Pediatrics in Practice provides interviews with pediatric subspecialists on timely, relevant content for physicians and providers who care for children.
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EMS Timely Tips: Tranexamic Acid (TXA) use in Pediatric Trauma
Andrew Wilner and Jennifer Flint
Massive transfusion protocols have become vital tools used within trauma centers across the country. Appropriately so, as many emergency providers know that hemorrhage is the most common cause of death within the first hour of arrival to a trauma center. Most recently, a medication called Tranexamic Acid or TXA has been found to assist in life-saving measures for trauma victims in both the pre-hospital setting and the emergency department. But is TXA a recommended medication for kids? This podcast segment highlights the safe use of TXA in pediatric traumas and beyond.
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Food Insecurity Screening in the Allergy Specialty
Andrew Wilner and Jodi Shroba
Did you know that more than 1 in 5 children with food allergies also experience food insecurity (FI)? Children whose families struggle to acquire adequate nutrition are at higher risk for a wide range of conditions, including asthma, obesity and mental health issues.
In this podcast, you’ll hear more on this topic, including guidance on FI screening in the pediatric care setting, from Jodi Shroba, MSN, APRN, CPNP, Food Allergy Program Coordinator for the Division of Allergy, Immunology, Pulmonary and Sleep Medicine at Children’s Mercy Kansas City. -
Evaluating Pediatric Obesity
Andrew Wilner and Kelsee Halpin
Currently 1 out of every 5 children (18.5%) meets the body mass index criteria for obesity (BMI ≥ 95th percentile). With this in mind, it’s important for providers to consider many factors when diagnosing and assessing a child for obesity. Kelsee Halpin, MD, MPH, pediatric endocrinologist at Children’s Mercy Kansas City, discusses more on this topic and what to look for in the primary care setting.
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Evaluating Abnormal Menstrual Patterns
Andrew Wilner and Emily Paprocki
Girls and adolescents with more than 3 months between periods or those that remain otherwise irregular 2 years after menarche, should be evaluated for underlying causes. Emily Paprocki, DO, pediatric endocrinologist at Children’s Mercy Kansas City, discusses more on this topic and what to look for in the primary care setting.
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Evaluating Abnormal Thyroid
Andrew Wilner and Francesco De Luca
Between 25-50% of the referrals to a pediatric endocrinology clinic are related to abnormal thyroid function tests (TFTs). However, the majority of these abnormal TFTs are not associated with a true thyroid problem, especially when these tests are ordered in the absence of any signs or symptoms suggestive of a thyroid disease. In this podcast, Francesco De Luca, MD, Division Director of Pediatric Endocrinology at Children’s Mercy Kansas City, covers tips for evaluating abnormal thyroid in the primary care setting.
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Evaluating Growth Failure
Andrew Wilner and Francesco De Luca
When it comes to growth failure, many factors are involved. How short is the child? Is the child’s height velocity impaired? Is the child’s height/growth within the range for the family? In this podcast, Francesco De Luca, MD, Division Director of Pediatric Endocrinology at Children’s Mercy Kansas City, discusses key considerations for evaluating growth failure in the pediatric population.
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Mind-Body Techniques for Pregnancy and Postpartum
Andrew Wilner and Shilpa Babbar
Maternal stress, while natural and common, can lead to adverse health outcomes. Based on her research, Shilpa Babbar, MD, OB/Gyn-Maternal and Fetal Medicine at Children’s Mercy Kansas City, describes mind-body therapies and interventions, such as muscle relaxation, biofeedback, tai chi, yoga, meditation, mindfulness and hypnosis, which may be effective during pregnancy and postpartum care.
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Managing Depression, Anxiety and ADHD in the Pediatric Population
Andrew Wilner and Ram Chettiar
Prevalence of depression, anxiety and ADHD continues to rise in the pediatric and adolescent population. Effective therapies are available for each of these conditions, although medication management can sometimes be problematic in the primary care setting. In this podcast, Ram Chettiar, DO, Child and Adolescent Psychiatrist at Children’s Mercy Kansas City, reviews current data on these conditions, discusses strategies for evaluation, and shares recommendations for treatment.
