Healthcare Consultant FAQ  

Click here to download and print the FEMA Disaster Assistance Fact Sheet.

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Department of Health in the Northwest District provides numerous services. For a list of services and contact information please click here.

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Choking kills more than 100 U.S. children 14 years or younger each year and thousands more - 15,000 in 2001 - are treated in emergency rooms. Food, including candy and gum, is among the leading culprits, along with items like coins and balloons. Of the 141 choking deaths in kids in 2006, 61 were food-related.

Doctors say high-risk foods, including hot dogs, raw carrots, grapes and apples - should be cut into pea-sized pieces for small children to reduce chances of choking. Some say other risky foods, including hard candies, popcorn, peanuts and marshmallows, shouldn't be given to young children at all.

What can I do to keep my child from choking? 

Choking is a very common cause of unintentional injury or death in children under age one, and the danger remains significant until the age of five. Objects such as safety pins, small parts from toys, and coins cause choking, but food is responsible for most incidents. You must be particularly watchful when children around the age of one are sampling new foods. Here are some additional suggestions for preventing choking.

• Don’t give young children hard, smooth foods (i.e., peanuts, raw vegetables) that must be chewed with a grinding motion. Children don’t master that kind of chewing until age four, so they may attempt to swallow the food whole. Do not give peanuts to children until age seven or older. 
• Don’t give your child round, firm foods (like hot dogs and carrot sticks) unless they are chopped completely. Cut or break food into bite-size pieces (no larger than ½ inch [1.27 cm]) and encourage your child to chew thoroughly. 
• Supervise mealtime for your infant or young child. Don’t let her eat while playing or running. Teach her to chew and swallow her food before talking or laughing.
• Chewing gum is inappropriate for young children.  

Because young children put everything into their mouths, small non-food objects are also responsible for many choking incidents. Look for age guidelines in selecting toys, but use your own judgment concerning your child. Also be aware that certain objects have been associated with choking, including uninflated or broken balloons; baby powder; items from the trash (e.g., eggshells, pop-tops from beverage cans); safety pins; coins; marbles; small balls; pen or marker caps; small, button- type batteries; hard, gooey, or sticky candy or vitamins; grapes; and popcorn. If you’re unsure whether an object or food item could be harmful, you can purchase a standard small-parts cylinder at juvenile products stores or test toys using a toilet paper roll, which has a diameter of approximately 1¾ inches.

Please click here to download a copy of the choking hazards poster.

Last Updated:  2/16/2010

Source:  Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

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Useful Websites 

http://www.betterkidcare.psu.edu/
This site is Penn State University based. Information concerning distance learning, newsletters, winter resources, H1N1, CDA information and staff orientation is available.

http://www.microbeworld.org 
All things concerning hand washing. Great posters!

http://www.nutrition.gov
This site provides easy, online access to government information on food and human nutrition
for consumers.
A service of the National Agricultural Library, USDA.

http://kidshealth.org/parent/ 

http://www.health.state.mn.us/handhygiene/materials.html 
Numerous print materials on hand washing 

http://healthymeals.nal.usda.gov/  
Use the signs and posters featured here to remind your children and staff about the importance of hand washing. Be sure to also view hand washing signs and posters for school food service professionals.  

http://www.douglascountyhealth.com/infectiousdisease/index.php 
This web site has great information on infectious disease and child care. Remember we are bound by PA laws and regulations but you can use most of the information. Has a great section regarding notification to parents and others about an outbreak in the day care.

http://lancaster.unl.edu/food/sinkgerms.shtml 
Gives you the directions and materials for the sink the germs hand washing game.

http://www.gojo.com/united-states/market/k-12/resources/gojo-hand-hygiene-program.aspx 
The GOJO Hand Hygiene Program   

http://www.fightbac.org/index.php 
fightbac.org, the website of the Partnership for Food Safety Education (PFSE), is a consumer food safety resource.  Get free downloads on safe food handling information from Fight BAC!®. The Partnership for Food Safety Education saves lives and improves public health through research-based, actionable consumer food safety initiatives that reduce foodborne illness.PFSE unites representatives from industry associations, professional societies in food science, nutrition and health consumer groups, the United States Department of Agriculture, the Environmental Protection Agency, the Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Food and Drug Administration in an important initiative to educate the public about preventing foodborne illness.

http://www.sanitize.com/why_sanitize.php 
Tested and evaluated under strict EPA testing protocols, STERAMINE 1-G TABLETS is the first sanitizing product to be developed that has been accepted and registered by the EPA as being effective in killing not only infectious bacteria but HIV-1 (AIDS Virus) as well.

http://www.henrythehand.com/pages/content/index. 
Great site for everyone. Fun activies, coloring pages, curriculum for hand washing and songs.

http://www.cdc.gov/h1n1flu/childcare/toolkit/actionsteps_preventflu.htm

http://www.h1n1inpa.com/info-for-specific-groups/information-for-child-care-facilities/communication-toolkit/

http://www.portal.state.pa.us/portal/server.pt/community/schools/14130

http://www.healthychildren.org

http://www.brightfutures.org/wellchildcare/toolkit/index.html

http://www.mypyramid.gov/preschoolers/index.html

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Use of Hand Sanitizers in Early Childhood Programs

To provide information regarding the use of hand sanitizers in early childhood programs that must comply with the Department of Public Welfare’s regulations for child care facilities. This information is also being shared with early childhood programs that are not required to comply with the regulations for child care facilities for information purposes and as a resource regarding the use of hand sanitizers.

