ChildrenÕs Hospital2018 Clinch Ave. ¥ P.O. Box 15010Knoxville, Tennessee 37901-5010

We always try to stay current with friends of the hospital.If for any reason you should receive a duplicate issue,please notify the hospital at (865) 541-8257.

NON-PROFITORGANIZATIONU.S. POSTAGE

PA I DPERMIT 433

KNOXVILLE, TN

22nd Annual Telethon raises more than $2.1 million

resonance imaging (MRI) scanner alongwith other radiology and ultrasoundequipment, operating room equipment,various equipment used in the NICU, andLifeline vehicles, which are mobileintensive care units to provide neonataland pediatric transport. This equipmentand technology enables the hospital tocontinue providing the best availablepediatric health care to childrenthroughout East Tennessee.

In 1983, ChildrenÕs Hospital becameone of the 22 charter hospitalsparticipating in the first CMN telethon. In 22 years, the local telethon has raisedmore than $20 million, all of which hasremained at ChildrenÕs Hospital for thedirect benefit of the hospital and itspatients.

ChildrenÕs Hospital would like to thankeveryone who generously gave their time

The 22nd annual ChildrenÕsMiracle Network Telethonwas a tremendous successagain this year, raising more than $2.1 million forChildrenÕs Hospital. The live,two-day broadcast aired on WBIR-TVChannel 10 June 5-6.

The money raised on-air by this yearÕstelethon will purchase Giraffe Omnibedunits for the hospitalÕs Neonatal IntensiveCare Unit (NICU). These beds offerpremature infants the specializedtreatment they need in the best possibleenvironment to support them during acritical growth period. The GiraffeOmnibed helps control light, sound andunnecessary touch to the baby whileoffering ideal warmth.

Funds raised by previous telethonshave been used to purchase a magnetic

and money to make the 2004 CMNtelethon so successful. ChildrenÕs Hospitalextends its gratitude to many areacompanies, including GoodyÕs, Wal-Martand SamÕs Club, which presented thehospital with substantial donations theyraised throughout the year. Additionally,the East Tennessee community raised$262,476 through telephone pledgesduring the 22-hour broadcast, madepossible by the more than 500 volunteerswho gave part of their weekend to answerphones during the telethon.

ChildrenÕs Hospital is indebted to thenews team and production crew of WBIR-TV Channel 10 for being a vital part of thetelethon for each of the past 22 years.They once again demonstrated theirextraordinary support for ChildrenÕsHospital and the children of this region.

by Rupal Mehta, student intern

Fall 2004Fall 2004

Board of DirectorsJames S. Bush

Chairman Robert Madigan, M.D.

Vice Chairman Robert M. Goodfriend

Secretary/Treasurer Michael Crabtree Dawn Ford Peyton Hairston Jeffory Jennings, M.D. Bob Koppel Donald E. Larmee, M.D. Dugan McLaughlin Chris Miller, M.D. Alvin Nance Dennis Ragsdale J. Finbarr Saunders, Jr. William F. Searle III Bill Terry, M.D. Laurens Tullock Danni Varlan

Medical Staff Chris Miller, M.D.

Chief of Staff Lewis Harris, M.D.

Vice Chief of Staff David Nickels, M.D.

Secretary

Chiefs of Services Lise Christensen, M.D.

Chief of Medicine Cameron Sears, M.D.

Chief of Surgery David Birdwell, M.D.

Chief of Pathology Clifford J. Meservy, M.D.

Chief of Radiology Mike Mysinger, D.D.S.

Chief of Dentistry Mark Cramolini, M.D.

Chief of Anesthesiology

Administration Bob Koppel

President Paul Bates

Vice President for Human Resources Joe Childs, M.D.

Vice President for Medical Services Rudy McKinley

Vice President for Operations Jim Pruitt

Vice President for Finance Beckie Thomas, R.N.

Vice President for Patient Care

A quarterly publication of East Tennessee Children’s Hospital, It’s About Children is designed to inform the East Tennessee community about the hospital and the patients we serve. Children’s Hospital is a private, independent, not-for-profit pediatricmedical center that has served the East Tennessee region for more than 65 years and is certified by the state of Tennessee as a Comprehensive Regional Pediatric Center.

Ellen Liston Director of Community Relations

David Rule Director of Development

Wendy Hames Editor

Neil Crosby Cover/Contributing Photographer

“Because Children are Special…” ...they deserve the best possible health care given in apositive, child/family-centered atmosphere of friendliness,cooperation, and support - regardless of race, religion,or ability to pay.”...their medical needs are closely related to theiremotional and informational needs; therefore, the totalchild must be considered in treating any illness or injury.”...their health care requires family involvement, specialunderstanding, special equipment, and specially trainedpersonnel who recognize that children are not miniatureadults.”...their health care can best be provided by a facilitywith a well-trained medical and hospital staff whoseonly interests and concerns are with the total health andwell-being of infants, children, and adolescents.”

Statement of Philosophy East Tennessee Children’s Hospital

www.etch.com

The Bottom LineArtwork by some of Children’s Hospital’s special patients

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Mauricesa

Lauren

Sarah

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Dear Bob Koppel, CEO,

I would like to comment on a couple of your employees.

My daughter Kaitlyn E. Reed was seen in the Emergency

Department on December 18, 2003. The doctor who saw her

was Ameeta Lall. I wanted to show my appreciation for her.

I have never seen such a caring doctor in an Emergency

Department before. She truly cares for her patients.

My daughter was having a reaction to some of her

medication. We were concerned, but that wasnÕt all; Ameeta

shared this concern and never made me feel uncomfortable.

She was honest and spent a lot of time making sure we were OK

and comfortable. My daughter improved with the Benedryl she

was given, and I have never seen a doctor so relieved and happy

as Dr. Lall was. I wish all doctors could have that bedside

manner, but they are few and far between. My daughter and I

will definitely remember her for years to come.

The second wonderful experience we had was the following

day, December 19, in the lab. Kaitlyn had to have some blood

drawn for some tests. The gentleman who took her blood, Ryan

Hillis, was just as wonderful as Dr. Lall. We were in the lab

around 12 p.m. that day. Kaitlyn has a hard time with being

stuck, even at her own doctorÕs office. He managed to stick her

twice, and she did not fight back once. After the experiences

with her and the lab work, it had to be his personality and

mannerisms. I hope he knows he was very much appreciated.

My daughter left both visits with lots of stickers and

happiness. Thank you for having these two people on your staff.

They are definitely assets to ChildrenÕs Hospital in my eyes.

Thank you,

Donna Reed

Knoxville

Dear ChildrenÕs Hospital,

Thank you so much. My daughter MacKenna Allen was seen inyour Emergency Department on June 7. Your staff couldnÕthave been more caring or compassionate. I cannot believe thelevel of commitment that your staff shows to children.

I have been to my local hospital before, but I drove an hour toChildrenÕs, because MacKenna broke her arm and was soscared. I was so heartbroken for her. She was met with smilesand kind words from everyone. When it was time for her armto be put in a splint, two of the friendliest nurses came in tohelp. Everyone explained everything to her. I was so impressedhow they made sure that she understood what was happening,in terms she knew. When the staff came in, they told her whathad happened, not just me; they didnÕt talk down to her likeshe was a child.

Please let everyone in the ED know that it really does make adifference. When a total stranger shows such compassion andlove to your child, it touches you more that I can express.Thank you from the bottom of my heart!

