Wildfires and Children’s Lungs

With recent wildfires in the area you may be wondering what this means for your children. The smoke from wildfires contains a mixture of gasses as well as fine particles of burnt material. These can irritate your eyes, nasal passage, as well as your lungs.

Children’s airways are still developing and are much smaller than adults, and therefore are at a higher risk to be affected by poor air quality. Children breathe in more air per pound of body weight and they also tend to be more active which also leads them to breath in more air.

via Krem

via Krem

When the air quality is poor it is important to avoid going outside. If this is not possible, limit the amount of activity that is done outside. Anytime your child runs and plays, they begin to breathe faster, leading to more exposure of the dirty air to their sensitive developing airways.

Keep windows and doors shut. Make sure to run the air conditioner on the recirculate setting to prevent the dirty air from coming inside. A simple mask is not helpful. The small particulates that are present in the smoke are small enough to be allowed through a paper mask. It is also important to keep track of the air quality index where you live. You can check this out at www.spokanecleanair.org to find out the current air quality.

Symptoms of exposure to wildfire smoke can include runny nose, burning eyes, cough, shortness of breath, and nausea. If your child has asthma make sure to have their rescue inhaler available at all times since the smoke can trigger an asthma exacerbation. If any of these symptoms persist or don’t improve after going inside and resting, please seek medical care.

by Ashlee Mickelson, Physician

The Itch of a biting insect: How do I protect my child from them?

With the hot wet days and nights of summer come the biting insects, especially in those early evening hours when eating outdoors and enjoying the gentle weather of a summer evening.

Children are at risk for multiple types of insect bites; biting flies,  mosquitoes, and ticks to name a few. The best way to protect your child from these pesky critters is to apply a repellent containing DEET.

According to the AAP (American Academy of Pediatrics) DEET remains themost effective in repelling these biting insects. It can safely be applied by an adult to the children’s clothing and exposed skin.

Application of the product is best done in an open area. DO NOT spray this directly onto the child’s head and face, instead spray into the adult’s hand and rub onto the face/ears/neck avoiding contact with the eyes.  Follow directions on timing for re-application typically anywhere from 2 to 5 hours depending on the concentration of DEET in the repellant being used.

A common question heard can be: Is it safe for my young child?

The answer is simply:  Yes.  A repellent containing DEET of no more than 30% is safe for application to an infant older than 2 months of age when safely applied by a responsible adult.  Remember to always wash the child’s skin at the end of the day to remove the product to avoid irritation and wash their clothing.

Avoid use of scented lotions/fabric softeners/detergents as these can attract those pests more.  Dressing a child in floral prints and bright colors also can attract the pests.  It’s a good idea to protect the child’s head/ears by having them wear a hat with a wide brim.  Using mosquito netting around strollers and those portable cribs also can help protect the child from those pesky flying insects.   Avoiding stagnant water is a good idea as these are frequently breeding grounds for mosquitoes.


Despite your best efforts your child ends up with an itchy bite, what next?

There are many over the counter products designed for this. Some good options to use are: a topical cream such as Calamine Lotion, Hydrocortisone Cream, or Benadryl Cream.  Another simple product is to mix baking soda and water into a paste and apply to the bite.

Remember if ever there is a question your Pediatrician is just a phone call away.  🙂

Enjoy your summer stay safe and protected!!

Daniel Moorman, MD

8 reasons for men to get screened…

Community Health Association of Spokane Valley Clinic

It’s Men’s Health Month, and an important part of staying healthy is engaging in routine health care maintenance (getting the screening you are due for). At age 18 men should be screened for high blood pressure, this can be accomplished quickly by an MA in provider’s office.

Men over age 18 should also be screened for depression, this can be accomplished by a quick questionnaire in the office.

If you have smoked 100 or more cigarettes in your lifetime, you should get screened once for abdominal aortic aneurysm (AAA). AAA is a bulging in your abdominal aorta, your largest artery. An AAA may burst, which can cause dangerous bleeding and death.

Annual colon cancer screening can be done with a take home stool test called the IFIT, screening should begin at age 50.  If you have a family history of colorectal cancer, you may need to be screened earlier. Colonoscopies can also be used and if normal may need to be done only every ten years.

Get screened for diabetes (high blood sugar) if you have high blood pressure or if you take medication for high blood pressure.

Get screened one time for HCV infection if you born between 1945 and 1965 (Boomers), have every injected drugs or used drugs intra-nasally, or received a blood transfusion before 1992. If you are a current injecting drug user you should get screened on a regular basis.

