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In this episode, I speak with Dr. Steve Eppes, a Pediatric Infectious Disease specialist, about the rising rates and re-emergence of various vaccine-preventable diseases. We discuss who is at risk, how and when to test for and diagnose these illnesses, and challenges and creative solutions to infection control in our hospitals and clinics.  

Below is a link to the Texas Department of State Health and Human Services page, which has compiled CDC recommendations for vaccination, testing and PEP, ongoing tracking of cases, infographics that can be printed into posters or handouts, and parent, school, and clinic resources regarding measles (I have no financial interest or association with the Texas DHHS, just found this to be a thorough, consolidated resource). 

https://www.dshs.texas.gov/measles

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This is the second of a two-part series on medical ethics with Dr. Kristina Brumme. In this episode, we discuss ethics in prehospital decision-making, resuscitation and termination protocols, debriefing and conversations around death and poor outcomes, the ethics of trainees in medicine, and navigating rapidly shifting laws and policies about medical care. Below are some of the studies Dr. Brumme referenced in the podcast:

CARES study: https://pubmed.ncbi.nlm.nih.gov/39299508/

Yale qualitative study: https://pubmed.ncbi.nlm.nih.gov/28376068/

Parental consent for emergency medical services: https://pubmed.ncbi.nlm.nih.gov/21788221/

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In this episode, the first of a two-part series, I speak with Dr. Kristina Brumme, who is a Pediatric Emergency Medicine physician with expertise in medical ethics. This episode focuses on the frameworks of ethical principles, coercion vs. persuasion in health decisions, end-of-life decisions, the ethics of pediatric readiness, and our duty as subspecialists to partner with and provide support to hospitals and health systems that do not have high levels of resources. Below is one of the AAP Policy Statements relevant to our discussions:

Weise KL, Okun AL, Carter BS, Christian CW; COMMITTEE ON BIOETHICS; SECTION ON HOSPICE AND PALLIATIVE MEDICINE; COMMITTEE ON CHILD ABUSE AND NEGLECT. Guidance on Forgoing Life-Sustaining Medical Treatment. Pediatrics. 2017 Sep;140(3):e20171905. doi: 10.1542/peds.2017-1905. PMID: 28847979.

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In this episode, I speak with Dr. Charlene Jones, a Pediatric Sports Medicine Physician, about updates on concussion management in the acute setting (and subacute for those kids who re-present to urgent care and emergency care settings). Below are links to the SCAT-6, and child SCAT-6, and information about the new SCOAT-6 for listeners who practice in the office setting. 

SCAT-6 Tool (for kids ages 13 and up): https://bjsm.bmj.com/content/57/11/622

Child SCAT-6 (for kids ages 8-12 years): https://bjsm.bmj.com/content/57/11/636

SCOAT-6 Article: https://bjsm.bmj.com/content/57/11/668.full

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In this episode, I speak with Dr. Kevin Ching about his experience teaching and developing experiential learning through BASE Camp, a multidisciplinary simulation boot camp for PEM fellows, nurses, child life staff, and others. He shares evidence-based approaches to medical education and his insights on engaging and supporting learners to create high-yield educational experiences. 

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In this episode, I speak with Chris Barbour and Mel Lebron, two of the many amazing nurses I've worked with over the years. We talk about trends in the nursing field, changes since the pandemic, and overall physician and nursing interactions, collaboration, and team dynamics. 

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In this episode, I speak with Dr. Jess Schnell, DO MBA, who transitioned from Pediatric Emergency Medicine and hospital administration to utilization management. We talk about career longevity, deciding to transition away from clinical medicine, and dealing with burnout.

Articles and Resources We Discuss:
Gettel CJ, Courtney DM, Agrawal P, Madsen TE, Rothenberg C, Mills AM, Lall MD, Keim SM, Kraus CK, Ranney ML, Venkatesh AK. Emergency medicine physician workforce attrition differences by age and gender. Acad Emerg Med. 2023 Nov;30(11):1092-1100. doi: 10.1111/acem.14764. Epub 2023 Jun 23. PMID: 37313983; PMCID: PMC10973949.

Chen YW, Orlas C, Kim T, Chang DC, Kelleher CM. Workforce Attrition Among Male and Female Physicians Working in US Academic Hospitals, 2014-2019. JAMA Netw Open. 2023 Jul 3;6(7):e2323872. doi: 10.1001/jamanetworkopen.2023.23872. Erratum in: JAMA Netw Open. 2023 Sep 5;6(9):e2334513. doi: 10.1001/jamanetworkopen.2023.34513. PMID: 37459094; PMCID: PMC10352856.

COVID Coach App

Psychologytoday.com

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In this episode, I speak with Dr. Allison Messina, an Assistant Professor of Pediatric Infectious Disease in Florida at Johns Hopkins All Children's Hospital. We talk about vector-born illnesses - their presentation and management, and where and when to look out for them. Ranges of many of these illnesses are expanding, both northward from the tropics, and for diseases like Lyme disease, to broadening regions within North America, so many of us will be seeing these illnesses in areas where they weren't previously found. Dr. Messina provides recommendations for us as treating physicians and for those of us planning to travel to areas with illnesses not endemic to where we're living.

We talk about the CDC Yellow Book as a guide for travel medicine and when treating patients who have recently traveled. Here is a link to the website - we both use this regularly and find it really helpful.

https://wwwnc.cdc.gov/travel/page/yellowbook-home

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In this episode, I speak with Dr. Kathy Sumpter, who is Division Chief of Pediatric Endocrinology at Le Bonheur Children's Hospital. We talk about diagnosing diabetes in children and risk-stratifying kids coming in with new-onset diabetes, as well as fluid and insulin management strategies for kids in DKA. Dr. Sumpter specializes in helping kids who struggle to control their diabetes improve their health, and shares insights about her successes and about the future of medical care for diabetes.

Some articles we mention in this episode include:
Kathleen M. Brown, et al, for the Pediatric Emergency Care Applied Research Network Diabetic Ketoacidosis FLUID Study Group; Rehydration Rates and Outcomes in Overweight Children With Diabetic Ketoacidosis. Pediatrics December 2023; 152 (6): e2023062004. 10.1542/peds.2023-062004

Kuppermann N, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018;378(24):2275-2287. doi:10.1056/NEJMoa1716816

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In this episode I meet with Dr. Jay Pershad from Children's National Hospital in Washington, DC. Dr. Pershad is an expert in high-value care and shares strategies for improving our quality of care to benefit patients, families, and healthcare providers together. A few studies that he mentions are here below for those who are interested in a deeper dive:

Bodenheimer T, Sinsky C. From Triple Aim to Quadruple Aim: Care of the Patient Requires Care of the Provider. Ann Fam Medicine 2014;12(6):573-576. doi: 10.1370/afm.1713

Foster C, et. al. Emergency Care Connect: Extending Pediatric Emergency Care Expertise to General Emergency Departments Through Telemedicine. Academic Pediatrics 2020;20(5):577-584. https://doi.org/10.1016/j.acap.2020.02.028

Paydar-Darien N, et al. Improving Discharge Safety in a Pediatric Emergency Department. Pediatrics 2022;150(5).