New Emergency Center Opens in Cedar Park, Providing 24-Hour Emergency Care and Medical Services

St. David’s HealthCare recently celebrated the opening of its newest free-standing emergency center—St. David’s Emergency Center in Cedar Park.

The new emergency center serves as an extension of St. David’s Round Rock Medical Center, a Level II Trauma Center, and it is designed to treat patients with medical emergencies in Cedar Park and the surrounding areas.

St. David’s Emergency Center in Cedar Park will operate 24 hours a day, seven days a week, as a full-service, free-standing emergency department, staffed by board-certified physicians and nurses trained in trauma care. The facility features 12 treatment beds; a CT scanner; advanced testing capabilities, including radiological testing; and a medical lab.

Please click here to take a virtual tour of St. David’s Emergency Center in Cedar Park.

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Back to School: Healthy Lunch Tips for Children

Things can feel rushed in the morning, especially at the start of the school year. The entire family is trying to get back into the routine of getting children to school on time, and parents are trying to ensure that homework has been completed and everyone has a quick, healthy breakfast to start the day. Multiple studies have shown that children who eat breakfast perform better in school. If you’re unable to provide breakfast at home due to time constraints, breakfast is also available at school.

The best way to ensure your children are eating healthy at lunch is to pack a meal full of nutritious options and educate your children about healthy choices in the lunch line. In effort to reduce time in the morning, lunches can be packed the night before and stored in the refrigerator. Eating healthy begins at home, and if the whole family makes good choices, children are more likely to do so, as well.

Healthy lunch tips from the home:

  • Try to include food that represents three to four of the basic food groups, such as protein, grain, dairy, and fruits or vegetables. The more color you can incorporate into your child’s lunch, the better!
  • Think outside the box when incorporating whole grains. Sandwiches do not have to be confined to whole-wheat bread—you can use pita bread or tortillas, as well. Whole-wheat pastas, rice and whole-grain crackers are also good alternatives to the typical bread choices.
  • Skim or one-percent milk, low-fat cheese, yogurt and cottage cheese are ideal ways to incorporate dairy into children’s lunches.
  • For fruits and vegetables, try cutting them into fun shapes and packing them with a dip. Many fruits can increase energy!

Healthy lunch tips for the lunch line:

  • If your child buys lunch from school, review the menu with them and help them determine the best meal choices ahead of time.
  • Ask your child’s school about how they prepare foods for breakfast and lunch and what emphasis is placed on providing balanced meals for students.
  • Get a first-person perspective of what is available in the lunch line by visiting your child’s school and having lunch with him or her. If you can see how the choices are presented, you can talk with your child about how to make good decisions in the lunch line.

Eating healthy can give children more energy, sharpen their minds and balance their moods, making them more productive and present at school. With healthy lunchtime habits, your children will be better prepared to tackle the school year!

Valerie Shurley, MS, RD/LD, is a clinical nutrition manager at St. David’s Georgetown Hospital

3-D Mammography at The Breast Center at St. David’s Medical Center Significantly Increases Cancer Detection

In the June 25, 2014 issue of the Journal of the American Medical Association (JAMA), a groundbreaking study was published that found 3-D mammography (also called breast tomosynthesis) screening technology significantly increased cancer detection while simultaneously reducing the number of false positives.

The study, “Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography,” reviewed close to half a million mammography exams, and was led by Sarah M. Friedewald, MD of the Caldwell Breast Center, Advocate Lutheran General Hospital in Park Ridge, Illinois.1

Researchers found that 3-D mammography finds significantly more invasive/lethal cancers than a traditional 2-D mammogram. According to the study’s results, 3-D mammography also reduces the number of women called back for unnecessary screenings due to false alarms, thereby reducing anxiety AND health care costs.

Other significant findings include:

  • A 41% increase in the detection of invasive breast cancers
  • A 29% increase in the detection of all breast cancers
  • A 15% decrease in women recalled for additional imaging
  • A 49% increase in Positive Predictive Value (PPV) for a recall
  • A 21% increase in PPV for biopsy
  • No significant change in the detection of ductal carcinoma in situ (DCIS)

This study used Hologic 3-D mammography systems and involved 13 U.S. breast screening sites and 139 radiologists.