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EMS Timely Tips: Pediatric Sports Injury Management
Melanie Cole and Jay Roberson
Whether it’s on the practice field or under the lights on Friday night, when kids play sports, injuries can occur. Unlike adults, their brains and bodies are still growing and developing, even when they’re playing sports at an elite level. The care that coaches, athletic trainers, and EMS personnel provide at the time of injury is crucial and oftentimes, emergent. Dr. Roberson will highlight ways in which effective collaboration and timely, evidence-based management of sports-related injuries correlates with positive outcomes for athletes and their families.
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Functional Abdominal Pain, IBS and Auricular Neurostimulation
Andrew Wilner and Pang Krasaelap
In this podcast, Dr. Krasaelap explains the brain-gut connection and what can happen when this is dysregulated. Listen as she describes misconceptions about abdominal pain and irritable bowel syndrome (IBS), and treatment options that exist – including the novel, FDA-approved auricular neurostimulator device.
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Managing Cystic Fibrosis - Outcomes, Challenges and Treatment Developments
Andrew Wilner and Christopher M. Oermann
In this podcast, Christopher Oermann, MD, Director of the Cystic Fibrosis Care Center at Children's Mercy Kansas City, discusses the current state of cystic fibrosis, developments and research underway, and how primary care providers can partner in managing the overall health of patients with cystic fibrosis.
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EMS Timely Tips: Recognizing and Reporting Sexual Exploitation/Human Commercial Sex Trafficking
Andrew Wilner, Heidi Olson, and Rachel Whitfield
Human trafficking often seems like a far-off crime in a movie that couldn’t possibly be happening in our communities. However, it’s far more common in the United States than people realize. Moreover, many trafficking victims (88%) have sought health care at some point while they were being trafficked, but very few victims are recognized by health care workers. Historically, trafficking victims were misidentified as drug addicts, prostitutes, “bad kids”, homeless patients, victims of domestic violence, mentally ill, etc. and we failed to recognize the exploitation occurring to the person in our care. Rachel and Heidi will touch on what signs of human trafficking to look for in the health care setting, how to report it, and why it’s so vital for us to speak up when we see something that seems “off”.
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PedsGuide App: Pediatric Decision Support at Your Fingertips
Melanie Cole and Brandan Kennedy
Created by a multidisciplinary team of pediatric experts, the Children's Mercy Ped's Guide App puts evidence-based resources—dose recommendations, drip calculations, resuscitation guides and more—right at your fingertips. Listen as Brandan Kennedy, MD, discusses the app, its features, and the evidenced-based resources behind it.
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Thyroid Nodules and Differentiated Carcinoma (Diagnosis, Treatment and Long-term Management)
Melanie Cole and Naim Mitre
The Thyroid Nodule and Carcinoma Clinic at Children’s Mercy Kansas City is the only pediatric clinic of its kind in the region to provide the comprehensive evaluation, diagnosis, treatment, and long-term management of thyroid nodules and differentiated carcinoma.
In this episode, Naim Mitre, MD, Pediatric Endocrinologist and Medical Director of the Thyroid Nodule and Carcinoma Clinic at Children's Mercy, discusses the incidence of thyroid cancer in children, how thyroid nodules are diagnosed, and the importance of treatment. -
EMS Timely Tips: Endocrine Emergencies in the Pre-Hospital Setting
Melanie Cole and Ryan J. McDonough
Endocrine disorders, specifically for pediatric patients, pose complex considerations in care based on the type of disorder and an individual’s course of therapy. For this reason, Children’s Mercy manages programs across the region, providing endocrinology care from western Kansas to south central Missouri. When a pediatric patient with an endocrine disorder requires emergency assistance in the pre-hospital setting, rapid intervention is necessary. In this segment, Children’s Mercy Endocrinologist, Dr. Ryan McDonough, will offer life-saving guidance on treating this population of pediatric patients.
