News:


Family Resource Center Update
The All Children’s Hospital Family Resource Center, a health information library for patients and families, marked its first anniversary in June. During its first year of operation, the Family Resource Center was visited by 4,800 individuals. The staff handled more than 1,000 research questions and prepared nearly 150 consumer health information packets for families of ACH patients. Early this year, the Resource Center created and distributed “Information Rx” prescription pads that physicians can use to refer families to the Center to learn more about a child’s illness or condition.

The Family Resource Center also has health-related books and magazines of general interest for patients and families and sponsors bimonthly story time sessions. All Children’s Hospital employees have donated more than 2,800 books and magazines to the Center, and children and their parents are invited to take a book away with them each time they visit. Families of patients receiving either inpatient or outpatient care are encouraged to visit the Family Resource Center. It is located on the second floor of the Outpatient Care Center and is open Monday through Friday.


Audiology, Psychiatry
& Developmental Pediatrics Make Temporary Move
The psychiatry, developmental pediatrics and outpatient audiology programs have relocated from the former Physicians Office Building (POB) to the adjacent Children's Health Center. The temporary move will facilitate renovations to the POB, which will reopen in late 2011 or early 2012 to accommodate these programs along with a wider range of outpatient rehabilitative services (pediatric occupational, physical and speech-language therapy services). The Children's Health Center is located at 800 Sixth Street South, St. Petersburg and driving directions are available at www.allkids.org/chc.


Pediatric Grand Rounds Still on Summer Hiatus
Pediatric Grand Rounds at All Children's Hospital remain on summer hiatus and will resume Friday, September 9.


2011 Camp Week
Was A Blast

While the space shuttle Atlantis made its final journey, the patients at All Children's Hospital did some space exploration of their own as part of 2011 Camp Week: Blast Off From ACH. Patients and siblings took part in morning and afternoon activities that included space-themed crafts and recreation, making moon rock cookies, playing Outer Space Bingo, a "campfire" and drum circle, and an "Out of this World" party to wrap up the week's events.

Children with serious illnesses don't usually have the opportunity to attend camps or summer programs, so the hospital's Child Life Department brings camp right here to the patients, explains department director Luci Weber, CCLS. "The Children's Auditorium in our new hospital gives us plenty of space for these kinds of activities, so last year we introduced the summertime camp week and it was an immediate success."

View event photos.


Andrew Helfgott, M.D., M.H.A., CPO is joining All Children's Perinatology Specialists, the maternal-fetal medicine program at All Children's Hospital. From 2005 through June 2011, Dr. Helfgott was Professor and Chief of the Section of Maternal Fetal Medicine, Department of Obstetrics and Gynecology at the Medical College of Georgia. Dr. Helfgott also served as Medical Director of the Regional Perinatal Center at the Medical College of Georgia. He held previous faculty appointments at the Florida State University School of Medicine, the University of Florida College of Medicine-Pensacola, and the University of Texas Health Science Center at Houston, where he also was an assistant professor in the School of Public Health.

Dr. Helfgott completed his medical education at the Universidad Autonoma de Guadalajara in Guadelajara, Mexico and at Queens Hospital-Long Island Jewish Hillside Medical Center, SUNY-Stony Brook. Following a residency in obstetrics and gynecology at The Brooklyn Hospital-Caledonian Hospital in Brooklyn, New York, he completed a fellowship in maternal fetal medicine at the University of Miami School of Medicine. He earned a master's degree in Health Policy and Administration from the School of Public Health at the University of North Carolina, Chapel Hill.

A recognized authority on the diagnosis and treatment of infectious diseases in pregnancy, Dr. Helfgott has served in Florida and Georgia on state committees for the prevention of perinatal transmission of HIV. He is currently on the Board of Directors for the Society of Maternal Fetal Medicine and also chairs the Society's Coding Committee. He has served as course director for the Society's Ultrasound Scientific Forum as well as for the American Institute of Ultrasound in Medicine's Obstetrical Film Panel. Dr. Helfgott's special interests include outcomes for high-risk mothers and their babies, infectious diseases in pregnancy and preterm labor.

Paola Dees, M.D., has joined the All Children's Hospitalist service and All Children's Specialty Physicians. Dr. Dees is a graduate of Florida State University College of Medicine, where she received the J. Ocie Harris, M.D. Outstanding Student Award and was named to the Alpha Omega Alpha Medical Honor Society. In June 2011 she completed her pediatric residency at the University of South Florida College of Medicine and All Children's Hospital. In 2009 Dr. Dees was named All Children's Hospital Resident of the Quarter and she received the All Children's Hospital Neonatal-Perinatal Resident Award for 2009-2010. She also received the Arnold P. Gold Foundation Humanism and Excellence in Teaching Award from the USF College of Medicine and was inducted into the Gold Humanism Honor Society by both FSU and USF.

