Seattle Children's Provider News

The U.S. population faces seven times more exposure to ionizing radiation from medical procedures than it did in the early 1980s, largely due to the growth in computed tomography (CT) and nuclear medicine, according to the National Council on Radiation Protection and Measurements. Children’s hospitals are increasingly looking for ways to use lower radiation doses for diagnosis and treatment. Success has come from using new technologies and equipment specially designed for children and constantly being on the lookout for opportunities to share information and collaborate better across teams.

Tom Lendvay

Why is radiation bad for children?  

Tom Lendvay, MD, urologist, Seattle Children’s: If you start receiving radiation exposure as a child, you run the risk of having a larger lifetime dose of radiation. Children exposed to radiation, especially those undergoing X-rays and CT scans to evaluate primary cancers, are also at increased risk of developing what is called a secondary malignancy, or cancer due to the DNA-damaging effects of radiation exposure as a child. These include hematologic (blood cell) cancers.

For all these reasons, we look for ways we can reduce the amount of radiation our patients are exposed to during diagnosis and treatment.

What are some of the ways kids are exposed to radiation in the hospital?

Dr. Lendvay: Children may be exposed to ionizing radiation through X-rays, CT scans, fluoroscopy (live X-rays), nuclear medicine tests and intraoperative imaging. Fortunately, children’s bodies are generally smaller and contain less fat than adults, which makes ultrasound technology a good choice much of the time. However, there are a number of conditions that require radiation imaging tests. Over the last two decades, CT scans have provided rapid, rich data and anatomic detail that surpass many other imaging modalities and has proven invaluable to the diagnosis of severe medical conditions. Thus, the use of CT scans has increased in adults and children over the last two decades. Read full post »

Seattle Children’s welcomes epilepsy specialists Dr. Priya Monrad and Dr. Ahmad Marashly to the Epilepsy Program, where they will serve as Epilepsy Monitoring Unit medical director and surgical program director, respectively. They come from Children’s Hospital of Wisconsin and bring a combined 15 years of experience seeing the most complex patients, including those needing surgery. They joined Seattle Children’s this fall.

What are your plans for the epilepsy program at Seattle Children’s?

Dr. Monrad: We have the largest epilepsy program in the Pacific Northwest, but we want to make it more accessible to families, especially to those families living in Washington state south of Seattle. Starting in December, we’ll be seeing patients at our regional clinic in Federal Way for the first time. Previously, we offered epilepsy services only at the main hospital and the Bellevue and Everett regional clinics.

Dr. Marashly: We’re also going to be putting a stronger emphasis on making sure providers in the community have easier access to us and can get their epilepsy-related questions answered. We know PCPs can handle so much of their patients’ epilepsy care if they have a good connection with a specialist when needed. We want to be a resource to them. Read full post »

More than 500 children have screened positive for suicide risk in Seattle Children’s Emergency Department and inpatient settings over the past six months who presented for concerns unrelated to their mental health. A new clinical pathway known as Seattle Children’s Zero Suicide Initiative (ZSI) is a universal screening method introduced in March 2019 to help identify and treat youth at risk of suicide. The pathway incorporates the National Institute of Mental Health’s (NIMH) Ask Suicide-Screening Questions (ASQ) — a brief, five-question screening by intake nurses that assesses if patients ages 10 and up are currently having or have recently had suicidal thoughts.

On average, every week in 2017, nearly four Washington youths died by suicide and two youths were hospitalized because of intentional self-injuries or suicide attempts. One of the most common misconceptions about youth suicide is the idea that talking about suicide will “plant the seed” of suicidal thoughts that weren’t already there — especially in younger children. While there’s no data to support this misleading theory, NIMH research shows that the suicide rate for children ages 10 to 12 has substantially risen over the past 10 years. Read full post »

Seattle Children’s Outreach Education Department invites you to register for the 2020 Pediatric Nursing Update all-day conference scheduled for Jan. 31, 2020, in Wright Auditorium from 7:50 a.m. to 4:45 p.m. Topics include the latest on school and child care immunization requirements, pediatric psychiatry and behavioral medicine, up-to-date trends in pediatric conditions and more. This year we are excited to offer breakout sessions as part of the conference. View the brochure for more details.

Seattle Children’s is recruiting infants for a new study at Seattle Children’s. The WONDER research study uses technology and behavioral assessments to monitor and map social brain development. The study consists of five in-person study visits during the first three years of life at our research lab in Seattle. During visits, researchers record brain activity and eye movements while showing the child pictures and videos. They engage the child in play-based activities to assess different aspects of development, such as language and motor skills.