Trisha CoutureSevierville

Flu shot added to children’s shot list

The Centers for Disease Control and Prevention has added the influenzavaccination to the recommended immunization schedule for children.

The Advisory Committee on Immunization Practices decided to expand theirflu shot recommendation to include children 6-23 months old for the 2004-2005flu season. Previously the vaccination had only been recommended for childrenover 2 years. Caregivers and all adults who have close contact with children,such as school personnel and church workers, are also recommended to receivethe vaccination. Vaccines should be given in the fall of each year.

"Recent studies show that children younger than age 2 and children withchronic conditions like diabetes, asthma and HIV have a higher risk ofhospitalization for influenza and related complications, including severepneumonia," according to a statement issued by the American Academy ofPediatrics.

Young children tend to also have a higher hospitalization rate for flu-related illnesses than most healthy adults, for whom the vaccination hasbeen recommended for many years.

During the 2003-2004 flu season, ChildrenÕs Hospital treated more than 2,000cases of flu, an overwhelming increase compared to previous years. The fluseason not only affected more people, but it also began several months earlierthan usual. Typically flu is more prominent in the months of January throughMarch; last year ChildrenÕs Hospital saw the majority of its cases in Novemberand December.

For more information about when and where to obtain the flu vaccination,contact your childÕs primary care physician or the ChildrenÕs HospitalCommunity Relations Department at (865) 541-8165. To find our more aboutinfluenza recommendations, visit www.etch.com or www.aap.org.

by Casey LaMarr, student intern

On The Cover: Twins David and Tony Restaino had neurosurgery at ChildrenÕs Hospital. Read their story on pages 4-5

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Eleven-year-old twins Tony andDavid Restaino spend most of theirdays diving off springboards orswimming at the University ofTennessee Recreation Center. However,when Tony began struggling withdouble vision last summer, the boardand the water didnÕt come into focuslike before, and each dive becameharder and more dangerous. He firstcomplained to his dive coach about theproblem and then to his parents, Dianeand Mike.

"We definitely wanted to investigatethe double vision, because we knewthat Tony couldnÕt dive with thatproblem," Diane said. "We couldnÕtunderstand where the problem wascoming from, but we wanted to makesure that he was not only safe divingbut in his every day life as well."

Tony had an MRI to see if somethingin his brain might be causing thedouble vision. After meeting withpediatric neurologist Dr. ChristopherMiller, the Restainos were referred topediatric neurosurgeon Dr. LewisHarris. When he first met Tony, Dr.

Harris asked him many questions:"What are your symptoms?" "When areyou experiencing these things?" "Howoften do they occur?" Dr. Harris wantedto do a spinal MRI on Tony, and oncehe learned that Tony had an identicaltwin brother named David, he wantedDavid to have an MRI as well.

Once Dr. Harris saw the results, heexplained to Tony and David and theirparents that both boys had a Chiarimalformation. A Chiari deformity ormalformation is a condition in whichthe most inferior part of the cerebellum(part of the brain) is displaceddownward through the base of theskull into the upper spine. Even thoughDavid was not experiencing thesymptoms that Tony was feeling, theMRI revealed the condition was presentin both twins.

"The results came back on both ofthe boys, and they both had fluidcollecting in their spines," Diane said."At that point, Dr. Harris recommendedwe do surgery on both of the twins,because their brains were actuallyslipping out of their skulls and blocking

the top of their spinal cords."TonyÕs and DavidÕs lives changed

immediately at that point. Not only didDr. Harris recommend brain surgery forboth boys, but he also wanted Tony toquit diving and David to quitswimming until they had the surgeryand had successfully recovered. Dr.Harris explained that not correcting theproblem could have led to spinal corddamage and future problems.

On June 30, 2003, Tony and Davidcame to ChildrenÕs Hospital for surgery.Each surgery required Dr. Harris toopen the back of the skull and pull thebone away from the spine and spinalcord. Each surgery lasted about fourhours, with TonyÕs lasting a littlelonger. Even though each boy was insurgery for that amount of time, theirparents were in the waiting room forover eight hours, knowing that one oftheir sons was undergoing majorsurgery.

"When we were in the waiting room,they called us every hour and let usknow what was happening," Dianesaid. "The surgery department took

great care of the boys in the operatingroom and just as good care of us in thewaiting room." Before Tony and Davidleft the recovery room, Diane and Mikewere informed that the boys would goto the Pediatric Intensive Care Unit(PICU) immediately afterward.

"Before David, who was second forsurgery, was even in recovery, thehospital staff came to tell us about thePICU," Diane said. "They told us wherewe could sleep if we wanted to stay, thecafeteria hours, and how we couldenter the PICU when we visited; therewere no questions left unanswered."

Tony and David spent slightly morethan a day in the PICU after surgery.Their entire swimming and divingteams came to visit Diane and Mikeand to check on them. "The hospitalwas so understanding of the situationand welcomed our visitors," Diane said."We never felt alone or removed fromour world of friends and family. Theywere all welcome, and ChildrenÕsHospital never made us feel like ourcalls, visitors or children were a botherat all."

"I thought the nurses and staff in thePICU were incredible," Mike said. "Notonly did we observe the great way theywere taking care of Tony and David,but they also were giving such greatcare and attention to all of the children(in the unit). It was amazing how theycontinued to be positive and calmunder circumstances like buzzers goingoff and being surrounded by very sickand injured children."

The Restainos were grateful that Dr.Harris spoke with Tony and David ontheir level and shared the truth aboutexactly what the family could expectfrom the surgery, recovery and possibleoutcomes. "He was wonderful and sogood with each of them," Diane said."He came to visit the boys in the PICUand laughed, telling them he knew thathe wasnÕt their favorite personanymore. He learned their senses ofhumor and their personalities, and hetreated them like he had always knownthem."

After spending time in the PICU,Tony and David were moved to theSecond Floor Inpatient Unit until theywere able to go home. While on thesecond floor, they were able to have

visitors in their room, which includedtheir older brother, Joe. As Tony andDavid focused on recovery, Joe wantedto help by picking movies from thehospital video cart and video games forthem to play.

During the recovery process in thehospital and after the boys came home,Joe was concerned about the pain hisyounger brothers were experiencing. "I was very nervous and scared thatthey might not be able to hang out withme again," Joe admitted. Mike andDiane noticed JoeÕs concerns. "We knewit disturbed him to see the boys betotally bed ridden and obviously in agreat deal of pain," Mike said.

Tony and David seem to be"frequent flyers" to childrenÕs hospitals,having been patients at the childrenÕshospitals in Boston and Dallas for otherhealth care needs. "We believe this is byfar the best childrenÕs hospital we haveever been in, without a doubt," Mikesaid.

Tony and David were expected tostay at the hospital for a week but wereable to leave after four days and wereat home on July 3, 2003. After gettinghome, it took the boys two weeks tobegin to move around. "IÕd say thewhole recovery period was six weeks,and then they didnÕt do any activityuntil they went back for their checkupwith Dr. Harris the end of August,"Diane said.

That checkup proved the surgeryworked the way it was supposed to.The brain had been moved away, thefluid was moving properly, and Tonyand David were able to go back todoing anything they wanted to do. Thefamily will always remember those sixweeks of recovery as the longest sixweeks of their lives.

