Teaching Rounds

Grand Rounds-style Teaching Capstones by our amazing graduating PGY-3s during their Teaching Elective

Childhood Obesity in COVID-19: Ways to Counsel

by Leslia Gonzalez (’22)
reviewed by Celeste Corcoran

Childhood obesity has been a growing problem for many years. The COVID pandemic has unfortunately exacerbated this. A study published in JAMA that utilized the Kaiser Permanente Southern California population found an increase in childhood obesity across all ages, with the largest being within the age group of 5-11 yo. There was an increase of approximately 9%. We have seen this trend amongst our patient population as well.

OUCH MY BACK! Spondylolysis in the Pediatric Population

by Maya Spencer (’22)

Spondylolysis is a stress fracture that occurs within the vertebrae, typically at the pars interarticularis. When the fracture occurs bilaterally and completes all the way through the bone this can progress to spondylolisthesis, where the vertebrae slides anteriorly over the bone below it. As children are becoming more active in sports at an earlier age with a higher intensity of practice this is becoming an increasingly common condition in the pediatric population.

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.”