Stories about: Pediatric Dose June 2015

Clinical Consult: Diarrhea in children

Diarrhea in children

Diarrhea is a very common problem. Almost every child has at least one episode of infectious viral gastroenteritis in his or her life (like rotavirus or norovirus) marked by fever, vomiting and watery diarrhea. While most diarrhea is self-limiting, it is important to recognize when testing is needed, when medical evaluation and fluid support may be helpful, and when to suspect a chronic problem that requires specialist testing and endoscopy to find the cause and direct specific treatments, be they drugs or special diets and supplements. …Read More

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Expert’s Corner: Three tricky hand and upper extremity injuries

child wrist cast hand upper extremity surgery

Accurately diagnosing and treating hand and upper extremity injuries can be tricky. Several injuries are commonly misperceived in the referring physician community, says Andrea Bauer, MD, a hand and upper extremity specialist and orthopedic surgeon who recently joined Boston Children’s Hospital’s Orthopedic Center.

Bauer highlights several of these injuries and reviews how treatment paradigms for some have evolved. …Read More

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Medical education for the modern world: Communication is key

communication hospital rounds residency medical training

While today’s doctors-in-training learn the most advanced clinical treatments and diagnostic methods, they may be missing out on something equally important: communication skills.

“Care delivery is moving towards a team-oriented model,” says Theodore Sectish, MD, director of education for the Boston Combined Residency Program (BRCP, a joint pediatric training program of Boston Children’s Hospital and Boston Medical Center). “We need to do a better job of training doctors to work with other clinicians and use standardized language.”

Poor communication can have a significant impact on patient outcomes. As Sectish points out, “Communication errors are the number one cause for sentinel events.” (A sentinel event is a death or serious injury in a health care setting that is unrelated to the natural course of the patient’s illness.)

And it’s not just discussions among clinicians that are important. Physicians must also be trained to translate complex medical information into a clear, comprehensible message for patients and families.

Recognizing that the era of maverick physicians working alone is over, hospital residency programs are developing initiatives to better prepare young doctors for the collaborative, patient-centered model of modern health care. …Read More

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Four things to know about what’s new in sickle cell disease

sickle cell disease anemia red blood cells
(OpenStax College/Wikimedia Commons)

An expert panel convened by the National Heart Lung and Blood Institute recently issued the first new guidelines (PDF) since 2002 for the management of sickle cell disease (SCD). In addition, the National Institutes of Health recently closed the Transcranial doppler With Transfusions Changing to Hydroxyurea (TWiTCH) study, which compared treatments to prevent stroke in children found to be at high risk of developing the complication.

Briefly, here is what these and other recent developments mean for the treatment of patients with SCD. …Read More

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