Where to go During an Emergency

Asthma attacks. Broken bones. Dehydration. Ear infections. Irregular heartbeat. Infectious diseases. Uncontrollable vomiting. This is a short list of the medical problems that are handled each year in the Pediatric Emergency Department at the University of Maryland Children’s Hospital.

Children and adults have different needs. This is why the University of Maryland Children’s Hospital has an exclusively pediatric emergency department staffed by highly experienced nurses and health care professionals trained to put children at ease. What makes this pediatric emergency department unique is the access to a large network of pediatric specialists who make up the Children’s Hospital. We are a resource for other physicians. When a case is very complicated, we are often called to help diagnose or treat complex problems. We pride ourselves on delivering care and compassion that can only come from an institution with a primary focus on providing the highest quality of care to children and their families.

Because we have access to specialists in more than 20 areas of pediatric medicine, we provide the most advanced care. The Pediatric Asthma Program is one example of how patients benefit from the close collaboration of physicians in the emergency department and other specialties. This asthma program, which is the first of its kind in the region to be awarded the Joint Commission’s Disease-Specific Certification, assures that children admitted to the emergency department not only leave breathing easier – they are also given the tools, knowledge and medication to improve their long-term asthma control.

During a medical emergency, there is little time to consider where to take your sick child. Remember the University of Maryland Children’s Hospital is here for you and your family.

Learn more about the University of Maryland Children’s Hospital by visiting www.umm.edu/pediatrics.

A Little Hero Recovers from Heart Surgery to Run Like Superman


Editor’s note:
For 2-year-old Thaddeous McKenzie, the Baltimore Running Festival was just a fun day when he got to run fast with a bunch of other kids. For his mother, Jennifer McAnany, and others who formed “Team Thaddeous,” it meant a lot more.  

By Jennifer McAnany

(as told to Amy Katz)

I felt my son grip my hand tightly as he wiggled in anticipation of the race. He was restless, but only because he was excited to run in the Kids Fun Run at the Baltimore Running Festival. I looked down at him, beaming with pride. I could think only about how truly blessed I am to have a healthy child who is living life to the fullest and being a normal 2-year-old.

When I was pregnant with my son Thaddeous, I wanted the best care possible for my baby. Because of complications, I was already considered a high-risk pregnancy, so I went to see Dr. Geoffrey Rosenthal at University of Maryland Medical Center. At 20 weeks, doctors found a heart defect and diagnosed Thaddeous with Tetralogy of Fallot. In this heart defect, it is difficult for the heart to pump oxygen properly, causing the child’s lips, tongue, and fingers to turn blue from lack of oxygen. The most common treatment for TOF is usually open heart surgery, and this surgery usually must occur within the first few months of life. It was scary for me because we wouldn’t even know how bad the defect was until he was born.

The day Thaddeous was born was very nerve-racking for me. He was born at UMMC – where they were prepared to perform open heart surgery on him immediately, if he needed it. As soon as he was born, the nurses came and assessed him. I was thrilled when I learned little Thaddeous was well enough to be able to go home from the hospital with me when I was released two days later. He was monitored every couple weeks and seemed to be doing okay.

About 11 weeks later, when we went in for a genetics appointment with Dr. Julie Kaplan at Upper Chesapeake Medical Center (part of the UM Medical System), she noticed that Thaddeous was looking a little blue, demonstrating one of his heart-defect symptoms. They had to immediately transport us from Upper Chesapeake hospital to the UM Medical Center in downtown Baltimore. It was a horrible weekend because his oxygen levels would drop every so often and he wasn’t scheduled to have open heart surgery until Monday morning. This is when we started calling him our little Superman because he pulled through his surgery and came out of it as our little hero.

Thaddeous McKenzie recovers after surgery. He's now a healthy 2-year-old.

Thaddeous McKenzie recovering after heart surgery at University of Maryland Children’s Hospital. 

 

The full-heart repair was a success and Thaddeous recovered fairly quickly. He was doing great. So when I heard about the Children’s Heart Program Running Team in the Baltimore Running Festival on Oct. 12, not only did I sign up to run – I signed up our little Superman. He even had his own bib number. And then several family members and friends signed up. As “Team Thaddeous,” we raised money for the program to be able to help other young patients and families.

