Clerkship Ready: Pediatrics

In this episode, we will discuss everything you need to know before seeing your first pediatric patient with eczema. We will review its pathogenesis, who gets eczema, what to look for on exam, and potential differential diagnoses. We will also elaborate upon the most recent AAP guidelines for treatment of eczema, which focuses on skin care maintenance, topical steroids, and avoidance of triggers. Show Outline: Introduction to Eczema Description of dermatologic terms Defining eczema and atopic dermatitis Pathogenesis Immune dysfunction Histological differences Involvement of filaggrin Racial disparities Who gets eczema? Age of onset Demographics of patients with eczema Atopic disease & “The Atopic March” Clinical Presentation / Diagnosis Characterization of eczematous lesions What to look for in people of color Most likely locations of eczema based on patient age Differential diagnoses Sleep disturbances Utilizing the Patient-Oriented Eczema Measure (POEM) Treatment AAP recently updated treatment guidelines The basic triad for eczema treatment Skin care maintenance Topical anti-inflammatory medications The 5-10-15 Plan Avoidance of triggers Side-effects of topical steroids (very rare) Skin atrophy Steroid withdrawal Complications Secondary infections Tinea Impetigo Eczema herpeticum Closing statements Resources/Links: POEM Eczema Questionnaire: https://www.rchsd.org/documents/2020/08/madp-poem.pdf/ Roduit C, et al. (the PASTURE study group). Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr. 2017 Jul 1;171(7):655-662. doi: 10.1001/jamapediatrics.2017.0556. PMID: 28531273; PMCID: PMC5710337. Schoch JJ, Anderson KR, Jones AE, Tollefson MM; Section on Dermatology. Atopic Dermatitis: Update on Skin-Directed Management: Clinical Report. Pediatrics. 2025 Jun 1;155(6):e2025071812. doi: 10.1542/peds.2025-071812. PMID: 40383540. Links: https://www.rchsd.org/documents/2020/08/madp-poem.pdf/ About the Speaker: Host: Carly Pierson, MD – Carly Pierson, MD is a pediatric resident in the Primary Care Track at UVA Health. She graduated from the University of the Incarnate Word School of Osteopathic Medicine and has interests in allergy and immunology. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

In this episode, we will discuss when and how to advise parents on introducing complementary foods (aka “solids”), including foods that are potentially allergenic. This is a topic that will invariably come up for you during your rotation. We’ll discuss the timing and sequence of introducing solids, and then talk about the rationale behind early introduction of potentially allergenic foods. Definition of “complementary” foods” - a catch all category for “all solid and liquid foods other than breast milk or infant formula”. Also referred to as “solid foods” Definition of potentially allergenic foods - eggs, peanut butters, nut butters, fish, shellfish, etc. When to Introduce solid foods We will start recommending the introduction of solid foods in the form of puree, around the time an infant turns 4-6 months old – Baby should be able to demonstrate adequate head control in the office with us An infant’s renal and gastrointestinal systems can only start to metabolize complementary foods around the age of 4 months. An infant will usually develop motor and dental development skills to sufficiently chew and swallow foods around 6 months. Introducing complementary foods too early can be associated with harmful health side effects, e.g., obesity Importance of introducing complementary foods Breastmilk and infant formula do not contain all the nutrients a growing infant will need to continue growing and developing appropriately. LEAP study – babies less likely to develop peanut allergy if peanut products were introduced at 4-11 months This study had HUGE implications regarding the introduction of potentially high allergen foods into infant’s diets to reduce the risk of developing a food allergy to them. The introduction of complementary foods First offer a variety of single-ingredient foods (such as pureed vegetables, fruits, grains and meats), in any order that parents desire Iron-fortified cereal is often a good choice as iron stores from mother become depleted by about 4-6 months of age. Recommend only providing 1-2 new foods per day in case the child has an adverse reaction The main calorie source for these infants should still be formula or human milkor Important foods to avoid include: honey (due to the risk of botulism), cow’s milk (we transition to cow’s milk instead of formula / breastfeeding at age 12 months but not prior. This is because it has a low absorbable iron content which can lead to iron deficiency anemia, and doesn’t have all of the nutritional value that infant’s need from breastmilk/formula), choking hazards (such as whole nuts, grapes, popcorn, etc). Introduction of potentially allergenic foods: The most common allergenic foods are milk, egg, soy, wheat, fish, shellfish, tree nuts, sesame Start to introduce these foods after the infant has tried and tolerated a few of the non-allergenic complementary foods (this is to make sure that the infant can tolerate non-allergenic foods first and foremost) For children with a history of atopy (or a family hx of atopy) it is recommended to start with a small serving of each of these foods, and then gradually increase the serving size as it is tolerated Avoid cow’s milk in a bottle but instead introduce other cow’s milk based products such as yogurts and cheese Allergic reactions vs contact dermatitis Bowel movements change in color and consistency when solid foods are introduced Summary Resources/Links: Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, Brough HA, Phippard D, Basting M, Feeney M, Turcanu V, Sever ML, Gomez Lorenzo M, Plaut M, Lack G; LEAP Study Team. Rando...

