The Importance of Choosing and Using the Correct Child Car Restraints

Author: Bridget Gardner, Injury Prevention Coordinator, UMC 

This week, UMC is participating in National Child Passenger Safety Week.  As motor vehicle crashes are the leading cause of death for children and teens, it is important for our community to realize the number one safety feature in a vehicle is a seat belt or child restraint.

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Although so simple to use, many do not take advantage of the engineering properties associated with the life saving measures or bio-mechanics of restraints.  Seat belts or child restraints work in the same way to lessen the impact of force from a motor vehicle crash. There are 5 basic benefits to being restrained prior to a crash.

  1. Keeps you in the vehicle: Being thrown from a vehicle can be deadly.  It’s just too much force on the body and goes back to your old science class about Newton’s Law of Motion.
  2. Restraints cross the bony structure: You are built like a cage, with bony structures that protect the internal organs. Bones can withstand greater forces than internal organs.
  3. Spreads forces: Simple force calculation experienced in a crash is your weight multiplied by the speed of the vehicle. Spreading the force allows a distribution across the body, rather than placing the energy in one place.
  4. Protects the head and spinal cord: Once damaged, injuries can last a lifetime.
  5. Provides ride down: In fractions of a second, seat belts or a child safety seat harness allow a slowing of the force in a crash.

No other devices will offer this type of protection. Children require child safety seats because they are too small to take advantage of the bio-mechanics with a seat belt alone.

Recently, the American Academy of Pediatrics made a few changes to their child safety seat policy. This caused much attention, however there were very few changes.  In summary, the following are considered best practice:

Infants and Toddlers



  • Rear-facing only
  • Rear-facing convertible

General Guidelines: All infants and toddlers should ride in a rear-facing seat until they reach the highest weight or height allowed by the car seat’s manufacturer. Most convertible seats have limits that will permit children to ride rear-facing for two years or more.

Toddlers and preschoolers

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  • Convertible
  • *Forward-facing with harness

General Guidelines: Children who have outgrown the rear-facing weight or height limit for their convertible seat should use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by their car safety seat manufacturer.

School-age children



  • Booster seats

General Guidelines: All children whose weight or height exceeds the forward-facing limit for their car safety seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 through 12 years of age. All children younger than 13 should ride in the back seat.

Older children



  • Seat belts

General Guidelines: When children are old enough and large enough for the vehicle seat belt to fit them correctly, they should always use lap and shoulder seat belts for the best protection. All children younger than 13 should ride in the back seat.

Let’s take the time to focus on the safe arrival of our friends and family.  After all, working in a Trauma Center, we know that no one is invincible from trauma, and the only way to lessen the number of injuries is through prevention.


National Seat Check Saturday

The community is able to join us this Saturday, September 29, as we have 9 FREE child safety seat events occurring statewide on National Seat Check Saturday! Thanks to our partners at Louisiana Sonic Restaurants, we will also be distributing child safety seats to those in need.  The process is no longer accepting applications at this point, as all requests have been confirmed.  If you are in need of a child safety seat and finances keep you from correctly securing your child in the proper restraint, we will open the link for applications again in March.  Follow us on the UMC Injury Prevention page for upcoming announcements.

Seat Check Saturday takes place from 9 a.m. to noon on Saturday, September 29 across the state at these locations:

  • Alexandria—Rapides Regional Trauma Center Medical Terrace, 211 Fourth St.
  • Baton Rouge—Baton Rouge Police Dept., 9000 Airline Dr.
  • Houma—Home Depot, 1717 Martin Luther King Blvd.
  • Kenner—Divine Mercy Church, 7337 Sal Lentini Pkwy.
  • Lafayette—Babies R’ Us, 5700 Johnston St.
  • Lake Charles—Southwest Beverage Company, 3860 Broad St.
  • Mandeville—Church of the King- Little Creek Campus, 22205 Little Creek Rd.
  • Monroe—Hixson Ford, 6300 Frontage Rd.
  • Shreveport—Sheriff’s Safety Town, 8910 Jewella St.


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Bridget Gardner, RN, is a registered nurse and coordinator of the Community Injury Prevention Program at UMC New Orleans. The Louisiana Passenger Safety Task Force is a network of certified child passenger safety technicians throughout the state, directed by the UMC  Trauma Program.


Yoga: An Exercise for Every Body

Author: Maryann Vicari, UMC Physical Therapist

In honor of September being National Yoga Awareness month, we wanted to shed some light on the practice of yoga and the many benefits it has for those who partake in it.

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Yoga, a series of stretches and poses associated with breathing techniques, offers the powerful gains of exercise. Some yoga styles are intense and vigorous while others are relaxing and meditative. No matter which type you choose, yoga is a great way to stretch and strengthen your body, focus your mind, and relax your spirit.

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Yoga can aid in strength and flexibility, as well as allow you to feel more focused and alert. In addition, a regular yoga practice (3-4 days/week) can improve functional mobility in activities of daily living (ADLs) and decrease fall risk. Moreover, yoga has been found to help improve these specific conditions:

  • Poor blood circulation
  • High blood pressure
  • Arthritis
  • Osteoporosis
  • Limited mobility
  • Lower back pain
  • Difficulty breathing
  • Headaches
  • Tension or stress
  • Depression


Yoga’s gentle movements are a one of the main reasons for its growing popularity.

