Stories about: Pediatric Dose January 2015

Expert’s Corner: The Pediatric to Adult Heart Care Transition

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Pediatric to adult transition Heart Center

Anne Marie Valente, MD, the outpatient director of the Boston Adult Congenital Heart Service (BACH), says there is no set age at which every person should transition from a pediatric cardiologist to an adult congenital specialist. “It’s a process that begins with teenagers increasingly taking ownership of their own care,” she says. “Lots of times, patients seek out an adult specialist because of a life event; for women, it’s often pregnancy. We want the transition to be a process and a partnership between the patient, family and cardiology teams.”

Valente says that pediatricians can assist with a heart patient’s transition to adult care by making the initial contact to the pediatric cardiologist proposing the idea. …Read More

Pediatric simulation training spreading to community hospitals

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mannequin pediatric simulation SIMPeds Peter Weinstock Karen Gruskin Lindsey Elliott

For 15 years, the Simulation Program at Boston Children’s Hospital has honed the concept of scenario-based simulation training in medicine. Through a recently launched initiative called SIM Network, the program is now taking the lessons it’s learned on the road, developing and offering more than 50 courses at nine community hospitals across eastern Massachusetts. …Read More

Clinical Consult: Neuroimaging Decisions

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brain mir neurological imaging scans

It’s natural for parents to worry: A headache. A seizure. A concussion. What if my child has a brain tumor? Brain scans are on the rise, and pediatricians may be tempted to turn to them as a diagnostic aid. That’s especially concerning for computed tomography (CT) scans, which expose children to ionizing radiation. A 2013 study in Pediatrics, for example, found that CT scans are widely used in children with headache, and that 67 percent of these pediatric brain scans were done outside the emergency department setting.

Sometimes brain scans can be misleading or even detrimental. “Most of the diagnosis of neurologic disease should be done at the bedside, through history and physical exam,” says Alan Cohen, MD, neurosurgeon-in-chief at Boston Children’s Hospital. “Imaging can then be used as a confirmatory measure.” …Read More