The Breast Center at St. David’s Medical Center is committed to early identification and the fight against breast cancer. The Breast Center provides 3-D mammography, the latest in breast screening technology. If you would like to schedule a mammogram, or if you have questions about this important breast health procedure, please call 512.544.8800.
Watch KVUE’s coverage of this study, including an interview with The Breast Center at St. David’s Medical Center’s director of imaging, Dr. Elizabeth Moorehead, M.D.

You may also click here to see JAMA’s full study.

References:
1 Friedewald SM, Rafferty EA, Rose SL, Durand MA, Plecha DM, Greenberg JS, Hayes MK, Copit DS, Carlson KL, Cink TM, Barke LD, Greer LN, Miller DP, Conant EF, Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography, JAMA June 25, 2014.

Heart Hospital of Austin Offers Student Athlete Heart Screenings

Hypertrophic cardiomyopathy (HCM) is a serious genetic heart condition in which the heart muscle thickens. It affects 1 in 500 student athletes every year, often without any warning or symptoms, and it is the leading cause of sudden cardiac death in young athletes. While it is relatively easy to detect, it can be fatal if it is not diagnosed and treated.

Heart Hospital of Austin provides free heart screenings to young athletes twice a year—once in February and then again in August, when many school sports programs begin and practices intensify. During the screening, students between the ages of 14 and 18 receive an electrocardiogram (EKG) and a limited two-dimensional echocardiogram, or ultrasound of the heart, to detect HCM. Both the EKG and echocardiogram, which take about five minutes each, are noninvasive and painless. The results of the screening are reviewed by a cardiologist and are available immediately.

The latest heart-screening event took place on Saturday, Aug. 23. To date, more than 6,000 young athletes have been screened at Heart Hospital of Austin.

To register your child for the next student athlete heart screenings, scheduled for February 14, 2015, please call 512.478.3627.

To view footage from a previous heart-screening event, click here.

Please click here to view this video if you are a St. David’s HealthCare employee who is viewing this message on a St. David’s HealthCare desktop computer.

Snake Safety Tips

Snakes are traditionally more active during the warmer months. We have seen an increase in snake sightings in Central Texas recently, presumably due to our area’s surge in urban development. Many different breeds of snakes are found throughout our region, but the snakes that are most dangerous are indigenous venomous snakes, such as: rattlesnakes, water moccasins, copperheads and coral snakes. It is important to know how to respond if you or someone you know is bit by a venomous snake.

Rattlesnake

Rattlesnake

Snake Bite Prevention Tips

  • Always be on alert.
  • Snakes are most often found in deep, ground holes, caves, bluffs, rocky areas, tall grasses, brush and water. They are often hiding under debris or fallen logs, or swimming in water—avoid these areas if possible.
  • Carry a long stick to poke at the ground while walking through tall grass or weeds.
  • Wear protective clothing, such as long pants and thick boots, when working outdoors.
  • Use a flashlight while walking at night.
  • If you see a snake, back away from it slowly. Never touch a snake, even if you think it is dead—you can still get bitten!

Snake Bite Response Tips

  • If you see the snake that bit you, try to remember what it looks like (color and shape). Take a picture if you can.
  • Do NOT approach or try to catch the snake.
  • Remain calm.
  • Rapidly remove any jewelry or tight clothing worn near the bite before swelling starts.
  • Elevate the bitten body part to the level of the heart.
  • Clean the bite by wiping away from the wound with a clean, dry cloth.
  • Seek medical attention as soon as possible.

What NOT To Do

  • Do NOT try to suck the venom out of the wound
  • Do NOT open or try to bleed the wound
  • Do NOT apply ice on the wound or submerge it in water

Stay safe!

Caroline Doyle, RN, BA
Trauma Program Coordinator
St. David’s Medical Center

Centers for Disease Control and Prevention. June 20, 2014. How to Prevent or Respond to a Snake Bite. Retrieved July 25, 2014 from, http://www.bt.cdc.gov/disasters/snakebite.asp

Secondary Drowning: Recognizing the Signs is Essential to Survival

It’s summertime again and we are all enjoying the hot summer sun and our cool lakes and pools! As we relax and play in the refreshing waters, it is also important to remember to practice safety in order to prevent water-related accidents, particularly those that may lead to secondary drowning events. Secondary drowning, as with all accidents, occurs when we least expect it. This type of drowning is rare – it occurs in only 1-2% of all drowning injuries, but it is very important to recognize the signs and seek treatment early to prevent serious injury or fatality.