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Common Cases for ENT
Melanie Cole and Pam Nicklaus
Pamela Nicklaus, MD, FACS, discusses protocols surrounding common ENT cases and referrals, difficulties that may arise, options for families, and therapies/support.
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Return to Play in the Pediatric Athlete After COVID-19 Infection
Melanie Cole, Daniel Forsha, Ryan Northup, Amol V. Purandare, and Natalie C. Stork
In the adult population, COVID-19 infections appear to affect the heart at a higher rate than other viruses, while in the pediatric population, the virus can cause multi-system inflammatory syndrome (MIS-C) involving the heart. Due to the lack of evidence for cardiac injury from COVID-19 infections in the pediatric population and the low number of pediatric cases, recommendations are made from expert opinion from the sports medicine, infectious disease, and cardiology departments and are subject to change.
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Preparing to Launch-Preparing to Land: Transition to Adulthood Intervention
Melanie Cole and Ann Modrcin
Pediatrics in Practice: Ann Modrcin, MD, EMBA, discusses the pediatric transition to adult care and best practices to achieve it. She also discusses values and pain points for families, and how providers can provide support through the transition.
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Hematology Dilemmas: Cases for the General Pediatrician
Melanie Cole and Lauren Amos MD
Struggling with an abnormal value on a screening complete blood count (CBC)? Frustrated that a toddler refuses to take oral iron? Wondering what to do when the 12 month screening hemoglobin comes back a little low? This podcast is for you! We will discuss common hematologic dilemmas in pediatric primary care and how to address them. From the dreaded hemoglobin Barts, to evaluation and management of iron deficiency anemia, and quick review of all those complete blood count indices, this podcast aims to make the CBC fun again!
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Headache Diagnostics
Melanie Cole and Anna E. Esparham
Anna Esparham, MD, Director of the Headache Treatment Center at Children's Mercy, discusses primary versus secondary headaches, causes of migraines/headaches, treatment approaches, and differences between prevention and abortive therapies.
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EMS Timely Tips: Autism Spectrum Disorders
Melanie Cole, Jo-Ann Youngblood, and Mary Anne Hammond
Autism is one of the fastest-growing developmental disabilities in the United States, affecting approximately 1 in 54 births. For the safety of emergency medical providers and patients with developmental disabilities, it is important to understand what Autism is and how to care for pediatric patients diagnosed with it. In this segment, Children’s Mercy specialists will discuss common misconceptions about Autism Spectrum Disorder, as well as share insight from a memorable EMS encounter involving a child with Autism.
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Comfort Promise
Melanie Cole and Amanda D. Deacy
Amanda Deacy PhD discusses comfort promise. She shares the concept of Comfort Promise and a quality improvement (QI) project she's leading in GI to assess gaps in documentation of the pain prevention bundle in order to better measure its uptake and success rate.
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Beta-lactam Antibiotic Allergies
Melanie Cole and Amol V. Purandare
While approximately 10% of US adults and children claim a penicillin allergy, only 1/20 with a reported allergy are truly allergic. Additionally, 80% of patients with IgE mediated penicillin allergy lose sensitivity after 10 years.
It is important to clarify and de-label patients to ensure they receive standard of care, avoid other adverse drug reactions and have a lowered risk of clinical failure. This practice also results in cost savings.
Amol Purandare, MD explains the de-labeling process in place at Children's Mercy and how to gain insight into what to prescribe to a patient with a penicillin allergy. -
Addressing Anxiety and Depression in Teens
Melanie Cole and Shayla Sullivant
Dr. Shayla Sullivant shares warning signs of anxiety and depression in teens, how to talk to your teen about their feelings, and when you should seek professional help.
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Bellyaches, Bowels and Barfs
Michael Smith and John Rosen
The most common reasons that children are seen by pediatric gastroenterologists relate to their bellyaches, bowels, and barfs. A simple approach to these disorders can guide general practitioners to help families find relief from these distressing symptoms.Dr. John Rosen explains when you might want to take your child to see a pediatric gastroenterologist, what to expect at an appointment, and treatments to common GI issues.