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Yoga is great for people who have not been active for some time. It is also helpful for people who have certain health conditions like arthritis or osteoporosis because it does not require your joints to move through their full range, which can sometime be painful. Most importantly, you can modify the exercises/poses to fit your needs/abilities. At the same time, yoga is also great if you’re already fit and want a more challenging workout. As you become stronger and more flexible, it’s easier to do other kinds of exercises/activities like dancing, walking, or swimming.

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Yoga can help:

  • Reduce your risk for injury. Each yoga pose targets specific muscles. This helps you increase your flexibility and reduce your risk for injury.
  • Reduce stress and increase concentration. Yoga can help soothe/focus the mind and lower stress levels. It does this by encouraging you to tune into your breathing which helps to focus your mind on the moment and poses.
  • Understand the mind and body connection. Yoga requires you to focus all your energy on each movement or pose exactly. This can help you tap into the connection between your mind and body.
  • Gain strength and stamina. More vigorous styles of yoga promote strength and stamina.
  • Improve balance and stability. Balancing poses require you to use your core muscles. This can help you improve your overall stability and decrease risk of falls.
  • Improve posture. Yoga poses strengthen and open tight areas of the body like the shoulders and muscles of the upper back. This can help you keep good posture throughout your day.
  • Develop body awareness. Yoga requires you to contract or relax specific muscles as you stretch into each pose. This can help you become more aware of your body’s strengths and weaknesses.

How Do I Start?

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It’s easy to find a variety of yoga classes. You can check with your local community centers, such as the Y or look at nearby gyms, dance studios, and health clubs. There are numerous yoga studios in the greater New Orleans area, many of which, offer specials (Groupon, etc) for new students. Finally, you can look up Yoga Journal’s Yoga Teacher Directory to see regional and national lists of yoga teachers and associations.

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It is important to find the right yoga style for you and a teacher you like. It’s hard to know what a class is like until you attend it. Even when two teachers use the same terms to describe their classes, the classes may be quite different, so feel free to experiment with different types of classes at different studios.

As always, be sure to talk with your health care provider before you begin yoga or any other kind of exercise. It’s a good idea to take a class with an experienced teacher. Let the teacher know about any health conditions you may have like high blood pressure or arthritis. Tell him or her about any injuries or physical problems. A good teacher will know which exercises are best for you and tell you which poses to avoid.

Give It a Try!

Yoga can help you get fit for life. It helps you deal with stress, pick up your child, control your dog, carry groceries, or work in your garden. It also can help to prevent or ease back pain and muscle or joint injury and give you self-reliance and self-esteem.


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Most important to keep in mind, the yoga routine is more than just physical — it involves the quieting of the mind. The bottom line is learning to pay attention. You fine-tune your attention, beginning with the body, and then moving to the mind. As you get deeper into your practice over the years, you start to see the mental and spiritual benefits. Namaste!

Maryann Vicari

I have a personal soft spot for yoga, as I have been practicing it consistently for the past two years.  I recently became certified to teach yoga this past spring because I wanted to deepen my personal yoga experience and help bring awareness of yoga to my patients and others in the community. I’m currently teaching classes at Balance Yoga and Wellness Studio, and I sometimes lead my coworkers at lunch when we have time. Yoga has had a profound effect on my life, both physically and mentally, as well as spiritually.  I would recommend it to anyone who is looking for a new exercise routine or a way to improve functional mobility and general quality of life.



Pain Care: Prevention Before Treatment

Author: Harry J. Gould, III, MD, PhD


When a patient says, “Doctor, it hurts when I do this,” the immediate thought in response to the implied request is “Don’t do that.”  Unfortunately, in today’s society, this seems to be the best and most effective advice that a physician can provide for their patients in pain.


The United States is in the midst of what the Centers for Disease Control describes as “The worst public health crisis in American history.”

There are reports, almost daily, to enlighten us about the fact that the over-prescribing of prescription painkillers has led to countless overdose deaths and serious consequences associated with misuse, abuse, addiction, and diversion that plague society in epidemic proportions.


As a result, there has been a strong push by the community and regulatory agencies to limit the prescribing and dispensing of opioid analgesics across the board, while paying little attention to the underlying cause.

Pain is often under-treated or over-treated, but mostly it is poorly treated.

The system’s response has precipitated a reluctance on the part of many physicians to provide pain care for many in need, further exacerbating the primary cause of the problem.

A frequent response is to change clinical focus and redirect efforts to offer one-dimensional assessment and management that relies on interventional modalities.  Unfortunately, not all patients are identical and interventions, if ordered inappropriately or too often, can be costly and have problems of their own.

The observations and policies have mandated change and have heightened the efforts of healthcare providers to find ways to “do no harm” in their efforts to help those in need.