BACKGROUND:

The outbreak of H1N1 influenza and resultant media coverage has increased awareness of hand hygiene and practices that prevent the spread of illnesses. Many publications that focus on preventing the spread of illness, including H1N1 flu, recommend the use of hand sanitizers when hand washing is not an available option or as a supplement to hand washing. As a result, the Office of Child Development and Early Learning is receiving an increased number of questions regarding the use of hand sanitizers in early childhood programs that must comply with the Department’s child care facility regulations.

The child care facility regulations require hand washing as follows:

• A staff person shall ensure that a child’s hands are washed before meals and snacks, after toileting and after being diapered (see 55 Pa. Code §§3270.134, 3280.134 and 3290.134, relating to child hygiene).

• A facility person shall wash his hands before meals and snacks, and after toileting and after diapering a child (see 55 Pa. Code §§3270.152, 3280.152 and 3290.152, relating to adult hygiene).

The regulations do not specifically address the use of hand sanitizers; therefore, programs are looking for guidance regarding using hand sanitizers in an effort to prevent the spread of disease.

DISCUSSION:

Child and adult hand washing is required by regulation before meals and snacks, after toileting and after diapering. The use of a hand sanitizer is not a substitute for hand washing in meeting the regulation. Many hand sanitizers are alcohol based. This poses a potential risk to a child who may ingest the hand sanitizer. For this reason, if an early childhood program wants to permit the use of hand sanitizers by adults, children or both adults and children, the program must exercise basic precautions.

Hand sanitizers may be used to supplement hand washing outside the regulatory requirements for example, using a hand sanitizer after blowing one’s nose, before and after handling toys, etc.

An early childhood program is not required to use hand sanitizers.

If a program wants to use hand sanitizers, the program must follow the guidelines below:

1. Read the label before using a hand sanitizer. If the instructions on the hand sanitizer prohibit its use for children, the hand sanitizer should not be in the facility. Also, note any age restrictions on the label and follow those restrictions. At all times, follow the directions on the product label.

2. When visible soil is present on the hands, hand washing is required. Use of a hand sanitizer is not an effective way to remove visible soil from the hands.

3. Facility persons and children may not use a hand sanitizer as a substitute for hand washing as required by regulation:

• A child’s hands must be washed before meals and snacks, after toileting and after being diapered.

• A facility person must wash his hands before meals and snacks, after toileting and after diapering a child.

4. The provider must obtain written parental permission for a child to use a hand sanitizer prior to permitting a child to use a hand sanitizer. The signed parental permission must be kept on file in the child’s record at the facility.

5. Hand sanitizers must be inaccessible to children when not in immediate use.

6. A staff person must be physically present with and supervising a child who is using a hand sanitizer. The staff person must remain with the child until the hand sanitizer has dried on the child’s hands.

7. The steps for using a hand sanitizer are as follows:

• Apply an appropriate amount of the product to the palm of one hand (refer to the directions on the label of the hand sanitizer).

• Rub hands together.

• Rub the product over all surfaces of hands and fingers until hands are dry.

NEXT STEPS:

1. The operator of an early childhood program should determine whether hand sanitizers will be used at the facility and whether they will be used by adults, by children or by both adults and children.

2. Prior to introducing hand sanitizers to the facility, the operator should:

a. Prepare any program policies or procedures needed to implement the above guidelines.

b. Discuss with staff the guidelines and any new polices or procedures resulting from the decision to use hand sanitizers.

c. Make parents aware that hand sanitizers will be in the facility and the guidelines that the program must follow in using the hand sanitizers. It is recommended that information provided to parents include the brand(s) of hand sanitizer the facility will use.

d. If hand sanitizers will be used for children, obtain the required signed parental permission.

e. Develop a method for staff to identify children who are permitted to use a hand sanitizer.

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Child care and preschool programs can help protect the health of their staff and the children and families they serve. Interruptions in child care services during an influenza (flu) pandemic may cause conflicts for working parents that could result in high absenteeism in workplaces. Some of that absenteeism could be expected to affect personnel and workplaces that are critical to the emergency response system. The U.S. Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) offer this checklist to help programs prepare for the effects of a flu pandemic. Many of these steps can also help in other types of emergencies. More information on pandemic flu is available at www.pandemicflu.gov.