We are recruiting English-speaking families with infants under the age of 6 months to be part of one of three groups:

1. Infants with an older sibling (whole or half) with a diagnosis of autism spectrum disorder.
2. Infants born with low birth weight – 3lbs., 15 oz. or less (1800 g).
3. Infants born weighing more than 5 lbs., 5oz. (2500 g) with no known serious medical conditions and no first- or second-degree relatives with autism.

Read full post »

Isabelle Zoerb, 13, and Elliot Fox, 5, both have primary ciliary dyskinesia (PCD), a rare genetic condition that prevents bacteria from clearing the lungs, sinuses, nose and ears. They are patients at Seattle Children’s, which is the only Pacific Northwest PCD referral center. Dr. Margaret Rosenfeld, an attending physician and researcher at Seattle Children’s, says parents often go through a “diagnostic odyssey” before their child is diagnosed. Most people with PCD have unexplained neonatal respiratory distress, requiring oxygen or breathing support. They generally develop chronic nasal drainage and chronic wet cough within the first six months of life. And it’s a progressive disorder, worsening with time.

“We hope to increase awareness of PCD, which is highly underdiagnosed, so doctors across different fields can identify children with PCD and help them,” said Dr. BreAnna Kinghorn, a researcher at Seattle Children’s.

Rosenfeld researches PCD as the Seattle Children’s site investigator for the Genetic Disorders of Mucociliary Clearance Consortium, which recently received a $7.5 million grant from the National Heart, Lung and Blood Institute. “We are hoping to make diagnosing PCD more streamlined so that we can hold clinical trials to develop new therapies for people with the condition,” Rosenfeld said. “We are hopeful that more effective therapies for PCD will exist in the future.”

Read the article: Families Raise Awareness of Rare, Underdiagnosed Lung Disease – On the Pulse

Kevin Urdahl

Dr. Kevin Urdahl, a Seattle Children’s researcher in the Center for Global Infectious Disease Research, recently received a seven-year, $83 million grant from the NIH to study how protection against tuberculosis (TB) works in order to develop a more effective TB vaccine. It is the NIH’s largest-ever investment in TB. Seattle Children’s is the largest of the four centers awarded funding and will lead a consortium made up of the University of Washington, Fred Hutch, Oregon Health & Science University, Beth Israel Deaconess Medical Center of Harvard and three sites in Africa. Read full post »

Dear Providers,

We are deeply sorry for the impact the air quality issues in our operating rooms (ORs) continue to have on our patients and families. We are grateful for your partnership and support during this period. Seattle Children’s remains committed to doing what’s right to keep our patients safe.

Dr. Mark Del Beccaro, SVP and Chief Medical Officer

Mady Murrey, SVP and Chief Clinical Officer

Dr. Jeff Ojemann, SVP and Surgeon-in-Chief

Read Our Additional FAQs

How should we refer patients with possible surgical needs?

Please continue to refer patients by calling our ED Communications Center at 206-987-8899. We will review potential surgical patients on a case-by-case basis with the appropriate surgical specialists and with our Surgeon-in-Chief. We still expect to have capacity for emergency cases. We will continue to divert some cases to other local hospitals and perform additional surgeries at our Bellevue Clinic and Surgery Center.

How does this affect patients currently scheduled for surgery at Seattle Children’s?

Over the coming days and weeks, our surgery coordinators will be contacting families to help them reschedule their procedures. We will review surgical patients on a case-by-case basis with the appropriate surgical specialists and with our Surgeon-in-Chief. If a family contacts you with a question about their child’s scheduled surgery, please ask them to call their surgery clinic at Seattle Children’s for assistance.

We are also telling families in clinics to anticipate longer than normal wait times when trying to schedule their surgeries, and that they are welcome to speak to their PCP if they would rather schedule somewhere else instead of waiting.  

We understand the impact that postponing surgeries has on our patients and families, and are deeply sorry for the inconvenience. We are grateful for our families’ understanding and your partnership and support during this period.

Will my patient’s surgery get cancelled?

This will depend on the type of surgery or procedure. Coordinators from the Surgery Center will call patients and families to give updates about rescheduled or postponed surgeries.

How many surgeries have been canceled or rescheduled due to the closure of the main campus operating rooms?

To date, we have postponed 255 surgeries, and our surgery coordinators are in close contact with patients and families whose scheduled surgeries are impacted. We are deeply sorry for the impact this closure will have on our patients and families.

During this temporary closure of most of our operating rooms, Seattle Children’s will perform surgeries at partner hospitals, including Harborview, Swedish, UW Medical Center and Mary Bridge Children’s Hospital.  We will continue to perform surgeries in our remaining operating rooms and at our Bellevue Clinic and Surgery Center.