"We had no idea how it was going toturn out," Diane said. "When we madethe decision about surgery, we had noidea if it would fix the problem, and itwas a very risky surgery for both boys.We are really thankful Dr. Harris was inKnoxville to take care of Tony andDavid."

When the Restainos first met withDr. Harris, he told them the worst-casescenario was the possibility it wouldtake two years for the twinsÕ problemto be fixed, but the best-case scenario

was that they would recoverimmediately. The end result was thebest-case scenario; the brain had movedaway and the fluid was coming out oftheir spines.

Tony and David are back to doingall the things that they enjoy in school,they are back swimming and diving,they have their same senses of humor,and they are bickering with oneanother and older brother Joe just likebefore the surgery.

"It is hard for us to believe that ourchildren had brain surgery just over ayear ago, and today they are just likeany other kids," Mike said. "It isremarkable; no one would ever know it."

"As far as ChildrenÕs Hospital goes,they really do put their arms aroundthe entire family," Mike said. "It is soobvious that when you walk in thedoor, you can understand that theirgoal is very simple; their goal is to takecare of your child, and hopefully whenyou leave, your children are healthierthan when they came in. There is noquestion that from the volunteers to the(clinical) staff to the doctors, ChildrenÕsHospitalÕs mission is very simple Ð toserve the children and families in thecommunity."

by Janya Marshall, Associate Director forPublic Relations

Tony DavidTony David&

The Restaino Family

Pediatric cardiologist developed love for medicine as a child

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David Hill, M.D.

B.A. Ð University of Tennessee, Knoxville, 1976M.D. Ð University of Tennessee Medical School, Memphis, 1980Internship and first year of residency (general surgery) Ð University of TexasSouthwestern Medical School, Dallas, 1980-82Residency (urology) Ð UT Memphis, 1982-85Fellowship (pediatric urology) Ð Mayo Clinic, Rochester, Minn., 1988-89Other education Ð spent two months working at the Great Ormond Street Hospital inLondon in 1985Family Ð Wife, Carolyn; sons, Matt (deceased) and Reid (age 18)Interests Ð family, hunting, fishing, flying airplanes

Always interested in working with children, David Hill, M.D., considered pursuinga specialty in pediatrics while he was in medical school. But he also knew he had asignificant interest in surgery.

Two of his mentors in Memphis, Drs. Butch Noe and Gerald Jerkins, were pediatricurologists who encouraged him to consider the subspecialty of pediatric urology as ameans to combine his two interests.

A native of Milan in West Tennessee, Dr. Hill most recently practiced in Nashville,and he joined the Children's Hospital-based practice of Drs. Preston Smith and DavidRiden in the spring. The busy and growing practice had a need for an additionalpediatric urologist to better serve this regionÕs children.

Pediatric urologists treat a broad spectrum of medical and surgical problems.Among the most common conditions are hernias and hydroceles, and pediatricurologists also frequently perform circumcisions.

More complex conditions include congenital anomalies such as bladder exstrophy(a rare but very serious condition in which the bladder is outside the body),neurogenic bladder in children with spina bifida, and kidney stones. "WeÕve begunseeing more and more kidney stones in children in recent years," Dr. Hill said.

Some of the conditions require extensive reconstructive surgery. Children withspina bifida, for example, may need reconstructive surgery to help them gain boweland bladder continence.

Dr. Hill is particularly interested in the treatment of hypospadias (an abnormalopening of the urethra on the penis) and kidney tumors (primarily WilmsÕ tumor).Hypospadias is one of the conditions that has been impacted greatly by the currenttrend toward outpatient surgery.

"The move toward outpatient surgery is probably the biggest change in pediatricurology since I began practicing. When I was a resident, surgery for hypospadiasrequired a four-day hospitalization," he said. "Now, itÕs an outpatient procedure.Vesicoureteral reflux also was a three- or four-day stay, and now itÕs usually a 23-hourinpatient stay or even an outpatient procedure."

Outpatient surgery is an important improvement in the health of children for manyreasons. Hospitalization is disruptive to a childÕs routine and emotional well-being,and it is clear that children recover more quickly when in the comfortableenvironment of their own homes.

Working in concert with Drs. Smith and Riden, Dr. HillÕs presence will benefit theareaÕs children by helping to expand the availability of pediatric urological care in theEast Tennessee region.

Physician treats variety of urological needs

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Yvonne A. Bremer, M.D.

B.S. Ð Cornell University, Ithaca, NY, 1994M.D. Ð State University of New York at Buffalo School of Medicine and Biomedical Sciences,Buffalo, N.Y., 1998Internship and residency (pediatrics) Ð Medical College of Virginia Hospitals, VirginiaCommonwealth University Health System, Richmond, Va., 1998-2001Fellowship (pediatric cardiology) Ð Medical College of Virginia Hospitals, VirginiaCommonwealth University Health System, 2001-04 Family Ð Husband, Richard L. Bremer, an internal medicine physician and hospitalist whowill be practicing at Baptist HospitalInterests Ð outdoor activities including skiing, canoeing, hiking, biking and kayaking

Growing up, Yvonne A. Bremer, M.D., knew she wanted to be a doctor. "In high school, Irotated with a pediatrician who was my mentor," she said. "I was goal-oriented early on."When she reached medical school, Dr. Bremer decided to schedule pediatrics as her lastrotation because deep down she knew that was where her interests were. "I wanted to keepan open mind, but nothing else caught my interest."

But she was also looking for a challenge, and she found that in cardiology. "It was veryrewarding and stimulating, as well," she said. She chose to combine the two interests andcompleted her fellowship in pediatric cardiology in June.

A native of Buffalo, N.Y., Dr. Bremer joined the pediatric cardiology practice of Dr. JefforyJennings at Children's Hospital in July. She and her husband, also a physician, found theKnoxville location to be ideal because of their interest in outdoor activities, and they also fellin love with the city when they visited. "We could see living here, raising a family here andworking here," she said.

As a pediatric cardiologist, Dr. Bremer treats children with a wide range of heartproblems, including heart murmurs, chest pain, syncopy (passing out), high blood pressureand congenital heart disease (for example, ventricular septal defects, atrial septal defects,patent ductus arteriosis and pulmonary stenosis). These problems can either correctthemselves, require medication or require surgery; more complicated congenital heartconditions include hypoplastic left heart syndrome, transposition of the great arteries andTetralogy of Fallot that may require multiple surgeries.

"Pediatric cardiology has come a long way over the past 50 years," she said. "We are ableto save so many more lives. But itÕs hard to tell a parent that his or her child has congenitalheart disease, and itÕs even harder to tell a parent the child will need open heart surgery."

Dr. Bremer also noted that pediatric cardiologists are unusual from other pediatricspecialties in that theyalso treat adults who have heart problems that developed in childhood.Adult cardiologists treat adult-onset problems, not problems that appeared in childhood.

She has a special interest in echocardiography, a noninvasive way to study the heart, andis especially interested in fetal echo, which examines the heart of a fetus before birth. Dr.Bremer also is trained in transesophageal echo, which goes through the esophagus to lookbehind the heart. Both of these types of tests have helped to improve care for babies andchildren with heart problems, because the problems can be diagnosed early (in the case offetal echo) and more thoroughly (in the case of transesophageal echo).