How then can we improve pain care and overall quality of life?  Perhaps it is time to return to basics.

As a starting point, we should consider some important truths about pain.


The Truth About Pain

  • Pain is subjective and is different for everyone based on culture, situation, experience, genetics, age and gender.
  • Pain is a modality that is essential for survival. It warns us of present and potential tissue injury so that we can respond and minimize damage.
  • The most important reason that chronic pain is so debilitating is less the uncomfortable sensation that is experienced and more the fact that pain robs us of our ability to control of own lives. Unfortunately, many chronic pain conditions are present for a lifetime.  Thus, the realistic goal should be to minimize the effect of the underlying condition causing the pain and reclaim control of our lives rather than to eliminate pain.

Too often, patients surrender responsibility for controlling their pain to friends, physicians, physicians, drugs or procedures.


Taking Responsibility for Your Pain

As a patient, it is essential for you to take responsibility for your pain and to participate in your own care. This process can begin by considering and implementing some obvious positive behavior changes that can maximize pain control and minimize both physical and fiscal cost.

Things You Can Do to Control Pain

  • Eat a regular healthy diet, avoiding excess, with a goal to optimize body mass index (BMI).
  • Exercise daily — regular activity from baseline to 30-60 min/day tailored to the patient’s ability to tolerate activity without a backward slide. “No pain, no gain” is not always the best approach.
  • Be sure to get enough restorative sleep.
  • Balance life experiences and schedule time for yourself that allows for participation in hobbies and enjoyable leisure activities.
  • Be aware of habitual activities and positions that add undo ergonomic stress, e.g., poor posture, wearing high heels, wearing shoes that lack adequate support, sleeping on an old or non-supportive mattress or pillow, using inadequately supportive chairs and car seats. Tailor work and living environments to minimize but not necessarily eliminate stressors and eliminate high-risk conditions.
  • Learn and take advantage of alternative forms of coping and pain control, e.g., meditation, guided imagery, self-hypnosis and relaxation.


With proper perspective and attention to basics, one is likely to realize improved general conditioning that enhances:

  • Healing and the immune system’s ability to fight off infection and disease
  • Improved cardiovascular, pulmonary and gastrointestinal health
  • Reduced stress
  • Improved mental health
  • Increased sense of self and well-being and an overall improved quality of life
  • Reduction in pain at any level



When setbacks occur, first consider the use of topical heat, cooling or massage and prudent physical activity to improve strength, range of motion and endurance and seek counsel for a comprehensive pain assessment early when the basics have not provided adequate results.

Suicide Prevention: Know the Signs and Where to Get Help

Author: David Fein, MD, Medical Director of  Behavioral Health Emergency Room Services

Suicide rates have been on the rise, now standing as the 10th leading cause of death in the U.S. and the 2nd leading cause of death in teens. Now more than ever, it’s critical to know the signs that might indicate a person is considering suicide, where to go for help, and how to provide appropriate support and interventions.

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Risk Factors

While there are known risk factors for suicide, such as being older, male, or single, there are additional risk factors to be mindful of as well. These include dramatic changes in behavior, such as getting one’s affairs in order, giving away possessions, increasing substance use, and expressing feelings of being trapped, a sense of hopelessness, or the belief that there is no purpose or meaning to life.

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Many suicides occur during moments of extreme anxiety and hopelessness about the future. In fact, interviews of people who attempted suicide reveal that, oftentimes, they experienced profound regret about their decision almost immediately.

We should strive to never let temporary feelings of hopelessness drive us or a loved one to a permanent act like suicide. If you feel you are trapped with no way out and think the only solution is death, know that many resources are available to help you through the crisis.

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Where to Find Help

Each parish has a community mental health center and a mobile crisis unit that are available 24/7 to provide support for people in a behavioral health crisis. Calling the crisis unit does not necessarily mean you will be brought to the E.R. They are there to provide support to you – sometimes over the phone, sometimes in person.

Metropolitan Human Services District serves Orleans, St Bernard, and Plaquemines parishes. Call (504) 568-3130 for their clinic, and (504) 826-2675 for their mobile crisis unit. Jefferson Parish Human Services Authority serves Jefferson Parish. Call (504) 838-5257 for their clinic and (504) 832-5123 for their mobile crisis unit.

If a friend or loved one is in crisis and unwilling to seek help, another option is an Order of Protective Custody, which is signed off by the parish’s coroner and gives the police legal authority to bring the person to the hospital for an evaluation. To  request for an Order of Protective Custody in Orleans Parish,  call (504) 658-9660; in Jefferson Parish, call (504) 365-9100; in St. Tammany Parish, call (985) 781-1150.  

There are also national services such as the Suicide Hotline (1-800-273-8255) and the National Alliance on Mental Illness (NAMI) (1-800-950-6264) which also has a Crisis Text Line (just text NAMI to 741-741). As always, emergency rooms and 911 are available 24/7 in case of an emergency.

Dr. Fein is an Assistant Professor of Psychiatry and Associate Director of the LSU-Ochsner Psychiatry Residency Training Program, LSU Health New Orleans School of Medicine.

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