusted health information, sometimes at no cost to them. With this knowledge, these patients are potentially able to self care at home and avoid unnecessary out-of-pocket healthcare spending, or even worse, a costly ER bill that may go unpaid. In some circumstances, Nurse-1-1 goes one step further and helps them find affordable care options, even community health centers that will set them up with health insurance and accessible care.  

Sure, we never expected to be an answer to America’s growing uninsured/underinsured crisis, but since we are, we take our role very seriously. It’s part of our mission to help all Americans, and as such we are building tools to help those a little less fortunate this holiday season. Soon, any American will be able to use Nurse-1-1 not just for trusted health information (that’s already available now), but as a way to receive comprehensive health care without breaking the bank. 

Is it your mission to do the same? Well then, let’s work together

Dr. Igor Shumskiy

How to choose a pediatrician

Giving birth has evolved. Now people are taking charge of their birth story and making more informed decisions about their care. That includes choosing a pediatrician.

Back in the “old days,” you went into the hospital on a horse and carriage, were knocked out and woke up with a baby. You didn’t pick a pediatrician, you got whomever was on call that day and that was that. No research, just hope for the best.

Now, we know better, so we do better. Most people make careful choices about where they would like to deliver, what kind of birth they prefer (if baby cooperates) and who their pediatrician will be. Pediatrician’s offices have time built into their busy schedules for appointments for new parents to “interview” them. They hold meet and greet nights at the office and local hospitals, and they have Facebook pages where you can see what kind of office you are getting. They have different cultures per se, and you as a parent, get to choose what is best for your family. 

Questions to consider when choosing a pediatrician

Do you want a solo practice where the doctor calls you from a cell phone but is only open 9-5? Do you want the office that has 15 providers and you never see the same person twice, but is open at 7 AM and closes at 9 PM? Most people want the best of both worlds. How do you choose?

What do you want and need from your pediatrician? How will you know what you are getting? The first stop for most of us is a Google search. Where is the closest office, what are their hours and who works there. What does the website look like? Easy to navigate? What hours is this office open? How quick can I be seen? Do they take my insurance? Does anyone answer the phone? Can you book appointments online? Do they have a Facebook page? Where did providers get their training? Are they nice? 

It’s common to see posts in the local Facebook mom groups from parents looking for provider recommendations and which offices to avoid. It’s the age of the internet, and decisions are made right there on smartphones, instantly. However, making your own judgement about a practice is best, given that your particular goals may be very different than other people’s. 

Is there an on call provider or nurse that is available when the office is closed?

Besides the obvious is this person a good medical provider and know what they are doing, there is lots to think about. 

According to Healthy Children, one question you should have for your pediatrician’s office is “What is the doctor’s policy on taking and returning phone calls? Is there a nurse in the office who can answer routine questions?”

We nurses know that this is a very important question. You as a parent need to know that there are nurses available to chat with when you have questions about your child, whether it be a brand new baby, toddler or teenager. These little humans don’t come with an instruction manual! Nurses and health care providers are basically like walking, talking kid manuals. Make sure your office has these human manuals available 24/7. 

As a mom of three, one of my biggest concerns is “Can I get in touch with a real person right away.” I am not one who enjoys waiting for a call back. I don’t have time for phone tag. My peaceful moment to chat when I make the initial call can turn into a loud and chaotic cry fest at any moment, especially with a sick kiddo. I am a nurse, but also a mom, so I want to be able to get medical advice when I call or text the office. It’s that simple. 

I also want to get an appointment when I need one. If I have to wait until tomorrow to see someone, or 1 hour to talk to someone, and I’m worried, I will likely end up at urgent care. Like many parents these days, I’m impatient. 

That being said, not everyone is impatient (LOL OK OK we all prob are). It’s important to think about what matters most to you and your family. 

Location of your pediatrician’s office

How close is this office to your home or daycare? Are the hours convenient? If your new office is 1 mile from your house, but closes before you get home from work, then it is likely not the best choice for you. Your new office needs to be accessible. Do you drive? Can you get there by train? Can you walk there if you have no car? Is there parking? What things stress you out– let’s avoid those things! 