Dr. Dees has had several articles on medical student education published online by the American Academy of Pediatrics and an article on Lemierre Syndrome published at antimicrobe.org. She is fluent in Spanish and conversant in Italian.
By Craig A. Kizewic, D.O.
All Children's Hospital
Emergency Center

There is a widespread belief that strokes do not happen in children. However, a small yet meaningful percentage of children do have strokes each year in the United States. Stroke and other cerebrovascular disorders are among the top ten causes of death in children. Perinatal acute ischemic strokes affect 1 in 4,000 term births. Childhood ischemic strokes affect 1 in 2,000 children, with the average age for an acute ischemic stroke being 7 years old. Males are at greater risk than females. Childhood non-traumatic intracranial bleeds affect 1 in 50,000 children. Unfortunately, of those children who suffer a stroke, 10 percent will die, 20 percent will have a recurrent stroke and 70 percent will have long-term neurological deficits.

At All Children's Hospital, we have developed a Stroke Team and Pathway to rapidly identify and treat children who are experiencing stroke symptoms and initiate a Stroke Alert page.

This alert contacts a team of specialized physicians and personnel capable of providing rapid care to diagnose the problem and institute life-saving treatments and interventions to prevent further neurological damage and death. Our multidisciplinary team consists of pediatric emergency medicine physicians, neurologists, radiologists, interventional neuroradiologists, hematologists, neurosurgeons, cardiologists, neonatologists and critical care physicians.

The team's goals are to:
Maintain and restore perfusion to the impacted area
Provide neuroprotection to limit the core, the infarcted area
Salvage the penumbra, the potentially viable tissue surrounding the infarcted area
Promote recovery and plasticity
Prevent recurrence

Strokes in adults often result from hypertension, cardiovascular heart disease, smoking and obesity. In children, however, the causes are varied and include birth trauma, heart disease such as a patent foramen ovale, malignancy, sickle cell anemia, traumatic injuries, and infections such as meningitis, encephalitis and intracranial abscesses.

In children it can be hard to differentiate a stroke from other diseases. For instance, seizures can be a presenting sign in 25 percent of children who suffer a stroke. There are many stroke mimics that occur in children that do not occur in adults. In fact, stroke mimics account for 20 percent of children presenting with stroke symptoms. Some of these mimics include acute disseminated encephalomyelitis (ADEM), which is an autoimmune demyelination similar to multiple sclerosis. It is caused by a viral, bacterial or parasitic infection and rarely by vaccinations. MELAS (mitochondrial encephalopathy, lactic acidosis and stroke-like episodes) appears in childhood after a period of normal development. These children develop muscle weakness, pain, recurrent headaches, vomiting, seizures and stroke-like episodes causing hemiparesis and altered mental status. Posterior reversible encephalopathy syndrome (PRES) causes headaches, confusion, seizures and visual loss. Other stroke mimics include brain tumors, Todd's paralysis, epileptic aphasia, complex migraine and psychogenic causes. This is why children need to have extra studies to confirm that they are indeed experiencing a stroke.

A barrier to getting children the appropriate care and testing they need is that parents and health care providers often have trouble recognizing the signs and symptoms of a stroke in children. Many times the child's caregivers assume it is anything but a stroke. They thought their child was just "acting out" or experiencing a "viral infection" or "migraine." Children cannot articulate their symptoms and infants fail to localize their symptoms. These factors all lead to a delay in diagnosis. In fact, even with all the public service announcements about adult stroke symptoms, only 20-25 percent of adults who are experiencing a stroke get to the hospital in the three-hour window. It usually takes adults 12-24 hours to seek medical care; with children who are experiencing a stroke this delay increases to 48-72 hours.

One tool to help people recognize the symptoms of stroke is the Cincinnati Stroke Scale FAST Exam:
Face Ask the child to smile.
Does one side of the face droop?
Arms Ask the child to raise both arms
(close eyes, extend arms, palms up).
Does one arm drift downward?
Speech Ask the child to repeat a simple sentence.
Are the words slurred? Can the patient repeat the sentence correctly?
Time If the child shows any of these symptoms, time is important. Call 911 or get to the hospital fast. Brain cells are dying.

Symptoms of stroke can also include:
Weakness on one side of the body (hemiparesis)
Slurred speech or difficulty communicating
Sudden lethargy and drowsiness
Seizures
Early hand preference in infants (before 12 months)
Ataxia or gait disturbances
Vision changes
Numbness
Headache
Vomiting

Our future goal is to be involved in the International Pediatric Stroke Study (IPSS) and Thrombolysis in Pediatric Stroke (TIPS) study. This international study, consisting of 167 centers in 41 countries, is the first of its kind to look in depth at childhood strokes and develop evidence-based therapies to reduce the incidence of stroke and improve the outcomes of children who have experienced a stroke.

If you have a patient you think may be experiencing a stroke, please do not hesitate to contact our Physician Access Line (PAL) at 1-877-222-0404. You will be put in contact with either an emergency medicine physician, critical care specialist or neonatologist to accept the patient at All Children's Hospital. We are able to provide transportation to All Children's Hospital with our Neonatal & Pediatric Transport Team that includes a critical care transport pediatric registered nurse, respiratory therapist and paramedic specializing in the care of critically ill and injured newborns, children and teenagers. Our transport team is available 24-hours a day, 7 days a week. If you are in an outlying location and time is a factor, we also provide air transport with our team utilizing Bayflite aeromedical helicopters.