Primary Care Perspectives: Podcast for Pediatricians

With fewer children seeking care due to physical distancing, the early detection of pediatric cancers is being impacted. Julie Stern, MD, Director of Outreach Services for the Division of Oncology at Children’s Hospital of Philadelphia, discusses how children with cancer may present differently during the COVID-19 pandemic and how pediatricians can optimize physical exams in telemedicine settings to screen for malignancies, common early presentations of a malignancy to watch for, what to include in initial lab workups, how to reassure parents it’s safe to seek care in this time and more.

Parenting challenges faced in typical times are heightened by the COVID-19 pandemic, and both parents and children may be feeling stressed. In this episode, Emily DePaul, MPH, MAC, and Linda McWhorter, PhD, talk about positive parenting during a pandemic and the PriCARE Parenting Program, which focuses on providing a toolbox of parenting techniques to increase positive behavior and build a strong caregiver-child relationship. They offer advice and tools to help address some of the common concerns and challenges parents are facing during COVID-19.

This episode’s guests Flaura Winston, MD, PhD, Founder and Scientific Director of the Center for Injury Research and Prevention, and Daria Ferro, MD, a pediatric hospitalist, discuss all things related to innovation and quality improvement, particularly during the times of a pandemic. They talk about the “innovation ecosystem” at Children’s Hospital of Philadelphia, where the goal is to efficiently, effectively, and safely address acute pain points in pediatric healthcare with sustainable, actionable solutions that can be widely shared -- especially important in a time when we need to get solutions out there safely but quickly.

In the age of COVID-19, many families are wanting to leave the hospital as soon as possible after delivering a new baby. But is it the right thing to do? Joanna Parga-Belinkie, MD, attending neonatologist at Children’s Hospital of Philadelphia, talks about the many factors that must be considered for the health and safety of both mothers and newborns, key newborn screenings, the role primary care providers can play in monitoring infants who were discharged early, resources for new mothers, and more.

Child abuse is unfortunately very common, and in the setting of a pandemic like COVID-19, the risk is elevated. Cindy Christian, MD, talks about the factors that increase the risk for abuse during a pandemic, such as heightened stressors facing families and the fact that children are not visible to those who often recognize and report abuse, like teachers and pediatricians. She also discusses what pediatricians can do to identify possible signs of abuse and neglect, specific injuries that warrant closer evaluation, recommendations for documentation and reporting, and more.

Preterm birth results in multiple challenges, both short term in newborn intensive care units, and long term in the neurodevelopmental outcomes of these babies. Gretchen Lawhon, PhD, RN, CBC, FAAN, a clinical nurse scientist at Abington-Jefferson Health’s Division of Neonatology, discusses how scientific advances continue to inform how we care for these vulnerable patients, with an emphasis on protecting a baby’s developing brain in the context of their specific behaviors, environment, and family unit.

Kevin Osterhoudt, MD, emergency medicine physician and Medical Director of the Poison Control Center at Children’s Hospital of Philadelphia, covers all things lead – common sources of lead exposure, long-term effects on children, screenings for blood lead levels, lead poisoning, and management of lead poisoning.

Pediatric cardiologist Shohba Natarajan, MD, talks about identifying and treating patients at risk for early cardiovascular disease. She identifies pediatric diagnoses that put a child at risk, what to look for in family history, and discusses the important role that primary care pediatricians play in cardiovascular disease screenings and identifying patients who may not otherwise be considered high risk.

Pediatric endocrinologist Marissa Kilberg, MD, gives a refresher on the hypothalamic pituitary adrenal (HPA) axis and endocrine labs, including a breakdown of what is being looked at and how to best evaluate adrenal function of a pediatric patient.

Roy Wade Jr., MD, PhD, MPH, MSHP, a researcher and pediatrician at Primary Care, Cobbs Creek, discusses adverse childhood experiences (ACEs) and their life course impact on the health and well-being of kids. He talks about how primary care pediatricians can assess for ACEs and help address these experiences by collaborating with agencies in our community that are directly addressing these issues with patients and families, current research trends and advocacy efforts, and much more.

Lan Chi “Krysti” Vo, MD, an attending psychiatrist at CHOP, discusses the current landscape of mental health care in the United States, the need for specialized child and adolescent psychiatrists, and how telepsychiatry has the potential to expand access to mental health services for more patients.

While any child can experience a febrile seizure, they are most common between the ages of 18 and 24 months. Sara Fridinger, MD, an attending pediatric neurologist at Children’s Hospital of Philadelphia, talks about causes, signs and symptoms of febrile seizures, as well as how to differentiate between simple and complex febrile seizures and when to take action.

Sarah Fesnak, MD, an attending physician in the Emergency Department at Children’s Hospital of Philadelphia, discusses the evaluation and management of lacerations in primary care. Appropriate referrals to the Emergency Department and the wound follow-up after repair are reviewed.

Sabrina Gmuca, MD, MSCE, and David Sherry, MD, pediatric rheumatologists at Children’s Hospital of Philadelphia, explain the intense pain experienced by children with amplified musculoskeletal pain syndrome (AMPS), common causes and presentations of amplified pain, and evidence-based interventions that can help manage pain in these patients.

Pediatric neurologist Elizabeth Kichula, MD, PhD, discusses the pathophysiology and clinical presentation of spinal muscular atrophy (SMA), prenatal screening, diagnosis and treatment for this neurodegenerative disease.