Listen along as we dive into the many causes of sore throat. Learn about the common causes such as allergies and viral illnesses while also what to do when a child with epiglottitis comes in. We will cover CENTOR criteria as well and when you should think about Group A strep testing. Common Causes Viral Presentation HSV Mononucleosis Allergic Presentation Group A Strep CENTOR Criteria Emergency Causes Peritonsillar Abscess Retropharyngeal Abscess Epiglottitis Wrap Up & Conclusion Resources/Links: https://www.chop.edu/conditions-diseases/throat-anatomy-and-physiology https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis References Aluma Chovel-Sella, Amir Ben Tov, Einat Lahav, Orna Mor, Hagit Rudich, Gideon Paret, Shimon Reif; Incidence of Rash After Amoxicillin Treatment in Children With Infectious Mononucleosis. Pediatrics May 2013; 131 (5): e1424–e1427. 10.1542/peds.2012-1575 Becker JA, Smith JA. Return to play after infectious mononucleosis. Sports Health. 2014 May;6(3):232-8. doi: 10.1177/1941738114521984. PMID: 24790693; PMCID: PMC4000473. Chowdhury MDS, Koziatek CA, Rajnik M. Acute Rheumatic Fever. [Updated 2023 Aug 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK594238/ Esposito, S.; De Guido, C.; Pappalardo, M.; Laudisio, S.; Meccariello, G.; Capoferri, G.; Rahman, S.; Vicini, C.; Principi, N. Retropharyngeal, Parapharyngeal and Peritonsillar Abscesses. Children 2022,9,618. https://doi.org/ 10.3390/children9050618 Martin JM. The Mysteries of Streptococcal Pharyngitis. Curr Treat Options Pediatr. 2015 Jun;1(2):180-189. doi: 10.1007/s40746-015-0013-9. PMID: 26146604; PMCID: PMC4486489. MCMILLAN, J. A. , WEINER, L. B. , HIGGINS, A. M. & LAMPARELLA, V. J. (1993). Pharyngitis associated with herpes simplex virus in college students. The Pediatric Infectious Disease Journal, 12 (4), 280-283. Mohseni M, Boniface MP, Graham C. Mononucleosis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470387/ Roggen I, van Berlaer G, Gordts F, et al. Centor criteria in children in a paediatric emergency department: for what it is worth. BMJ Open 2013;3: e002712. doi:10.1136/ bmjopen-2013-002712 Links: https://www.chop.edu/conditions-diseases/throat-anatomy-and-physiology https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis https://www.ncbi.nlm.nih.gov/books/NBK594238/ https://doi.org/ https://www.ncbi.nlm.nih.gov/books/NBK470387/ About the Speaker: Host: Chris Stadnick, MD – Chris Stadnick, MD is a board-certified pediatrician at Metropolitan Pediatrics in Portland, Oregon. He earned his MD from the University of Tennessee Health Science Center and completed his pediatric residency at the University of Virginia. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

