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doctor’s digest A MONTHLY NEWSLETTER FOR ST. LOUIS CHILDREN’S HOSPITAL ATTENDING AND REFERRING MEDICAL STAFFS july 2013 _________________________________________________________ In this issue 3 Pediatric Hospital Medicine Moves Toward Specialty Status 5 Cole Elected to March of Dimes National Board 7 Graduating Residents and Fellows Make Plans for the Future Rapid Assessment, Treatment of Neonates with Neurological Problems is Critical [clinical focus] Christopher Smyser, MD, assistant professor, For babies born with neurological problems, neurology, at Washington University School the treatment they receive in the first few hours of Medicine, attending pediatric neurologist at of life has the potential to significantly improve SLCH and a member of the consultation service. their outcomes. St. Louis Children’s Hospital “We also offer advanced treatments for which we (SLCH) is one of only a few pediatric facilities in have participated in multi-center studies proving the country with a specialized, multidisciplinary their effectiveness.” service specifically developed to care for these For babies born with neurological One of these treatments newborns. The neonatal is therapeutic hypothermia problems, treatment received neurology consultation for newborns with within the first six hours of life service includes neonatal encephalopathy. may significantly improve their pediatric neurologists, It involves lowering neonatologists, outcomes. the newborn’s body neurosurgeons and — Dr. Christopher Smyser temperature from a neuroradiologists who standard 37 degrees take a “neuro-protective Celsius to 33.5 Celsius. Cooling wraps that approach” to ensuring the best possible outcomes circulate cool water are placed around an infant’s for these newborns. legs and trunk. After three days, babies are slowly “ “In combination with a thorough medical history and physical exam, we use advanced diagnostic tools like EEGs, MRI scans, ultrasound studies and lumbar punctures, the results of which are interpreted by specialists who treat newborns with neurological concerns every day. At any given time, we are typically providing care for 15 to 20 patients in the hospital’s NICU,” says ” warmed over a 24-hour period. “Studies show that therapeutic hypothermia can significantly reduce the chance of brain injury in these patients,” says Dr. Smyser. “However, it appears that it is most effective when begun within six hours of birth, which means a quick referral to the NICU is critical.” continued on next page WUSM Providers Participate in the HCUSA Network Washington University School of Medicine (WUSM) physicians are again participating providers with HealthCare USA (HCUSA). St. Louis Children’s Hospital is also an in-network provider. Children’s Direct Line 800.678.4357 • StLouisChildrens.org [ 1 ] Share Your Ideas Should you have ideas or suggestions you would like brought before the Children’s Medical Executive Committee (CMEC), contact one of your CMEC private physician representatives: Seth Brownridge, MD 314.731.1299 Joe Goldenberg, MD 314.576.1616 David Hartenbach, MD 314.567.7337 Stacie Laff, MD 618.257.2800 Christina M. Ruby-Ziegler, MD 314.535.7855 _________________________________________________________ Let Us Hear From You If you have comments or suggestions regarding Doctor’s Digest, or if you would like to share information about your activities as a physician, contact: Amy Connelly Marketing and Communications St. Louis Children’s Hospital 4901 Forest Park Avenue Suite 1022 St. Louis, MO 63108 Mailstop 90.75.560 314.286.0324 fax: 314.747.8644 [email protected] _________________________________________________________ Doctor’s Digest Published for the attending and referring medical staffs of St. Louis Children’s Hospital. Joan Magruder President Perry L. Schoenecker, MD Medical Staff President Joe Goldenberg, MD Medical Staff President-Elect rapid assessment of Neonates continued from page 1 Another advanced approach is using specialized equipment to continuously monitor newborns’ brain function. “Our team strives to identify and manage seizures appropriately, and these can go undetected if a baby’s brain is not monitored,” says Dr. Smyser. “Interpretation of the complex EEG data is performed by our service’s neurologists and neonatologists. Our