Dr. Bremer says she especially enjoys the counseling component of her specialty. "Tellinga parent, Ôhere is the problem, here is what weÕll do,Õ and being able to prepare them,sometimes even before the childÕs birth, about what to expect. ItÕs scary for the parent, butitÕs not the end of the world because there is so much we can do."

Dr. Bremer is looking forward to entering into practice with Dr. Jennings at Children'sHospital and helping provide the specialized cardiology care needed by an increasingnumber of children in this region.

Subspecialist Prof iles

Children’s News...As A Grand Event enters its 5th year

this fall, a new element has been addedto the Grand Legacy program that wassuch a success during last yearÕs event.

Sponsored by ChildrenÕs Hospital andBaptist Senior Services, A Grand Event andits Grand Legacy program have anobjective to bring grandparents andgrandchildren together to create theirhistory, both individually and together. It urges grandparents to commit to takingthe time to record their own legacy -- not only to preserve their legacy for theirgrandchildren but also to bridge thegenerations with the importance of historyand traditions.

Ina Hughs, award-winning columnistfor the Knoxville News Sentinel, will leadthis yearÕs new Grand Legacy program Ð acreative writing workshop that will "Tell The Story Only You Can Tell," whichwill concentrate on family stories andbeliefs that define who we are and what isimportant. Hughs said the session will"use specific assignments to jump-start ourÔmuse,Õ and we will look back to thosepeople and places, events, circumstances,experiences and ideas that shaped us andremain as part of our family lore."

The series will begin September 7, andeach assignment will include examplesfrom other writers as a guideline. In a non-threatening environment, participants willbe inspired and encouraged to begin acollection of story "pictures" and picture"stories" that will become part of a book, agift of life, to those they love and who lovethem. "It is, after all, our stories that bindfamilies together and through which itsmembers live on in the eyes and hearts ofthe next generation," Hughs said.

Hughs, whose career as a writer of non-fiction and family stories spans 35 years,will help participants focus on specificassignments and offer suggestions andinspiration. "DonÕt worry if you are not aÔwriter,Õ" she says. "A writer, justremember, is a person who writes --nothing more, nothing less. Five minutes

in the room, and you will be a writer, Ipromise!"

The final session of "Tell The Story OnlyYou Can Tell" on September 28 will tie allthe elements of each grandparentÕs specialstory together by uniting the writtenstories with photographs from each personillustrating these special life experiences.Neil Crosby, a professional photographerwith Neil Studios in Knoxville, will offertips and techniques for using photographyas a way to enhance the gift of memoriesto children and grandchildren.

Other events for this yearÕs A Grand Event will include:Walk on the Wild SideSaturday, September 11

Take a "Walk on the Wild Side" duringA Grand Event, a fun-filled day at theKnoxville Zoo for seniors and theirgrandchildren from 8 a.m. to noon. This recreational event is a great way forgrandparents to bring their grandchildrento enjoy the zoo, take advantage of seeingthe animal exhibits and, most importantly,exercise. Each Baptist Senior Plus memberwill receive a free gift, a snack bag and a

free blood pressure check, all while theirgrandchildren enjoy a variety of gamesand activities.

Grandparents can sign up withBaptistÕs Senior Plus program and enjoythe zoo for just $2 if tickets are purchasedin advance and $3 if bought at the event.Tickets for accompanying grandchildren12 years and younger are also only $3each, and any other person attendingwith the Senior Plus member will receive$1 off the regular admission price to thezoo (not valid with any other discount orcoupon). For more information, call (865) 632-5170.Walk on the Cultural SideTuesday, October 5

Grandparents and grandchildren cantake a "Walk on the Arts Side" togetherduring a special evening, beginning at6 p.m., at the Knoxville Museum of Art,where there will be opportunities to learnmore about and experience a variety ofcultural arts experiences from throughoutKnoxville and East Tennessee.

More information about ÒA GrandEventÓ is available on www.etch.com.

A GRAND EVENT!Creative writing element introduced for 5th annual program

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The 20th annual Fantasy of Trees tobenefit ChildrenÕs Hospital is fastapproaching. This year the event will takeplace November 24-28 at the KnoxvilleConvention Center and will feature thetheme, "Where Your Heart Finds Christmas."

Co-chairs Becky Vanzant and KarenWaldbauer, assistant co-chair LindaRedmond and dozens of volunteer leadersare planning many new activities for thisyearÕs 20th anniversary show.

Some of the new childrenÕs activitiesinclude holiday aprons, necklaces, woodenornaments and tote bags, while a 20-foot-long, six-foot-tall Holiday Mosaic featuringa festive holiday scene will take shape

throughout the five-day event as childrenadd their artwork to the unique display.

Adults and children alike will enjoy anightly Christmas tree lighting ceremonyas well as three new designer categories,new holiday shops and a new "Hobbies forthe Holidays" area from Scripps Networks.

Net funds from the 2004 Fantasy ofTrees will be placed in the Open DoorEndowment Fund. This fund will providegreater security to the families of EastTennessee by ensuring the hospitalALWAYS is able to provide care to childrenwhose families cannot afford the care theyneed. With an endowment fund, only the

income is spent, while the principal remainssecure and untouched -- thereforeguaranteeing that care is always availableto the uninsured children of East Tennessee.

Volunteers are needed to help at thefive-day holiday event, and sponsors anddesigners are currently being recruited.

For more information about the 2004Fantasy of Trees and how to volunteer,contact the ChildrenÕs Hospital VolunteerServices and Resources Department at(865) 541-8385, send an e-mail tofot@etch.com, or visitwww.etch.com/fantasy.cfm.

by Suzann Hollingsworth, student intern

Planning continues for 20th annual Fantasy of Trees

Children’s Hospitalhonors volunteers

The success of ChildrenÕs Hospital is due in large part to the countless hours ofhard work by the hospitalÕs volunteers.Their smiling faces can be foundthroughout the hospital assisting with anumber of duties, from helping in the GiftShop to pushing the video and toy cartsby patientsÕ rooms.

Four of the hospitalÕs volunteers wererecently honored for their dedication andhard work during the VolunteerAppreciation Luncheon April 17 at theKnoxville Convention Center.

The Anne D. Regas Award, named inmemory of the founder of the ChildrenÕsHospital Auxiliary, was awarded to NancyFinley for her exemplary service andcommitment in volunteer service. Finleybegan volunteering in 1993 on the toy cart

and then took on additional duties in theHematology/Oncology Outpatient Clinicin 1997. In the past, she has served on theAuxiliary board and numerouscommittees and has assisted with manyfund-raising efforts. She currently chairsthe Board of Directors for HOPP(Hematology/Oncology Patients andParents support group) and supportsCamp EagleÕs Nest.

Tom Elsea received the Edna H.Duncan Award for professional andpersonal excellence during his years ofvolunteer service. This award was namedin memory of a 10-year volunteer whodonated more than 25,000 hours of serviceto ChildrenÕs Hospital. Elsea began hisvolunteer service in 1993 at the Fantasy ofTrees and became a volunteer at thehospital in 2000. Today you will find himat ChildrenÕs two days a week, one daygreeting visitors at the Information Desk,the other day staffing the video cart. Inthe last four years, he has accumulatednearly 2,000 hours of service.