In this episode, we discuss lead toxicity and lead screening. We will talk about what lead is, what happens when a child is exposed to lead, what to ask parents about if you’re worried about lead exposure, how to screen for lead toxicity, and what to do if your patient has an elevated lead level. Sources of lead exposure Ingestion of contaminated food or water Ingestion or breathing in of lead dust Other sources: lead-acid batteries, ammunition, lead-based pigments and paints, stained glass, lead crystal glasses, ceramic glazes, jewelry, toys For families from other cultures, think about ceramic glazes, traditional cosmetics, traditional medicines Government policies to decrease lead exposure Unleaded gasoline Lead-free paint Lead-free solder in food cans Lead-free water pipes Why young children are at risk for lead toxicity Hand-to-mouth behavior Increased absorption of lead Developing nervous system is vulnerable Calcium or iron deficiency increase absorption of lead Effects of lead toxicity in children can be seen at levels as low as 3.5 µg/dL Growth and development delays Lower IQ Learning and behavior problems Hearing and speech problems School underperformance At higher levels, you may see Irritability Loss of appetite, weight loss, fatigue Abdominal pain, vomiting, and/or constipation Anemia Pica Seizures, coma, death Universal lead screening at 1 and 2 years Screening questionnaires are not very sensitive or specific Blood lead test Capillary – get results quickly, but can be falsely elevated Venous – results more accurate, but may take some time to come back Management of elevated lead level Repeat it if it was a capillary sample Review results with family Ask about potential exposures – may need to contact health department, landlord, or independent certified lead inspector to test home for lead Assess risk factors for iron or calcium deficiency Ask about developmental milestones – may need to refer to early intervention services Consider abdominal xray if history of pica For levels >45, may need chelation therapy Resources/Links: CDC, Childhood Lead Poisoning Prevention, https://www.cdc.gov/nceh/lead/default.htm AAP policy statement. Prevention of Childhood Lead Toxicity, Pediatrics 2016: 138(1):e20161493. https://publications.aap.org/pediatrics/article/138/1/e20161493/52600/Prevention-of-Childhood-Lead-Toxicity Mona Hanna-Attisha, What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City, 2018. https://www.amazon.com/What-Eyes-Dont-See-Resistance/dp/0399590838 Links: https://www.cdc.gov/nceh/lead/default.htm https://publications.aap.org/pediatrics/article/138/1/e20161493/52600/Prevention-of-Childhood-Lead-Toxicity https://www.amazon.com/What-Eyes-Dont-See-Resistance/dp/0399590838 About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatr...

Sepsis is a clinical syndrome in which an infection leads to an inflammatory response throughout the body that rapidly progresses to organ dysfunction or even death. Worldwide, neonatal sepsis affects 2,202 infants per 100,000 live births, and has a mortality rate of >11%. In the United States, early onset sepsis affects 50 in 100,000 live births, with a mortality rate of about 3%. So it’s a big problem that we don’t want to miss. In this episode, we will define neonatal sepsis, talk about the presentation of sepsis, what a sepsis workup entails, how to make the diagnosis and treatment of neonatal sepsis. Defining Neonatal Sepsis Early Onset Sepsis Late Onset Sepsis Neonatal Early Onset Sepsis Calculator - https://neonatalsepsiscalculator.kaiserpermanente.org/ Presentation of Illness and Physical Exam Pathogenesis Group B Strep Screening and prophylaxis E coli Strep viridans Klebsiella Enterococcus Listeria HSV Screening and prophylaxis Types of Infection Bacteremia Pneumonia Meningitis Work up CBC with differential Blood Culture Urinalysis and Urine Culture Cerebrospinal Fluid culture Chest X-Ray Surface swabs of mucous membranes Antimicrobial coverage Evaluation and Treatment of a Well Appearing Febrile Infant 8-60 days old https://doi.org/10.1542/peds.2021-052228 8-21 days 22-28 days 29-60 days References: Neonatal Early Onset Sepsis Calculator - https://neonatalsepsiscalculator.kaiserpermanente.org/ AAP Guidelines for Evaluation and Treatment of a Well Appearing Febrile Infant 8-60 days old: https://doi.org/10.1542/peds.2021-052228 Links: https://neonatalsepsiscalculator.kaiserpermanente.org/ https://doi.org/10.1542/peds.2021-052228 About the Speaker: Host: Elizabeth (Blair) Davis, MD – Elizabeth Blair Davis, MD, FAAP graduated from the University of Virginia School of Medicine and completed her pediatric residency at UVA. She received her undergraduate education from Washington and Lee University. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

