Category Archives: Ped EM Section Columns

Find your Coach’s Cap

Michael Greenwald, MD
Associate Professor, Pediatrics and Emergency Medicine
Emory University/Children’s Healthcare of Atlanta

Physicians wear many hats. At times we are teachers and other times psychotherapists. We are asked to diagnose and also to counsel. With experience each of us learns when to switch hats. But there is one important role that we sometimes fail to recognize and embrace: the role of “coach.”

Coaching is very similar to teaching but there are important differences. read more

Children’s National Health System Fellows Blog

Author:  Mohsen Saidinejad, MD, MBA, FAAP

The fellows at Children’s National Health System have developed an open source academic blogsite, which includes various areas of interest to fellows and attending PEM providers.  A weekly “Hot Seat” case, which enjoys tremendous popularity, evidence-based articles with large impact on PEM practice, and a one-of-a-kind ECG training module are just some of the resources that can be found there.

The blogsite was the original creation of Sonny Tat, MD, a former fellow at Children’s National and a current PEM faculty at UCSF.  Sonny is also the site administrator for PEMNetwork. read more

Pediatric Readiness Project in the news

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

Searching For Myocarditis during Bronchiolitis Season

Author

Michael S. Mitchell

Assistant Professor of Emergency Medicine

Section of Pediatric Emergency Medicine

Wake Forest University School of Medicine

Winston Salem, NC 27157

msmitche@wakehealth.edu

Introduction

“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

Welcoming Spring as a new mom

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