familiarity with existing and newly available anti-seizure medications means we not only have a broad selection from which to choose, but also an understanding of when it is best to use each medication.” He adds, “Another major advantage of our service is that our team members have developed close working relationships amongst sub-specialties, and that this collaborative approach results in improved care for our patients.” An example of that collaborative effort is the care provided for newborns with intraventricular hemorrhage. “Working with our neonatology, neuroradiology and neurosurgery colleagues, we’ve learned that increasing the frequency of ultrasound studies to monitor these patients and in some cases providing early neurosurgical intervention have made a significant difference in their outcomes,” explains Dr. Smyser. Other conditions evaluated and treated by the neonatal neurology consultation service include perinatal stroke, meningitis, cerebral malformations, periventricular leukomalacia (PVL), hypotonia and neuromuscular disorders. For all patients seen by the service, the goal is to provide continuity and coordination of care that continues even after their discharge from the hospital. Both the neonatal neurology and newborn medicine follow-up clinics are held on the same appointment day for the convenience of families. “We are committed to improving our patients’ outcomes through a development-friendly care plan specific for each infant and family, and coordination with referring physicians,” says Dr. Smyser. “We want to make sure families are educated about their child’s conditions and the resources available to them, both at the hospital and in the community, so that the transition to home goes as well as possible. In addition, we continue following these patients in clinic until the age of 2 or older, depending on their diagnosis and progress. This long-term relationship helps us ensure our patients have every opportunity to do well in life.” To consult with a member of the neonatal neurology consultation service or to refer a patient, call Children’s Direct at 800.678.HELP (4357). SLCH’s neurology and newborn medicine specialties are national leaders, as ranked by U.S.News World & Report. Neurology and neurosurgery rank #2; neonatology/newborn medicine ranks #3. Neonatal Neurology Consultation Service The St. Louis Children’s Hospital neonatal neurology consulting service cares for infants in the neonatal intensive care unit (NICU) with neurological concerns. Conditions commonly treated: • Neonatal (hypoxic-ischemic) encephalopathy •Seizures •Stroke •Meningitis •Intraventricular hemorrhage • Cerebral malformations • Hypotonia/Neuromuscular disorders Sleep Center Receives Accreditation continued from page 8 had the capabilities and knowledge to perform those tests.” Dr. Kemp sees the five-year accreditation as an acknowledgement of the high standards that have guided the Sleep Center for the past 20 years. to provide services commensurate with what is recognized as the gold standard of care,” he says. “Now the country’s premier sleep medicine professional organization has recognized those efforts.” “As an entity within the Children’s Hospital and Washington University systems, we always strive To refer a patient to the sleep center, contact Children’s Direct at 800.678.4357. [ 2 ] Children’s Direct Line 800.678.4357 • StLouisChildrens.org [medical update] Pediatric Hospital Medicine Moves Toward Specialty Status At the National Pediatric Hospital Medicine Leaders Conference held in April, participants discussed options related to the field’s potential certification. The overwhelming consensus was that the practice of pediatric hospital medicine requires post-residency training. “Pediatric hospital medicine is in the same position now as pediatric emergency medicine was 20 years ago,” says Douglas Carlson, MD, professor of pediatrics and director, division of hospital medicine, department of pediatrics at Washington University School of Medicine and St. Louis Children’s Hospital (SLCH). Dr. Carlson is a member of national committees of the Society of Hospital Medicine and serves as co-chair of the Workforce Committee of the National Pediatric Hospital Medicine Roundtable. “Just as emergency medicine did in the 1980s, hospital medicine has developed into an integral