Ear pain is one of the most common chief complaints pediatricians encounter in the outpatient setting and there are quite a few things you need to consider to make a thoughtful diagnosis, assessment, and plan. In this episode, we will discuss the differential diagnosis of ear pain in children, physical exam findings that will help you make a diagnosis, and treatment for the most common causes of ear pain. Ear anatomy Outer ear, tympanic membrane (TM), middle ear, inner ear Eustacian tube in children is smaller in diameter and angled more horizontally than in adults. This makes it more difficult to drain fluid behind the middle ear and why kids are more prone to get ear infections when they get a cold than adults are. The adenoids also are thought to play a role in fluid collection and buildup. Taking a history for patient with chief complaint of ear pain How old is this child? Have they had a fever? Are there any other viral symptoms such as cough, runny nose, or sore throat? Has the child been swimming recently? Has the child put anything in their ears? Has there been any ear drainage or changes in hearing? Ear examination Make sure that the child’s head is as still as possible How to use the otoscope What to look for: Color of the TM. Fluid behind the TM Is the TM bulging or not bulging Light reflex of the TM Ear canal Acute otitis media Infectious causes - bacteria (especially Strep pneumonia, H influenzae, and Moraxella catarrhalis), viruses Treatment Antibiotics vs. “watch and wait approach” Criteria for using antibiotics Antibiotic options Indications for tympanostomy tubes Acute otitis externa (“Swimmer’s ear”) Causes Clinical presentation Treatment Foreign body in ear Mastoiditis Resources and Links: Anatomy and Ear Tubes/Adenoidectomy https://www.texaschildrens.org/departments/ear-nose-and-throat-otolaryngology/conditions-we-treat/dysfunction-eustachian-tube#:~:text=Eustachian%20tubes%20in%20children%20are,cause%20pain%20for%20the%20child. https://www.childrensmn.org/educationmaterials/childrensmn/article/18784/adenoidectomy-and-ear-tubes/#:~:text=The%20adenoid%20is%20located%20next,is%20for%20recurrent%20nasal%20infections https://www.ncbi.nlm.nih.gov/books/NBK570549/#:~:text=The%20middle%20ear%20consists%20of,the%20transmission%20of%20sound%20waves. https://www.ncbi.nlm.nih.gov/books/NBK551658/#:~:t...

Discussing menses and pregnancy prevention is an important part of preventative care and reproductive health. Patients and parents come in with a wide range of preconceptions and understanding. It can be daunting to counsel about the many types of contraception to come to a shared decision about what is best for the patient. This podcast will review the following about contraception: Medical contraindications Physiology of hormonal options Efficacy of pregnancy prevention Patient considerations and concerns Emergency contraception Myths Resources/links: CDC MEC: https://www.cdc.gov/reproductivehealth/contraception/pdf/summary-chart-us-medical-eligibility-criteria_508tagged.pdf ACOG contraception chart: https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods https://www.reproductiveaccess.org/ https://www.bedsider.org/ Links: https://www.cdc.gov/reproductivehealth/contraception/pdf/summary-chart-us-medical-eligibility-criteria_508tagged.pdf https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods https://www.reproductiveaccess.org/ https://www.bedsider.org/ About the Speaker: Host: Rebecca Hu, MD – Rebecca Hu, MD is a pediatrician at Signature Healthcare in Brockton, Massachusetts. She completed her pediatric residency at the University of Virginia, where she served as a chief resident with interests in adolescent health and developmental-behavioral pediatrics. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