Ready, Set, GO! The buzzer went off to signal the start.

Thaddeous ran as fast as he could, trying his hardest to keep up with the other kids and pulling me along with him. He was having a blast in his Superman shirt with his cape blowing in the wind, and I felt so glad he is still on the mend.

He will still have to have yearly check-ups for the rest of his life, but he is living life like a normal 2-year-old. He has his hiccups at times but what 2-year-old doesn’t? He walks, he plays, he kicks the ball and does everything he wants to do. The sky is the limit for him now.

As we crossed the finish line, still hand-in-hand, I once again realized how thankful I was.  He wouldn’t be able to be here running this race beside me for the Children’s Heart Program if it wasn’t for all of his doctors, nurses, and everyone who helped him get where he is today. I did the race for Thaddeous and to give back to the program that had helped us. It was like everything came full circle, and I can’t thank everyone at the University of Maryland Medical System enough.

Go to the Team Thaddeous page to see more photos of Thaddeous or to make a donation to sponsor his team’s fundraising effort.

Team Thaddeous

Team Thaddeous after running to raise money for the Children’s Heart Program and, below, with Dr. Rosenthal (third from left).

 

Group picture with Dr. Rosenthal

 

Nurses Run for their ‘Heart Kids’

By Jen Arrington, MS, RN, CPN, and Kristen Fantel, BSN, RN, CEN

On Oct. 12, 17 nurses and friends of the Pediatric Intensive Care Unit (PICU) will be running in the Baltimore Running Festival to raise money for the UMMC Children’s Heart Program. When people ask us why we run, there’s one easy answer. We run for patients like Brandon Kerrigan and all of the heart kids that we care for everyday.

When Brandon celebrated his 15th birthday on Aug. 16, no one had any idea that two days later he would be fighting for his life. Brandon was diagnosed with dilated cardiomyopathy, and went into cardiac arrest while being flown from Easton to the University of Maryland Children’s Hospital. Once Brandon was stabilized, his family was told that he would need a heart transplant. Since his arrival to the PICU, Brandon has been determined to get strong while he waits for his heart. He charms the nurses and staff with his bright smile and Nerf guns, just trying to be a normal 15-year-old, while cooped up in the hospital. You can see how charming he is in this picture of us with him at the bottom of our team page.

Brandon is only one example of a patient we are running for. We care for many cardiac patients in collaboration with the Children’s Heart Program. This program provides comprehensive cardiac care for children with a wide range of conditions — from rhythm abnormalities to childhood hypertension, from heart murmurs to serious birth defects requiring complicated heart surgery. While we care for these complex patients, they quickly become a part of our unit – we offer an encouraging smile to their parents in the hallway, we say our silent prayers. And on good days – we dodge Nerf guns as we enter the patient’s room.

The strength and resilience of these children, who battle against all odds, is simply inspiring. As nurses, we are often left with the feeling of wanting to do more. We carefully assess these patients for any changes in condition, we give medications, we advocate for their every need, and we attempt to play and create normalcy whenever we can. But we want to do more.

This is why we decided to run as part of the Children’s Heart Team. We don’t have a miracle drug and we can’t take away the heartache in the eyes of the parents of these patients. But we can run.

As with all of the patients we care for, the teamwork involved in the care of these patients is also inspiring. The team includes Nurses, Doctors, Child Life Specialists, Respiratory Therapists, OR and Cath Lab Staff, Rehabilitation Services – and many, many other people who deserve to be celebrated.

This strong team work was the inspiration for our fundraising efforts. We created a T-shirt that recognizes this team effort, and we are selling the T-shirt around the hospital in order to raise money for the Children’s Heart Program.

In addition to the shirt, we are also hosting a fundraiser at a local restaurant. Join us on Wednesday, Oct. 2, at Blue Hill Tavern in Canton. The restaurant will be donating 20% of its proceeds from the day to our cause. Schedule a lunch with your co-workers, dinner with your family, or join the PICU nurses for Happy Hour – and help an important cause.

Want to join us in our effort to do more? Contact us! Maybe today we can give back a little bit of the inspiration that we have received from these amazing children.