The 24 Karat Award, given to avolunteer who illustrates enthusiasticparticipation, was presented to KattySmith, who volunteers with the

Information Desk. She startedvolunteering in 1998 with the video cartand in the Hematology/OncologyOutpatient Clinic. Smith can also befound volunteering for the Fantasy ofTrees, the ChildrenÕs Miracle NetworkTelethon, and the ChildrenÕs HospitalInvitational Golf Tournament, as well asleading preschool groups on tours of thehospital. She also serves as ProgramChair of the ChildrenÕs Hospital Auxiliary.

Susan Bascom received the 2004Shining Star Award for dedication toevening and weekend service. Bascomstarted volunteering at ChildrenÕsHospital in August 2002 and is anAuxiliary member. She now leads a localgroup of volunteers with HOPE, anational organization, who have adoptedthe video cart service. She is in charge ofrecruiting, training and scheduling HOPEvolunteers to staff the cart. When shebegan this effort, she noticed there was aneed for more volunteers on Sundays.Presently, she and the other HOPEvolunteers can be found working the carton Sunday afternoons and Mondayevenings.

by Suzann Hollingsworth, student intern

One of the AuxiliaryÕs most popular services for patients atChildrenÕs Hospital is undergoing a major change. The "videocart" of loaned movies will change to a new closed-circuitdigital television system in the hospitalÕs new patient rooms. In anticipation of this growth and change, the Auxiliary hasdiligently raised funds through the last few years, and on May18, the group presented a check for $75,000 to the hospital.

According to Auxiliary President Nancy Mason, this is thelargest single contribution ever made to ChildrenÕs Hospital bythe Auxiliary. "The Auxiliary funded the establishment of thevideo lending library some 12 years ago, following a gift from a

hospital supporter which placed VCRs in each patient room.We have continued to purchase videos and loan them topatients and families in the hospital for more than a decadenow, all free-of-charge," Mason said.

Fund-raising efforts have included the AuxiliaryÕs annualholiday greeting card sale, plant sales and other special events.

With this substantial donation from the Auxiliary, ChildrenÕsHospital will be able to offer pre-programmed movies 24 hoursa day to patients, as well as provide educational programmingfor parents regarding care for their childÕs injury or illness.

by Rupal Mehta, student intern

Auxiliary gives record donation to Children’s Hospital

Award Winners left to right: Tom Elsen, Katty Smith, Nancy Finley and Susan BascomAward Winners left to right: Tom Elsen, Katty Smith, Nancy Finley and Susan Bascom

ChildrenÕs Hospital is in the midst ofmajor construction as a 115,000-square-foot, seven-story patient tower is beingadded at the corner of Clinch Avenueand 20th Street. After working aroundunpredictable spring weather, the toweris now fully enclosed, and work isunderway on the interior of thebuilding. After the tower is complete,the hospital will undergo renovation onmost of the existing facility. Therenovation will continue untilSeptember 2005, when the entire three-year project should be complete.

The hospital hopes to start movinginto the following spaces in the newtower by fall 2004: ¥ New area of the EmergencyDepartment, Neurology and Phlebotomy

open in August and September¥ New areas of Second and Thirdinpatient medical floors open inSeptember and October ¥ New area of Fourth surgical patientfloor opens in October¥ New Kitchen and Dining areas openin October and a new servery area opensin December¥ New Pediatric Intensive Care Unitopens in November ¥ New Post-Anesthesia Care Unit andEndoscopy Suite open in November.

The hospital is also adding an in-house television system, morecomfortable family areas and a laundryarea for patient families that will be inplace by November.

An Expansion/Renovation Timeline

is available on our website atwww.etch.com/attractions.cfm. Click on"WeÕre Growing."

This $31.8 million expansion andrenovation of ChildrenÕs Hospital willallow more space and comfort forpatients and families. Features of theexpansion include 95 private patientrooms with full baths, an expanded 13-bed Pediatric Intensive Care Unit and anexpanded 44-bed Neonatal IntensiveCare Unit. The hospitalÕs licensed bedswill increase from 122 to 152, and alarger Emergency Department willincrease from 18 to 35 beds. In addition,the Surgery and Radiology departments,cafeteria, support services and storagewill be expanded.

by Amber Birdwell, student intern

Medicine specialists, started PediatricAnalgesia and Sedation Specialists, PLLC(PASS). PASS provides the pediatricsedation service at ChildrenÕs Hospital,offering improved patient safety and afamily-centered, consistent sedationpractice in strict compliance with policiesof ChildrenÕs Hospital and the JointCommission for the Accreditation ofHealthcare Organizations.

The service is available Mondaythrough Friday from 7 a.m. to 4 p.m. forpatients undergoing certain tests in theRadiology Department (especially CTand MRI scans that require children toremain still for extended periods of time),as well as for patients in theHematology/Oncology Outpatient Clinicand in the Gastroenterology Lab.

The need for sedation depends on theage of the child, the length of theprocedure and the degree of discomfort itmight cause, Drs. Connors andLembersky explained. Any child underage 5 will need sedation for an MRIbecause the test requires the child toremain still for about 45 minutes. Anolder child or teen probably can undergoan MRI without sedation but may need itfor an uncomfortable procedure in the GILab.

PASS utilizes some newer sedationmedications that may be administeredonly by certain specialists. These drugsare more effective and safer but areadministered in a different manner,making it necessary for a doctor solelyresponsible for sedation to be present.The drugs work quickly and wear offquickly and also can put patients into adeeper state of sedation for a shorteramount of time. This enables the child tobe motionless for the test. While anysedation ensures the child doesnÕtremember the discomfort of a test, amilder level of sedation would notnecessarily keep the child still enough toensure the most accurate test results.

In the past, sedation drugs were oftenadministered by the physicianperforming the test, as the test was beingconducted. Now, a sedated patient isunder the eye of the "sedation doctor"while a second physician focuses entirelyon conducting the test, ensuring a safertest for the child.

Pediatric hospitals like Children's areutilizing these new services on anincreasing basis to improve care for their

1110

patients. The new service also addressesa change in the Joint CommissionÕscredentialing process that requireshospitals to address sedation services.

Physicians who are members ofPediatric Analgesia & SedationSpecialists, PLLC, the service offered atChildren's Hospital, are: J. MichaelConnors, M.D.; Robert Lembersky, M.D.;Lise Christensen, M.D.; and JohnWilliams, M.D. These PediatricEmergency Medicine specialists alreadywere certified to perform sedation in theEmergency Department but now canextend their services to other areas of thehospital. They have performed morethan 400 sedation procedures just sincebeginning the service at the start of 2004.

Drs. Connors and Lembersky havecommunicated with and/or visitedseveral sedation services in other areas ofthe country and have researchedprotocols to ensure that the service atChildren's Hospital performs sedation inthe best manner. After attending a recentconference on the subject in Denver, Dr.Connors noted,"We were delighted to seethat our service at Children's Hospital isfar more advanced than most otherpediatric sedation services around thecountry."

State children’s hospitalsform alliance

East Tennessee ChildrenÕs Hospital isone of four Comprehensive RegionalPediatric Centers in Tennessee thatrecently joined forces to form a newadvocacy group for pediatric healthcare. Called the ChildrenÕs Hospitals Allianceof Tennessee, or CHAT, ChildrenÕs isjoined in the new organization by LeBonheur ChildrenÕs Medical Center inMemphis, TC Thompson ChildrenÕsHospital in Chattanooga and VanderbiltChildrenÕs Hospital in Nashville.

The goal of the alliance is to addressgaps in health care for children caused byinadequate state laws and complexities inthe health insurance system. Tennesseehas ranked for many years near thebottom for childrenÕs health care undersome criteria.

