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Safe and Sound

Cathleen Caltabiano sees the world differently from most parents.

“You know that movie where Haley Joel Osment says, ‘I see dead people’?” she says during a break from her duties as a nurse practitioner at Upstate Medical University’s Pediatric Surgery Clinic. “Well, I see trauma.”

A nursing professional since 2003, Caltabiano has seen a multitude of trauma injuries. Her experiences have influenced her parenting, and have inspired her to go to events and educate people about preventing accidents. “I’ve been going out into the community to health fairs, school, and things like that—talking about trauma.”

The move toward public education was a natural one. “What I like about nursing is being able to make an impact on patients and their families,” Caltabiano, 38, says. “A lot of times when patients come in, it’s for things that they didn’t expect to happen. They are accidents, but a lot of these accidents are truly preventable. People don’t know how to prevent them, or they don’t know things are dangerous.”

Certain injuries are more common in some counties than others. Caltabiano’s office, the Division of Pediatric Surgery and Pediatric Trauma, keeps track of that data. “The more rural counties, like Oswego County, have more ATV accidents,” she says. “Whereas in Onondaga County we have more pedestrian accidents.”

With this information, Caltabiano and her colleagues can prepare more precise information and programming for parents and first responders, so people know what to look out for. “In Syracuse, it may be pedestrian safety. We may talk to kids about looking both ways, encouraging parents to be looking when their children are outside.”

Despite efforts at the state and national levels to legislate safety measures over the past 30 years (think bike helmets and seatbelts), Caltabiano—herself a survivor of a serious childhood head injury—says the need for this kind of information might be greater than ever before.

“There are new concerns that were not here when we were little,” she says. “Did we even have ATVs? No. Was there the distraction of texting and things like that—texting and driving? No. Speed limits have changed. And we have learned a lot from the injuries we saw in the past. We can do things more safely now, like with car seats. We can make them safer, we can position them safer.”

That babies are now required to face backward in their car seats is one example of a change prompted by accident data. Doctors documented evidence that children in rear-facing car seats suffered less-severe injuries in accidents than those facing forward.

Caltabiano recognized the need for more public education early in her career. At one point, half of the children in Upstate’s pediatric trauma unit were injured in a mishap with a lawnmower. “People seem to think that lawnmowers are not that big a deal, but they really are. A child can lose part of a foot or an arm. On a riding mower, they can hit a rock and fall off.”

These days, “distracted parenting” is a frequent topic in Caltabiano’s discussions. Electronic devices are too often diverting parents’ attention. “If you’re going to take your child to a pool, or a playground, those are the times when the phone needs to be put away,” she says. “Monitor your child.”

Trauma is the No. 1 cause of death nationwide for children ages 1 to 18. “One child dies every hour from a pediatric trauma,” she says. “People tend to think, ‘Oh, they bump their head, they’ll go home and be fine.’ But it’s bigger than that. There are lots of kids who get head injuries and die or are disabled from their injury. Those are the kinds of things we want to prevent.”

Caltabiano’s job has made her a more vigilant parent to her children—Michael, 9 and Emma, 2. She and her husband, William, live in Eastwood, and they are the kind of parents who always stay for the parties (“I don’t care how many adults are there.”). And she doesn’t allow trampolines (“There’s no way, ever.”).

“There are things they want to do that they know are just off the plate. Trampolines are one of them. With other things, we do them, but do them in a way that’s safe. For example, my daughter is 2 and she has never been on her tricycle without a helmet. They don’t question it.”

Ultimately, Caltabiano believes her children are learning important life skills. Her son went with her to an event on bike helmets, and he felt proud to share life-saving information with other kids. “He likes that part of it. He doesn’t like the ‘We’re not getting a trampoline’ part,” she says with a laugh.

Can parents be too trauma-
phobic? “That’s a tough balance because I want my child to be able to go out and safely make decisions on their own. But then again, I want to make sure I’m watching for things that could happen injury-wise. So, I look for other ways to teach responsibility.”

And not every danger is foreseeable. “Accidents happen,” Caltabiano says. “Kids are going to run through the yard, trip and fall. You can’t prevent that. But there are certain things you can prevent. That’s what we’re trying to focus on.”

If an accident does happen, Caltabiano and her colleagues are prepared to give the best care possible. Upstate was recently verified as a Level I Pediatric Trauma Center by the American College of Surgeons. As such, it is considered a comprehensive, regional resource capable of addressing every aspect of trauma care.

“We want the community to see us as a source of information, not just the place you go when you’re hurt,” Caltabiano says. Upstate will soon launch a pediatric trauma web page, enabling organizations and individuals free access to safety information. Groups can also request presentations from Caltabiano and others in her office.

“We are trying to get this information out to local pediatricians, police departments and fire departments so that they can better gear their education to families,” she says.

Her division looks at the trends in how children are getting hurt and  spreads the word. The message: “This is what we’re seeing. We want to help you. So, what can we do together to help prevent some of these injuries?”

Hazards by Season

As seasons change, the injuries that health care practitioners see in children change, too, says Cathleen Caltabiano, nurse practitioner with Upstate Medical University’s Division of Pediatric Surgery and Pediatric Trauma.

“As soon as spring hits, we prepare for the children who are going to fall out of windows. People open their windows after being cooped up all winter, and they don’t think to check their screens,” she says. “The nice weather brings more bike and pool accidents. With toddlers, we see a lot of things with carrier car seats. They can fall out of them. Those things we see all year.”

In the fall, back-to-school means more playground incidents and bus-stop mishaps. “The monkey bars are huge,” she says. “Kids fall off of them. And a lot of people don’t realize that kids don’t really have the physical strength to get across them.”

Halloween is another busy time for the pediatric trauma department. “Kids are outside in the dark, everybody’s dressed in a costume, they can’t see well. The most common injury results from kids being out in the dark and (drivers) can’t see them, so they get hit (by cars).”

Fall also means the start of two of the most aggressive scholastic sports: football and soccer.

Local doctors and coaches have gotten more detailed, useful information to parents and students about concussions and head trauma recovery, Caltabiano says. The Centers for Disease Control and Prevention has taken the lead in educating players, parents, physicians and coaches on the symptoms, and the importance of an individualized “return to play” plan for those who have suffered head trauma on the field.

Many patients Caltabiano sees are eager to get back on the field—often too eager. Having a specific plan helps prevent a reoccurrence. “We give them guidelines for going back to all those things they want to do, and how to do it safely,” she says.

Winter brings skiing and sledding accidents. “It’s not always the person on the sleds or skis,” she says. “Children get hurt when they are hit by other kids sledding, too.”

Caltabiano hopes to work with some local ski centers this winter on educating kids and parents about the importance of winter sport helmets. Upstate supports proposed legislation to make helmets mandatory for skiers under age 14.

“More ski centers are offering helmets as part of their rental packages, but not all,” Caltabiano says. “And ski helmets are not like bike helmets: You don’t just run into Target and buy one for $15. Parents need more information.”


Award-winning writer Tammy DiDomenico lives in DeWitt with her husband and two sons.

© Family Times: The Parenting Guide of Central New York