What types of surgeries are being sent to other hospitals?

We will continue to conduct surgeries in three of our ORs that already have HEPA filtration, and prioritize those surgeries that are most emergent. Additionally, one non-HEPA filtered OR will remain open for procedures that carry very low or no risk of infection. We will cancel, postpone or divert some surgical cases to other area hospitals including Mary Bridge Children’s Hospital, UW Medical Center, Harborview and Swedish, and move others to our Bellevue campus.

In addition to installing HEPA filters what else is Children’s doing to make improvements?

In addition to addressing the air-quality issues in our operating rooms, we will conduct a rigorous, thorough review of the factors that led to this situation. Among other issues, we will examine our culture, our leadership, and how our teams communicate problems and escalate concerns.

Where should I direct families who have questions?

If your patient or family has a concern, please ask them to visit our website for the most up-to-date information or call 206-987-2550. If they need an interpreter, they may call 866-583-1527 and ask to be connected to this number: 7-2550.

What if I have more questions?

If you would like to speak with Seattle Children’s leadership team directly, please contact Dr. Jeff Ojemann, Seattle Children’s Surgeon-in-Chief (206-987-2544  or [email protected]).

If you have an urgent clinical concern, please call the Provider-to-Provider Line at 206-987-7777 and ask to speak to the specific surgical service on call.

Dear Providers,

We are deeply sorry for the impact the air quality issues in our operating rooms (ORs) continue to have on our patients and families. Seattle Children’s remains committed to doing what’s right to keep our patients safe.

Dr. Mark Del Beccaro, SVP and Chief Medical Officer

Mady Murrey, SVP and Chief Clinical Officer

Dr. Jeff Ojemann, SVP and Surgeon-in-Chief

Plan for Installing HEPA and Re-Opening ORs

On Wednesday, Nov. 13, we closed our main operating rooms (ORs) at the hospital to inspect our air handling system and determine the appropriate corrective actions.

After careful consideration and in consultation with outside experts, we have decided to proceed with the immediate installation of custom in-room HEPA filtration in 10 ORs and two equipment storage rooms, and to continue with the planned installation of the new air handling system. We had previously planned to build in-room filtration systems room-by-room in order to minimize disruption to our patients, and have already completed this work in three rooms. The room-by-room installation was previously scheduled to be completed by July 2020.

Our patients’ safety is our top priority and we remain committed to doing what’s right to keep them safe.  HEPA is an extremely effective filtration system that removes more than 99% of particles from the air passing through the filter. Installing in-room HEPA filtration requires custom-building a system for each OR – an extraordinary measure – but one that we know is the right thing to do for our patients and families.

To allow for the installation of the new filtration systems, 10 ORs will remain closed until the end of January. We will continue to perform surgeries in the four remaining ORs, three of which already have HEPA filtration. Cases that must be done at Seattle Children’s will be performed in the ORs with HEPA filtration. Only those surgeries that pose little or no risk of infection will be performed in the OR that does not yet have HEPA filtration. After February, the one remaining OR will receive its in-room HEPA filtration system.

We know this closure will result in the postponement of many surgeries, and we are sorry for the impact this will have on our patients and families. We are confident this is the safest option for our patients.

How does this affect patients who are referred with possible surgical needs?

Please continue to refer patients by calling our ED Communications Center at 206-987-8899. We will review potential surgical patients on a case-by-case basis with the appropriate surgical specialists and with our Surgeon-in-Chief. We will continue to divert some cases to other local hospitals and perform additional surgeries at our Bellevue Clinic and Surgery Center.

How does this affect patients currently scheduled for surgery at Seattle Children’s?

Our surgery coordinators will be contacting families to help them reschedule their procedures. We will review surgical patients on a case-by-case basis with the appropriate surgical specialists and with our Surgeon-in-Chief. If a family contacts you with a question about their child’s scheduled surgery, please ask them to call their surgery clinic at Seattle Children’s for assistance.

We understand the impact that postponing surgeries has on our patients and families, and are deeply sorry for the inconvenience. We are grateful for our families’ understanding and your partnership and support during this period.

Is my patient at risk if he/she had surgery at Seattle Children’s recently?

We have been actively monitoring all high-risk patients since re-opening our ORs in July and have contacted those families.

Where should I direct families who have questions?

If your patient or family has a concern, please ask them to visit our website for the most up-to-date information or call 206-987-2550. If they need an interpreter, they may call 866-583-1527 and ask to be connected to this number: 7-2550.

