Clinical Track Workshop Sessions

Session Objective and Discription

Accident, Neglect or Abuse- Pathways to an Answer
Margaret McHugh

This session will review the various clinical presentations in which the diagnosis of child maltreatment may be considered in the inpatient setting. Defi nitions of the types of physical abuse and neglect will be discussed with particular emphasis on individual distinctions based on state child protection legislation. The basic concepts of (1) history (2) physical examination and (3) labs/radiographic studies will be utilized to suggest how evaluations should be done to determine if abuse and/or neglect may have occurred. The range of presentations will be reviewed, from the acute trauma resulting from child abuse as seen in the emergency room to an incidental disclosure of abuse by a child admitted for a unrelated medical problem. The use of hospital services, namely social work and child development staff , will be discussed, both in the evaluation of possible abuse cases and the interactions with the child protection system after a case is reported. Protocols and hospital procedures will be discussed.

Clinical Conundrums 1 and 2
Jennifer Maniscalco

Clinical conundrums are back! This is an interactive session designed to facilitate discussion regarding several challenging or intriguing clinical cases, representing a variety of disciplines. Come test your knowledge, contribute to the discussion, and learn from your colleagues! This session will focus primarily on clinical issues related to inpatient pediatric medicine.

Clinical Conundrums 3
Jennifer Daru

This session will highlight 2-3 case scenarios submitted and presented by attendees with a focus on difficult decisions encountered by pediatric hospitalists. Group participation will be encouraged to outline diff erent solutions to ethical or other problems encountered by hospitalists as a clinical scenario is presented and resolved.

The Diagnosis and Management of Entropy: Complex Care Made Simple
Allison Ballantine

The care of children with complex medical needs is an inevitability for today’s hospitalist. In this session we will explore a systematic approach to these patients and defi ning their goals of care. This framework enhances the hospitalist’s ability to partner with families and other providers to provide effi cient and eff ective care to this challenging population.

Imaging of Common Diagnostic Dilemmas: Where do you begin?
Nakul Jerath and Riva Kamat

The range of diagnostic dilemmas facing the pediatric hospitalist is increasingly broad, and the workup of each potential disease more complex. This workshop is designed to help the practicing hospitalist order the correct diagnostic test for their patient.

Learning Objectives:

To address in a manner suffi cient to enable participants to better understand the following areas:

  • Choosing through the arsenal of radiologist tests to best identify the diagnosis, limiting expense and decreasing length of hospital stay.
  • Minimizing radiation exposure to a vulnerable patient population.
  • Understanding exam ordering and patient procedure preparation.
  • Reviewing clinical case scenarios to highlight the best radiologic test to obtain a diagnosis using evidence based medicine.

At the conclusion of this education activity, the participant should be better able to:

  • Weigh pros and cons of varying imaging algorithms.
  • Understand limitations of frequently used imaging modalities.
  • Navigate off hours testing and varying imager comfort with pediatric patients.

The Newborn and the Hospitalist: Care Updates and Diagnostic Conundrums
Jennifer Daru

This session will review delivery room and newborn scenarios that will cover newer topics including; neonatal cooling, and diagnostic conundrums, such as a child with dropping Apgars despite resuscitation.

Through these scenarios we will also review billing and coding tips/updates. The active participant will walk away with an updated neonatal approach and a way to bill for it as well.

Pediatric EKGs for Morons:
The Simple, Fun Way to Make Sense of All Those Annoying Squiggly Lines
Erich C. Maul

Basic interpretation of electrocardiograms (EKG’s) is an everyday occurrence in the adult inpatient unit. However the same cannot be said for inpatient pediatrics. While we all learned this skill in residency, unless practiced is maintained, the familiarity with the process degrades. Knowing EKG interpretation beyond simple pattern recognition is an essential skill for the pediatric hospitalist. It is a valuable tool in the diagnosis of congenital heart disease, hypertension, electrolyte disturbances, and conduction anomalies, just to name a few.

The objectives of the workshop are the following:

  • Review EKG physiology,
  • Emphasize age related changes in EKG’s,
  • Construct a reliable system for EKG review and interpretation.

At the conclusion of this session, the participant should comprehend the skills necessary for proper EKG evaluation and apply them to daily inpatient situations. Also, the learner should be able to make more effective and effi cient cardiology referrals based on proper EKG interpretation.

Pediatric Neurologic Emergencies Edward E. Conway Jr.

This session will address the most common pediatric neurologic emergencies which the hospitalist will encounter in their daily practice. The goal(s) of the session will be to increase the participant’s knowledge base and their level of comfort and confi dence when challenged by children presenting with these clinical issues. The participants will learn to recognize and manage life-threatening neurologic emergencies. This session will be based on interactive case scenarios combined with didactic, evidence based summaries of the recognition and management of the neurologic process presented in the vignette. Cases will include those which highlight the following entities: cerebral edema in patients with DKA, intracranial hypertension, status epilepticus, nonaccidental head injury, altered mental status and coma and ventricular shunt malfunction.

Providing Safe and Eff ective Sedation: the Role of the Hospitalist
Douglas Carlson

This session will highlight safe sedation practice, using recommendations of the American Academy of Pediatrics and the American Society of Anesthesiology. Safe systems of care will be highlighted. Training and credentialing of pediatric hospitalists to provide safe sedation will also be discussed.

Skin Conditions in the Hospitalized Child
Julie Schaffer

This session will provide a framework for the approach to cutaneous eruptions in pediatric inpatients. A case-based format will be utilized to illustrate the diff erential diagnosis, evaluation, and management of exanthematous, bullous, and purpuric skin conditions. Common and potentially severe dermatoses with infectious, drug-induced, and primary infl ammatory etiologies will be discussed. Special considerations in immunocompromised patients, including hematopoietic stem cell transplant recipients, will also be addressed.

Treatment of Childhood Pneumonia (and other common infections):
Transitioning from Intravenous to Oral Therapy
Samir Shah

Learning Objectives:

  • Explain the rationale for sequential intravenous-oral therapy for common childhood infections
  • Identify situations that merit transition from intravenous to oral therapy
  • Describe characteristics and clinical usefulness of oral antibiotics used to treat common childhood infections

Advances in drug development have increased the availability of antibiotics with good bioavailability. Furthermore, economic pressures in healthcare delivery have necessitated a focus on reducing costs and resource utilization while maintaining or improving the quality of care. For several diseases, there is frequently controversy and occasionally consensus regarding the cost-eff ectiveness and safety of switching from intravenous to oral therapy. Within the framework of common childhood infections, participants will be able to understand the rationale for sequential intravenous-oral therapy, identify situations that merit consideration of switching from intravenous to oral therapy, and describe the spectrum of activity and pharmacokinetics of antibiotics that are often used to transition children from intravenous to oral therapy.




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