To make a donation: http://www.ummsfoundation.org/picuheart

Mandatory Pulse Oximetry Screening for Newborns Takes Effect in Maryland

By Carissa M. Baker-Smith, MD, MPH

Assistant Professor, University of Maryland School of Medicine

Pediatric Cardiologist, University of Maryland Children’s Heart Program

A quick, painless and non-invasive test to determine the amount of oxygen in a newborn baby’s blood is a first step in screening infants for congenital heart defects. Beginning September 1, 2012, hospitals in Maryland must administer the test to all newborns.

Congenital heart disease (CHD) occurs in approximately 8 of every 1,000 children.  Infants born with congenital heart disease have structural defects of the heart. Approximately 25% of all CHD cases are critical and require intervention during the infant’s first month of life. Interventions can include the administration of special medications or even surgery. Pulse oximetry may be helpful in improving the detection of critical CHD (CCHD).

On September 1, 2012, hospitals across Maryland begin mandatory pulse oximetry screening for all newborns. The screening must be done by a health professional before the infant is discharged and within 24 to 48 hours after birth. All hospitals in Maryland will be responsible for creating and implementing pulse oximetry screening protocols.

Children who “fail” pulse oximetry screening will undergo further evaluation, and their primary care providers will work closely with pediatric cardiologists to make the correct diagnosis. Failing the pulse oximetry test means oxygen saturation is lower than normal without another explanation, such as infection or lung disease.

What is pulse oximetry?

Pulse oximetry relies on the use of a non-invasive, painless method for detecting the amount of oxygen in the blood.  Probes are applied to the palm of the hand and the sole of the foot. The protocol selected by the State of Maryland for screening  is published in the Journal of Pediatrics (Pediatrics 2011; 128; e1259). Children with oxygen saturation less than 90% automatically test positive and fail screening.  Children with oxygen saturation greater than 95% test negative and pass screening. Children with oxygen saturation between 90% and 95% will undergo repeat testing and evaluation.

What is the potential impact of pulse oximetry screening?

We anticipate that pulse oximetry screening will enhance detection of CCHD. Data indicate that for every 1,000 children born in Maryland, 2.3 have CCHD.  Currently, between 60% and 70% of these infants are diagnosed through prenatal screening, leaving approximately 30% who are not yet diagnosed by the time they are born. Combined with physical examination, pulse oximetry is reported to improve sensitivity for detecting CHD by 20%.

What is the role of the Children’s Heart Program?

The University of Maryland Children’s Heart Program offers a comprehensive panel of services designed to accurately diagnose and effectively manage and treat children with CHD and CCHD.  Pediatric cardiologists are available 24 hours a day, 7 days a week, to assist with the diagnosis of CHD.  Through consultation and telemedicine services, the Children’s Heart Program is ready to assist surrounding providers and families with the evaluation of infants with suspected CCHD.

For more information on pulse oximetry, please contact the Children’s Heart Program at 410-328-4FIT (4348).

Dr. Baker-Smith is a member of the Maryland State Advisory Council’s Committee for CCHD and the Newborn Screening for Critical Congenital Heart Disease multi-institutional group.

A Mission to Ecuador for Pediatric Heart Surgeon

By Meghan Scalea

UMMC Communications Account Leader

Sunjay Kaushal, M.D., Ph.D., associate professor at UM School of Medicine and director of pediatric cardiac surgery at UMMC, recently returned from a medical mission to Ecuador, where he performed life-saving heart surgeries on nearly 20 children who would have died without surgery.

 

Dr. Kaushal, a father of two, is a huge advocate for kids. This medical mission to Guayaquil, Ecuador, was his fifth trip with the International Children’s Heart Foundation (ICHF), a group dedicated to providing supplies, training and surgical resources to care for underprivileged children with heart disease in dozens of countries around the world.

According to the ICHF, 1% of the world’s population is born with heart disease, only about one-third is diagnosed, and even fewer receive life-saving heart surgery. Congenital heart disease is the most common birth defect in the world.

“There is a huge surplus of kids with congenital heart disease,” says Kaushal. “Traveling with this group allows me to provide free health care for children who wouldn’t otherwise be treated.”

Joining him in Ecuadorwas UMMC certified surgical technologist, Nicolette Dupuis, who supports Dr. Kaushal in his pediatric heart surgeries in the OR in Baltimore. This marked Dr. Kaushal and Ms. Dupuis’s third medical mission trip together. During their week inEcuador, they worked with cardiologists and intensivists from hospitals around theU.S. in the sparse operating rooms.