Neonatal hypoglycemia is a common and often transient issue for newborns during a period of transition from intrauterine to extrauterine life. Many infants with hypoglycemia are screened for it and treated for it in the nursery, and a handful will require NICU admissions. This podcast will help you understand these things about neonatal hypoglycemia: Why we worry What causes it Which infants are most at risk How to treat it and who needs the NICU Resources/Links: https://downloads.aap.org/AAP/PDF/Seminars_in_Fetal_Neonatal_Medicine.pdf https://publications.aap.org/hospitalpediatrics/article/11/6/595/180015/Practice-Variations-in-Diagnosis-and-Treatment-of https://publications.aap.org/aapnews/news/25073/Myriad-unknowns-regarding-neonatal-hypoglycemia?autologincheck=redirected Links: https://downloads.aap.org/AAP/PDF/Seminars_in_Fetal_Neonatal_Medicine.pdf https://publications.aap.org/hospitalpediatrics/article/11/6/595/180015/Practice-Variations-in-Diagnosis-and-Treatment-of https://publications.aap.org/aapnews/news/25073/Myriad-unknowns-regarding-neonatal-hypoglycemia?autologincheck=redirected About the Speaker: Host: Joanna Parga-Belinkie, MD – Joanna Parga-Belinkie, MD is an Associate Professor of Clinical Pediatrics in Neonatology at the University of Pennsylvania and Attending Physician at Children's Hospital of Philadelphia (CHOP). Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

In this episode, we discuss things you’ll need to know and think about before seeing an infant with jaundice. We will focus on infants from birth to 2 months of age. We will discuss the pathophysiology of hyperbilirubinemia, the difference between unconjugated and conjugated hyperbilirubinemia, the differential diagnosis, key elements of the history and physical exam, laboratory and imaging workup, and management. Introduction to jaundice and hyperbilirubinemia Jaundice is the yellowing of skin, sclerae, and mucous membranes caused by hyperbilirubinemia Hyperbilirubinemia can be further separated into unconjugated or conjugated forms, which allows us to further differentiate etiology Review of bilirubin breakdown pathway, to include enterohepatic circulation Unconjugated hyperbilirubinemia etiologies: Excessive or increased production of bilirubin Cephalohematomas Hemolysis: ABO and Rh incompatibilities; Red Blood Cell (RBC) membrane or enzyme defects, RBC oxidative stress (secondary to sepsis, asphyxia, and acidosis) Decreased clearance of bilirubin Breast milk jaundice Prematurity Hypothyroidism Gilbert Syndrome Crigler-Najjar Syndrome Suboptimal Intake Jaundice Medications Combination of both Physiologic jaundice Conjugated hyperbilirubinemia etiologies: Always pathologic Biliary atresia Briefly mentioned the vast range of other etiologies: infectious, genetic, metabolic, and anatomic Key elements of history and physical examination for a jaundiced infant History: Onset Feeding patterns (what, how much/often, quality of feeding) Urine and stool diapers Prenatal history Delivery history Family history Physical exam: Growth curves Assessing liver size: percussion vs scratch test Neurologic exam Review of laboratory and imaging work up for a jaundiced infant Brief discussion on management of unconjugated hyperbilirubinemia etiologies Feeding Phototherapy Review of neurotoxicity risk factors Brief discussion on management of conjugated hyperbilirubinemia, specifically biliary atresia Early referral to Pediatric Gastroenterology Kasai portoenterostomy Liver transplant Maximizing nutrition Resources/Links: Kemper, A. R., Newman, T. B., Slaughter, J. L., Maisels, M. J., Watchko, J. F., Downs, S. M., ... & Russell, T. L. (2022). Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 150(3). Pan, D. H., & Rivas, Y. (2017). Jaundice: newborn to age 2 months. Pediatrics in Review, 38(11), 499-510. Chou, J. PediTools. AAP 2022 Hyperbilirubinemia management guidelines. https://peditools.org/bili2022/. Published 2012. Updated 2023. Accessed Aug 18, 2023. Links: https://peditools.org/bili2022/ About the Speaker: Host: Ashlee Commeree, MD – Ashlee Commeree, MD is a pediatric critical care medicine physician at the University of Utah in Salt Lake City. She completed her pediatric residency at the University of Virginia before pursuing fellowship training in pediatric critical care. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