What hospital is your pediatrician’s office affiliated with

Another really important question is to know where your child’s new provider is affiliated. Will they send you to your preferred hospital if you need emergency care? If you don’t like the hospital they are affiliated with, or they can’t access records from your hospital of choice, then maybe you should pick a different office. It is important to know that you will get the best care, and emergency care is part of that care. Make sure you are comfortable with emergency care choices that your new pediatrician’s office will be recommending and potentially admitting your child to. If you have no preference on what hospital you would go to if there was an emergency, then move on to something more important to you.

Does your office have labs or imaging

Can your office draw necessary lab tests (aka drawing blood) or conduct imaging on site, such as x-rays, ultrasounds, or MRIs? This is good to know for when your child needs to get routine lab work or needs any special testing or imaging such as x-rays or ultrasounds. Will you have to drive 20 min with a screaming 3 year old who just got a flu shot and doesn’t want labs too? Or can you walk across the hall and get it done asap. 

Another thing to think about is how frequently patients in the practice are getting labs done on and how old those patients are. I have a hard time watching someone struggle poking my children for bloodwork, but if the person drawing labs is experienced then it makes the whole process that much easier. If you are lucky, you won’t need more than a few routine labs and this won’t be an issue!

Is your new office supportive?

Are the people in the office nice? By nice, I mean, how were you greeted? Do you feel supported when you call? What kind of triage is available? Will your provider call you if you want to talk to them? Will the nurses give you home care advice? Will you be brought in for every concern? Do the people in the office make you feel cared for? 

An important aspect of health care is trust. In order to build trust, you must have a relationship with the people that give you the information. Feeling that your needs and concerns are important is the first step in developing trust. As a patient or parent, it is important that your health care providers listen to you, and validate your concerns (or explain to you in a clear way why you are worrying unnecessarily 😂 ). 

Physician rating and review sites

Consult online medical review sites to see ratings and opinions from other parents who take their kids to this pediatrician office. There are a lot of these sites to choose from, so be sure to compare a few to help get a full picture of what reviewers have to say. This is an important part of any pediatrician selection process, but it is only one factor in your overall decision making process. 

You can do this! There are lots of really great providers. You will figure out which one is right for you and your child. 

And as always, if you have health questions, or you’re not sure whether an appointment is required, feel free to chat with one of our nurses!

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, tell me about eczema treatments and causes. How to check for head lice in kids, and how to use a lice comb. How to rehydrate an adult who has the stomach bug. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.


Did someone say asthma?

It’s that time of year.  The fall 🍂 and spring 🌷and winter ❄ can trigger asthma. So basically all year. What the heck is actually going on in the lungs though? Asthma is a chronic condition that is made up of two main problems happening behind the scenes:

  1. People with asthma are often allergic to something. Mold, dust, seasonal allergies, pet dander, air pollution if living in busy cities, and even roaches and mice (ewww, I know, but they are the worst!). Whatever it is they are allergic to gets into the lungs as they breath, and causes inflammation in the airways of the lungs without them even noticing! Over time, this can build up into thick mucus, or what I like to call “gunk.” Yup, it’s the technical term. 😂 This gunk can hang out in the lungs and create the perfect environment for bad asthma flares (aka “asthma attacks”). This is why steroid (aka “controller”) inhalers are so important. See more about this below.  These controller inhalers work only to keep the inflammation down over time. They DO NOT work acutely, as it takes time to remove the “gunk.”
  2. Now that the lungs have some “gunk” in them, all of a sudden a certain trigger will hit that causes the muscles in the lungs of the airways to spasm.  Yup, your lungs have muscles in them. Sounds bad right? Well, it kinda is. Now the lungs have some “gunk” in them, and the muscles are spasming/tightening/swelling. This causes the airways in the lungs to really have a hard time getting oxygen to the place we need it to go. Check out this great illustration from the National Institutes of Health. Here is where “rescue” inhalers, for example, Albuterol come in handy to help calm the muscles down. They DO NOT remove the “gunk” (see above). 

Asthma triggers can vary greatly, but most people get asthma attacks from upper respiratory infections, often just common colds. Other triggers include seasonal allergies, environmental allergies, abrupt cold weather, and even sports. Everyone is different and can have various triggers. Asthma causes shortness of breath, difficulty breathing, coughing, wheezing and chest tightness. 😷   Here is what you need to know.

Allergy induced asthma

One example of allergy-induced asthma is seasonal allergies. When fall and spring arrive, the pollen falls. If you have an allergy or sensitivity to pollen and ragweed, these particles in the air can cause more irritation in the lungs, triggering more “gunk” to build up, and eventually an attack. Asthmatics begin to cough and wheeze when things reach a certain threshold that the body can’t tolerate anymore. 