What is secondary drowning?

Secondary drowning can occur after a person inhales water into the lungs during a near-drowning or water-struggle event. Those affected tend to appear to recover quickly and resume their normal activities. Unfortunately, if water is inhaled in large enough amounts, the person can suffer a cascade of physical changes in the lungs that result in lung swelling and reduced air exchange. The signs and symptoms are often not immediately apparent, and may take as long as 72 hours after the incident to occur. Airway spasms in the throat and bronchial areas may also ensue, once again leading to reduced oxygen exchange. Secondary drowning creates a perfect environment for pneumonia to cultivate in the lungs, complicating treatment and prohibiting recovery.

What are the signs and symptoms of secondary drowning?

Initial signs and symptoms are often subtle and difficult to determine, particularly in children who are already tired after an active day of water play. They include:

  • Fatigue
  • Drowsiness
  • Cough, wheezing, or complaints of chest pain
  • Changes in their voice
  • White, blue, purple, or pale pallor to the face, lips, or nail beds
  • Sudden changes in behavior
  • A person experiencing airway spasms (indicating an inability to breathe) or frothy, pink foam in the mouth or throat is having a serious medical emergency — 911 emergency services should be notified immediately!

What should I do if I witness or experience a water-struggle event?

It is essential to closely monitor the person for signs and symptoms over the next 24-72 hours. If any of the above symptoms are detected, or you notice any abnormal behavior, seek medical evaluation immediately. Early intervention is key to recovery.

If you have any concerns that water inhalation has occurred, report to the ER for evaluation, even if signs and symptoms do not appear to be present.

How can I prevent secondary drowning?

  • Everyone should know how to swim – and all adults should learn CPR so they may be able to assist in an airway emergency.
  • Provide close, attentive adult supervision of children at all times when water is nearby – put away your cell phones, magazines, alcoholic beverages and other distractions.
  • Remember, water drowning can also occur in bathtubs, baby pools and even buckets, so be alert to unexpected sources of water when children are in the area. And don’t forget to flip over those baby pools and water buckets to empty them of water when not in use.
  • Designate a group of adults to supervise children and take turns relieving the adults of duty.
  • Erect security fencing around pool areas with self-latching locks out of reach of children. You can also add fence and pool alarms to alert you if an unsupervised entrance occurs.
  • Teach children not to panic in water, to be familiar with water safety, and to ‘blow out’ water that gets in their mouth, not inhale it.
  • Always wear Coast Guard-approved flotation devices in the water, especially in open swim areas (oceans, lakes and rivers).
  • Avoid alcoholic drinks or other mind-altering substances which may impair judgment.
  • Learn water and boating safety at your local community pools, YMCA, American Red Cross, aquatic and fitness centers, and state parks and wildlife departments.

I hope you have found this information beneficial. Have a safe and happy summer!

For more information on this topic, you may access the following resources

WebMD information about Dry Drowning
PubMed
CDC information on child water safety
CDC information on recreational water illness and injury prevention
News story from Asbury Park Press about a recent secondary drowning
News story from Good Day Austin

Donna Welborn, B.S.N., R.N.
Trauma Injury Prevention Coordinator
St. David’s Round Rock Medical Center

8 Steps to Proper Food Handling For Your 4th of July

Millions of Americans will be dusting off their grills for Independence Day. St David’s Round Rock Medical Center wants to make sure you are taking proper steps when preparing your 4th of July meals. Follow these tips to help keep you and your guests free of tummy troubles and out of the emergency room this holiday weekend.

Steps to Ensure Proper Food Safety

  1. Wash your hands thoroughly with warm water and soap for at least 20 seconds before and after handling food—especially when handling raw meats.
  2. Use separate cutting boards—one for raw meats and another for fruits and vegetables.
  3. Wash all surfaces that come in contact with your food with warm, sudsy water after food preparation, this includes cutting boards, countertops, utensils and knives.
  4. Thaw frozen food safely in the refrigerator, under cold running water or in the microwave. Never thaw food at room temperature. Remember to allow enough time for thawing before cooking (consult your cookbooks or meat labels for recommended thawing times).
  5. Don’t prepare food for others if you have diarrhea or vomiting.
  6. Use a food thermometer to ensure meats are cooked to a safe internal temperature, making sure to place the thermometer at the thickest, inner section of the meat. Cook to an internal temperature of 145°F for whole meats, 160°F for ground meats and 165°F for poultry.
  7. Refrigerate or freeze leftovers within two hours of cooking. Make sure to consume refrigerated food within 3-4 days. Don’t taste or consume foods that look or smell questionable. When in doubt, throw it out!
  8. Keep your refrigerator temperature below 40°F and your freezer below 0°F.
  9. Separate raw meats and seafood from prepared foods, raw fruits and vegetables in your refrigerator and freezer.