If you are 35 or older, have your blood cholesterol checked regularly with a blood test. High cholesterol increases your chance of heart disease, stroke, and poor circulation. Talk to your doctor or nurse about having your cholesterol checked starting at age 20 if you use tobacco, are overweight or obese, have diabetes or high blood pressure, have a history of heart disease or a man in your family had a heart attack before age 50 or a woman before age 60.

Prostate cancer screening is no longer routinely recommended, but talk to your provider if you are having symptoms for frequent urination, urgency of urine, decreased urine stream or hesitancy of urine.

It can be difficult to make the time to get a screening, but we try to make it easy. It’s never too late to start the conversation, and it will always be worth your time to make that appointment. One appointment, screening, or check up could make all the difference. It’s time to take control of your health.


Article by Bill Bomberger, Deputy Medical Director

Hello Summer!

536714_10151589741797814_821778485_nHello Kids! Welcome to summer!

Parents, time to start thinking about summer fun and activities. Time to get kids outside and moving. But while moving about the wild summer days don’t forget a little bit of safety for your children. Simple reminders for the kids such as, “Wear your helmet!” can prevent injury and save lives. Kids 5 and up should be learning their home address and parents cell phone number and know about stranger danger. A safety plan should be discussed in case they get lost or separated from family while out having fun.

Helmets– Are highly recommended with all wheeled sports. Please help children remember that they only have one head and they need to protect that brain for many years to come. If your child gets a concussion, please get them in for evaluation and follow up. Problems from head injury can linger for a long time so let us know how we can continue to support you and your family.


Swimming-Time to look into swim lessons for you children, keep them safe around all bodies of water with the upcoming hot weather. Please remember that even children who are believed to be good swimmers should be watched closely in the water especially when under the age of 7.


Sunblock- A layer of clothing can be a good form of sunblock so keep your kids covered up if you don’t have sunblock for them. We recommend children use a sunblock that covers both UVA and UVB and an SPF of 70 would be best (with the way most people put on sunblock you only get about half the SPF number listed on the bottle).


Camp Physicals-Summer time is a great time to get kids to camp and out of the house with the scouts. Make time now to get them in for their annual physical so they are ready for all activities at camp and get a jump on the next School Year.

Summer Treats– What summer is complete without a few sweets. Please help remind kids that we don’t get a summer break from brushing our teeth, we have to do it every day. If they haven’t been into the dentist in a while, now is a time to get them reestablished. We also have fluoride supplements for kids from 6 months old until 16 years old. If your child needs help with dental care please let us know how we can help or if you need a dental appointment with our staff.

The Scoop (via the Inlander)

The Scoop (via the Inlander)


Dr. Dan

Summer Kebabs

Beef KebabsSummer is unofficially here in the Inland Northwest and what better way to welcome it than to break out the barbecue grill! Grilling is a great way to cook a variety of foods. It is also a healthier way to cook meats because it will reduce the fat content as the fat drips away from the food. Try these beef and vegetable kebabs tonight!


Serves 2


-½ cup brown rice

-2 cups water

-4 ounces top sirloin (choice)

-4 tablespoons fat-free Italian dressing

-1 green pepper, seeded and cut into 4 pieces

-4 cherry tomatoes

-1 small onion, cut into 4 wedges

-2 wooden skewers, soaked in water for 30 minutes, or metal skewers



  • In a saucepan over high heat, combine the rice and water. Bring to a boil. Reduce the heat to low, cover and simmer until the water is absorbed and the rice is tender, about 30 to 45 minutes. Add more water if necessary to keep the rice from drying out. Transfer to a small bowl to keep warm.
  • Cut the meat into 4 equal portions. Put the meat in a small bowl and pour Italian dressing over the top. Put in the refrigerator for at least 20 minutes to marinate, turning as needed.
  • Prepare a hot fire in a charcoal grill or heat a gas grill or a broiler. Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source.
  • Thread 2 cubes of meat, 2 green pepper pieces, 2 cherry tomatoes and 2 onion wedges onto each skewer. Place the kebabs on the grill rack or broiler pan. Grill or broil the kebabs for about 5 to 10 minutes, turning as needed.
  • Divide the rice onto individual plates. Top with 1 kebab and serve immediately.


Nutritional analysis per serving

Serving size: 1 kebab and ¾ cup rice

Calories 300

Total carbohydrate 49 g

Dietary fiber 4 g

Sugars 0 g

Sodium 450 mg

Total fat 3 g

Saturated fat 1 g

Monounsaturated fat 1 g

Trans fat trace

Cholesterol 39 mg

Protein 18 g


By Keri Smith, Registered Dietician