Episode 23: Nephritis

Education, Emergency Medicine, Medical Education, Nephrology, Pediatric Emergency Medicine

What is it and why are there so many names?

On this episode, host Jason Woods speaks with Dr. Danielle Soranno, pediatric nephrologist, about nephritis in children. What is it, why are the terms so confusing, how do we diagnosis it, and when should we involve a nephrologist? Did the nephrologists invent terminology just to confuse us?

Guests

Danielle Soranno MD,  Assistant Professor, Pediatrics, Bioengineering & Medicine
University of Colorado and Children’s Hospital Colorado

References

  1. Floege J, Amann K. Primary glomerulonephritides. Lancet. 2016 May;387:2036-2048.
  2. Brogan P, Eleftheriou D. Vasculitis update: pathogenesis and biomarkers. Pediatr Nephrol. 2018 Feb;33:187-198.
  3. Chadban SJ, Atkins RC. Glomerulonephritis. Lancet. 2005 May;365:1797-1806.

Little Big Little: What is Vaping?

Adolescent Medicine, Education, Emergency Medicine, Podcast, Pulmonology, Uncategorized

This is the first segment in a series of “shorts” – smaller quick hit episodes on a focused topic. I’m going to affectionately call them “Little Big Littles”.

On this Little Big Little, host Jason Woods speaks with Dr. Heather Hoch about what we might need to know about vaping to take care of our patients.

Guests

Heather Hoch MD – Assistant Professor, Dept. of Pediatrics, Section of Pulmonary and Sleep Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado

Important Resources

  1. CDC Electronic Cigarette Information
  2. Smokefree.gov

Episode 15b: Specific Renal Issues

Education, Nephrology, Podcast, Uncategorized

This is part 2 of a discussion with Dr. Danielle Soranno, on specific renal issues in the ED. She discusses hyperkalemia, end-stage renal disease, and HUS among others. If you haven’t listened to Part 1 yet, got back an episode in the feed.

Guests

Danielle Soranno MD,  Assistant Professor, Pediatrics, Bioengineering & Medicine
University of Colorado and Children’s Hospital Colorado

Episode 15a: Nephrology Overview with Danielle Sorrano

Education, Emergency Medicine, Nephrology, Pediatric Emergency Medicine, Podcast, Uncategorized

On this episode, host Jason Woods tries to tackle all things renal. This is part 1 of a discussion with Dr. Danielle Soranno, who gives an overview of how she approaches the kidney and what things we need to know in general. She talks about common renal issues in the emergency department and what information she wants to hear when called for a consult

Part 2 will post later this week and digs into some specific illnesses such as HUS, hyperkalemia, and end-stage renal disease.

Guests

Danielle Soranno MD,  Assistant Professor, Pediatrics, Bioengineering & Medicine
University of Colorado and Children’s Hospital Colorado

Important Information

  1. Fab Four – FABU
    1. Function
    2. Anatomy
    3. Blood Pressure
    4. Urine

Episode 12: High Altitude Illness with Elaine Reno

Education, Emergency Medicine, Medical Education, Pediatric Emergency Medicine, Podcast, Uncategorized, Wilderness Medicine

On this episode, host Jason Woods speaks with Dr. Elaine Reno, an emergency medicine physician who is also a wilderness medicine expert, about high altitude illness in pediatrics. We focus on risk factors, identification of illness, and recommendations for initial treatment.

Important points

  1. Significant altitude illness is rare below 8000 feet
  2. Pre-verbal children DO experience high altitude illness but can be more difficult to diagnose given the difficulty in communication.
  3. Dr. Reno strongly prefers slow acclimatization for children, rather than prophylactic medication.

Point of Care Resources

  1. Wilderness Medical Society
  2. Colorado Wilderness Medicine
  3. Lake Louise Acute Mountain Sickness Score
  4. Children’s Lake Louise Score

Guests

Elaine Reno MD – Assistant Professor of Emergency Medicine, University of Colorado School of Medicine, Department of Emergency Medicine, Section of Wilderness and Environmental Medicine

 

Episode 8: Firearm and Youth Violence in Canada

Education, Emergency Medicine, Firearm Violence, Medical Education, Pediatric Emergency Medicine, Podcast, Uncategorized

We continue our look at firearm and violent injury in the youth population by examing the issue outside of the United States. Host Jason Woods MD gathered Canadian physicians Carolyn Snider and Natasha Saunders, both researchers on violent injury (and specifically firearm-related injury), to discuss the scope of violent youth injury in Canada, ED-based intervention programs, risk factors, and the rising rates of injury due to air guns and BB guns.