The idea is pretty similar for environmental allergies causing asthma. Instead of pollen, household mold, perfumes, air freshener sprays, pet dander, or even rodents can trigger the asthma attack. If you live in a big city where there are lots of cars and buses, your asthma may be worse during times of high automobile traffic. 

Asthma can be hard to control and is a serious medical condition. It’s important to identify your asthma triggers and control your asthma for optimal health. Have you talked to your primary provider about your asthma and your asthma triggers? Certain cities have programs in place to help people keep their homes clean and allergen free. Some even provide free HEPA filters for vacuums. Check out HUD’s website to learn more about steps you can take to decrease allergens in your home. Oh, and if you smoke (even just outside the home), it can be super irritating to lungs, especially those of little children! Need help quitting? It’s free!

Asthma medications

There are various medications for the treatment and control of asthma. Asthma is a chronic condition. There are many different medications to help keep asthma under control. Most are listed here on this great resource from the Mayo clinic.  You will usually be prescribed one rescue inhaler and one controller inhaler. 

Your provider should review these medications as well as your asthma action plan (“AAP”). Your AAP helps you to know when you should start your controller medications or take your rescue medication, which symptoms to look for and when to seek medical care. Each person is different, and you should have a plan that your provider makes specifically for you. Asthma can be overwhelming, but let’s see if we can make it easier to understand. 😊

Asthma controller medications

You may have heard the term asthma controller medicine.  Long term asthma CONTROLLER medications are key to keeping asthma under control (get it!?) and prevent asthma exacerbations (aka “attacks”). 😩 Controller medications usually contain a small dose of steroids that reduces the inflammation/swelling, mucus, and “gunk” in your lungs’ airways. 

Controller medications work best when taken every day. Why? Well, if you have mucus build up in your lungs due to allergens in your environment, then that means every day you are exposed to allergens that put you at risk for worsening asthma symptoms. So doesn’t it make sense to take the controller medication every day to help keep this inflammation down? Use the controller medication daily, and slowly but surely you will keep the mucus away. Stop using it, and the mucus will build up again. Sadly, this medication does not work right away. So if you haven’t taken it for a while and start feeling like an attack is coming on, the controller medication will not help you much the same day, or even the next day. This medication needs to be used daily to work! 

Daily use keeps asthma symptoms at a minimum and decreases the risk of severe asthma attacks and death. Examples of controller medications include inhaled corticosteroids such as Flovent, Adviar, Pulmicort, Qvar as well as a daily oral medication called Singular, to name a few. They work best when they are taken daily.  They are long acting and will not provide quick relief. They are extremely important in keeping daily symptoms at bay and lower the risk for asthma attacks. They won’t help much during an asthma attack so be sure to travel with your fast acting rescue inhalers, too. 

Fast acting rescue medications

Fast acting medications (aka “rescue inhalers”) are used for quick relief.  They open up the lungs and relax the airways within minutes. They can stop or reduce symptoms of an asthma attack. Fast acting medications work within minutes. These fast acting medications are not intended for daily use. That’s what controller medications are for.  

Fast acting medications should be used for quick action and rescue.  If you are using your rescue inhaler daily, or more than your provider recommends, you should have a follow up to discuss your uncontrolled asthma.  Uncontrolled asthma puts you at risk for a serious asthma attack, and you probably need the addition of a controller medication (see above). 

Common rescue inhalers include Proair, Albuterol, Xopenex and Atrovent. If you use your rescue inhaler and it doesn’t help with your difficulty breathing, call 911 or get to a hospital immediately.  🏥

Oral steroids

Oral steroids can sometimes be necessary when people have moderate to severe asthma symptoms that are not responding well to the asthma action plan. Long term use of these oral steroids 💊can come with side effects.  Having good control of your asthma by using your controller medications helps prevent your asthma from getting so bad that you need an oral steroid. 

It might sound like taking a controller medication every day is way too much medication. Hey, I get it, I don’t like taking medications either 🙄. BUT, it’s better to take a controller inhaler with steroids in it every day for a year than having your asthma flare up and needing to take a single course of oral steroids. How is that possible? 

