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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 ]
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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
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