January 28, 2019

 

Director of Texas Children’s Trauma and Grief Center Dr. Julie Kaplow was recently named Chief of Psychology.

Kaplow, who also serves as head of psychology in the Department of Pediatrics at Baylor College of Medicine, is an expert in childhood trauma and bereavement. As director of the Trauma and Grief Center, a SAMHSA-funded Treatment and Service Adaptation Center of the National Child Traumatic Stress Network, Kaplow oversees evidence-based assessment, treatment and research with youth and families exposed to traumas and/or losses, and develops and disseminates trauma- and bereavement-informed “best practices” to community providers nationwide.

A strong proponent of a scientist-practitioner approach, Kaplow’s primary research interests focus on the biological, behavioral and psychological consequences of childhood trauma and bereavement, with an emphasis on therapeutically modifiable factors that can be used to inform psychosocial interventions. Kaplow’s ongoing studies examine the effectiveness of treatments for various populations of youth including those with a history of trauma, youth exposed to traumatic bereavement, and youth anticipating the death of a loved one.

Shortly after joining Texas Children’s, Kaplow helped launch the Harvey Resiliency and Recovery Program, dedicated to serving the needs of the many children and families adversely affected by the storm and its aftermath. She was also integral in the creation of the Santa Fe Strong Resiliency Center, along with the Gulf Coast Center and others in the Santa Fe community, to provide mental health services to those impacted by the shooting. These efforts have been made possible by the generous support of the Hurricane Harvey Relief Fund, New York Life Foundation, Robert Wood Johnson Foundation, Rebuild Texas Fund, Center for Disaster Philanthropy, Children’s Health Fund, and the JPB Foundation. Additional funding for the Santa Fe Strong Resiliency Center was provided by the Victims of Crime Act.

Kaplow is also actively engaged in community-based participatory research. She leads a practice-research network of sites across the country (including community clinics, grief support organizations, schools and academic medical centers) that use “common denominator” theory, assessment tools and interventions to address the unique needs and strengths of bereaved youth and families.

Kaplow earned her Ph.D. degree in clinical psychology from Duke University in 2002. She completed her internship at Harvard Medical School/Boston Children’s Hospital and a postdoctoral fellowship in childhood trauma at Boston Medical Center. She is board-certified by the American Board of Clinical Child and Adolescent Psychology of the American Board of Professional Psychology.

To learn more visit texaschildrens.org/departments/psychology.

January 14, 2019

Emergency medical service professionals from across Texas recently gathered in Fort Worth for the 2018 Texas EMS Conference and Texas EMS Awards ceremony, where representatives from Texas Children’s trauma center accepted this year’s Trauma Center Award – the state EMS and Trauma system’s top honor for trauma facilities.

“This really is a big deal for Texas Children’s,” said Texas Children’s Associate Surgeon-in-Chief Dr. David Wesson. “The award signals that we’re among the best trauma centers in the state, adult or pediatric, and it represents a team effort by all of the Texas Children’s Trauma Team – doctors, nurses, data specialists, prevention experts, social workers and so many others, and our leaders, Dr. Bindi Naik-Mathuria and Christi Reeves.”

The Texas EMS Awards, sponsored by the Texas Department of State Health Services, honor individuals and organizations that exemplify the best that state EMS and Trauma have to offer. The Trauma Center Award is presented each year to one facility in the state that has demonstrated leadership and high standards in implementing injury prevention programs and in providing trauma patient care both to citizens and visitors of Texas. Most notably, the winning trauma center is selected from among both adult and pediatric trauma facilities by members of the Texas EMS community.

“These pre-hospital providers have a unique perspective on the quality of care delivered at trauma centers across the state,” said Wesson. “They want the best care for the patients they rescue in the field. So we should be very proud to have been recognized.”

The full continuum of trauma care

Texas Children’s Level I trauma center provides comprehensive, around-the-clock evaluation and treatment for the most severely injured patients that come to the hospital. Considering there are more than 1,000 annual trauma admissions at our Texas Medical Center campus, teamwork is absolutely essential for the rapid and decisive action needed to treat traumatic injuries. The multidisciplinary team includes pediatric surgeons and surgical subspecialists, emergency medicine physicians, critical care physicians, anesthesiologists, nurses, child life specialists, social workers, rehabilitation specialists, physical, occupational and respiratory therapists, and other support staff – all working together effectively and efficiently when every second matters.

In addition to the world-class clinical care we provide in our trauma center, we also work with state and regional organizations to provide educational opportunities for pre-hospital providers, nurses, community groups and other hospitals. Furthermore, we have teams specially dedicated to public health and injury prevention and to the prevention and management of child abuse and neglect.

Learn more about Texas Children’s trauma center.

April 24, 2018

Texas Children’s Hospital’s Trauma Center has received the prestigious 2018 Trauma System of Care Award from the Southeast Texas Regional Advisory Council (SETRAC). The Trauma System of Care Award recognizes Texas Children’s Hospital as one of the best in SETRAC’s nine-county region for excellence in the development and advancement of pediatric trauma services.

At a recent awards ceremony, SETRAC honored Texas Children’s as well as other hospitals and first responders who have exhibited outstanding performance in areas such as trauma care, stroke care, cardiac care, multi-agency teamwork, disaster preparedness and citizen hero of the year. The ceremony was held at the Hilton of America’s and was attended by nearly 700 individuals and elected officials, including State Representatives, City of Houston EMS Physician Director Dr. David Persse, and Jim “Mattress Mack” McIngvale, owner and operator of Gallery Furniture.