component of clinical care for hospitalized pediatric patients.” Dr. Carlson notes that the growth of acute-care, hospital-based medicine can be traced in part to the Institute of Medicine’s “To Err is Human” report in 1999, which called for building a safer health system. “Pediatric hospital medicine has evolved into an area highly concentrated on working with our medical professional colleagues to improve quality systems and safety within hospitals’ inpatient units,” he says. In years past, becoming a pediatric hospitalist often was seen as a transitional position, with physicians eventually leaving to enter private practice or a fellowship program. Today, it is viewed as a viable career path for pediatricians who like caring for children in a hospital setting, enjoy teaching medical students and residents, and have a desire to advance clinical care through cooperative Pediatric Hospital Medicine at SLCH research with their medical colleagues. “Training for those new to the field now consists of didactic teaching, on-the-job training and mentorship, much as it was in pediatric emergency medicine as it evolved,” says Dr. Carlson. “At the April leadership conference, we agreed that a standardized training program—a twoHospitalist Kelly Ross, MD year fellowship—resulting in certification was the best option to ensure adequate training in pediatric hospital medicine core competencies.” Those competencies include communication skills, negotiation, leadership, quality improvement, pain management, sedation, procedures, transport, billing/coding, autonomous decision-making and scholarly practice. To achieve specialty status, approval by the American Board of Pediatrics and then the American Board of Medical Specialties is needed. That approval process probably will take five to seven years. Then accreditation of fellowship programs can begin. “Establishing these fellowships will guarantee those entering the field of pediatric hospital medicine are prepared to provide excellent patient care and to move the specialty forward through clinical research focused on improving quality and safety within the hospital setting,” says Dr. Carlson. community physicians have all the information they need to continue caring for their patients upon discharge from the hospital.” At St. Louis Children’s Hospital (SLCH), the precursor to the pediatric hospitalist position began in 1996, when five pediatric generalists were hired to help expand SLCH’s services at Missouri Baptist Medical Center. The pediatricians were responsible for providing clinical and educational programs in Missouri Baptist’s pediatric emergency unit and normal newborn nursery. Eventually, those services were expanded to Progress West HealthCare Center, as well. • providing coverage of the normal newborn nursery at Barnes-Jewish Hospital Today, 50 hospitalists at SLCH fill the equivalent of 41 full-time positions. Qualities required of those entering the field include excellent clinical backgrounds gained from residency training or previous hospitalist positions, exceptional communication skills and an ability to work well within a team. • coordinating medical oversight for transfer patients “One of our main goals is to help bridge the transition from the primary care home into the hospital and then back again,” says Douglas Carlson, MD, director, division of hospital medicine, department of pediatrics at Washington University School of Medicine and SLCH. “Our providing the best care to hospitalized patients means holding ourselves to a high standard of communication with primary care physicians. We want to ensure In addition to their work at Missouri Baptist and Progress West, SLCH’s pediatric hospitalists are instrumental in: • providing coverage for sedation services for the main campus’ radiology department, Ambulatory Procedure Center (APC) and Pediatric Acute Wound Service (PAWS) and urgent care within SLCH’s emergency unit • serving as attending physicians for general pediatric wards “Our pediatric hospitalists possess a unique flexibility that allows them to fill diverse roles within the hospital setting,” says Dr. Carlson. “And it is an area that is constantly changing. For instance, in recent years as residents’ work hours are being reduced, hospitalists serving as attending physicians have become more integrated into the day-to-day