Well, inhaled steroid medications are low dose and mostly just go straight to your lungs, while oral steroids go everywhere in your body in much higher doses even though the rest of your body doesn’t really need them. Take your inhaled controller medication as recommended by your provider and you will likely prevent asthma attacks and the need for oral steroids. If at any point you stop your inhaled controller medication without the consent of your provider, make sure to start it back up if you are having an increase of asthma symptoms. It never hurts to talk to your provider and check-in about your asthma, especially if you are having daily symptoms! Of course Nurse-1-1 is here to help answer your questions as well.

What are the symptoms of asthma

Everyone with asthma is different.  Some people have mild symptoms on occasion, while others have more severe symptoms that interfere with daily life.  Coughing and wheezing can occur daily, only with exercise, or with the onset of illness. Coughing and wheezing can increase at night, and interfere with sleep.  😴 Some people just have a chronic, pesky cough that will not go away! Yup, this could be an asthmatic cough and you don’t even know! 

Asthma symptoms in children– when to get checked

Asthma symptoms in children can be subtle. Sometimes, if children have severe wheezing, the only symptom they may have is labored breathing. Labored breathing in a baby 👶 or child is usually noticed when the parent thinks the breathing looks “off.”  Often the child’s belly is puffing in and out and they are taking short small breaths. Something called retractions happen in children when they are having difficulty breathing. 

Retractions occur when someone is working hard to breathe. These retractions can be seen around the neck and chest as skin gets pulled around the bones due to difficulty breathing. In babies you may notice that they are reaching their head back, and their nose may be flaring as they struggle to take in more air.  These symptoms need to be seen emergently.  

Babies and young children will eventually tire out from this kind of breathing and will need support such as oxygen that can be provided in the doctor’s office, urgent care, or emergency room. On the other hand, some children might have such mild symptoms that all you notice is they get “winded” faster than other players during sports (this could be sports-induced asthma). 

When to seek emergency treatment in adults

Severe asthma attacks can be life-threatening. Don’t hesitate to call 911 if you have difficulty breathing. An asthma action plan can help you when you aren’t sure what to do. Always feel free to chat with us if you are feeling well enough to text.🤳

Signs of an asthma emergency can include wheezing or shortness of breath that suddenly feels worse, increased use of your rescue inhaler (such as albuterol or proair) or no improvement after use of your inhaler.  If you feel shortness of breath while sitting around, or while asleep, it’s important to get checked out right away. 🏥

Want to learn more about asthma? Chat with us anytime!

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, tell me about eczema treatments and causes. How to check for head lice in kids, and how to use a lice comb. How to rehydrate an adult who has the stomach bug. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Eczema treatments and causes

What is eczema?

That one little word you may have heard over, and over, and over again. It’s a little word, but it causes you BIG problems. 🙄 Up late itching? Eczema. 🙄 Can’t focus at work? Eczema. 🙄 Covering up embarrassing dry skin? Eczema. 🙄 Let me guess, you must be exhausted by eczema! Let’s start off discussing what the heck eczema even is…

Eczema, or what we in healthcare call “atopic dermatitis” (atopic = allergic, dermatitis = skin inflammation), is a chronic condition characterized by itchy, inflammatory skin. Yes, sadly it is chronic (you have it for life) 😔, but symptoms can be well controlled by taking certain measures. It’s unclear exactly what causes the disease, but most believe it’s some combination of an overactive immune system that is going a little haywire and an abnormal skin barrier. Yes, many people with severe eczema are also sensitive to environmental and/or food allergens. But this is usually not the main cause of eczema, and instead a contributing factor. 

With eczema, the skin becomes dry, flaky and very itchy. Once the person starts to itch the skin, the affected area can become thick, open up and start to ooze. Broken skin is at risk of infection with bacteria, viruses, or fungus (yikes! 😳). Itchy skin can be very disruptive and painful. The more you itch, the more your eczema will disrupt your life. Before you get too itchy… read on, as there is lots you can do! 

Can stress increase eczema symptoms?

Stress can worsen eczema symptoms. The way that stress increases the response in your skin is poorly understood. What we do know is that stress causes an inflammatory response in the skin. This makes eczema worse which can make sleep worse and stress levels rise even more. Taking care of yourself becomes a priority during times of stress. Try to reduce stress in your life to help reduce triggers for your eczema. When you start to feel stressed, it’s common to start to itch. Some people experience flushing of the skin or a hive-like rash. Getting an itchy rash can make you feel even more stressed, exacerbating the eczema. Make a list of things that work for you to help decrease stress. Try and do something other than itch!

