The practice of Pediatric Emergency Medicine requires us to stay up to date with a immense amount of information. This column can help us relearn many of those items that seemed to slip out of our brains.
“I would like to tell you that you have inspired me to change my career goal from being a cardiologist, to an ER doctor. I want to help people when they need it most urgently. When I grow up, I want to be just like you.” –Kashika Bharol
In the summer of 2016, I was approached with an opportunity to do something completely out my scope of practice and I said yes.
No, I was not asked to initiate ECMO on an emergency department patient.read more
In recent years pediatric emergency departments have seen a dramatic rise in the number of children and families presenting seeking mental health treatment. As a child and adolescent psychiatrist primarily working in the emergency room, I’m often asked by my Emergency Medicine colleagues to develop an “agitation plan” for patients who are deemed at risk of acting out in an aggressive manner. Most often these requests tend to focus on the PRN medication plan should a child become aggressive or upset. However, most successful agitation plans begin well before any medication needs to be administered.read more
After years of steady decline in smoking among young people, we are now seeing a significant rise in the use of e-cigarettes or “vaping.” In December the AAP, AAFP, ACP, and ACOG joined the AMA in issuing a public statement of support for a Surgeon General report highlighting the increased use and dangers of e-cigarettes in young people. At the same time there is a widespread counter message seen in advertisements and social media claiming the benefits of e-cigarettes and attacking the efforts of the CDC, Surgeon General and FDA. All physicians should become educated about the issues and be prepared to discuss them with their patients. What are the facts?read more
Maybelle Kou MD, Fellowship Director, The Altieri PEM Fellowship at Inova Children’s Hospital.
For some medical educators June and July can conjure up feelings reminiscent of Bill Murray’s character in the movie “Groundhog Day”. You’ve probably laughed at the scenes where he goes to extremes of self- injurious behavior before waking up the next morning in exactly the same place. No matter what time of year, this can feel like a daily ritual in the Emergency Department. The environment is massively complex with patient and practitioner variability, team interpersonal dynamics, regulatory and local administrative mandates, all of which contribute to the chaos. Add workforce regulations and it seldom seems as though one works with the same learner more than once or twice during a rotation.read more
Recent studies have shed light on a concerning trend among physicians in-training: un-wellness. This is manifest in increased burnout, depression and suicide rates seen among those undergoing medical training when compared to other professions. This crisis becomes cyclic when physicians with low baseline levels of wellness are unable to give optimal patient care, which in turn detrimentally influences their poor levels of wellness. Historically physician wellness has not been a focus of medical training. New endeavors are hampered by inadequate structure, funding and resources.read more