Parenting – We all know that there is little real world preparation or training for the experience, even as a pediatrician, believe it or not. We therefore have to rely on others to help guide us as we raise our children.
It takes a family. We ask for advice from our moms and dads, our grandmothers and grandfathers, and our siblings with kids.
It takes a village.We get advice from friends who have their own kids, and from colleagues at our schools or in our local community.
Every morning at C.S. Mott Children’s Hospital, 40 to 50 people gather for our 15-minute safety huddle. It’s an opportunity for staff to share safety concerns that can range from equipment issues to challenging family situations with the potential to cause safety issues. It’s not the place where we solve the concerns, but it’s a place for concerns to be voiced and connections to be made so issues can be addressed. After the huddle, a quick email recap is sent out to more than 250 staff members.
Not all medications are formulated by manufacturers in dosages appropriate for children. Pharmacies make those medications by compounding them — meaning they crush and dissolve the adult medication and suspend it in liquid in a dosage appropriate for the child’s size. The problem is that different pharmacies may compound the same medication at different concentrations — meaning a teaspoon of medication from one pharmacy may not be the same as a teaspoon of the same medication from another pharmacy.
We wanted to investigate the prevalence of compounding variability and create a solution that would decrease the potential for medication adverse events occurring due to inadvertent wrong doses being administered. Data was collected that identified 147 medications that are compounded for children and found that there were 470 different concentrations of those medications being made. The concentrations of which varied widely.
The hospital world is one of many codes. For those of us who work here, we are trained to react quickly and with great precision when a code is initiated.
Just like with the many codes used in the healthcare world, the tools and procedures that child life specialists reach for when we’re called upon are truly evidence-based, and are an important part of your child’s health care.
As I child life specialist, when I hear the sound of crying toddlers who are having their vitals taken in preoperative bays, I grab the magical bubbles that are packaged in a crayon shape. Off I go down the hall, like the Pied Piper playing a flute of bubbles. Ninety percent of the time, bubbles work to quickly calm a tearful child. The other 10 percent, the Certified Child Life Specialist (CCLS) becomes any number of extraordinary characters equipped with magical toys. Okay, that may be a bit exaggerated, but that often is how my day feels as I enter the PACU and the preoperative work ups begin.
A cardiac catheterization is a procedure performed by a cardiologist to diagnose and often treat heart conditions. Many patients with congenital heart disease require cardiac catheterizations. During catheterization procedures, we use fluoroscopy to obtain real-time moving images of your heart.
Fluoroscopy is basically a series of x-rays that are played very quickly. It’s similar to how movies work – when the still images are played back quickly, they produces a moving image.
The fields of pediatric cardiology and cardiac surgery have come a long way. Today, conditions that were universally fatal as recent as 30 years ago can now be successfully treated, allowing children with congenital heart disease to thrive into adulthood.
However, we also know that there is much more work to be done to ensure that all children with heart disease have access to the highest quality care. One thing that is important is to be able to identify and learn from those hospitals with the best outcomes who are providing the highest pediatric heart care quality to children with heart disease.
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