What if I have more questions?

If you would like to speak with Seattle Children’s leadership team directly, please contact Dr. Jeff Ojemann, Seattle Children’s Surgeon-in-Chief (206-987-2544 or [email protected]).

If you have an urgent clinical concern, please call the Provider-to-Provider Line at 206-987-7777 and ask to speak to the specific surgical service on call.

Dear Providers,

We are deeply sorry for the impact the air quality issues in our operating rooms (ORs) continue to have on our patients and families. Aspergillus is again present in some of our ORs. Out of an abundance of caution, we have closed all main ORs at our main campus in order to investigate the air handling system and take corrective actions. Seattle Children’s remains committed to doing what’s right to keep our patients safe.

The duration of the OR closures is still being determined.

We have provided a Q&A below to help answer your questions. We will update you again when we have new information to share.

Dr. Mark Del Beccaro, SVP and Chief Medical Officer

Mady Murrey, SVP and Chief Clinical Officer

Dr. Jeff Ojemann, SVP and Surgeon-in-Chief

What is happening?

On November 10, routine air tests detected Aspergillus in three operating rooms and two procedural areas. Aspergillus is a common mold often present in the air we breathe. However, in some instances it can cause complications for surgical patients.

What are we doing in response?

We have closed all main ORs at our main campus. The duration of the operating room closures is still being determined.

Some surgical cases may be postponed, diverted to other local hospitals temporarily, or performed at one of our community-partner sites by Seattle Children’s surgeons who have privileges at that site. We will perform some procedures at our Bellevue Surgery Center or at other sites on our main campus that are not in the main ORs.

We have also self-reported the issue to the Washington State Department of Health and Public Health – Seattle & King County.

Have patients been affected?

We recently confirmed one new Aspergillus surgical site infection, and continue to investigate one other potential infection.

How does this affect patients who are referred to the ER with possible surgical needs?

Please continue to refer patients by calling our ED Communications Center at 206-987-8899. We will review potential surgical patients on a case-by-case basis with the appropriate surgical specialists and with our Surgeon-in-Chief.

How does this affect patients currently scheduled for surgery at Seattle Children’s?

Our surgery coordinators will be contacting families to help them reschedule their procedures. We will review surgical patients on a case-by-case basis with the appropriate surgical specialists and with our Surgeon-in-Chief. If a family contacts you with a question about their child’s scheduled surgery, please ask them to call their surgery clinic at Seattle Children’s for assistance.

We understand the impact that postponing surgeries has on our patients and families, and are deeply sorry for the inconvenience. We are grateful for our families’ understanding and your partnership and support during this period.

What should PCPs be monitoring for?

Signs of Aspergillus infection may include:

• Redness
• Swelling or drainage from the surgical site or fever
• Neurosurgery patients might experience headache or a stiff neck.

If you have a clinical concern, you may call the Provider-to-Provider Line at 206-987-7777 and ask to speak to Infectious Disease.

What is causing Aspergillus to be present in the operating rooms?

At this time, the source of Aspergillus in the operating rooms is unknown and we are actively investigating.

What did Seattle Children’s do previously to address its air quality issues?

During the summer of 2019, we implemented multiple improvements recommended by outside industrial hygiene experts. These included:

• Removing our previous air handling and purification system and switching to a newer air handler, which has been upgraded, cleaned, sanitized and tested to verify proper performance.
• Installing and testing a new humidification system.
• Sealing potential sources of air leaks in all of the operating rooms.
• Extensively and repeatedly deep cleaning all of our operating rooms and core rooms.
• Adding a new device to our operating room cleaning protocol that emits ultraviolet light to disinfect surfaces.
• Continuing to monitor and test our air handling system in an effort to maintain a safe environment for our patients.

To validate that our operating rooms were safe for patient care, this summer we invited the Centers for Disease Control and Prevention (CDC), the Washington Department of Health and Public Health – Seattle & King County to tour our facilities, assess our safety protocols and share in our learnings. They confirmed we have taken appropriate actions to reduce the risk of future Aspergillus infections.

Where should I direct families who have questions?

If your patient or family has a concern, please ask them to visit our website for the most up-to-date information or call 206-987-2550. If they need an interpreter, they may call 866-583-1527 and ask to be connected to this number: 7-2550.

What if I have more questions?

If you would like to speak with Seattle Children’s leadership team directly, please contact Dr. Jeff Ojemann, Seattle Children’s Surgeon-in-Chief (206-987-2544 or [email protected]).

If you have an urgent clinical concern, please call the Provider-to-Provider Line at 206-987-7777 and ask to speak to the specific surgical service on call.