 “Part of our job while we were inEcuadorwas to teach the local medical professionals to do congenital heart surgeries like we do, but on a smaller level,” says Dr. Kaushal. “Our day began at 7:30 am, and we’d operate until 9:00 pm. We staffed the ICU 24/7 during the time we were there to make sure those children had the post-operative care they needed.”

Dr. Kaushal is the only board-certified congenital heart surgeon inMaryland, giving him a unique expertise in performing surgical procedures on babies just a few days old who were born with heart disease, children with congenital and acquired heart disease, and adults living with heart conditions they developed as babies, known as adult congenital heart disease.

Dr. Kaushal performs the most complex pediatric heart surgeries available today, including surgeries for babies with hypoplastic left heart syndrome, Tetralogy of Fallot and ventricular septal defect, and those in need of pulmonary valve replacement. He is also preparing to open a clinical trial that will use a baby’s own stem cells to regenerate the underdeveloped portion of their heart caused by hypoplastic left heart syndrome.

We invite you to learn more about what Dr. Kaushal and the Children’s Heart Program at UMMC are doing for children within the Mid-Atlantic region.

Pediatric Leukemia Patient Raises Funds for Second Year in a Row

Brasen

Brasen VonMoose-Lemin

Editor’s Note: Brasen’s second fundraiser was a success –he raised $2,756 for the University of Maryland Children’s Hospital! See pictures of Brasen presenting the check to UMCH pediatric oncologist Dr. Teresa York.

My name is Brasen VonMoose-Lemin. I am a 7-year old who has won the battle with leukemia. I am planning my second fundraiser for my hospital, the University of Maryland Children’s Hospital on May 19. Last year I raised over $1880 and this year I’d like to raise even more than that (see my story from last year).

I plan to sell lemonade and other sweet treats with the help of my family members.

My plan is to raise money to help children who are fighting cancer. I will continue this journey every year until they find a cure and no child will have to suffer through the pain, hospitalization, chemo, spinal taps and so much more.

My fundraiser and raffle will take place on May 19th 10 a.m. to 2 p.m. at my school parking lot, George T. Cromwell Elementary School at 525 Wellham Ave, Glen Burnie MD. The rain date will be May 20th.

A few local grocery stores will donate baked goods. In addition we will have several raffles including movie basket, Thirty-One basket, Scrapbook Basket, Longaberger, and more. I also plan to have some special characters arriving including balloon characters, and we’ll also offer face painting and glitter tattoos.

This year’s event is extra special to me since I have been chemo-free since November 2011. We are hoping you will come out and join my cause in the fight in helping children with cancer. Checks will be accepted and can be made payable to the UMMS Foundation.

For information regarding the fundraiser or the University of Maryland Children’s Hospital, please contact Jennifer Summers at 410-328-9546 or jsummers@umm.edu
You can also visit the Children’s Hospital Web site at www.umm.edu/pediatrics.

How to Raise a Veggie-Eating Kid

By Faith Hicks, MS, RD, LD/N, CSP

Senior Clinical Dietitian

Editor’s Note: A version of this article appeared in The Baltimore Sun 03/07/12, in the Taste section and online.

How is it that some kids will eat whatever is put in front of them, while others live on hot dogs and chicken nuggets and have a phobia for vegetables, especially anything green?  As adults, we know that we ourselves probably should be eating more fruits and vegetables, and we would like to raise our kids to have healthier eating habits and a varied diet right from the start.  There are a number of ways parents and other adults can promote good eating habits from early childhood and throughout the teen years.

Make a regular “date night” – a family dinner date night, that is!

One of the best ways of promoting good eating habits in children is to make eating meals together a priority. This is something that often gets lost in the shuffle of soccer practice and scout meetings, but try to identify at least one or two nights a week to have dinner as a family.  Children who are raised having regular family meals generally consume more servings of fruits and vegetables and develop a liking for a wider variety.  They also tend to have a diet lower in fat and are less likely to become overweight than children from families who eat on the run.  From the start, toddlers mimic their parents’ eating habits.  So a parent who includes fruits and vegetables at mealtimes sets the example that these foods are tasty and that consuming them is the norm and is expected.

