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  Public Service Announcement  
Fidget Spinner Ingestion Hazard
From the Division of Pediatric Gastroenterology, Hepatology, and Nutrition at Monroe Carell Jr. Children’s Hospital at Vanderbilt

The Division of Pediatric Gastroenterology, Hepatology and Nutrition at Monroe Carell Jr. Children’s Hospital at Vanderbilt would like to inform the members of our pediatric community about a new button battery danger for children. There have been several cases nationwide of severe damage to the esophagus caused by children ingesting the parts of “fidget spinners” that contain LED lights and button batteries. These cases can be accidentally confused with coin ingestions, as the encasing around the batteries can obscure the “double halo” sign we usually look for with button batteries. This can cause severe damage to the esophagus within hours and requires emergent endoscopic removal. Fortunately, we have not had any cases to date in Nashville, but given how popular these toys have become and the increasing number of flimsy knock offs, we should all be on the lookout for this. Please be counseling your patient families about this potential danger.

Sample Letter to Parents:

Warning to families about the potential dangers of the popular “fidget spinners.” Many of these toys have parts that pop off and can lead to choking. They may also contain button batteries that can cause severe damage to your child’s intestinal tract in the span of a few hours, and possibly even death if not quickly diagnosed and removed.

If your children are playing with fidget spinners, we recommend you take the following precautions:

1. Check for small parts. Anything with small parts (i.e. they can pass through the center of a toilet paper roll), or that can be broken into small parts, should be kept away from small children. Remember that little sisters and brothers often grab older siblings’ toys, even if it wasn’t bought with them in mind.

2. Get rid of broken toys

3. Supervise use of fidget spinners

4. Register to be alerted if your toy has been recalled at recalls.gov and report any product issues to saferproducts.gov.

May 18, 2017

Dear Cumberland Pediatrics Foundation Members,

We are pleased to inform you that our team has developed a multi-disciplinary clinic specializing in disorders of sex development.

The Program for Pediatric Disorders of Sex Development at Monroe Carell Jr. Children’s Hospital at Vanderbilt began in January 2017 and is currently scheduling new patients. This specialty clinic’s goal is to provide a comprehensive clinic visit, allowing patients to see multiple doctors and other specialists while remaining in the same clinic room.

During the appointment, the child will be seen by both pediatric endocrinology and pediatric urology. In addition, the child may have a genetic counseling appointment in the same afternoon. We also may recommend additional tests like a pelvic ultrasound the morning of the visit. Other specialists will be scheduled as needed. We are working to find a clinical psychologist to join our team in the near future.

This clinic will take place quarterly on the 3 rd Monday afternoon. The clinic is located on the 6th floor of the Doctor’s Office Tower. Our goal is that each child with a Disorder of Sex Development will be seen annually in this clinic.

If you have further questions or would like to make a referral , please call Becca Hardin at (615)936-8866. Thank you very much for trusting us to provide care for your patients. We truly feel that this program will meet both the needs of the parents and those of the children.

Sincerely,

Cassandra Brady, MD

John C. Pope, IV, MD

Jennifer Najjar-Leeper, MD 

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Congratulations, Dr. Chakrabarty!

Dr. Satya Chakrabarty from Tennessee Pediatric & Adolescent Center has been awarded the CDC’s Champion Immunization award!

Before practicing pediatrics in Tennessee, Dr. Satya Chakrabarty treated patients in various parts of the world. Because he grew up and worked in an environment with limited healthcare resources, he often touches upon his background when educating parents on the importance of vaccines to protect their children from dangerous diseases. Dr. Chakrabarty is a pediatrician who cares deeply about his patients’ health and well-being. His office hosts Well Child days at least once a month to immunize patients who may have fallen behind on the vaccine schedule and accommodates children who may be uninsured for a period of time by scheduling vaccine only appointments. His practice also offers combined well and immunization visits (especially to children 0-2). If a child comes in sick and is behind on their vaccines, he will make sure to vaccinate, as long as the child falls within CDC’s vaccination guidelines. He also gives a strong recommendation for vaccines and shares their benefits with every parent, even if they want their child to be exempt. Thanks to his hard work and leadership, his practice currently has a vaccination rate of 90%. Together with his office staff and colleagues, he educates parents in a way that builds trust and ensures kids are vaccinated. Former patients who learned the value of vaccines from Dr. Chakrabarty now bring their babies to him for vaccination. Outside of his practice, Dr. Chakrabarty educates everyone he can reach within his community about the importance of vaccines at open houses, health fairs, and public health initiatives. He shares vaccine schedules, and even offers flu vaccines at these events. He is an AAP Fellow, an active member of the Cumberland Pediatric Society, and a member of the Tennessee Pediatric Association. His commitments to supporting vaccines in his practice and in his state make him Tennessee’s 2017 CDC Childhood Immunization Champion!

