Category Archives: Uncategorized

Peanuts and Choking

Dr. Tamara Willoughby

Recently, the lay press reported a promising breakthrough in decreasing the frequency of peanut allergies in children at high risk for peanut allergy by early introduction of peanuts. (1)  In the study “peanuts” were introduced to infants between the ages of 4 and 11 months. (1)  The research shows promise to combat the increasing prevalence of peanut allergy in Western countries. (1) Although, not discussed in news reports, the peanut product given to infants in the study was not whole peanuts.  Infants were given “Bamba,” a peanut butter flavored puffed maize product. (1) Some news reports, although not all, discussed that early introduction of peanuts should be done under a physician’s care. The general public should also be reminded about the choking risk of peanuts especially in children 3 and under and that babies in this study were not given whole peanuts.   Choking is a leading cause of mortality and morbidity in children 3 and under with food, toys and coins most often the culprits. (2) Small children are vulnerable to choking in many ways.  A child’s airway occludes easily with small objects because of the small diameter of the airway and young children often can’t cough with enough force to dislodge a foreign body. (2) Additionally until molars erupt, children are unable to sufficiently chew food into smaller portions adequate for swallowing. (2) Finally, even though children at age 3 to 4 have molars, they are still learning to chew and are easily distracted which can lead to choking. (2) Approximately 1 child every 5 days in the United States dies from choking on food. (2) High risk foods for choking include hot dogs, hard candy, peanuts, nuts and seeds, whole grapes, raw carrots, apples,  popcorn, marshmallows, chewing gum and globs of peanut butter. (2)  In conclusion,  lets take this opportunity to educate the public regarding choking risks in children along with enthusiasm for promising  research on peanut allergy prevention. read more

Electronic health records (EHRs): Are they good for emergency department providers and for throughput?

Mohsen Saidinejad, MD, MBA, FAAP

Children’s National Health System

With the passage of meaningful use act of 2009, requiring a phased implementation of electronic health record (EHR) system, more and more healthcare organizations have rushed to beat the technology compliance clock and to be eligible for incentives and reimbursements.  As a result of this electronic transformation, all patient-encounter data is now potentially more transparent, accurate and up to date.1   More importantly, data is more accessible, shareable, and coordinated.2 On the flipside, reliance of digital data can paralyze the entire system during system downtimes, data breaches, or data loss.  In addition to this, back-up systems and servers that are sometimes thousands of miles away can potentially put sensitive personal patient information at risk. EHRs are also expensive and are challenging to successfully implement without growing pains.  Electronic documentation also can be more tedious and time-consuming. In this article, we examine the impact of EHRs specifically on ED providers. read more

Mount Sinai Pediatric Bedside Ultrasound Course- April 19, 2015

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

Surround Yourself with Artists.

3 year old Jimmy was excited when he saw his Daddy’s truck coming up the driveway.  The subtle bump as the giant 4×4 ran over Jimmy’s abdomen was almost missed, but Jimmy’s cry was heard by dad in the cab and mom in the house.  He was awake and alert, boarded and collared as our trauma team descended.  The large tire tread mark over his abdomen was the only obvious injury as we pounced upon him masked and gloved, with hands palpating, scissors tearing and IVs plunging.  As I peered down all forehead and nose to his view he looked back with terror.  Calmly, quietly I did my best to explain in terms a 3 year old would understand the action unfolding.  He was being incredibly brave as I assessed him.  As I tried to illicit any other injuries I asked, “Jimmy what hurts?”  He looked straight up into my eyes and responded, “Being run over by daddy’s truck.” read more

The Armchair ED.

armchair physician

It’s a busy day in the ED.  Thirty deep in the waiting room.  Patients are threatening to leave.  Staffing is short.  Your colleagues are dying for help and you are the one who gets the call to pitch in and lend a hand.  With a heavy sigh, you flop on the sofa, flip open your lap top, and start seeing patients.

Future fantasy?  It is not as farfetched as you might think.  Although the medical industry is often maligned as being a slow moving monolith resistant to adaptation, there are a slew of groups, both academic and commercial, looking into bringing telemedicine to the mainstream. read more