Eczema and allergens

Allergens can definitely worsen eczema symptoms, especially when your skin barrier (the epidermis) is not working as well as it should. Allergies to dust, dander, and certain foods (among others) can trigger symptoms of eczema. Other triggers include bathing too often without moisturizing your skin, living in dry environments, just having chronic dry skin, and overheating the skin. For long-term eczema management, it is helpful to figure out what triggers your eczema to worsen, and then avoid those triggers. . Basically, it’s not rocket science, whatever causes your itch, avoid it! 😜 

Dust mites, animal danders, molds, and pollens can make eczema worse. Have you noticed these allergens in your living space? What can you do to minimize your exposure to them? Thorough home cleaning can help. I know, I know, who has time for thorough home cleaning? 🙄 But it’s important! Using hypoallergenic sheets and pillow covers, and removing mold are also good places to start. Got pets? If they worsen your eczema then they better not be sleeping in your room, or even worse, in your bed 😆. Vacuum, a lot! Use hypoallergenic sheets and pillow covers. 

Some people have a sensitivity and/or an allergy to different foods that causes an inflammatory response and eczema symptoms as well. Following up with an allergist to determine if you or your child has an allergy will be helpful if you are suffering from eczema. Identifying your triggers, then avoiding or treating them, can help to alleviate your symptoms. 

Eczema in children

In children under 5 years of age with eczema, up to 30% also have a food allergy, according to The National Eczema Association. Causes of eczema can be complicated and it can be hard to treat. Eczema can be disruptive to sleep and daily life, and can cause infections and complications. It is important to really pay attention to your child’s skin and make an effort many times a day to help alleviate symptoms. Definitely have your pediatrician evaluate your child’s eczema and discuss a plan of action! 

What can I do for my eczema?

First, let’s start with what irritants you can remove before we jump to medication treatments. Eczema is usually worsened by an irritant. You must identify what the irritant is and remove it. Start by removing any fragranced products from your daily routine. Washes, shampoos, lotions, laundry detergents, and fabric softeners are often the culprits in causing irritation to the skin. It’s important to find products that are hypoallergenic and fragrance free. The National Eczema Association lists some of their recommendations to help decrease the irritants in your life. Start looking at labels to see what is in the products you are using. Try switching to hypoallergenic products for your home and skin. Many times, simply switching to a non-fragranced fabric softener will significantly improve eczema symptoms. 

Often times your eczema may not flair until the heat is blasting in your home, or you are out in the summer heat sweating. It all depends on how your skin reacts. If it helps, write down what bothers your skin so you can remember next year! For example, it may help to add a reminder to your calendar to start moisturizing in late September before the heat turns on at home.

Treatment for eczema

Treating eczema is hard work and takes dedication and action on multiple fronts. Annoying, I know. But, we promise, it will be worth the work! 😊 The main goals are to (1) remove possible external causes of eczema, and (2) keep the skin as moisturized💧as possible! If you’ve been trying a lot on your own without much improvement, working with a primary care provider or dermatologist can be super helpful! The following eczema treatments are worth trying:

  1. Eliminate fragranced products from your daily routine, including fragranced detergents, body washes, lotions… anything that touches your body.
  2. Use a cool mist humidifier in your home and room, especially when the heat is on or if you live in a very dry place.
  3. Take a warm oatmeal or baking soda bath (sometimes doctors even recommend bleach baths. You can ask your provider if this is right for you– don’t go dumping bleach anywhere without a plan!) 
  4. Use daily emollients (types of creams) such as Aquaphor, hydrolatum or Eucerin cream to keep skin moisture locked in. Use the creams directly out of the bath when the skin is still wet. This will help lock in the moisture. I often recommend applying a moisturizing cream onto damp skin, then covering that with vaseline/hydrolatum to lock in the moisture. Some people even recommend wearing damp clothing on top of that to help keep the skin moisturized for hours.
  5. Apply an over the counter hydrocortisone cream to reddened, irritated areas, once or twice a day. Limit use to 1 week and avoid the face and genital regions. Overuse of steroid creams can thin the skin and cause wrinkles (and that is no fun). If you use hydrocortisone for a week and the problem still persists, or if you need treatment on the face/genital areas, then please discuss with your primary provider, as they can monitor stronger steroid cream use.
  6. Moisturize, moisturize, moisturize!
  7. Don’t scratch! If you are having trouble holding back 😤 then consider trying an over the counter antihistamine cream or antihistamine oral medication such as cetirizine (aka Zyrtec) or diphenhydramine (aka Benadryl). Please use only as directed and discuss with your provider if using long term for severe itching. 
  8. If you have any skin breakdowns, or if the rash is starting to become red, consider speaking with your provider and applying antibiotic ointment such as bacitracin or mupirocin. 