This episode is a follow-up to “Before Your First Time Working with a Breastfeeding Mother”. We’ll be reviewing additional details about breastfeeding that can help you to answer some of the most common questions that come up for families. We will discuss strategies to improve milk production, newborn stomach volumes, how to know if baby is getting enough milk, what to do if baby isn’t getting enough milk, and breastfeeding complications. Strategies to improve milk production Latching Newborn stomach volumes How to know if baby is getting enough milk What to do if baby isn’t getting enough milk Manual expression and pumping Breastfeeding complications Resources/Links: Bella Breastfeeding Curriculum on Open Pediatrics (free): www.openpediatrics.org Virginia Department of Health/Breastfeeding Education Consortium Online Course (free for those who live or work in Virginia): https://bfconsortium.org American Academy of Pediatrics Residency Breastfeeding Curriculum: https://www.aap.org/en/learning/breastfeeding-curriculum/ ACOG Statement on Optimizing Support for Breastfeeding: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/optimizing-support-for-breastfeeding-as-part-of-obstetric-practice AAP Policy Statement: Breastfeeding and the Use of Human Milk, 2022: https://publications.aap.org/journal-blogs/blog/20699/Welcome-to-the-AAP-s-2022-Policy-on-Breastfeeding?autologincheck=redirected# US Breastfeeding Guidelines for Mothers with HIV: https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states NEWT Curve: https://newbornweight.org UpToDate “Initiation of Breastfeeding”: https://www.uptodate.com/contents/initiation-of-breastfeeding Links: https://newbornweight.org/ https://bfconsortium.org https://www.aap.org/en/learning/breastfeeding-curriculum/ https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/optimizing-support-for-breastfeeding-as-part-of-obstetric-practice https://publications.aap.org/journal-blogs/blog/20699/Welcome-to-the-AAP-s-2022-Policy-on-Breastfeeding?autologincheck=redirected# https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states https://newbornweight.org https://www.uptodate.com/contents/initiation-of-breastfeeding About the Speaker: Host: Emily Fronk – Emily Fronk is a former UVA School of Medicine student who has published research on virtual reality in pediatrics and pain management in pediatric patients. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

Today we will talk about what to expect before attending your first delivery as part of the pediatrics team while on the Newborn rotation. Each delivery is different and what is needed for each infant at the delivery can be different depending on the status of the infant at birth. In this episode, we will focus on the lower risk deliveries that you are most likely to attend during your newborn rotation, and what you can expect once the baby is born. Newborn deliveries: Low Risk Low-risk delivery team members What constitutes a low-risk delivery page Differences in Operating Room (OR) versus labor room deliveries Differences in attending delivery in the delivery room versus the operating room Operating room attire Importance of Apgar (timer button) on radiant warmer Delayed Cord clamping Delayed cord clamping: When this happens and the importance Why it matters if umbilical cord is clamped before 1 minute and infant brought to the radiant warmer Neonatal Resuscitation NRP guidelines from American Academy of Pediatrics Pertinent Physical Exam at delivery Importance of full, efficient exam in delivery room Need for Higher Level Intervention: Neonatal Intensive Care Reasons for calling for NICU: high-risk delivery team Resources/Links: Neonatal Resuscitation Program (NRP)/American Academy of Pediatrics Neonatal Resuscitation Program (aap.org) Links: https://www.aap.org/en/learning/neonatal-resuscitation-program/ About the Speaker: Host: Jolene "Jody" Carlton, DNP, APRN, CPNP-PC/AC, RNC-NIC, EMT-B – Jolene "Jody" Carlton, DNP, APRN is a Pediatric Nurse Practitioner affiliated with UVA Health University Medical Center in Charlottesville. She holds multiple certifications including CPNP-PC/AC and RNC-NIC. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