Read Full Article Here

Snapshot:

Improving the HPV vaccination rate has been a focus of the CPF for several years, said CPF Executive Director Lora Harnack, MSN, R.N., and the organization has teamed with VUMC and other organizations in efforts to do so, including community-based educational events and quality improvement initiatives with CPF member practices. CPF currently has 77 community-based pediatric practice locations in its membership.

“Pediatricians want to take the best possible care of their patients,” said Harnack. “In having conversations with them, we learned that a lot of physicians perceived that they were doing a lot better than they were, in terms of getting these vaccinations completed. When parents hear a strong recommendation from a clinician for their child needing the vaccination, they respect that advice.”

The study involves implementing a quality improvement project starting this summer at 22 CPF-affiliated pediatric practices in Tennessee, in which two methods of coaching will be tested for their efficacy in increasing vaccination rates.

One method will use an in-person coach — a nurse educator — who will travel to 11 of the pediatric offices to conduct a needs assessment and train staff on how the HPV vaccine should be presented to patients and their families. The second method will provide a web-based version of this service to the remaining 11 participating clinics. The clinics’ HPV vaccination rates will be measured at the study’s completion.

The clinics will also be provided patient education materials (www.get3shots.org) that were developed in a previous study under the Meharry Medical College, Vanderbilt-Ingram Cancer Center (VICC) and Tennessee State University (TSU) Cancer Partnership led by Hull; Maureen Sanderson, MPH, Ph.D. (Meharry); and Elizabeth Williams, Ph.D. (TSU); in collaboration with a Community Advisory Board.

“The program was simple and surprisingly effective. Our patient’s care givers truly want to do right by their children, and they perceive pediatricians as a trusted voice.”
-Dr. Mary Dundon, Goodlettsville Pediatrics

Health & Wellness Tips

On 3/16/17, CPF had the pleasure of co-hosting an event with Dr. Lee Ann O’Brien and our partners at NashvilleHealth and HealthierTN.
The event was a fun, relaxed party focused on healthy living. Attendees got to enjoy delicious healthy food, networking, and a brief presentation from a wellness panel. There was excellent discussion about patient resources and talking points to get your patients the right information. 

Some take aways were….

1. Getting your patients (and maybe their families) to understand that they need a lifestyle change vs a prescription/procedure is a challenge. Solutions included empowering at least one family member to make small changes. One excellent resource for the “small starts” initiative is HealthierTN’s app “Streaks”.

2. There is not always enough time in your patient’s appointment to cover ALL the health and wellness points that you would like to. One of the community’s mentors suggested asking your patient if they would like to make a change in a certain area (i.e. diet), and then proceed with your information based on the patient’s willingness to move forward on that topic. 
Tip: Have a network of health/lifestyle professionals on hand that you can refer your patients to. 

3. Advocacy! Make the time for events like TNAAP’s and TMA’s “Doctors’ Day on the Hill” to share relevant health information with TN’s legislators. 

4. Focus groups: If you are passionate about your patients having easier access to resources, consider identifying the top lifestyle issue among your patients and starting a focus group on that topic or finding a community partner that is hosting/can host the group. Often times a program such as the YMCA may already have a group your patients can join for free, it is important to be aware of the free resources that exist for your patients. KidCentralTN, Parent to Parent, and the TN Disability Pathfinder are great tools to locate resources. 

5. Always acknowledge your feelings. There was great discussion about protecting and taking care of yourself at the event; one of the biggest take aways was to not discount your emotions. If you feel sad, feel it! If you need help, get it! 
Tip: Try to refocus on the “big picture” when you feel particularly bothered by a case. 

Do you have any Health and Wellness tips to share?