continuity of care. Hospitalists’ ability to fulfill these types of needs as they arise is what makes this position an attractive, challenging career path for many physicians.” Children’s Direct Line 800.678.4357 • StLouisChildrens.org [ 3 ] [research update] Splints Favored for Kids’ Forearm Buckle Fractures Among the most common pediatric injuries seen in emergency rooms are fractures that occur when children fall and try to catch themselves with an outstretched hand. For many, that tumble on the playground, around the bases or off a bunk bed results in a “buckle fracture,” a forearm injury traditionally treated with a cast. But new research from Washington University School of Medicine shows that removable splints are clearly preferred by patients and their parents, building on earlier findings that such splints are just as effective as casts. “Our goal is to manage these fractures in a manner that allows healing while maximizing comfort and convenience yet minimizing disruptions in children’s active lifestyles,” said senior author Janet D. Luhmann, MD, an associate professor of pediatrics and physician in the emergency department at St. Louis Children’s Hospital. “Traditionally, forearm buckle fractures have been managed with casts, which can be heavy, uncomfortable and, in the summer, hot and cumbersome. Without an expensive liner, children can’t get them wet, which results in significant inconvenience regarding swimming and hygiene.” The new findings, coupled with earlier research into the effectiveness of splints versus casts, have led to a recent change in the standard treatment of uncomplicated forearm buckle fractures in the emergency department at St. Louis Children’s. Now, prefabricated splints are the chosen treatment. Further, absent pain experienced by patients, no longer is it recommended that they follow up with orthopedic surgeons and possibly undergo more X-rays. Rather, explained Kristine G. Williams, MD, the study’s lead author and assistant professor of pediatrics, who treats patients in St. Louis Children’s emergency department, children can be seen by their pediatricians two or three weeks later. The researchers’ findings are available online in Pediatric Emergency Care. The recommendations are based on the study’s findings that splints were clearly favored over casts in terms of convenience, satisfaction and preference in the treatment of buckle fractures in children. A significant percentage of emergency department visits involve children seeking care for orthopedic injuries, said Dr. Luhmann. And of these, the most commonly affected area is the forearm, near where the wrist absorbs a fall. “Buckle fractures are a significant and increasingly common injury in children, likely due in part to increased participation in organized sports,” she said. The fracture most often occurs in the radius, the bone on the thumb side of the forearm. For that reason, the study’s focus was on radial buckle fractures that occur near the wrist. Children’s bones, when compared with the bones of adults, are less dense, more porous and more likely to bend than break. “Because children’s bones are more plastic, they actually can buckle, [ 4 ] Children’s Direct Line 800.678.4357 • StLouisChildrens.org bend or bow instead of break all the way through,” Dr. Luhmann explained. “Kind of like pavement that has sustained too much heat, the bone buckles under too much stress.” Buckle fractures are inherently Kristine G. Williams, MD, holds a removable splint stable and are alongside study co-author Janet D. Luhmann, MD. at low risk for displacement and complete breakage, so they tend to heal well with minimal intervention, according to findings in previous studies. The questions researchers set out to answer in this study focused on just how patients and parents felt about two accepted treatment options: casts and splints. The study took place from April 2006 through May 2009 and involved 94 patients, ages 2 to 17, treated by Washington University physicians at St. Louis Children’s emergency department. The patients were randomly assigned to either short-arm casts or prefabricated wrist splints. They or their parents then were interviewed in the emergency department and again post treatment at days one, three, seven and 21. Areas assessed were satisfaction, convenience, preference and