Author: Kathleen Brown, MD – Children’s National Health System
It is with great excitement that we announce the first paper from the National Pediatric Readiness (Peds Ready) Project was released online today, April 13, and will be released in print in the near future. Authored by Marianne Gausche-Hill, MD, the online article, “A National Assessment of Pediatric Readiness of Emergency Departments,” appears in JAMA Pediatrics, along with an editorial by Joseph Wright, MD, MPH, and Evaline Alessandrini MD, MSCE. (Please note the EMSC National Resource Center is hoping to secure grantees “open access” to the full article. More information will be forthcoming.)read more
“In this world nothing can be said to be certain, except death and taxes.” –Benjamin Franklin
Death, taxes, and bronchiolitis.
Providers of pediatric patients know all too well that the winter season is characterized by colder weather, shorter days, and an abundance of children with bronchiolitis. Bronchiolitis is a dynamic disease and thus can have a varied presentation. It is within this variety of symptoms that overlapping medical conditions can hide, masquerading as bronchiolitis, especially as providers quickly become numb to the disease due to the overwhelming volume of patients presenting with similar symptoms. Myocarditis is one such disease with the potential for significant morbidity. Although it is rare, its symptoms significantly overlap those of bronchiolitis. It is the intent of this article to highlight these two disease states in helping pediatric providers identify myocarditis, essentially finding the proverbial needle in the haystack.read more
SinaiPedsUltrasoundCME-minPlease join us on April 19, 2015 at Mount Sinai Hospital in New York City for a Pediatric Bedside Ultrasound CME Course. Faculty including Jim Tsung, Ee Tay and Bret Nelson will cover topics such as abdominal, thoracic and procedure guidance ultrasound. The course is intended for physicians and providers who treat pediatric patients in emergency, intensive care, hospitalist, and general practice environments. Users at all levels are welcome! We are offering two options for this course:read more
As we head into spring this year, I let out the biggest sigh of relief that we have passed the peak of RSV season. Somehow my 7 month old, who was a mere 2 months old when the bronchiolitis patients started trickling in, has come out the other side unscathed.
It has been year of new demands, learning to balance the needs of my very new, very dependent baby, with the challenges of being a fellow. Each time I disappear for 15 minutes to pump, I might miss an incoming sick patient, or delay a child’s disposition. When I stay late to finish charting, or supervise an intern suturing, I risk missing the bedtime ritual, or worse, arrive home to a very hungry, very grumpy baby.
My son arrived two months into fellowship, and within 2 weeks of my return from maternity leave, our ED had its first Ebola scare and my husband and I had to think about what to do about breastfeeding in the unlikely event I came across a case and had to be quarantined. In November, for the first time since my intern year, I picked up a viral URI from one of my tiny patients that lingered at least 3 weeks, and I had to worry about getting my face too close to my baby’s. By some miracle, and thanks to a strict adherence to an after work disinfecting routine, my son giggles on, with nothing more than occasional sniffles. He hasn’t even ever mounted a fever in response to a vaccine. And now, I must pause to knock on wood as hard as I possibly can.
At times, the jobs of being a new mother and being a new fellow are at odds, and I feel stretched thin balancing the needs of my little boy, and my need to protect him, with the needs other, sicker children at work. Nearly every day though, each of my two jobs makes me better at the other.
As an emergency medicine trained fellow, I am, for the first time, intimately familiar with bilirubin normograms and vaccine schedules. I can guesstimate appropriate acetaminophen doses from across the room. As a new mother, I can identify with the sleep deprived haze that might foster a near panicked visit to the ED to find out if it really is normal to cry that much, or if that odd facial expression was a seizure or just gas. In residency, when asked a question that clearly fell into the realm of parenting rather than medicine, I’d be quick to defer to the pediatrician. I finally feel I have legitimate advice to offer.
There is such a nice synergy right now, learning to take care of my own baby while I learn to take care of so many others’ as well. My two new jobs will continue to stretch me, often from opposite directions, but I am so glad I chose to start both. And in the end, I think just maybe, they will be worth all the sleep I’ve had to give up for them.read more
I look down the signout list in preparation for the day. My heart sinks and I feel myself sweating. Palpitations ensue and I have to stop and take my pulse and an aspirin. No, I’m not having a cardiac arrest. At least not yet. The patient in room 1 stole that thunder already.
Am I back in the adult ED again this month? Nope! PICU is the flavor of the month! Back into the world of rounding for hours on every system of the body, discussing vent settings, sedation drips, whether or not to diurese, whether or not to feed, whether or not to extubate; and yet all of those things are not why I opted out of doing a PICU fellowship. The medicine is great! I love a challenge, and these patients are certainly not disappointing me in that way. I am in way over my head and being inundated with a dictionary of words from a language that I have not used in several years. So why the heck am I so exhausted when every day is a steady adrenaline rush?read more