Helmet Safety: Preventing Head Injuries in Children During Summer Activities

Summer is here, and with it comes outdoor activities, such as skating, skateboarding and biking. It is important to practice safety measures when participating in wheeled-sport activities.

A study in the New England Journal of Medicine reported safety helmets can reduce the risk of severe brain injuries by 88 percent, yet only 55 percent of children typically wear a bike helmet.

Head injuries are classified as any trauma that leads to injury of the scalp, skull or brain. They can range from a minor bump on the skull to a serious brain injury.

Head injuries are divided into two types, closed-head injuries and open-head injuries. An open-head injury is an injury in which the head is struck with an object that breaks the skull and enters the brain. This usually occurs when a person is moving at a high rate of speed. A closed-head injury is one in which the skull is not penetrated.

Closed-head injuries in children are, unfortunately, a common occurrence in emergency rooms. Incidents can range from a mild bruise to a skull fracture with brain hemorrhage, requiring urgent neurosurgical intervention.

A study published by the medical journal of the American Academy of Pediatrics found that simply wearing a bicycle helmet is not enough to protect a child’s head—a helmet must be properly fitted. Surprisingly, only 4 percent of children in the study wore helmets that were in acceptable condition with a good fit. Too often, helmets are loose, not buckled or ride too high on the forehead, allowing them to slide or fall off. When a helmet doesn’t fit properly, it is of little or no use.

A properly fitting helmet can turn a potential emergency into a minor occurrence. The helmet is designed to absorb the impact and protect the vulnerable brain underneath.

To help ensure children are safe when biking, skateboarding or skating, the St. David’s Round Rock Medical Center trauma department partnered with the Texas Medical Association to distribute and fit bicycle safety helmets during H-E-B Wellness Days in Round Rock. On Saturday, June 14, St. David’s Round Rock Medical Center donated 50 helmets.

The Pool “Noodle” – Not Just for Relaxing

It is officially summer in Austin, and that means more time spent in the water cooling off. At St. David’s Rehabilitation Hospital, we find that many of our patients benefit from the buoyant and resistive properties of water year-round in our indoor therapy pool. One of the tools used most frequently in our pool is the “noodle.” These inexpensive pool toys can be found almost anywhere during the summer season, and many rehabilitation patients have no idea they can use their noodle for exercise in addition to using it for floating and relaxing.

Below are just a few of the many exercises you can do with just a pool and a noodle. Try them out next time you find yourself in the water – your body will thank you!

Getting started:

  • Start in the deep end of the pool, where your feet will not hit the floor
  • Keep your body vertical with your legs underneath you, rather than out in front of your body
  • Straddle a large-diameter noodle between your legs, as if sitting on a horse
  • Sit up “high in the saddle” – don’t slouch!
  • Engage your abdominal muscles by pulling your belly button in and up.

Exercise 1: Bicycling
Pedal your legs as if riding a bicycle. Begin slowly with large revolutions to stretch out your muscles. Gradually go faster once you have warmed up.

Exercise 2: “Half” Jumping Jacks
Keeping your knees straight and ankles flexed (toes pulled up toward you), bring your legs out to the side and then back together in the center. It’s like doing jumping jacks without using your arms.

Exercise 3: Cross-country Skiing
Keeping your legs straight and ankles flexed, “scissor” your legs as if cross-country skiing. Bring one leg to the front while the other goes slightly behind you. Remember to stay vertical!

Not so fast:

You can do any of the above exercises quickly, slowly or at your own pace. In general, slower movements will be larger and will help you stretch your muscles. Quick movements will be smaller and will provide more resistance for strengthening of the muscles. Make sure not go so fast that you end up sacrificing good form – and remember to sit up tall!