pain. The findings showed a clear trend favoring splints at almost every period throughout the study. The only exception noted involved pain experienced by patients immediately after receiving splints or casts, before discharge from the emergency department. Those in the splinted group reported a higher incidence of pain at that stage, though the difference was not statistically significant. The findings, Drs. Williams and Luhmann said, show that when treating uncomplicated buckle fractures near the wrist, splints are preferred by patients and their parents—in addition to the fact they are easier, less time-consuming and less expensive to apply than casts. ‘’We found very clearly that over the entire study period, parents rated the splint higher in almost all categories,” said Dr. Williams. “They tended to say they would definitely choose the splint again over a cast if they had a similar kind of injury.” In the event a health professional recommends a cast for a child who suffers a forearm buckle fracture, Dr. Williams suggests that the parent request a splint, based on the study’s findings. Williams KG, Smith G, Luhmann SJ, Mao J, Gunn III JD, Luhmann JD. A randomized controlled trial of cast versus splint for distal radial buckle fracture. Pediatric Emergency Care. May 2013. [faculty update] Cole Elected to March of Dimes National Board F. Sessions Cole, MD, the Park J. White, MD, Professor and vice chair of the Department of Pediatrics at Washington University School of Medicine, has been elected to the March of Dimes National Board of Trustees. March of Dimes trustees, who serve as volunteers, represent the public in governing the organization and advancing its mission for the health of mothers and babies. Trustees serve five-year terms. “My involvement with the Missouri Chapter of March of Dimes dates back more than two decades, and I am honored to be joining the national board of such a respected organization,” Dr. Cole said. “I am looking forward to this new role and the opportunity to work to give more babies a healthy start in life.” Dr. Cole, who also is the chief medical officer of St. Louis Children’s Hospital, is recognized as a driving force behind the success of the hospital and its newborn intensive care unit (NICU). Additionally, he is the university’s assistant vice chancellor for children’s health and director of the division of newborn medicine. He is a leading national advocate of the consequences of premature birth and advises colleagues and would-be parents about in vitro fertilization and delayed childbirth. [faculty update] Dr. Cole received his medical degree from Yale University School of Medicine in 1973. He joined Washington University School of Medicine in 1986 as an associate F. Sessions Cole, MD professor of pediatrics and he was named director of newborn medicine. He restructured the newborn medicine service at St. Louis Children’s Hospital, Barnes Hospital and Jewish Hospital. Under his direction, the department has become a leader in providing medical services to infants. This year, the March of Dimes, a leading nonprofit organization for pregnancy and baby health, is celebrating its 75th anniversary and its ongoing work to help babies get a healthy start in life. Wolff Honored for Life-Saving Work in Haiti The World Affairs Council of St. Louis has named Patricia Wolff, MD, Washington University School of Medicine, as the recipient of its 2013 International Humanitarian of the Year Award. Dr. Wolff, a professor of clinical pediatrics and member of the St. Louis Children’s Hospital medical staff since 1977, is being honored along with Meds & Food for Kids, a nonprofit organization she founded in 2004 to battle child malnutrition in Haiti. Dr. Cole, who in 1997 was awarded the FDR Leadership Award from the March of Dimes, is a member of the organization’s Scientific Advisory Committee on Prematurity. He has worked with the March of Dimes Missouri chapter for many years. [medical staff news] After Dr. Wolff first visited Haiti more than a decade ago, she began treating malnourished Haitian children with Ready-to-Use Therapeutic Food (RUTF), as she had seen her Washington University and Children’s Hospital colleague Mark Manary, MD, do in sub-Saharan Africa. Since then, Dr. Wolff’s work has led to the start-up of a factory in Haiti that produces and distributes