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Understanding and Managing Childhood Asthma
Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."
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Renown Cardiologist Shares Insight on Warfarin
Renown Health's Dr. Christopher Rowan recently joined a distinguished panel of experts on the "Game Changers in Medicine" podcast to discuss the science behind the discovery of warfarin. Renown Health Cardiologist Dr. Christopher Rowan was just featured on an episode of Game Changers in Medicine, a groundbreaking medical history podcast from Dramatic Health about some of the world’s most significant medical discoveries. The episode, Warfarin: How a rat poison became one of the world's most widely prescribed drugs, dives into the fascinating history of Warfarin and its life-saving effects on humans. During the episode, Dr. Rowan, whose research focus is heart disease and atherosclerosis, is joined by experts Kevin Walters, Historian and Strategic Research Coordinator at the Wisconsin Alumni Research Foundation (WARF); and Ramya M. Rajagopalan, Ph.D. of the Institute for Practical Ethics at UC San Diego. Listen to the episode now or download it wherever you listen to podcasts. History of Warfarin Warfarin prevents blood clots from forming or expanding. The drug is especially important for individuals who have experienced a heart attack or stroke, or are at risk of experiencing either. However, the backstory of the drug is rather fascinating. Beginning in the 1920s, an unknown disease was killing cattle throughout the U.S. and Canada. Desperate to find a solution, one farmer drove 200 miles to the University of Wisconsin with a dead cow, bales of spoiled hay and a milk can of unclotted blood in tow. He crossed paths with a scientist, whose team set out to determine the hemorrhagic component of the spoiled hay, resulting in a series of medical discoveries that would revolutionize medicine. After learning more about Warfarin and how Vitamin K could reverse its blood thinning properties, doctors first prescribed the drug for human use in 1954. It is perhaps most widely known for saving President Dwight D. Eisenhower after he suffered a heart attack in 1955. Today, Warfarin continues to saves millions of lives each year. “Before blood thinners like Warfarin, people would experience strokes, blood clots in their lungs, blood clots in their legs, blood clots in their hearts, along with countless other clotting disorders - these conditions likely cutting their lifespans short,” Dr. Rowan said during the podcast. “Warfarin revolutionized the treatment of patients who suffer from heart attacks and strokes, helping them to live normal and healthy lives. The drug changed medicine forever and helped make incredible innovations such as mechanical heart valves a reality.” Interview Opportunity Dr. Rowan is available for interviews to discuss the importance of this unique medical discovery and the positive impact it has on many of the patients he treats every day. Please email news@renown.org or call 775-691- 7308 to coordinate an interview. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. 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, 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. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project® . For more information, visit renown.org. About Dramatic Health Dramatic Health, a national healthcare video company, is the producer of the six-part podcast series Game Changers in Medicine. The series premiered in July with an episode about Vitamin K and an enterprising Boston house doctor. The August episode showcased the creation of a smallpox vaccine and its parallels to today's urgent search for a COVID-19 vaccine. Game Changers in Medicine ranked #27 in Apple Podcasts: Life Sciences in the United States according to Chartable as of August 21, 2020. Both episodes, a series backgrounder, and additional material about the podcast series are available at www.gamechangersinmedicine.com and can be accessed wherever you listen to podcasts.