Antibiotic selection can be complicated. In this episode, we discuss how you should approach choosing the appropriate antibiotic for your pediatric patient. There are multiple considerations, including: What organisms do you want to treat? What does anatomy have to do with antibiotic selection? You also have to think about individual circumstances, such as immunzation status, chronic disease, drug allergies, and environmental exposures. Know what organisms you want to treat Because we often treat empirically, we need to know organisms that typically case this typical infection Narrow-spectrum antibiotics if possible Anatomy of the infection For fever in first 4-6 weeks, think about organisms that infant was exposed to during pregnancy and delivery For respiratory infections, think about organisms that live in the respiratory tract Abnormal anatomy Immunization status of child may change your differential diagnosis Drug allergies Look in medical record and ask patient and family about allergies Consider cross-reactivity of antibiotics Geographic location: resistance patterns Individual circumstances Chronic diseases Environmental exposures Resources/Links: Up to date: uptodate.com American Academy of Pediatrics Red Book: https://publications.aap.org/redbook?autologincheck=redirected Sanford Guide to Antimicrobial therapy: https://www.sanfordguide.com/products/print-guides/?gad=1&gclid=CjwKCAjwtuOlBhBREiwA7agf1oWtsyBrx0OFaHxpG2ZpDTXYukd1JGs5R_ZpRWrECT_v0bqhboN15hoCijIQAvD_BwE American Academy of Pediatrics clinical practice guideline: The Diagnosis and Management of Acute Otitis Media. 2013. https://publications.aap.org/pediatrics/article/131/3/e964/30912/The-Diagnosis-and-Management-of-Acute-Otitis-Media Links: https://publications.aap.org/redbook?autologincheck=redirected https://www.sanfordguide.com/products/print-guides/?gad=1&gclid=CjwKCAjwtuOlBhBREiwA7agf1oWtsyBrx0OFaHxpG2ZpDTXYukd1JGs5R_ZpRWrECT_v0bqhboN15hoCijIQAvD_BwE https://publications.aap.org/pediatrics/article/131/3/e964/30912/The-Diagnosis-and-Management-of-Acute-Otitis-Media About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.

Many of our patients and their families are not proficient in English, and it's important to be able to communicate effectively with them. In this episode, you’ll learn about how to work with an interpreter during encounters with patients who are not proficient in English. We’ll discuss dos and don’ts, common challenges, and tips for interacting with interpreters and families. Definitions Interpretation vs translation Modes of interpretation When do I need an interpreter? III. Who should not serve as an interpreter? Non-certified team members Patient’s non-certified friends or community members Patient’s family members Getting started Verify preferred language Positions in the room Introductions, including of the interpreter and recording interpreter’s information Conducting the visit How long to speak before awaiting interpretation During the physical exam Teach-back method via interpreter Trouble-shooting When the patient declines interpreter services When you think the interpreter is misinterpreting When you have technical difficulties or ambient noise VII. At the end of the encounter Translating written patient materials Considering variable written and medical literacies Next steps and follow-up care VIII. After the visit Documentation of your use of interpreter services Verification of preferred language Resources: – “Addressing Low Health Literacy and Limited English Proficiency,” American Academy of Pediatrics: https://www.aap.org/en/practice-management/providing-patient--and-family-centered-care/addressing-low-health-literacy-and-limited-english-proficiency/ – “Guidelines for Use of Medical Interpreter Services,” Association of American Medical Colleges: https://www.aamc.org/media/24801/download – “Appropriate Use of Medical Interpreters,” American Academy of Family Physicians: https://www.aafp.org/pubs/afp/issues/2014/1001/p476.html – “Working effectively with an interpreter,” U.S. Department of Health and Human Services Office of Minority Health: https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/working-effectively-with-interpreter.pdf Links: https://www.aap.org/en/practice-management/providing-patient--and-family-centered-care/addressing-low-health-literacy-and-limited-english-proficiency/ https://www.aamc.org/media/24801/download https://www.aafp.org/pubs/afp/issues/2014/1001/p476.html https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/working-effectively-with-interpreter.pdf About the Speaker: Host: Irène Mathieu, MD, MPH, FAAP – Irène Mathieu, MD, MPH, FAAP is an Associate Professor of Pediatrics at UVA and core faculty at the Center for Health Humanities & Ethics. She is a primary care pediatrician, award-winning poet with four published collections, and a Fulbright Fellow who completed her residency at CHOP. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.