Peds-Centered

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In this episode, I'll be talking with Dr. Matt Harris from Cohen Children's Hospital about medical transport of kids, both in the prehospital and interfacility settings. We will discuss level of skills, training, and equipment available with various teams, factors to consider when choosing transport options, safety and legal concerns, and transport cost.

After recording this episode, Dr. Harris and I were discussing the components of the safety checklist his institution uses for transport of kids with behavioral health emergencies. His team does a huddle prior to transfer and answers these questions:

1. Who participates in huddle (referring doc, EMS clinicians, occasionally tele-psych physician).
2. Was a complete report given?
3. Was the patient aware of the intent to transfer (transparency with patients reduces discord)
4. Type of transfer (voluntary, involuntary, etc)
5. Any concerns from the sending physician?
6. Does the patient appear compliant and willing to transfer?
7. Is crew comfortable transporting the patient as presented?

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In this episode, I talk with Dr. Sing-Yi Feng, a Pediatric Emergency Medicine physician and Toxicologist, about ingestions of acetaminophen and ibuprofen, and general guidelines for evaluation of ingestions. We discuss important knowledge points for diagnosis, management, and continuation of care for our patients at home, in the inpatient unit, and in the critical care setting. Although Dr. Feng is a pediatrician first, she reviews care for patients of all ages, as ibuprofen and acetaminophen are among the most common ingestions of people at any age.

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In this episode I chat with Dr. Chris Amato about pediatric fractures - management of pain, when to call Orthopedics, and practical tips on splinting and immobilization strategies.

Side note: I mention in this that a femur fracture will heal if you get the two ends "in the same room together" - I should clarify, "in the same room together AND in a spica cast." Cast those femur fractures, people!

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In this episode I talk with Dr. David Sas, a Pediatric Nephrologist from the Mayo Clinic, about kids and kidney stones, with a discussion of stone diagnosis, management, and complications. We also discuss pyelonephritis, dysfunctional voiding, and long-term management and recurrence prevention after the initial diagnosis of all of these issues.

Spoiler alert: Dr. Sas mentions briefly in this episode the work he has done to develop a CURE for a rare genetic cause of renal stones, and his team at Mayo has a special interest in the evaluation of kids with kidney stones for genetic and underlying causes that can be managed to prevent future stones and kidney injury. If you have a patient with renal stones who needs assessment, I have listed his contact information and department website here:

https://www.mayoclinic.org/departments-centers/pediatric-nephrology-clinic
[email protected]

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In this episode I speak with Dr. Deb Kahal, Medical Director of the Holloway Community Program in Delaware, which provides testing and treatment for HIV, AIDS, and Hep C, and with Dr. Steve Eppes, Pediatric Infectious Disease Physician. We'll be reviewing the epidemiology of adolescent STIs, screening recommendations, treatment, and why it's important for us non-PCPs to address adolescent STIs.

Here is the link for the USPSTF (US Preventive Services Task Force) Infectious Disease Screening Recommendations:  uspreventiveservicestaskforce.org. These are the summary statements and are pretty detailed if you like in-depth reviews of the literature behind the decision making.

For a quicker reference table, the CDC has a table of screening guidelines: https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm

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In this episode, I'll be reviewing button battery ingestions and superficial/mucosal injuries, including risk factors, pathophysiology, and management of known and suspected ingestions. Below is the link I mentioned to a time-lapse video modeling a button battery's effects on tissue, made by Dr. Robert Kramer who is a pediatric gastroenterologist. It's pretty impressive to watch!

https://youtu.be/-wI_Vl3LH78

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In this episode I'll be speaking with Carl Baum, a Pediatric Toxicologist and Emergency Medicine Physician from Yale School of Medicine about common pediatric toxidromes. We'll also cover assessment and management of the obtunded child, polysubstance ingestion, and some interesting toxicology tidbits. 

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In this episode, I'll review pediatric anaphylaxis, including diagnosis, management best practice, and aftercare for kids treated in the acute care setting. 

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In this episode, I'll be chatting with Pediatric Neurologists Drs. Richard Fischer and Mitra Assadi-Khansari about common neurologic emergencies in kids. We will focus on seizure evaluation and management (febrile, epileptic, and non-epileptiform) as well as a review of pediatric migraine headache.
For further reading about pediatric headache, the American Headache Society website provides practice guidelines summarizing literature on a variety of headache syndromes:
https://americanheadachesociety.org/news/?tag=pediatric-headache

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In this episode, I'll be reviewing best practice recommendations for bronchiolitis management, and evidence behind the advice for and against some of the most popular treatment options.