There are other important benefits of having meals as a family. Children whose families dine together regularly develop better language skills.  During dinner conversation, they are exposed to a larger vocabulary. They become adept at participating in a higher level conversation.  Another benefit of family meals extends into the teen years, teens that regularly have dinner with the family get better grades and are less likely to try drugs, tobacco, and alcohol.  It seems that mealtimes help foster a sense of connectedness within the family and when parents are tuned into their teens, teens are less tempted to dabble in risky behavior. 

Lighten up and don’t turn mealtime into a “pressure cooker”

Another way of fostering a varied diet is to offer new foods several times and without undue pressure.  It may take more than several times trying a new food for a toddler or preschooler to accept it, so don’t give up after the first try! Place a small portion of each food that you are having on your child’s plate.  When they see that you eat it, the expectation is set that they will like it, too.  Beware of trying too hard to persuade a child to eat because this might backfire! It can send the message that the food item is not very appealing.  For example, if a child is rewarded for eating green beans by getting a cookie, the parent sends a message that green beans are yucky.  The child may think “that must not taste very good if I have to be bribed with treat.”  Rather, make a light-hearted request for the child to just to try “just a bite.”

Involve kids in food shopping and preparation.

Children and teens are more interested in foods they have selected, prepared, or even grown at home.  Wander the produce section of the grocery store with your child and let him choose a new vegetable or fruit to try each week.  Buy a colorful, child-oriented cookbook to provide ideas for foods you can prepare together.  Cooking together provides an opportunity to learn other skills, such as fractions.  Even small children can be safely involved in cooking activities such as washing produce or putting toppings on a veggie pizza. Consider planting even a small garden and check out seed displays with your child. Seed companies sell kid-friendly vegetables in packets bearing very appealing pictures. Children who are drawn to miniature things may be fascinated by picking cherry tomatoes or pulling from the ground the baby carrots planted earlier in the spring. Brussels sprouts might be a little more fun to eat once you have seen how they seem to march in lines as they grow from the plant’s stem! 

In summary, the key to raising a “good eater” is having fun with food together, right from the start.

Snowpile: Santa Sets Up a Satellite Workshop at the UM Children’s Hospital

By Shannon Joslin, MS, CCLS

Child Life Manager
University of Maryland Children’s Hospital

Being in the hospital at any time is a challenge, but especially so for young patients during the holidays.  Children miss their family, friends and their traditional holiday activities.

Here at the University of Maryland Children’s Hospital (UMCH), it’s a little easier thanks to some generous people in the community — grateful families of current and former patients, companies, local businesses and other individuals who open their hearts and checkbooks to allow the Child Life Program to host the second annual Snowpile event for children and families in the hospital over the holidays.

The Child Life team sets up a toy workshop from Dec. 21 to Dec. 23 each year and invites parents of children who are in the hospital over the holiday to come shopping (for free) for their child.

In addition to the toys, every parent is able to “stuff a stocking” full of goodies for their child in the hospital as well as stockings for any siblings at home so they don’t feel left out while their brother or sister is hospitalized.

We have volunteer gift wrappers to help with wrapping the gifts and we have coffee, cookies and snacks for parents so they can take a moment for themselves in the midst of their child’s hospitalization.  Last year, we had Girl Scout cookies donated through a troop whose leader works at UMMC. This year, we got donated food and drinks from the Au Bon Pain restaurant in the hospital lobby and The Penn Restaurant nearby onPratt Street.

Parents either take their gifts with them if there’s a chance their child is being discharged before the 25th, or they leave them with our Child Life team for delivery on the 25th.  Parents who have participated have commented on how this was such a help, for two reasons — finances are usually tight and their time to go shopping is limited because they want to stay at the hospital with their child.

If you would like more information about the Child Life Program at UMCH or how to help support children and families in the hospital, please visit our Child Life Web site.

10 Healthy Lunch Tips: Add Punch to Your Kid’s Lunch!

Childhood obesity is a growing public health crisis among children and adolescents that has continued to rise every year.  To address this epidemic, the University of  Maryland, in partnership with the Maryland Department of Health and Mental Hygiene, sponsored  The Summit on Childhood Obesity  November 15-16, 2011, at the Hilton Baltimore Hotel.  