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Helmsley Charitable Trust Grants $3.1 Million to Renown Health
Pictured left to right: Erin VanKirk, MSN, RN, Renown Health Director of Nursing Education; Mitch Krebs, Program Director at Helmsley Charitable Trust; Dr. Graf, Renown Health CEO; Greg Walaitis Renown Health Chief Development Officer. Renown Health will use the grant to build the Helmsley Simulation and Innovation Center to improve the health system’s training abilities The Leona M. and Harry B. Helmsley Charitable Trust has granted $3.1 million to Renown Health for construction of a new simulation and innovation center that will greatly expand the health system’s ability to train healthcare providers throughout northern Nevada. The new center will be named the Helmsley Simulation and Innovation Center. Expected to open in April 2023, the center will feature three simulated patient rooms, classroom space, computer labs and a conference center, allowing trainers to run current and future healthcare professionals through real-life acute, outpatient, telemedicine and specialty care scenarios. The new center will let Renown Health train substantially more nurses, physicians, community clinical partners, medical students and rural providers while improving medical and nursing expertise to support staff throughout northern Nevada. “The Helmsley Charitable Trust is excited to fund this new simulation center, which will provide healthcare professionals across rural Nevada with state-of-the-art training in a variety of situations they’ll encounter,” said Walter Panzirer, a trustee of the Helmsley Charitable Trust. “The project fits with our goal to level the playing field by giving rural residents access to top-notch healthcare, regardless of their ZIP code.” “Simulation education has become standard practice for many of our healthcare personnel,” said Erin Van Kirk MSN, RN, Director of Nursing Education. “This lab will provide expanded opportunities in a controlled setting where physicians, nurses, and students can gain valuable experience in providing the best care possible.” Renown Health has outgrown its current simulation lab, which opened in 2016 in Renown Regional Medical Center. The new, larger, state-of-the-art simulation and innovation center will increase Renown Health’s training capacity from 1,500 to 2,500 each year. The new facility will be equipped with state-of-the-art simulation mannequins and other equipment that includes a telemetry monitor, IV and epidural equipment, a code cart, a defibrillator, a balloon pump, ventilators and a cooling machine. The center will also support Renown Health’s recently established partnership with the University of Nevada, Reno School of Medicine, expanding training modules focused on rural health and virtual care through telemedicine. “The facility will help Renown Health respond to our region’s growing population by allowing us to support the training and competency necessary for our care providers to make a genuine difference in the health and well-being of the people and communities we serve,” said Melodie Osborn, RN, MBA, Chief Nursing Executive at Renown Health. “This generous grant for the new simulation and innovation center from the Helmsley Charitable Trust is truly an investment in the bright future we envision for Renown, our care teams and the community.” About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. 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, 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. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org. About the Helmsley Charitable Trust The Leona M. and Harry B. Helmsley Charitable Trust aspires to improve lives by supporting exceptional efforts in the U.S. and around the world in health and select place-based initiatives. Since beginning active grantmaking in 2008, Helmsley has committed more than $3 billion for a wide range of charitable purposes. Helmsley’s Rural Healthcare Program funds innovative projects that use information technologies to connect rural patients to emergency medical care, bring the latest medical therapies to patients in remote areas, and provide state-of-the-art training for rural hospitals and EMS personnel. To date, this program has awarded more than $500 million to organizations and initiatives in the states of North Dakota, South Dakota, Nebraska, Wyoming, Minnesota, Iowa, Montana, and Nevada. For more information, visit helmsleytrust.org.
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Where There is Smoke; There May Be More Headaches, Nausea and Coughing
Renown Urgent Care team prepares you to stay safe this season and is available seven days a week at 11 locations across northern Nevada Millions of people across the West live in areas where air pollution can cause serious health problems. Local air quality can affect our daily lives. Like the weather, it can change from day to day. The Northern Sierra Air Quality Management District issued an Air Quality Health Advisory for Plumas County, to notify the public of the possibility of poor air quality conditions resulting from the Beckwourth Complex Fire in addition to other wildfires in northern California. In addition, there is the potential for wind shifts to carry smoke to other parts of Plumas County from the Beckwourth and several other regional wildfires. Air quality is expected to vary greatly depending on fire behavior and weather conditions, with smoke settling in low areas at night and in the early mornings as long as these fires are active. The advisory mentions, “Exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain, especially among sensitive individuals such as the elderly, children, people with asthma, people with heart or lung conditions, pregnant women and anyone who is exercising or working hard outdoors.” Kouros Farro, MD, a physician with Renown Urgent Care advises that there are people who are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy, physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Farro, who is board certified in family medicine and practices at Renown Urgent Care at 975 Ryland St in Reno. “If you do not have a health care provider, know we have a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change, or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD make sure you have your relief/rescue inhaler with you. People with asthma should review and follow guidance in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. “Even just one hour of smoke exposure can affect our lungs and hearts, and these consequences can reach people far beyond the direct area endangered by the fire. Children, older adults, pregnant women, people with preexisting cardiopulmonary disease, communities of color, economically disadvantaged communities, and people with preexisting chronic health conditions like asthma, diabetes, and obesity are all especially vulnerable to the air pollution that wildfires cause," says Dr. David Lemak, Division Chief of Urgent Care at Renown. Renown Urgent Care provides treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening, that require same-day medical attention and avoid the long wait times and high prices of the emergency room at 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk-in or book ahead online. You can get the latest fire and smoke information at the Washoe County Health District’s Be Smoke Smart webpage. It includes information about air pollution levels and how to protect yourself from the smoke. An on-line subscription page allows you to sign up for EnviroFlash, notifying you about air quality. About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. For more information, visit renown.org.