But according to Jim Schmerling, CEOof Vanderbilt ChildrenÕs Hospital andchair of CHAT, TennesseeÕs new car seatlegislation is one example of how thatwill change. Tennessee ranked 50th out of

50 states in compliance with car seatlaws, but now the new law is one of themost stringent in the country.

The Alliance believes promotingresearch, formulating new policies, andtraining health care professionals willallow CHAT to foster development ofchildrenÕs hospitals and better promotethe health and well being of children inTennessee. CHAT will work with theTennessee Legislature on such issues asTennCare, childhood immunization, childpassenger safety, healthy food vending inschools and use of lottery funds to helpkeep children healthy.

Mary Nell Bryan has been namedCHAT President and CEO. She has anextensive background in legislation andgovernment relations and has spent 15years lobbying with a concentration inhealth care and not-for-profit issues.Bryan will advocate on the state andnational levels for the interests and policypositions to drive the quality of childrenÕshealth care. SheÕll also develop andimplement programs and services of theassociation.

CHATÕs Board of Directors is made upof two representatives from each hospital;ChildrenÕs HospitalÕs representatives areBob Koppel, President and CEO, and Dr.Joe Childs, Vice President for MedicalServices.

Koppel said the alliance will enablethe four hospitals to work together andwith other agencies to better address theneeds of children. "Whether it relates tostate or federal legislation, TennCare orlegal issues, for each of us, itÕs about ouryoung patients, their families and theirquality of life," he said.

All four CHAT member hospitals arecertified as Comprehensive RegionalPediatric Centers, which is the highestlevel of certification for pediatric care inthe state of Tennessee. Each of thepediatric institutions is equipped to carefor seriously ill children in a uniquepediatric environment separate fromadult care areas. Comprehensive centersalso provide training to help communityhospitals meet pediatric medicalrequirements.

by Kathryn DeNovo, student intern

Relocation, construction continue at Children’s Hospital

New sedation service offers greater safety, comfort to patients In early 2004, a pediatric sedation

service was created at ChildrenÕsHospital to offer greater safety andcomfort for patients for medicalprocedures and tests when general

anesthesia is not necessary.More hospitals across the country are

developing pediatric sedation servicesdue to an increasing number of childrenrequiring sedation for painful or lengthy

procedures and stricter requirements forproviding sedation.

At ChildrenÕs Hospital, Dr. MickConnors and Dr. Robert Lembersky, bothboard certified Pediatric Emergency

13

BOOMSDAYTraditionally, Journal Broadcast Group

holds its Star 102.1 Boomsday celebrationon Labor Day (Monday), but this year theevent has been moved to Saturday,September 4.

Star 102.1 Boomsday is the largestLabor Day weekend celebration in theSoutheast. Over 250,000 guests are drawnannually to Neyland Drive on the banksof the Tennessee River for a day of food,entertainment and fun. After the sun sets,a spectacular fireworks show is presentedfrom the Henley Street Bridge.

Volunteers will be at the event to sellsoft drinks to the thirsty crowd to benefitChildrenÕs Hospital. Last yearÕs eventraised more than $12,000.

Call (865) 541-8567 to volunteer.

TUNNEL THUNDER VITunnel Thunder VI will take place

September 11 at Jaycee Park in Clinton.The ride is a poker run to the CumberlandGap Tunnel and then back to the park.The first bike out will be at 11 a.m., andthe last bike out at noon. Cost is $10 perperson, and lunch will be provided at theend of the ride. The event also features asilent auction, door prizes and a $250grand prize. The event is presented by theVolunteer Road Riders. For moreinformation, call the Children's HospitalDevelopment Department at (865) 541-8441.

WAR OF THE WINGSThis event gives the term "hot wings" a

whole new meaning. The University ofTennesseeÕs Kappa Delta sorority willpresent the 12th annual "War of the Wings"on Saturday, September 18, before theTennessee-Florida football game. Eventvisitors can vote for their favorite wingsprepared by local restaurants and UTfraternities.

Football fans are encouraged to stop byFiji Island any time three hours before the8 p.m. kickoff and enjoy "All You Can EatWings." In 2003, the "wing fest" raisedmore than $3,000 for ChildrenÕs Hospital.Tickets are $5 in advance and $6 on gameday. For tickets or more information,call (865) 541-8437.

OAKES FARM CORN MAZEWhat do you get when you combine 12

acres of corn stalks, 5.3 miles of trails, over960,000 stalks of corn, and three differentmazes? Fall family fun at the Oakes FarmCorn Maze in Corryton, located at 8240Corryton Road. And for a few weeksaround Halloween when the mazebecomes "haunted," Oakes Farm donatesproceeds from the maze to ChildrenÕsHospital. This year, those dates areOctober 6-30 (excluding Sunday nights).

During the day, the maze is a funchallenge for the whole family, while atnight, it becomes a haunted adventureamid the cornstalks. In addition to themaze, visitors can take a hayride, strollthrough the pumpkin patch, and enjoymany other fall activities.

For more information about visiting themaze, call (865) 688-6200 or visitwww.oakesfarm.com. If you are interested involunteering with the "haunted" cornmaze, call (865) 541-8745.

GIBBS HAUNTED FORESTFamilies can enjoy a safe and spooky

night of fun at the Gibbs Haunted Forestin late October. The haunting begins theweekend of October 15 and continuesthrough Halloween night, Sunday,October 31; the event opens each eveningat sundown and closes at 11 p.m. on mostnights. On the walking tour of theHaunted Forest, visitors will encounter ahaunting collection of monsters, ghosts,goblins and ghouls. There is also achildrenÕs Halloween activity area foryounger visitors to enjoy while olderchildren and adults tour the forest.

The Haunted Forest has been atradition for Susan and Robby Taylor overthe last 10 years; they help sponsor theevent to raise money for ChildrenÕsHospital in honor of their daughterStephanie, a long-time patient. In 2003,the event raised more than $8,000 for the hospital.

Admission to Gibbs Haunted Forest is$7, and children 6 and under are admittedfree; all proceeds benefit ChildrenÕsHospital. For more information on theevent, call (865) 541-8437.

NEILL SANDLER FORD LINCOLNMERCURY SALE

If youÕre looking for a new vehicle,consider buying from Neill Sandler FordLincoln Mercury on the Airport MotorMile and benefit ChildrenÕs Hospital. Theauto dealership began a yearlong fund-raiser for the hospital in May and willdonate $50 to the hospital after the sale ofnew or used vehicles through March 8,2005.

Proceeds from this program will bepresented at TKÕs Breakfast for ChildrenÕsHospital on March 12, 2005

For more information, contact GeneWishon or Michael Borkman at NeillSandler Ford Lincoln Mercury at (865)970-2500 or the ChildrenÕs HospitalDevelopment Office at (865) 541-8437.

by Casey LaMarr, student intern

U P C O M I N G E V E N T S T O B E N E F I T C H I L D R E N ’ SMark your calendars now for several upcoming events to entertain families and benefit ChildrenÕs Hospital.

Thanks to the generous people of East Tennessee who host and participate in these events, ChildrenÕs Hospital can continue to provide the best pediatric health care for all the children of this region.