The purpose of the University of Maryland’s Summit on Childhood Obesity is to exchange information, educate and engage prominent figures at the local and federal levels in discussions about how to confront the problem and develop an action plan to promote a healthier lifestyle for children and families.  Below, UMMC Nutritionist Shanti Lewis offers 10 healthy lunch tips to help pack a fun, healthy lunch for your kids.

 

by Shanti Lewis, RD, LDN, CSP, CNSD

Since 1 out of 3 children in the U.S.  is overweight or obese, parents play a vital role in teaching children healthy eating habits and helping them maintain a healthy weight.  One of the ways that parents can help children learn about nutrition is by getting them involved in preparing meals.  Getting kids involved in preparing their school lunch helps them learn about portion control and allows them to select healthy foods that they enjoy.

  • Choose the good stuff! Plenty of fruits, veggies, beans, lean meats, low-fat dairy and whole grains.
  • Make fun shapes! Use cookie cutters for flower, heart, star, or snowflake sandwich bites. Form a funny face, mermaid body, or spooky spider shape.
  • Get your kids involved! Have them pick pasta shapes, their favorite fresh fruits, nuts, seeds and veggies.
  • Utilize leftovers from last night’s dinner or today’s breakfast: think pizza bites, egg roll-ups, or mini bagels with low-fat cream cheese.
  • Remember food safety: Keep the hot foods HOT and the cold foods COLD. Use insulated lunchboxes with ice packs and a thermos for soup.
  • Choose water or low-fat milk in place of juice or sugary drinks.
  • Watch the salt! Select lower sodium lunchmeats and cheeses.
  • Find the fiber: Choose whole grain crackers, breads, wraps, and muffins. Try popcorn or whole wheat pretzels as a substitute for chips.
  • Be creative! Offer a variety of different textures, shapes, and colors from local and seasonal fruits and vegetables.
  • Decorate plastic bags with fun stickers, jot a note on the banana or orange skin, and tuck a handwritten love note inside the lunchbox.

Additional Resources

Shanti Lewis is a neonatal nutritionist at the University of Maryland Medical Center.  She is an author and frequent contributor to blogs and articles on fitness and nutrition. Lewis received her bachelor’s in nutrition and food science from Drexel University and completed her dietetic internship at the National Institutes of Health.

Grateful Father Organizes Concert to Benefit University of Maryland Children’s Hospital

By Daniel Purdie and Cynthia McClain Purdie

Last year, our healthy, vibrant 2-year-old son Adam suddenly began having convulsive seizures. Another emergency facility thought they were caused by a fever or an allergic reaction, but the University of Maryland Medical Center soon ruled that out. They performed thorough exams and Adam spent several nights in the PICU while we wondered, worried, and waited by his side. We knew he was getting the best care possible, because we have trusted the University of Maryland Children’s Hospital with our family’s health care for more than a decade. But that didn’t mean we weren’t afraid and nervous about what was happening with our baby.

Drs. Kathleen Currey, Jack Gladstein and the entire team at the Pediatric Epilepsy Center were attentive and addressed all our concerns when they diagnosed Adam with epilepsy (seizure disorder).  At first, we were disappointed about the extent of his treatment — our healthy 2-year-old would suddenly need to take medications twice a day for at least a year.  We thought there was a cure! But we were relieved that he had not suffered any brain damage or injuries, which could have happened over time had we not caught the problem.  Now, our son is 3 and we are happy he is responding well to treatment and has not had a seizure in a long time.

We wanted to thank the team at UMMC for the special kind of care they give to children and families, and to raise awareness about epilepsy in our community. Daniel is a performer and the second closest thing to his heart after family is music. He decided a benefit concert was in order and called it ‘AFAC: Applause for a Cause, Baltimore.’  He put the plans in motion and gathered support from fellow regional and national artists who donated performances.

The concert was held on campus at the Community Colleges of Baltimore County, Catonsville on October 14, 2011 and we had a great time. We were able to raise some money and share information about the great team at the Children’s Hospital. Plans are underway for an AFAC Baltimore Web site and a spring fundraiser. We want to continue to support the UMCH Pediatric Epilepsy Program.