October 7, 2006, 11:43 pm

Hey There! Hi There! Ho There! You’re As Welcome As Can Be…To Pediatric Rounds, Spell It G-R-A-N-D!


Welcome to the Clubhouse!

Emergiblog is proud to host this week’s Pediatric Grand Rounds!

Volume One, Edition Thirteen!

And hopefully most of you recognize that mouthful of a title as a take-off on the old Mickey Mouse Club theme.

If you are too young to remember it, you missed a fun old show.

Of course, I was just a baby when it was on….


A pediatric code in the hospital is a gut-wrenching experience. A pediatic code in the field is unfathomable…unless you happen to be the EMT on scene. PDXEMT recalls the emotions (and the outcome) at his blog, Drug Induced Hallucinations. Check out the story, entitled Gone Too Long.

Neonatal Nurse (and fellow fan of James Lileks!) Marcia recounts her feelings in caring for premature babies in What I Do. But don’t stop there. Her blog, Ants Marching, is full of posts that grab you by the gut. Go get a box of Kleenex. Got it? Good . Now follow the link and read Everything For Everybody – Part 2. Marcia, you are so linked on my sidebar!

Parent know their child better than anyone and dealing with hospital bureaucracy can be frustrating. Awesome Mom gives us an example in The Coumadin Nightmare, found at The Adventures of An Awesome (Sometimes) Mother. But don’t stop there! Click on the sidebar links for the amazing story of her son Evan and what life is like when you are only working with one heart ventricle. Amazing!


She’s cool, she’s tanned, she’s an ER nurse, she’s….Urban Mom! And she weighs in with her first experience with pediatric respiratory distress in Croup Is A Bitch, Especially When You’ve Got Things To Do. This is Urban Mom’s first entry into a carnival/rounds and here’s hoping there are many more!

Alyson from RN Wannbe talks about her personal experiences with ear infections and the “watchful waiting” vs. antibiotic debate in A Parent’s Take On Ear Infections (note: Blogger is being a bugger and will not link to the appropriate post. Just go to the main site and scroll down to find post) and a great post on Nasal Lacrimal Duct Obstruction. “Yellow gunk”. I think that should become an official medical term!

Dr. Joel Fuhrman of diseaseproof.com tackles the topic of flu immunizations in the pediatric population. Are they necessary? What exactly can you expect them to cover? What is the risk to benefit ratio? Batton down the hatches, The Flu Is Coming!


Dr. Clark Bartram at Unintelligent Design submits a fascinating case study/explanation of a complex disease in a two-part post. Elementary, My Dear Bartram sets the stage. Elementary, My Dear Bartram, Part II fleshes out the mystery. No, I won’t tell you what the disease is, you have to read it!

Dr. Kavokin, our Grand Rounds host from last week presents a SIDS Quiz posted at RDoctor Medical Syndication. Now, I had some trouble with this – it may be that I am working on a Mac using Safari and Firefox. I’ve let Dr. K know, so hopefully we can find out just how much we know about SIDS!

Laura, an NICU nurse presents a personal story of what it is like to be the parent of a preemie in Normal Vertigo posted at Adventures in Juggling. This is the first blog I have seen with a “film loop”, amazing to watch. While you are there, click over on the sidebar on the name “Daniel” to hear the beginning of his story.


Dr. Flea takes on the history of pediatrics in his review of a book on the same topic. In As ususal, a lively discussion follows. Has pediatrics taken on the medicalization of societal and emotional problems or are pediatricians now able to focus on treating the entire patient? You’ll enjoy reading Fleas As Claimsmakers and the discussion that follows!

Dr. Deborah Serani reminds us about World Mental Health Day ~ October 10th posted at Dr. Deborah Serani. No matter what the age of our patients, we all need to focus on the importance of mental health. Thanks Dr. Deb – I would have put this in Change of Shift if I had known!

Neonatal Doc writes from the gut, and the heart, as he describes the emotionally draining process of trying to help parents understand just how ill their child really is in Eighteen II, posted at Neonatal Doc. Be sure to read the entire post.