Dates to RememberUpcoming events to benefit Children’s Hospital

AugustKaraoke in the Park

August 28Sons of Thunder Fun Ride

August 28SamÕs Club Golf TournamentAt Cedar Hill in Lenoir City

August 28

SeptemberBoomsday

September 5Tunnel Thunder Ride

September 11

OctoberOakes Farm Corn Maze

October 6-30 (except Sundays)Gibbs Haunted Forest

October 15-31

NovemberTodd Helton Celebrity Golf Tournament

November 8Tino Sale

November 10-11Fantasy of Trees Gala

November 23Fantasy of TreesNovember 24-28

For more information about any of these events, call (865) 541-8441 or visit our Web site at

www.etch.com and click on “Coming Attractions.”

12

Estate Planning...ÒYour will, the foundation of your estate planÓ

IncludeChildren’s Hospitalin your estate plans.Join the ABC Club.For more information,call (865) 541-8441.

Please send the free brochure titled ÒPersonal RecordsÓ

Name______________________________ Address__________________________________________

City___________________________ State_______ Zip_____________ Phone#(______)___________

r Please call me at the above phone number for a free confidential consultation concerning planned giving.

r Please send me more information about deferred giving.

r I have already included ChildrenÕs Hospital in my estate plan in the following way:

__________________________________________________________________________

r Please send me information about the ABC Club.

ChildrenÕs Hospital Development Office (865) 541-8441

Making a will is one of

the most important activities

you will ever undertake.It need not be difficult or unpleasant,

but it is very important. A will is the onlylegal document that records your finalwishes. Your family members will alreadybe under a great deal of stress simplybecause you have passed away, and youcan significantly reduce their burden byleaving a properly executed will.

People have many excuses for notplanning or writing a will. Someexpress concern over paying a lawyerto prepare their will. This should not bea consideration; the few dollars youspend on professional fees for aproperly prepared will are trulyminiscule compared to the expense andheartache of failing to plan. Bypreparing a will, you are telling thoseyou leave behind how to care for yourminor children and how to dispense ofall you have accumulated during yourentire lifetime. Putting yourinstructions in a valid will eliminatesany room to speculate about yourintentions.

You can save time and money byfocusing your efforts and "doing yourhomework" before visiting with yourattorney.

1. Sit down with your spouse andhave that difficult discussion aboutwho should raise your children if you

some time with your executor to discussyour wishes and make certain they willagree to serve.

5. Write all of this informationdown.

6. Select an attorney. Choosesomeone who has experience in estateplanning, and make an appointment.Feel free to discuss fees in advance, andfollow through by mailing the attorneya copy of your information well inadvance. The attorney will appreciatedealing with a well-prepared client andwill also be glad not to waste timeserving as a "referee" between you andyour spouse on important matters suchas custody of children and selection ofan executor.

7. After your will is finalized, sign it,give a copy to the executor and keepthe original in your safe deposit box.Then sit back and enjoy the securitythat comes from knowing you havemade all the necessary arrangements toprevent unnecessary expense and avoidfamily strife after you are gone.

For more information on wills andestate planning, including a copy of ourfree planning booklet "PersonalRecords," please send your name andaddress to us via the reply form below.Or you may email David Rule, Directorof Development, at dsrule@etch.com or Teresa Goddard, CFRE, SeniorDevelopment Officer, attgoddard@etch.com, or call them at (865) 541-8441.

should both die together in an accident.Then both of you should meet with thepeople you select to make certain theywill agree to accept the responsibility.Choose an alternate in case your firstchoice is deceased or unable to takeyour children. Specify who is tomanage any money left for yourchildrenÕs benefit and consider havingsomeone separate involved withoverseeing those funds.

2. Pull together a listing of thepeople to whom you will give yourbelongings. List their name, currentaddress and phone number and theirrelationship to you Ð son, daughter,niece, nephew, grandson orgranddaughter, neighbor, friend. Listwhat you would like them to have andbe specific.

3. List all of your assets: house, land,securities, retirement plans, IRA, jewelry,art, collectible items, bank accounts,vehicles and other personal property.Make a list of your favorite charities.List the location of your safe deposit box.Consider attaching a letter to the willindicating any wishes you may have fora funeral and the location of cemeterylots and information about any prepaidfuneral arrangements you have made.

4. Choose an executor. It is especiallyimportant to determine which of yourrelatives or friends is wise and honestenough to serve as executor of yourestate. This is the person whom thecourt will hold accountable for carryingout your wishes as listed in your will.You and your spouse should spend

available that will hold a child whoweighs more than 100 pounds, regardlessof height. Currently, there is only onebooster seat that is designed for childrentaller than 4 feet 9 inches (it is intendedfor children up to 5 feet tall). It isavailable only at Babies R Us, and weunderstand the model may soon bediscontinued.

If your child weighs more than 100pounds or is between 4 feet 9 inches and5 feet tall, you need to follow the boosterseat manufacturersÕ guidelines.Remember that the law was created forsafety, not for punishment. So if yourchild is under age 9 but is above theweight and/or height guidelines forbooster seats, use the following tips toensure your child is safe if you choosenot to put him or her into a booster seat:¥ The seat belt should be positioned overthe child's pelvis and across thecollarbone and sternum (the child mustride in a seat with both a lap andshoulder belt).¥ Have the child sit closer to the seat beltbuckle so that the shoulder strap will notgo across his or her neck.¥ The childÕs legs should bendcomfortably at the edge of the carÕs seatwhen he or she is sitting all the way backin the seat.

If you have additional questions orconcerns regarding this issue, please visita car seat checkpoint or contact your localpolice department.

Q : What are some common mistakesthat someone should avoid with carsafety restraints?A : The following common mistakes caneasily be avoided by taking extra timeand care in placing your children in arestraint seat:

1. Car seat is too loose in the seat.2. The harness is too loose on the child.3. The infant has been turned forward

facing too soon.4. The rear-facing seat has not been

placed at a 45-degree angle.5. The retainer clip is used incorrectly.6. The harness straps are placed

through the wrong slots.7. Not using a booster seat with a child

Q : Do you recommend secondhand carseats?A : Here are some things that you shouldconsider if it is absolutely necessary touse a secondhand car seat: ¥ Is the seat more than 10 years old?Look on the label for the date it wasmade. If it is more than 10 years old, itshould not be used. Some manufacturersrecommend that car safety seats only beused for 5-6 years. Check with themanufacturer to find out the companyÕsrecommendation.¥ Was it ever in a crash?¥ Does the seat have any visible cracks inthe frame?¥ Are there any parts missing? ¥ Has the seat been recalled?If you answered yes to any of thequestions above, you should NOT use thesecondhand car seat.Other questions to consider include: ¥ Does it have a label with a date ofmanufacture and model number?¥ Does it have the original instructions?¥ Is it less than 1 year old?

If these questions are not clearlyanswered, I would recommend getting anew seat. If you have questions orconcerns, visit a Safety Seat Checkpointor call the local law enforcement agencyin your area to have the seat inspectedand properly installed before you beginusing it.

Q : What if my children donÕt like safetyseats or safety belts?A : It really is not their choice. Childrensimply canÕt understand the risks of amotor vehicle crash and the benefits thesedevices provide. As an adult and parent,you must insist on children and allpassengers using proper restraints fortheir own safety and protection. DonÕtstart the car until everyone (includingyourself) is buckled up. If you make it ahabit and start practicing when yourchildren are young, buckling up andgetting in a booster seat will not besomething "odd" or "not coolÓ; it willsimply be part of the ride.