RUTF — called Medika Mamba in Haiti. Her organization also has worked with Haitian farmers to help them improve their peanut yields. Those peanuts then are used to make Medika Mamba. Such efforts not only have saved many lives in Haiti but have created needed jobs. The World Affairs Council honored her June 6 at the Four Seasons Hotel in St. Louis. Election of Officers in August Election of the St. Louis Children’s Hospital medical staff officers will be held in August. As in the past, the election will be conducted electronically via Survey Monkey. The ballot will be sent to medical staff email addresses currently on file with the medical staff office. Physicians needing to update their email addresses should contact the medical staff office at 314.454.6088. Nominees: Medical Staff President-Elect • Doug Carlson, MD • Doug Coplen, MD • David Molter, MD Children’s Medical Executive Committee (CMEC) Secretary-Treasurer Children’s Medical Executive Committee (CMEC) Community Members • John Galgani, MD • Matt Dougherty, MD • Earl Beeks, MD Children’s Direct Line 800.678.4357 • StLouisChildrens.org [ 5 ] New Physicians aT SLCH: July 2013 Jacob Leo Christensen, MD Assistant Professor in Anesthesiology Specialty: Pediatric Anesthesiology Education/Training: •Pediatric cardiovascular anesthesiology fellowship, Baylor College of Medicine, Houston, TX • Pediatric anesthesiology fellowship, St. Louis Children’s Hospital/ Washington University School of Medicine, St. Louis, MO • Anesthesiology internship/residency, Washington University School of Medicine (WUSM), St. Louis, MO • Medical degree, The University of Texas Medical Branch at Galveston, TX Carlos J. Guevara, MD Instructor in Radiology Specialty: Vascular and Interventional Radiology Education/Training: • Pediatric interventional radiology fellowship, Boston Children’s Hospital, Boston, MA • Vascular and interventional radiology fellowship, Duke University Medical Center, Durham, NC • Radiology residency, Duke University Medical Center, Durham, NC • Orthopaedic surgery internship, Harvard Medical School, Boston • Medical degree, Duke University School of Medicine, Durham, NC Laura Evelyn Hall, MD Jennifer Sprague, MD Instructor in Pediatrics Specialty: Pediatric Endocrinology Education/Training: •Pediatric endocrinology fellowship, WUSM, St. Louis, MO • Pediatrics internship/residency, St. Louis Children’s Hospital/ WUSM, St. Louis, MO • Medical degree, WUSM, St. Louis, MO Robert Peter Stachecki, MD Instructor in Clinical Radiology Specialty: Neuroradiology Education/Training: •Neuroradiology fellowship, WUSM, St. Louis, MO •Diagnostic radiology residency, WUSM • Internal medicine internship, St. Mary’s Health Center, St. Louis, MO • Medical degree, Georgetown University School of Medicine, Washington, D.C. Instructor in Pediatrics Specialty: Pediatric Hospitalist Education/Training: •Pediatrics residency, St. Louis Children’s Hospital/ WUSM, St. Louis, MO • Medical degree, University of Toledo College of Medicine, Toledo, OH Jamie Lynn Kondis, MD Instructor in Pediatrics Specialty: Pediatric Child Abuse Education/Training: •Child abuse pediatrics fellowship, St. Louis Children’s Hospital/WUSM, St. Louis, MO • Pediatrics internship/residency, St. Louis Children’s Hospital/ WUSM, St. Louis, MO • Medical degree, Indiana University School of Medicine, Indianapolis, IN Departing Medical Staff Members Georgeann Keh-Teng Groh, MD Instructor in Pediatrics Specialty: Pediatric Cardiology Education/Training: •Pediatric cardiology fellowship, St. Louis Children’s Hospital/WUSM, St. Louis, MO • Internal medicine and pediatrics internship/residency, Baylor College of Medicine/Baylor Affiliated Hospitals and Texas Children’s Hospital, Houston, TX • Medical degree, Baylor College of Medicine, Houston, TX [slch news] David Haslam, MD, Infectious Diseases Robert Heuckeroth, MD, Gastroenterology Claudia Lares, MD, Hospitalist Medicine Shakir Mohamed, MD, Newborn Medicine Phineas Oren, MD, Critical Care Medicine Robert Paschall, MD, Emergency Medicine Jonathan Strutt, MD, Hospitalist Medicine Otolaryngology Expands to West County David Leonard, MBBCh, assistant professor of otolaryngology at Washington University School of Medicine and pediatric otolaryngology at St. Louis Children’s Hospital, now has weekly office hours near the campus of Barnes-Jewish