Have you ever heard of the “Triple A Triad”? This was new to me and so it was with interest that I checked out TheTundraPAs post on Really Bad Eczema at Tundra Medicine Dreams. My heart goes out to her little patient.

This post appeared earlier this week in Change of Shift. As this particular issue can be rather pressing in the case of neonates and pediatrics, I felt it to appropriate here in Pediatric Grand Rounds. You don’t have to be a chaplain to perform a baptism. Susan Palwick, our resident volunteer ER Chaplain, explains the situation in Emergency Baptism for Everybody at Rickety Contivances of Doing Good.


Those of you who follow Grand Rounds may have noticed a couple of duplicates in the submissions. I included them here on the chance that

  • (1) Some readers may not have had a chance to see them and
  • (2) the possibility that PGR may attract a different subset of readers.

Both were excellent, and so they were included this week.


And so ends this edition of Pediatric Grand Rounds. I leave you to ponder the lyrics of “Rhymes and Reasons” (John Denver, 1969)

“…It is here we must begin
To seek the wisdom of the children
And the graceful way of flowers in the wind…

…Like the music of the mountains
And the colours of the rainbow
They’re a promise of the future
And a blessing for today.”

I definitely was not a baby when that was written…..

The next Pediatric Grand Rounds will be hosted by Moreena at The Wait and the Wonder on October 22nd.


  • Clark Bartram

    October 8, 2006 at 5:38 am

    Wonderful edition Kim. Thanks for hosting and don’t be shy about signing up for future editions either.

    I do have to say that I was a little saddened by the inclusion of yet another Joel Fuhrman advertisement with little useful information or evidence for what he is claiming. His opinion about the flu vaccine is unfounded as well as dangerous and his “advice” for avoiding the flu ranges from common sense to nonsense.

    Someone holding himself out to be a medical expert should back up what he says especially when it flies in the face of medical knowledge accepted by the CDC, AAP, the vast majority of pediatricians, etc, etc. We have tried to address this before but Dr. Fuhrman and his marketing team(Gerry Pugliese was hired by Dr. Fuhrman to promote book sales) just don’t seem to get it. Submissions from them should be taken on a case by case basis, although some have called for a complete ban, but I didn’t much care for this one and wouldn’t have accepted it. But every editor has complete control over content of their edition so feel free to take my advice or leave it if you choose to host again. And I hope you do.

  • Gerry Pugliese

    October 8, 2006 at 6:07 am


    Why would you ban the DiseaseProof post?

  • Susan

    October 8, 2006 at 8:42 am

    Great job, Kim! Thank you for your excellent carnival work this week. May you enjoy many funnel cakes!

  • Clark Bartram

    October 8, 2006 at 10:57 am

    I don’t have the power to ban anything except from my own website. I just wouldn’t have accepted it as a submission to the PGR. Why? Because it is alarmist and makes extreme claims not based in reality. Claims that might discourage people from seeking appropriate medical care. I’m not going to go through this with you again. Check out Flea’s take on this particular post if you want it spelled out for you.

  • enoch choi

    October 8, 2006 at 2:43 pm

  • Neonatal Doc

    October 8, 2006 at 6:35 pm

    Excellent job on Peds Grand Rounds, Kim. Also, I agree with Clark.

  • Moreena

    October 8, 2006 at 8:24 pm

    The Dr. Fuhrman/Pugliese post scares me, too. And talk about your weird segues–it goes from discussing Avian Flu, for which there is no vaccination and is obviously not seen around these parts, to a discussion of our usual flu, which we see in boatloads every year. Of course I recognize that there is a connection to be made, but flu vaccines have undeniably saved many lives. But never mind that! Be sure to feed your kids well, folks, because that’s the key to stopping the spread of infection! Good Grief.

    (p.s. Kim, I really meant to submit something this time around, but I didn’t feel like anything I wrote these past two weeks was submission-worthy. Thanks for the good reads!)

  • Irishdoc

    October 26, 2006 at 10:54 pm

    I wondered how to submit something for grand rounds. I is my recent blog entitled it from a formidible night in the ED

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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