Arm movements:

When you feel comfortable enough, you can start to add arm movements to these exercises. This will increase your cardiovascular involvement and offer a better overall workout. To do so, you can cup your hands for resistance as you make circles. You can also swing your arms at your sides or bring them horizontally out and in across the surface of the water.

Enjoy the summer and your new water exercise regimen!

Vickie Walker, PT, Aquatics Program
St. David’s Rehabilitation Hospital

Managing Heart Failure

Heart failure has a variety of causes, including damage from a previous heart attack, chronic high blood pressure, valve disorders, infections and genetics. In general, a weakened heart isn’t able to pump blood adequately to meet the body’s demands, causing a buildup of fluid that leads to swelling (edema), shortness of breath and severe weakness. Sadly, the body’s feedback mechanisms tell the heart to work harder to compensate, further weakening an already damaged heart.

This cycle often repeats in a downward spiral. In fact, patients with heart failure can often feel like they are in a revolving door that leads back to the hospital. It is estimated that as many as 50% of patients hospitalized for an exacerbation of heart failure will be re-hospitalized within six months. However, by making some changes to your lifestyle you can help manage your heart failure, live longer, feel better and reduce trips through the hospital doors.

Here are some tips to help you manage heart failure:

Medications

  • Refill all of your prescriptions before you run out, and make sure you take your prescriptions exactly as directed at the same time(s) each day.
  • Some medications for heart failure may cause unpleasant side effects, such as a dry, hacking cough or frequent urination. Let your doctor know about side effects that are bothering you. A dosing adjustment, timing adjustment or alternative medication prescribed by your doctor may help decrease side effects.
  • Never stop taking medication or change your medication dose without your doctor’s approval.


Diet

  • Follow your doctor’s orders regarding limits on the amount of fluid you should consume each day. Invest in a mug or cup with volume measurements, and keep a log of your daily fluid intake.
  • Keep your salt intake within the doctor’s limits. Start by making small changes, like taking the salt shaker off the table. Over time, your taste buds will adjust.
  • Replace the salt shaker with salt-free herb mixes found in the spice aisle at your grocery store, or make your own mix. (Some salt substitutes are high in potassium, so ask your doctor which ones are okay for you).
  • Become a food label reader. Look for low-sodium or no-sodium versions of your favorite foods.

Activity

  • Remain as physically active as possible, within the guidelines of your doctor, and listen to your body.
  • Find physical activity that you enjoy, like walking, swimming or riding a stationary bike, and incorporate it into your routine. Start out slowly, with a few minutes of exercise several times a day, and increase the time and intensity as you are able.
  • Alternate your periods of activity with periods of rest. Be sure to sit down, and take a rest whenever you begin to feel tired or short of breath.

Daily Weigh-ins

  • Sudden weight gain, or a steady increase in weight, is a warning sign of fluid build-up in the body. Weigh yourself each day, and keep a record.
  • Weigh yourself each morning at the same time (before eating, after urinating), in the same clothes and on the same scale.
  • Keep a weight record and take it with you to your doctor appointments.

Follow up

  • Keep all follow-up appointments with your primary physician and cardiologist.
  • Pay attention to your symptoms, and update your doctor when things change. Addressing symptoms early may lead to an adjustment in your treatment plan that might save you from a more severe exacerbation or hospitalization.
  • Call your doctor if you gain more than 2 pounds in 1 day, or more than 5 pounds in 1 week (as per physician’s instructions).
  • Monitor swelling, and call your doctor to report any increased swelling in your feet, ankles or legs. You may first notice that your shoes, clothes or rings fit more tightly.
  • Call your doctor if you have difficulty breathing, including shortness of breath during usual activities, trouble breathing when lying flat or waking up breathless at night.
  • Call 911 if you experience chest pain, fainting, severe weakness, severe shortness of breath or coughing up pink, frothy mucus.

For more information and tips on managing heart failure, visit the Heart Hospital of Austin’s online Health Library at http://www.hearthospitalofaustin.com/connect-learn-interact/health-library. By taking an active role in your health, and working closely with your doctor, you can better manage your heart failure diagnosis and stay out of the hospital’s revolving door.

Resources:

Amy McGowan, RN
St. David’s South Austin Medical Center
Intermediate Care Unit

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