Pediatrics in Practice

Every summer children and families are drawn to oceans, pools, ponds, lakes, rivers, or streams for entertainment and exercise. As prehospital providers know all too well, fun events and gatherings near bodies of water can turn into an emergency setting in an instant.
Although drowning injuries can affect anyone, according to the CDC, children ages 1-4 have the highest drowning rates, with most occurring in swimming pools. Fatal drowning is the 2nd leading cause of unintentional injury death for children ages 1-14 with the 1st leading cause being motor vehicle crashes.

The risk for moderate to severe neurological complications and long-term disabilities are concerns for survivors of non-fatal drowning incidents. Whether in the hospital or prehospital setting, management of the pediatric drowning patient should aim to identify and treat complications, as well as prevent further anoxic injury.

The national Asthma Education and Prevention Program (NAEPP) published the first expert panel report on the diagnosis and management of asthma in 1991. A comprehensive revision was published in 1997, and an update in 2002. the EPR 3 was published in 2007. The most recent guidelines, published in 2020, represent a paradigm shift in asthma treatment.

In this episode, Dr, Brandon Newell and NP Rebecca Flynn leads an interactive discussion on some of the more common cases seen in dermatology.

Idiopathic congenital clubfoot occurs in 1 in 1,000 infants in the U.S. and is considered the most prevalent musculoskeletal birth defect in the world. In this podcast, Richard Schwend, MD, FAOA, FAAP, Interim Chair, Department of Orthopedic Surgery and Musculoskeletal Science at Children’s Mercy Kansas City, discusses a clinical report published by the American Academy of Pediatrics which covers background on the condition, evaluation and treatment – including the Ponseti technique, which is considered the gold standard of care.

Click here to view the clinical report.

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.

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.

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. For more information, visit the Common Endocrinology Conditions page on the Children’s Mercy website.

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. For more information, visit the Common Endocrinology Conditions page on the Children’s Mercy website.

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. For more information, visit the Common Endocrinology Conditions page on the Children’s Mercy website.

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. For more information, visit the Common Endocrinology Conditions page on the Children’s Mercy website.

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.

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.

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.

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.

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.

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”.

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.

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.

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.

Pamela Nicklaus, MD, FACS, discusses protocols surrounding common ENT cases and referrals, difficulties that may arise, options for families, and therapies/support.