Multidisciplinary care to treat severe asthma

Multidisciplinary care for severe asthma

The Severe Asthma Program at Boston Children’s Hospital provides care to children and young adults with severe persistent asthma who have difficulty with disease management or chronic systemic steroid use. “We’ve developed a one-stop shop for the highest risk, highest cost, highest morbidity population of pediatric asthma,” says pulmonologist Jonathan Gaffin, MD, MMSc, who conceived of the program after witnessing hundreds of patients crossing between Boston Children’s Division of Pulmonary Respiratory Diseases and Division of Allergy and Immunology…Read More

Assessing pain in our tiniest patients

Babies in the NICU can feel pain

An infant rests in the Neonatal Intensive Care Unit (NICU), recovering from elective surgery. She’s crying, but is it because the procedure caused pain, because she’s hungry or for some other reason? An inspired research collaboration between the NICU and the Division of Pain Medicine at Boston Children’s Hospital is determined to find out. …Read More

The dangers of sleep deprivation

Sleep deprivation in physicians is dangerous

An emergency room physician completes her overnight shift in a busy, inner city emergency department. She stays an extra hour and a half to complete paperwork then goes home. Although exhausted, she’s “too wired” to sleep.

Eventually she dozes off but the phone calls from family and friends begin. She’s only able to get six hours of interrupted sleep before leaving home for the next shift. The ER physician is fatigued, irritable and frustrated.

Now repeat.

“This sleep pattern takes a terrible toll in the short and long term,” says Judith Owens, MD, MPH, director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital. “Shift work is associated with “deficient” sleep, meaning that both the amount and timing of sleep are altered. Our natural circadian rhythms result in humans being hardwired to sleep at night and be awake during the day, and the combination of this “misalignment” with insufficient sleep can be very problematic.” …Read More

Is it Kawasaki disease? Diagnosing challenging cases

Is it Kawasaki disease?A young child presents in your office with a fever of several days, erythema of the palms and soles of the feet, a rash on the trunk and a bright red tongue. For most pediatricians, this classic presentation of Kawasaki disease is fairly straightforward to diagnose.

“A majority of pediatricians have seen at least one case of Kawasaki in training,” says David Fulton, MD, chief emeritus of the Division of Cardiology Outpatient Services at Boston Children’s Hospital. “And most know how to make a diagnosis when all the clinical signs are present. But it’s important to understand the features of this disease that can make diagnosis more challenging.” …Read More