West County Hospital. Dr. Leonard sees patients on Wednesdays from 8:30 a.m. to 3:45 p.m. at 605 Old Ballas Road in Suite 124. To schedule an appointment with Dr. Leonard or a member of the pediatric otolaryngology team, call Children’s Direct at 800.678.HELP (4357). [ 6 ] Children’s Direct Line 800.678.4357 • StLouisChildrens.org [SLCH News] Graduating Residents and Fellows Make Plans for the Future On June 30, 2013, residents and fellows practicing at St. Louis Children’s Hospital moved into the next phase of their career— as community pediatricians, hospitalists, researchers or specialists, or by continuing subspecialty training. departing residents - pediatrics Graduating Pediatric Residency Program - June 30, 2013 departing fellows WUSM Department of Pediatrics Allergy / Immunology Natalie Miller, MD Private practice, Louisville, KY Cardiology Sanmit Basu, MD Nationwide Children’s Hospital, (4th year imaging fellowship), Ohio State University, Columbus, OH Brian Birnbaum, MD Children’s Mercy Hospital of Kansas City, University of Missouri, Kansas City, MO Georgeann Groh, MD WUSM/SLCH Erin E. Barker, MD. Fellow - Pediatric Critical Care-WUSM/SLCH Whitney B. Bour, MD Fellow - Neonatology-WUSM/SLCH Andrew S. Cluster, MD Fellow - Pediatric Hematology/OncologyWUSM/SLCH Bryanne N. Colvin, MD Fellow - Neonatology-WUSM/SLCH Emergency Medicine Tara D. Copper, MD (Conway) Chief Resident - SLCH Jamie L. Kondis, MD WUSM/SLCH Tina S. Lee, MD Phoenix Children’s Hospital, Phoenix, AZ Indi Trehan, MD, MPH WUSM/SLCH Nicole Cresalia, MD Fellow - Pediatric Cardiology-University of Mich. Joshua C. Euteneuer, MD Fellow - Neonatology-University of Cincinnati, OH Michael A. Goodman, MD Fellow - Pediatric Allergy/Immunology-University of Cincinnati, OH Critical Care Medicine Ryan Majcina, MD Mercy Hospital, St. Louis, MO Renee Potera, MD Southwestern Medical Center, University of Texas Endocrinology Jennifer Sprague, MD, PhD WUSM/SLCH Emily H. George, MD General Pediatrics - Jefferson City Med Group, MO Gastroenterology Laura E. Hall, MD Hospitalist - WUSM/SLCH Shannon Joerger, MD Jennifer A. Horst, MD Fellow - Pediatric Emergency MedicineWUSM/SLCH Amy Barone, MD WUSM (4th year fellowship) Rachel Kassel, MD, PhD Fellow - Pediatric Gastroenterology-WUSM/SLCH Gayle Murray, MD Brody School of Medicine, Greenville, NC Kathryn B. Leonard, MD Fellow - Emergency Medicine-WUSM Infectious Diseases Christopher T. Lux, MD, PhD Fellow - Pediatric Hematology/Oncology Seattle Children’s Hospital, Seattle, WA Duha Al-Zubeidi, MD Children’s Mercy Hospital of Kansas City, University of Missouri, Kansas City, MO Carrie A. Nalisnick, MD Chief Resident - SLCH Rana El Feghaly, MD Batson Children’s Hospital, University of Mississippi Medical Center, Jackson, MS Indi Trehan, MD, MPH WUSM/SLCH WUSM/SLCH Hematology/Oncology Kevin S. O’Bryan, MD Chief Resident - SLCH Shawn D. O’Connor, MD Fellow - Neonatology-WUSM/SLCH Maghna D. Patel, MD Fellow - Pediatric Cardiology-WUSM/SLCH Margarita M. Sergonis, MD Hospitalist - Children’s Hospital of Philadelphia Laura M. Seske, MD Fellow - Neonatology-University of Cincinnati Newborn Medicine Jennifer M. Sucre, MD Fellow - Neonatology-University of California, LA Meghan Coghlan, MD SSM Cardinal Glennon Medical Center, St. Louis University School of Medicine, St. Louis, MO Jade B. Tam-Williams, MD Fellow - Pediatric Pulmonary Medicine WUSM/SLCH Philip Levy, MD WUSM/SLCH Douglas Moeckle, MD Carolinas Hospital System, Florence, SC Michael J. TeKippe, MD, PhD Fellow - Pediatric Infectious Diseases-Vanderbilt University, Nashville, TN Kristin K. Wenger, MD, PhD Hospitalist - SSM Cardinal Glennon Medical Center, St. Louis, MO Outgoing Chiefs - June 2013 Nephrology Elizabeth Anyaegbu, MD Corpus Christi Texas/Driscoll Children’s Hospital, Texas A&M University, Corpus Christi, TX Pulmonary Oscar Rodriguez, MD Cincinnati Children’s Hospital, Cincinnati, OH, Sleep Medicine Fellowship Rheumatology Children’s Hospital of Omaha, University of Nebraska Medical Center, Omaha, NE Kora N. Felsch, MD Hospitalist - SSM Cardinal Glennon Medical Center, St. Louis, MO Emilina Lim, MD Josie V. Lorbert (Vitale), MD Fellow - Pediatric Allergy/Immunology-St. Louis University, St. Louis, MO WUSM Department of Ophthalmology & Visual Sciences Kali L. Svarczkopf, MD Fellow - Pediatric Allergy/Immunology-Vanderbilt