When to be seen by a medical professional for eczema symptoms

There are many steps in improving eczema and it can take some effort, so be patient. Get checked out by a medical professional if you or your child has a rash that doesn’t improve or gets worse after a few days of really moisturizing and protecting your skin. It’s important to get checked out if the rash begins to have any oozing, pus, redness, swelling, or warmth at the site, or if develop a fever along with the rash then. 

For some, eczema can be severe and requires prescription medication to treat eczema flares. We can chat with you if you aren’t sure about your symptoms or want us to look at a photo of your rash.

– Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, does cold weather cause the flu Is the Hep A vaccine safe How to stop pertussis or whooping cough in babies. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Americans Trust Nurses Most to Improve the Healthcare System. Shouldn’t Your Organization?

Author: Nurse-1-1 Medical Team

Hey, have you heard? Americans trust Nurses to improve the U.S. healthcare system over every other healthcare group. By far. Why should it matter to your organization? Because trust may be the single most important factor that dictates your patients’ healthcare decisions. 

This past October (of 2019), The New York Times, the Commonwealth Fund, and the Harvard T.H. Chan School of Public Health conducted a survey of 2,005 adults titled “Americans’ Values and Beliefs About National Health Insurance Reform.” The survey specifically asked how much trust the public has in various healthcare stakeholders to improve the U.S. healthcare system. Over half of respondents (58%) trust nurses to undertake this goal. Only 30% of those same respondents trust doctors, and 18% trust hospitals to improve the system. The stats are even worse for health insurance companies, the government, and business leaders. Find the final report here

Americans trust nurses over doctors

Were we surprised to see nurses as the most trusted group to improve healthcare? With nearly double the trust rate compared to doctors? Nope! After all, we are called Nurse-1-1 for a reason. However, this knowledge does make me wonder if our healthcare system is doing enough to put nurses at the center, and creating opportunities for them to innovate and improve the system.

It’s not like the jury is still out on whether patients will respond positively to more interactions with nurses during their care journeys. Opinion polls in the U.S. have rated nurses as the most trusted profession for the past 17 years. Nurses exude ethics, honesty, and care. They were “mission-driven” way before this became the cool buzzword for startups. And most importantly, patients trust them. 

Patients trust nurse to care for their ill grandfathers. They trust them to explain the complicated jargon that just came out of the doctor’s mouth. They trust them to be honest. And, they trust them to make healthcare better than it is today. 

Trust leads to patient engagement

This one little factor, trust, can make or break a patient’s experience as they navigate the healthcare landscape and make decisions that greatly affect them. From step one, when illness strikes and patients’ journeys begin, patients are searching for a place they can trust to return them back to health. If you are a healthcare entity of any kind (payer, provider, employer, information source), how you engage with patients during this critical moment will greatly dictate the next steps of the patient’s journey. 

Please note the emphasis in the last sentence, it’s how YOU engage with your patients, not how patients engage with you. Fail to build the right level of trust at the outset and your patient is more likely to make poorer healthcare decisions, like postponing care or unnecessarily ending up in an ER. Postponed care can lead to increased healthcare costs and bad outcomes, both things we strive to avoid. Create solid trust from inception and patients will seek care as recommended, stay engaged, avoid the ER, and live healthier lives. 

Are you building high-levels of trust with your patients from step one? If you don’t have nurses involved at this crucial step, chances are the answer is no. 

When we decided to build a company that helps people during the very first step of their illness journey, we knew nurses must be the foundation. That’s why patients who use Nurse-1-1 are messaging with a nurse within 30 seconds. When it comes to our product, our motto is: “get the heck out of the way and let nurses work their trust-building magic.” 

Want to build more trust with your patients at this critical moment? Nurse-1-1 is here to help. Learn more by visiting the providers, payers, and employers sections of our website. Or contact us below and we’ll tell you more.