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Wildfire Smoke More Dangerous Than Other Air Pollution for People With Asthma
Stage 2 Air Quality Index and alarming research studies from DRI, Renown Health and the Washoe County Health District leads to public health advisory- seek care if needed For people who suffer from asthma, wildfire smoke is more hazardous than other types of air pollution, according to a study from the Desert Research Institute (DRI), the Renown Institute for Health Innovation (Renown IHI) and the Washoe County Health District (WCHD). The study published in the journal Environmental Health examined associations between airborne particulate matter (PM) from sources such as wildfire, transportation and industry, and medical visits for asthma at Renown Health’s emergency departments and urgent care centers in Reno, Nev. during the six-year period from 2013-2018. In places like Reno, where wildfire events occur regularly during parts of the year and are expected to become more frequent in the future, an accurate understanding of the impacts of wildfire smoke on population health is critical. We have an exceptional process in place through our urgent care sites, Renown Medical Group offices and hospital emergency departments to screen, diagnose and treat members of our community who come to us for care related to asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, and other upper respiratory diseases that may be exacerbated by wildfire smoke. At the same time, we continue to develop and refine, in real-time, the data that supports our predictive analytic models. We are using every tool and resource-including scientific data and clinical reporting, to ensure that we are meeting both the health and healthcare needs of the people we serve. In the study, researchers found that air quality in the Reno area was affected by wildfire smoke on a total of 188 days during the study period. A total of 18,836 asthma-related emergency room and urgent care visits occurred over the same five-year period of time, indicating that the influences of wildfire smoke and other types of air pollution on this medical condition are important to understand. The Washoe County Health District – Air Quality Management Division (AQMD) has issued a Stage 2 Air Pollution Warning due to smoke from area wildfires. Air quality in the Reno-Sparks area is now “Very Unhealthy” with an Air Quality Index of 247. The Stage 2 warning means that all residents should stay indoors and reduce activity levels due to the susceptibility of increased health risks. To see current air quality in Reno-Sparks, click here. Brion Hill, MD who practices at the Renown Urgent Care - Los Altos location warns, “This is an important health advisory, exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain. Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Hill. “If you do not have a health care provider, we have 11 conveniently located Renown Urgent Care offices with providers ready to see you 7 days a week." Dr. Joseph Grzymski, a research professor at Desert Research Institute, a corresponding author on the study and Chief Scientific Officer, Renown Health, says, “This air is very bad for your health. Given today’s Air Quality Index in Reno, being outside and breathing this air for a day equals about smoking half a package of cigarettes.” Additional Information: The full text of the article “Particulate matter and emergency visits for asthma: a time-series study of their association in the presence and absence of wildfire smoke in Reno, Nevada, 2013–2018,” is available from Environmental Health: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-020-00646-2 To learn more about the Renown Institute for Health Innovation, please visit: https://www.dri.edu/renown-ihi/ Renown Urgent Care provides treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening, that require same-day medical attention and avoid the long wait times and high prices of the emergency room at 13 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk-in or book ahead online. The Washoe County Health District offers online health information on its Be Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. About the Desert Research Institute The Desert Research Institute (DRI) is a recognized world leader in basic and applied interdisciplinary research. Committed to scientific excellence and integrity, DRI faculty, students, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Since 1959, DRI’s research has advanced scientific knowledge, supported Nevada’s diversifying economy, provided science-based educational opportunities, and informed policymakers, business leaders, and community members. With campuses in Reno and Las Vegas, DRI serves as the non-profit research arm of the Nevada System of Higher Education. For more information, visit www.dri.edu. About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to improve the care and the health of our community. For more information, visit renown.org.
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