Guests

Carolyn Snider MD, MPH – Associate Professor, Department of Emergency Medicine, University of Toronto, Staff Physician Winnipeg Health Sciences Center, founder of the Emergency Department Violent Injury Prevention program (EDVIP)

Natasha Saunders MD – Assitant Professor Department of Pediatrics University of Toronto, Staff Physician Hospital for Sick Children, Adjunct Scientist Institute for Clinical Evaluative Sciences

Resources

National Network of Hospital-based Violence Intervention Programs – http://nnhvip.org/

  1. Saunders NR, Lee H, Macpherson A, Guan J, Guttmann A. Risk of firearm injuries among children and youth of immigrant families. CMAJ. 2017;189(12):E452-E458.
  2. Snider CE, Ovens H, Drummond A, Kapur AK. CAEP Position Statement on Gun Control. Canadian Journal of Emergency Medicine. 2009;11(1):64-72
  3. Snider CE, Brownell M, Dufault B, Barrett N, Prior H, Cochrane C. A multilevel analysis of risk and protective factors for Canadian youth injured or killed by interpersonal violence. Inj Prev. July 2017:injuryprev–2016–042235–7
  4. Snider C, Woodward H, Mordoch E, et al. Development of an Emergency Department Violence Intervention Program for Youth: An Integrated Knowledge Translation Approach. Progress in Community Health Partnerships. 2016;10(2):285-291

Episode 7: Reframing how we think about firearm violence

Education, Emergency Medicine, Firearm Violence, Medical Education, Pediatric Emergency Medicine, Podcast, Uncategorized

Violent injury, particularly related to firearms, has been at the forefront of national discussion recently. Pediatric victims and survivors have begun to enter into the public discussion via a strong social media presence, and as clinicians who treat these patients’ injuries, we are also obligated to participate in prevention. This is the first in a series of episodes to address what we know about firearm violence, what interventions have been tried, and how we can reframe the discussion to focus less on political beliefs and more on harm reduction.

Host Jason Woods MD gathered national firearm violence experts Megan Ranney MD MPH, Patrick Carter MD, and Stephen Hargarten MD MPH to introduce where the research, policy, and political climate sits currently and to give some ideas on how to think and speak about this issue with patients and families.

Guests

Megan Ranney MD MPH- Associate Professor of Emergency Medicine at Brown University, violence prevention researcher, past chair of ACEP Trauma and Injury Prevention Section
Stephen Hargarten MD MPH – Professor and chair of Emergency Medicine of Medical College of Wiscone, Director of MCW Comprehensive Injury Center
Patrick Carter MD – Assistant Professor of Emergency medicine, and Assistant Director of the Injury Prevention Center at the University of Michigan

Resources

Videos from University of Michigan  “Open Michigan” site on how to talk to patients and families about firearms

Articles

  1. McCourt AD, Vernick JS, Betz ME, Brandspigel S, Runyan CW. Temporary Transfer of Firearms From the Home to Prevent Suicide. JAMA Intern Med 2017;177(1):96–6.
  2. Wintemute GJ, Betz ME, Ranney ML. Yes, You Can: Physicians, Patients, and Firearms. Ann Intern Med 2016;165(3):205–10.
  3. MPH MLRM, MD JF, MPH HAM, et al. A Consensus-Driven Agenda for Emergency Medicine Firearm Injury Prevention Research. YMEM 2017;69(2):227–40.
  4. Parikh K, Silver A, Patel SJ, Iqbal SF, Goyal M. Pediatric Firearm-Related Injuries in the United States. Hospital Pediatrics 2017;:hpeds.2016–0146–12.
  5. Hargarten S. Firearm Injury in the United States: Effective Management Must Address Biophysical and Biopsychosocial Factors. Ann Intern Med 2016;165(12):882–2.
  6. Carter PM, Cook LJ, Macy ML, et al. Individual and Neighborhood Characteristics of Children Seeking Emergency Department Care for Firearm Injuries Within the PECARN Network. Acad Emerg Med 2017;24(7):803–13.
  7. Goldstick JE, Carter PM, Walton MA, et al. Development of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence Risk. Ann Intern Med 2017;166(10):707–15.
  8. Carter PM, Walton MA, Goldstick J, et al. Violent firearm-related conflicts among high-risk youth: An event-level and daily calendar analysis. Preventive Medicine 2017;102(C):112–9.

Episode 6: What is the ED role in Child Abuse Evaluation and Documentation?

Education, Emergency Medicine, Medical Education, Pediatric Emergency Medicine, Podcast, Uncategorized

Host Jason Woods MD chats with Dan Lindberg MD, national expert in Child Abuse evaluation, on what role the ED plays in the evaluation of child abuse, and addresses the things that scare the ED doc the most. How do I avoid going to court? What and how should I document? What can I do so that I don’t screw up the case for the lawyers?

Episode 5: Establishing an Education Brand with Brad Sobolewski

Education, Emergency Medicine, Medical Education, Pediatric Emergency Medicine, Podcast

Host Jason Woods MD chats with Brad Sobolewski MD, on how he established his own brand as a medical educator, with advice for new medical educators just starting on this path.

Episode 4: Youth Concussions with Joe Grubenhoff

Concussion, Education, Emergency Medicine, Medical Education, Pediatric Emergency Medicine, Podcast, Uncategorized

Host Jason Woods MD chats with Joe Grubenhoff MD, on what role the ED plays in concussion evaluation, the updated concussion guidelines, and where the pendulum will come to rest on rest versus activity in the post-concussion time period.