Okay, y’all, I left my camera at home this time, thinking a bunch of photos of people at the podium really isn’t going to add much. But I will take notes on the presentations and try to include the most interesting bullet points.
Friday, 8/21/2009
Executive committee:
- Please send in BC/BS complaints to NCPS for negotiations over court settlement.
- Look at new OSHA requirements for cleaning crews. Yes, they exist, and yes, they’re slightly ridiculous.
Open Forum:
Brandon Rector, MSW Immunization Branch, Gerri Mattson, MD, MSPH
Division of Public Health
- H1N1 Recommendations continue to evolve
- Make sure health department knows you want to give H1N1 vaccine in your office.
- Still hoping for two-way interface between EMR’s and NCIR
- Remember HIB booster is now available
- State Fluzone Influenza vaccine to be shipped starting Monday.
- Seasonal flu vaccine is recommended for all children ages 6 months to 18 years.
- H1N1 recommendations are in flux, to be addressed in a later talk.
Newborn CF Screening Review
- Screening is identifying about 10% of CF carriers, not the intent of the program
- If immunoreactive trypsinogen (IRT) is >95% then DNA testing is done (46 most common)
- DNA testing can still miss some mutations.
- Kids with two mutations get preferential scheduling by CF centers. Must be 14 days old, 2 kg in weight.
- If IRT >99.8% then sweat chloride. Also if one or two genes positive.
- Sweat chloride must be done at accredited CF center. (Duke, Kings Daughters in Norfolk VA, Mission, UNC, Wake Forest, Western Carolinas CF Center)
- Genetic counseling is recommended for infants with CF or with mutation.
- Notification comes to physician of record by phone, fax, and mail. ONLINE results do not include abnormal CF results.
UNC EMR web access should be available to community physicians!
H1N1 Influenza
- Obesity and pregnancy are significant co-morbidities for influenza death risk.
- May only have 45 million doses of vaccine against H1N1 by October
- Priority groups are likely to be more limited than initially thought.
- Healthcare workers, pregnant women, contacts of 0-6 month infants, and children 6 to 60 months along with other young people with underlying illnesses will be in the first tier along with elderly adults.
- Oseltamivir dosing for children under 12 months can be found at the CDC website.
Francis Rushton, MD, Healthcare Reform
- 12 million uninsured children in the US now.
- AAP DOES endorse healthcare reform, although it does not back a specific bill.
- Overall pediatricians, pediatric specialists, and children stand to benefit from universal care.
- Kaiser Family Foundation and AAP websites both help with the details of current proposed legislation.
- This is NOT the English healthcare plan.
- HB 3200 would raise what we get paid to 100% of Medicare.
- HB 3200 would provide reimbursement for medical home services, financial assistance with medical training.
- Please be vocal in your communities in support of universal care for children.
- Also, be aware Redbook recommendations on RSV prophylaxis and Medimmune’s recommendations differ.
- AAP budget only $800,000 or 1% in the red.
Pediatric Palliative Care
- Kids Path Program is available in Lower Cape Fear Hospice, includes counseling for children who have suffered a loss of a parent or sibling.
- Palliative care is not just about end of life, but about quality of life when coping with the challenges of a complex or life-threatening disease.
- Individualized Care Planning and Coordination Model
Frank Loda, MD Purple Crying Project www.dontshake.org
- Make sure practicing physician reinforces to family (not just mother) the importance of not shaking babies.
- There are cards for MD’s to hand to parents to confirm they received the Purple Crying DVD and get their feedback on it.
- The project is now contacting practices to participate in distributing these materials.
- If you don’t already have these materials please contact the program at jana.thompson@duke.edu
NC KIDBase Access System for Emergencies, Gloria Hale, NC State Office of Emergency Medical Services
- EMSC is Emergency Medical Services for Children, based in NC Office of EMS
- Goal is to optimize emergency care to children from the point of entry to the system through child’s return home.
- Ensures essential pediatric equipment is present on ambulances, improve safety of pediatric ambulance transport
- Ambulance crashes are much more common than private vehicle crashes, so kids really should be properly secured.
- Create emergency care guidelines for schools when school nurse is not available.
- Develop hospital guidelines for inter-facility transfers
- Kids Information Data base Access System for Emergencies: ensure children with special needs receive the care they need in medical emergencies.
- KIDBase medical information form is a double-sided form to be completed by parent/caregiver and by primary physician
- Get your copy of the form here: http://www.co.dare.nc.us/depts/ems/KidbaseForm.pdf
- Make sure families keep a copy of this form in the child’s “go bag”, also at school or daycare if needed
Carol Ford, MD on NC Institute of Medicine Adolescent Health Task Force
- Create evidence-based roadmap to improve health of children aged 10 to 20 in NC
- Portrait of adolescent health to be released next Tuesday!
- Call to Action December 15, 2009 to kick off roadmap from task force.
- Working toward new adolescent Health Check based on EBM practices.
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