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    • Wednesday, Feb 07, 2024

    American College of Surgeons Awards Level II Pediatric Trauma Designation to Renown Children's Hospital

    (Pictured Above: Dr. Frieda Hulka, Pediatric Trauma Program Medical Director at Renown Children’s Hospital, helps announce pediatric trauma verification on Wednesday, Feb. 7, 2024) Renown Health, a locally governed, not-for-profit academic healthcare network serving northern Nevada, Lake Tahoe and northeast California and the teaching hospital for the University of Nevada, Reno School of Medicine, has been verified as the first level-2 pediatric trauma center in northern Nevada by the American College of Surgeons (ACS). This recognition is a historic first for children’s healthcare in northern Nevada. Renown Regional Medical Center is the region’s only Level II Trauma Center (adult) and one of the largest hospitals in the United States, with 826 licensed beds, providing care to approximately one million patients across 17 counties, across 100,000 square miles between Sacramento and Salt Lake City. Serving urban, suburban, and rural communities, Renown Health is one of the region’s only providers of neonatal care with both a pediatric intensive care unit (PICU) and the largest newborn intensive care unit (NICU) in the area. RENOWN ONLY ONE OF TWO IN NV; ONE OF 153 IN THE US The pediatric trauma verification by the ACS recognizes that the Renown team offers immediate, around-the-clock, emergency treatment for pediatric trauma patients. Renown is one of only two health systems to receive the designation of a Level II Pediatric Trauma Center in Nevada by the ACS; and the first in northern Nevada to earn this national distinction. To achieve verification, the hospital must meet rigorous standards for comprehensive care, staffing, facilities, research, and educational contributions. Nationwide, only 153 hospitals are pediatric trauma centers. The new status considers trauma treatment capabilities of Renown’s pediatric emergency department as well as the ability of Renown Children's Hospital to offer such services as pediatric surgery, pediatric intensive care unit stays and pediatric physical and occupational therapy to children recovering from traumatic injuries. EXTENSIVE ON-SITE REVIEW “This new achievement was granted after an extensive on-site review conducted by an expert team from the American College of Surgeons; a group dedicated to improving the care of surgical patients and safeguarding standards of care in a safe, optimal and ethical practice environment,” said Brian Erling, MD, MBA, President & CEO of Renown Health. “We are proud that Renown Regional Medical Center has earned the designation of being the only ACS verified Level 2 Trauma Center for adults in the region since 1984. This verification process, renewed every three years, was completed in late December 2023 alongside the new verification for Renown Children’s Hospital. Now with UNR Med, we celebrate serving our community with a robust Level 2 Pediatric Trauma Center; and have grown to become a nationally recognized children’s hospital with a robust academic department of pediatrics.” “The team at Renown Children’s Hospital consistently provides outstanding pediatric trauma care, and we are thrilled that the American College of Surgeons has awarded us with this official distinction,” said Dr. Frieda Hulka, Pediatric Trauma Program Medical Director at Renown Children’s Hospital. “This is particularly significant for families in northern Nevada, where trauma remains the leading cause of death in infants and children. Some nationwide studies show that children treated at pediatric trauma centers have a lower mortality risk compared to children treated at other facilities.” This year marked the first time the emergency department's pediatric capabilities were evaluated separately. To be a designated Level II Trauma Center, a hospital must have 24-hour immediate coverage by general surgeons and multiple specialties, such as orthopedic surgery, neurosurgery, and emergency medicine. In addition, the hospital must provide trauma prevention and ongoing education for its teams and incorporate a comprehensive quality assessment program. The emergency department did not meet the minimum volume of 200 pediatric trauma patients per year to qualify for the level-1 pediatric designation, but the Renown team anticipates with growing community support, combined with UNR Med’s research and residency programs, that they will pass this threshold in the future. “More than 100,000 children between the ages of zero and 17 live in Washoe County, and that number continues to grow,” said Nicholas Mannering, Trauma Program Manager at Renown Health. “Caring for our community’s children is a responsibility we take extremely seriously, and we are so grateful to our patients and the families for trusting us with their care.” “Both the pediatric and adult trauma verification honor the many pioneering trauma physicians, surgeons and clinical and support teams who have built a stellar reputation over the last 160 years for Renown; and align with our strategic vision for providing comprehensive and best-in-class healthcare for the people of northern Nevada for the next 160 years,” said Chris Nicholas, CEO of Renown Regional Medical Center. “These designations celebrate our team’s commitment to maintaining and exceeding the highest standards of care for our patients.” GRATEFUL DONORS INVEST IN NORTHERN NEVADA’S CHILDREN In 2016, The William N. Pennington Foundation recognized the need for enhanced care and expertise for pediatrics and donated $7.5 million to Renown Children’s Hospital to establish the William N. Pennington Fund for Advanced Pediatric Care. “Through these gifts,” adds Kristina Deeter, MD, MBA, FAAP, Chair of Pediatrics (UNR Med) and Physician-in-Chief, Renown Children’s Hospital, “100,000 area children now have access to more than 30 pediatricians, including general pediatricians and specializing specialists in oncology, orthopedics, pulmonology, emergency medicine, urology and many other subspecialties previously lacking in the community, as well as a pediatric emergency room, pediatric ICU and a dedicated pediatric floor at Renown Children’s Hospital. Prior to 2016, a significant percentage of pediatric patients requiring critical and specialty care had to be transferred outside of our region to receive the specialty care they needed. Now, thanks to donor support, Renown estimates that 97% of all pediatric patients and their families can receive both general and specialty pediatric care locally. The next nearest children’s hospital in the state is 7 hours or 438 miles away in Las Vegas.” In 2022, the hospital treated 82,544 patients, performed 26,388 inpatient and same-day surgeries, gave care to 37,380 children through its pediatric providers, and delivered 3,792 babies. In June 2023, Renown Regional Medical Center expanded its pediatric critical care services to the region with a New Neonatal Intensive Care Unit with advanced technology and trained healthcare professionals to give special care for women and babies. Renown also has a Neonatal Transport Team which brings infants with serious illnesses, injuries, or complications from outlying communities to the comfort of Renown's NICU. In July 2023, The University of Nevada, Reno School of Medicine (UNR Med) and Renown Health welcomed members of the first resident class of the new UNR Med Pediatric Residency Program. Renown Health is a 501 c3 not for profit organization. Donations to the Children’s Hospital are needed and accepted here.   About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit academic healthcare network serving Nevada, Lake Tahoe, and northeast California. Renown Regional Medical Center is the teaching hospital for the University of Nevada, Reno School of Medicine. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center for both adults and children, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health.

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    • Pediatric Care
    • Toddler Health

    Ask the Expert: What is Scoliosis?

    Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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