University, Nashville, TN WUSM Mallinckrodt Institute of Radiology (MIR) Preliminary - Continuing residency as PGY 3 in Jason A. Helis, MD Neurology/Child Neurology-BJH Young Min Kim, MD Neurology/Child Neurology-BJH Shannon N. Liang, MD Neurology/Child Neurology-BJH Stephanie M. Morris, MD Neurology/Child Neurology-BJH Mohamed Soliman, MD University of Texas, Medical Branch, Galveston, TX Garima Agrawal, MD Fellowship, MIR Dhanashree Rajderkar, MD Fellowship, MIR WUSM Department of Surgery, Pediatric Surgery Elizabeth Fialkowski, MD Pediatric surgical oncology fellowship, Memorial Sloan Kettering, New York, NY WUSM Department of Anesthesiology Preliminary - Continuing Residency as PGY 2 in Timothy Welch, MD WUSM Lauren J. Saling, MD Rebecca Young, MD WUSM Angela Saettele, MD WUSM Brandon A. Roberts, MD Children’s Medical Center, Dayton, OH Sumeeta Varma, MD Resident - Radiology-BJH Resident - Radiation Oncology- Vanderbilt University, Nashville, TN Children’s Direct Line 800.678.4357 • StLouisChildrens.org [ 7 ] Non-profit Organization U.S. Postage PAID St. Louis, MO Permit No. 617 One Children’s Place St. Louis, MO 63110 Marketing and Communications 314.286.0324 Fax: 314.747.8644 In this issue __________________________________________________________________________________________________ 1 Rapid Assessment, Treatment of Neonates with Neurological Problems 4 Splints Favored for Kids’ Forearm Buckle Fractures 6 New Physicians at SLCH [slch news] SLCH Sleep Center Receives Prestigious Accreditation In May, the American Academy of Sleep Medicine (AASM) designated the Pediatric Sleep Center at St. Louis Children’s Hospital (SLCH) as an accredited sleep disorder center. According to the AASM, achieving this accreditation demonstrates a center’s commitment to ensuring patients receive the highest level of care through quality services and longitudinal management of their sleep disorders. is strengthened through joint continuing education in-service training that provides us all with a broader base of knowledge about sleep disorders.” “It is important to note that our accreditation is as a sleep disorder center, not just as a sleep laboratory,” says James Kemp, MD, SLCH pediatric pulmonologist and professor of pediatrics. Dr. Kemp and Kelvin Yamada, MD, SLCH pediatric neurologist, serve as co-directors of the Pediatric Sleep Center. “That means we not only have state-of-theart testing and diagnostic capabilities, but also the expertise in-house to provide patients with comprehensive therapeutic options.” To attain accreditation, the center’s staff members spent a year reviewing and revising standards, practices, policies and procedures to ensure they were in line with the gold standard of care set by the AASM. In addition to Drs. Kemp and Yamada and David Molter, MD, Washington University pediatric otolaryngologist, the Pediatric Sleep Center’s team of consulting physicians includes representatives from allergy, genetics, psychology and plastic surgery. Among the conditions treated are central apnea, central alveolar hypoventilation, obstructive apnea syndrome, chronic respiratory failure, narcolepsy, restless leg/periodic limb movements, and rhythmic movement disorders. Behavioral sleep issues are addressed by SLCH psychologists Suzanne Thompson, PhD, and Kasey Davis, PhD. “Our center opened in 1993, so we have well-established lines of referral throughout the hospital,” says Dr. Kemp. “This familiarity Ashley Greulich, RT, a registered polysomnographic technician, removes electrodes from the face and scalp of patient Zachary Volz, 7. The painless, noninvasive sleep study measures the quality of the patient’s sleep and is used to diagnose and treat many sleep disorders. “Ensuring standards were met for both the pediatric and adult population was a process that involved the entire sleep team,” says Claudia Cleveland, RRT, RPSGT, sleep lab coordinator. “Our patients range in age from neonates to young adults. Children 13 and older are evaluated using adult standards, which meant our policies, procedures and standards had to encompass both adults and pediatrics. Even though some adult sleep tests are not done in children of any age, we needed to ensure we had the documentation available showing we continued on page 2 [ 8 ] Children’s Direct Line 800.678.4357 • StLouisChildrens.org SLC16129 7/13