IT TAKES A VILLAGE: Community Approach to Preventing Child Abuse

by Greg Lopez (’24)

If we can identify community risk factors that contribute to higher rates of child maltreatment, we do our kids a disservice if we do not actively confront those issues. Thinking upstream widens the scope of possible solutions, as any approach that seeks to reduce poverty or make communities safer becomes viable. Advocating for causes like universal healthcare, increased wages, and more affordable housing would all directly impact risk factors of child maltreatment by providing socioeconomic benefits to families and communities. These broader efforts, in conjunction with existing targeted interventions, provide a truly comprehensive approach to addressing child maltreatment and ensure that we are doing everything we can to keep kids safe.

HEART ON FIRE: Post-COVID Vaccine Myocarditis

by Torie Quinn, DO (’23)

n between the Pfizer and Moderna mRNA SARS-CoV-2 vaccines and myocarditis. Recently, Marshall et al. Pediatrics. 2021 illustrated a case series of seven healthy males aged 14-19 who, just like the patient above, presented with chest pain within four days of their second dose of the Pfizer vaccine and were found to have ST elevations, significant troponin leak, cardiac dysfunction and positive cardiac MRI findings. 

While this is fascinating and ever-evolving science, it also highlights what I believe to be one of the most crucial skills in pediatrics – the ability to sift through the literature, look parents in the eyes, and counsel them on how to keep their children safe. It requires shared decision making, anticipatory guidance, and benefit-risk discussions. Because while we as medical professionals view a 12-in-one-million chance of developing myocarditis after receipt of a vaccine that can help curtail a pandemic as a significant benefit, parents will understandably focus on the risk of their child being one of those 12.

BITE ME!…NOT: Management of Animal Bites

by Bruna Olson, MD (’22)
Reviewed by Alison Heinly, MD

Animal bites are a common complaint seen in the Emergency Department throughout the year. Questions regarding whether to manage the wounds through suturing or antibiotics are common and this article aims to clarify the indications for these different management options when appropriate. 

MAKING PAIN MANAGEMENT LESS PAINFUL: Opioid Use in Pediatrics

by Sarah Harney, MD (’21)
reviewed by Angie Anderson, MD

As pediatric residents spending a lot of time in the inpatient setting, we encounter opioid use fairly frequently. There is a great deal of concern about opioid use in society at large, given the current opioid crisis our country faces. However, opioids are an important tool in our pain management toolbox, and can be an excellent choice when used safely in the appropriate clinical context. Therefore, it is critical for pediatric trainees to feel comfortable with opioid prescribing. Opioids may be indicated in pediatric patients with moderate to severe acute pain, acute exacerbations of chronic pain, and cancer-related pain. Even for these patients, your pain management approach should always be multifactorial including non-pharmacologic pain control techniques and non-opioid analgesics.

LET’S PARDS OUT THE DETAILS: Pediatric Acute Respiratory Distress Syndrome

by Carly Schmidt, MD (’21)
reviewed by Sarah Welsh, MD

Pediatric Acute Respiratory Distress Syndrome is a disease process of severe hypoxemia with oxygenation and (often) ventilation failure, with lung inflammation and poor lung compliance (see Pathophysiology below). It is similar to the adult counterpart (ARDS) but carries slightly different definitions. PARDS is an important cause of morbidity and mortality in the pediatric ICU, and awareness of degree of hypoxia is key, especially in patients who have not yet developed ventilatory failure.

IN TOO DEEP: Diving into Pediatric Drowning

by Alli Georgadarellis, MD (’21)
reviewed by Meghan Beucher, MD

While summertime usually brings decreased patient volume in our hospital, it is often accompanied by increased traumas and injuries. Fatal and nonfatal drownings are unfortunate but common causes of pediatric injury and death. In fact, unintentional drowning is the leading cause of death in the 1-4 year old age group in the United States

DEEP BREATHS: Asthma and Controller Medications

by Melissa Rodriguez, MD (’21)
reviewed by Alison Heinly, MD

Proper identification of asthma severity along with optimization of treatment in the outpatient setting becomes paramount to help maintain a healthy lung function, preserve children’s abilities to carry out their daily activities, and decrease ED visits and hospitalizations.

BIG HEARTS, LITTLE BODIES: Pediatric Congestive Heart Failure

by Vanessa Ogueri, MD
Reviewed by Kristin Lombardi, MD

“When we hear CHF or congestive heart failure, most times our minds tend to drift towards our adult colleagues who help manage the acute and chronic manifestations of heart failure. As pediatricians, luckily, this is a phenomenon we do not often encounter. While infrequent, it is a diagnosis that should be quickly recognized and treated.”

GO WITH THE FLOW: Bronchiolitis

Bronchiolitis Infographic

by Jessica Kelly, MD (’21) and Justin Berk, MD (Med-Peds Faculty)

Episode #2 of The Cribsiders podcast (a sub-cast of the popular medical podcast The Curbsiders) produced by Hasbro Pediatrics Resident, Jess Kelly, MD and Med-Peds Hospitalist, Justin Berk, MD, featuring guest Brian Alverson, MD, Hasbro Pediatrics Hospitalist.