Trust me, if you havenÕt seen someoneinjured in a motor vehicle crash, youdonÕt want to. Buckle up and be safe.

LetÕs all work to lower the highmortality on Tennessee roads. Parentsshould start the trend of seat belt wearingby setting an example for the entirefamily, friends, and neighbors. Make it aroutine for everyone in the car to beproperly restrained and use car seats,booster seats and lap shoulder belts.Make sure you use them properly. If youdonÕt make sure your child is safe whenriding in a car or van, unfortunately yournext trip with your child might be to ahospital emergency department.

Compiled by Janya Marshall, Associate Director for Public Relations

14 15

Parents, grandparents and child care professionals place children in cars, vans and other vehicles every day.Where in the car should children of different ages ride? Should children be in car seats, booster seats or seat belts?

Many caregivers have had training inthe appropriate way to install a car seator a booster seat, while others try tofollow the instructions on the box, andothers remain unclear on these issues.Not only do many people not understandthe proper way to restrain a child, nor theimportance of doing so for a childÕssafety, but caregivers of children shouldalso know that the current state ofTennessee law on child restraints ischanging.

Dr. Mick Connors, EmergencyDepartment physician at East TennesseeChildrenÕs Hospital, offers the followinginformation on the proper installationand importance of using a childpassenger safety seat and the newTennessee law on this important childsafety issue.

Q : Why is the current law changing?A : The old law was outdated and not accurate to current safety standards. Thestate of Tennessee and its lawmakers areworking hard to keep our children safer.The current changes basically followedthe child passenger safetyrecommendations of the NationalHighway Traffic Safety Administration.

Q : What are the dangers of not placing achild in a car or booster seat correctly orin a restraint completely? A : More children in the United States arekilled and injured in car crashes thanfrom any other cause of injury, and trafficcrashes are the number one killer ofchildren ages 1-5. Even with currentlegislation related to car seats, more than1,000 infants and toddlers die andanother 40, 000 are seriously injured eachyear because they aren't properlyrestrained, according to the NationalSafety Council. Shockingly, TennesseeÕsfatality rate is 50 percent higher than thenational average. To me and other

Seat belts,booster seats and car seats: Do you know the law?

who is age 4-8 and less than 5 feet tall (regardless of weight).

8. Using a seat that has been recalled or is outdated.

9. A child under the age of 12 riding in the front seat.

10. The belts positioned incorrectly on the child; remember "belts over bones."

If you still have questions aboutproper installation, consider going to asafety seat checkpoint.

Q : How can a caregiver find a safety seatcheckpoint?A : Checkpoints, which are free, areorganized twice a month by the SAFEKIDS Coalition of the Greater Knox Areaand the Knoxville Police Department.They are staffed by NHTSA-trained andAAA-certified child passenger safetytechnicians who will check theinstallation of your seat(s) and teach youproper installation techniques.

Checkpoints are offered the FIRSTSaturday of each month at RodgersCadillac at 8360 Kingston Pike inKnoxville. Hours are 9 a.m. to noon.Remaining dates for 2004 are July 3,August 7, September 4, October 2,November 6 and December 4.

Checkpoints are offered the SECONDSaturday of each month at Rusty WallaceHonda on Callahan Road in Knoxville.Hours are 10 a.m. to 1 p.m., andremaining dates for 2004 are July 10,August 14, September 11, October 9,November 13 and December 11.

For additional information, call theSAFE KIDS office at (865) 215-5175 or theKnoxville Police Department at (865) 215-8633.

If you live outside the Knoxville area,check with your local police departmentfor assistance.

Q : ArenÕt car restraint systems expensive?A : The cost of a new child restraintdevice varies according to type, modeland place of purchase. The leastexpensive devices are the nonconvertibleinfant restraint devices and the harnessrestraint device. In general, the morefeatures a device has, the more it willcost, although a higher price does notnecessarily mean a safer device. I wouldrecommend a car seat with a five-pointrestraint. These generally range from $40to $100.

Booster seats needed for children ages4-8 can range in price from $15 to $50 andare available at most area retailers such asWal-Mart, Babies R Us and Toys R Us.Visit the American Academy ofPediatrics' Car Safety Seats Guide atwww.aap.org/family/carseatguide.htm for adetailed explanation about seats and a listof available seats, including type, priceand weight/height the seat willaccomodate (scroll down the page to findthe list).

These costs are tiny compared to themedical costs and the pain and sufferingof a child who is improperly restrainedand who suffers an injury in a motorvehicle crash.

pediatricians, it is very simple: putting achild properly in a car or booster seat canbe the difference between life and death ifthe child is involved in a wreck.

Q : What are the specific changes to thechild passenger restraint law inTennessee?A : Here are the law's provisions: ¥ Any child under 1 year old (even if heor she weighs more than 20 pounds) orany older child weighing 20 pounds orless must be in a rear-facing car seat andshould be placed in the back seat, ifavailable.¥ Children should be in car seats untilthey are 4 years old and weigh 40pounds. Again, they should sit in theback seat. ¥ All children ages 12 and under shouldride in the back seat (when available).¥ Children ages 4-8 who are less than 5feet tall, regardless of weight, arerequired to ride in a belt-positioningbooster seat, located in the rear seat (ifavailable). Previously, children ages 4 andolder were not required to be in a boosterseat.¥ Every child and teenager under age 18must use a seat belt.¥ If you need to take the child out of therestraint, you must stop the vehicle.¥ The driver of the car is responsible forensuring children under age 16 areproperly restrained. If a childÕs parent orguardian is in the car but is not thedriver, the parent or guardian isresponsible, rather than the driver. Finesare issued for violation of the laws.

Q : What are the basic types of childrestraint devices?A : There are four types of child restraintseats:¥ Infant seats Ð These should be usedfrom birth until 12 months to reduce therisk of cervical spine injury in the event

of a crash. Any child under 1 year old(even if he or she weighs more than 20pounds) or any child weighing 20pounds or less must be in a rear-facingcar seat.¥ Convertible seats Ð These seats can beused from birth until about age 4, or aweight of about 40 pounds. Infants ridebackward; later the seat can be convertedinto a forward-facing seat for toddlers.¥ Toddler seats Ð This type of seat is usedfor children 20-40 pounds who are able tosit without support. The childÕs sizeshould be such that the ears are belowthe top of the seat and shoulders arebelow the seat strap slots. ¥ Booster seats Ð These seats are usedwhen a child has outgrown a toddler orconvertible seat but is still too small to fitproperly in a vehicle safety seat.All of these seats are required by law inTennessee as of July 1, 2004.

Q : Why booster seats? Are they really soimportant that the state made their use alaw?A : Absolutely. The reason for boosterseats is simply to better position the childin his/her seat belt. Children less than 5feet tall, when wearing their seat belt,will typically have the shoulder portionacross their neck and the lap portion ofthe belt over their belly button area. If thebelt is in this position in a crash, the childcould suffer severe neck injuries andinternal abdominal and spine injuries.This common injury is called "lap beltsyndrome." By using a booster, theshoulder strap will go across the chestand the lap belt will be over the child'sbony pelvis, thus preventing theseserious injuries.

Q : What if I canÕt find a booster seat thatwill accommodate my larger child?A : This is a concern for many parents.Unfortunately, there is NO booster seat

Dr. Mick Conners