“This award means a lot because, being only in our eighth year, we are the youngest Level I trauma center in Houston,” said Dr. Bindi Naik-Mathuria, Trauma Center director. “We have come a long way in developing programs to provide the best care for injured children as well as injury prevention education for our community. It was rewarding to be recognized as the best pediatric trauma hospital in the region.”

Texas Children’s Hospital has been verified as a level I Pediatric Trauma Center since 2010. The level of verification was requested by the hospital and the on-site review of the hospital was conducted by a team of reviewers experienced in the field of trauma. Using the current Resources for Optimal Care of the Injured Patient manual as a guideline, this team determined if the criteria for the requested level have been met.

Established by the American College of Surgeons in 1987, the Consultation/Verification Program for Hospitals promotes the development of trauma centers in which participants provide not only the hospital resources necessary for trauma care, but also the entire spectrum of care to address the needs of all injured patients. This spectrum encompasses the prehospital phase through the rehabilitation process. Verified trauma centers must meet the essential criteria that ensure trauma care capability and institutional performance.

SETRAC was founded by the late Dr. James H. “Red” Duke, Jr., legendary trauma surgeon at Memorial Hermann-Texas Medical Center and John B. Holmes Professor of Clinical Sciences at UT Health Medical School, and has been funded by the Texas Department of State Health Services for the last 25 years.

October 3, 2017

While flood waters have receded, Hurricane Harvey will have long-lasting effects on the Houston community. To help support the most vulnerable populations, and serve the mental health needs of those children adversely impacted by the recent hurricane and flooding, the Harvey Resiliency and Recovery Program is launching as part of Texas Children’s Hospital’s new Trauma and Grief Center.

The Harvey Resiliency and Recovery Program was made possible through the support of Children’s Health Fund, and a generous donation from singer/songwriter and co-founder of Children’s Health Fund (CHF), Paul Simon, and his wife, singer/songwriter Edie Brickell, a Texas native.

Under the umbrella of the Trauma and Grief Center, the Harvey Resiliency and Recovery Program will be dedicated to serving the needs of the many children and families adversely affected by the storm and its aftermath. The Trauma and Grief Center at Texas Children’s is one of the only health service agencies within this region of Texas with significant child trauma and bereavement expertise. The Center will evaluate traumatized and/or bereaved youth between the ages of 7 and 17 and provide ongoing evidence-based treatments to those youth requiring intervention.

“Using evidence-based assessments and interventions, as well as providing trauma-informed training to mental health professionals and teachers in impacted communities, we hope to more quickly recognize and address the needs of children who are at risk for developing post-traumatic stress disorder and related psychological difficulties,” said Dr. Julie Kaplow, director of both the Trauma and Grief Center and Harvey Resiliency and Recovery Program at Texas Children’s. “Surviving a disaster can be distressing for anyone, but youth who have already been exposed to trauma, traumatic loss and/or severe adversity are at particularly high risk for severe persisting stress and may need the support of a mental health professional. This new program will connect our experts to these children.”

Many of the immediate effects of a major disaster are visible to the public eye and include infrastructure damage, flooding and public health issues, such as water contamination. The long-term psychological impacts of a major event are harder to see. This newly-formed program will address the mental health needs of those who survived the recent storm and were exposed to trauma-related risk factors that research indicates is likely to predispose them to long-term mental, emotional and physical consequences.

“Children’s Health Fund has been responding to the needs of children and families post-crisis for 25 years now,” said Dennis Walto, chief executive officer of Children’s Health Fund. “We know kids who were living in poverty before the storm are now at the highest risk for short- and long-term negative impact on mental health and well-being. CHF looks forward to working with Texas Children’s team to develop programs that will reach all children and families impacted by the crisis – especially those who often struggle to access even basic health care – and to take those lessons to other communities that may be facing similar challenges.”

Texas Children’s is working with several community partners, including impacted school districts, to train professionals in how to screen and assess children who may need additional support. A formal screening tool is being used to help identify children who need higher level interventions, and experts at Texas Children’s Harvey Resiliency and Recovery Program will be available to meet with and treat these patients starting in early October.

To learn more about this program, visit Texas Children’s website.

February 28, 2017

Texas Children’s Hospital was recently re-verified as a Level 1 Pediatric Trauma Center by the American College of Surgeons and the Texas Department of State and Health Services.

During the re-verification process, the American College of Surgeons evaluated whether Texas Children’s Hospital met criteria put forth in its Committee on Trauma’s manual, Resources for Optimal Care of the Injured Patient. The evaluation included a lengthy and through questionnaire as well as a site visit.

The evaluation found no deficiencies and listed multiple strengths highlighting the excellent multidisciplinary efforts, leadership, quality improvement, and commitment to research by the hospital and its staff.

The trauma center is led by Dr. Bindi Naik-Mathuria, medical director, and Christi Reeves, the director of trauma services.

There are only 49 Level 1 pediatric trauma centers nationwide. Texas Children’s Hospital was first verified as one in 2010. The re-verification process occurs every three years.

August 30, 2016

83116Wesson640By Andrew Kragie, Houston Chronicle

Pediatric surgeon Dr. David Wesson talks to the Houston Chronicle about gunshot wounds in children.

Dr. David Wesson points to a spot below his belly button. That’s where the .22-caliber bullet pierced the abdomen of the first pediatric gunshot victim he ever treated.

The boy was 1 month old. He was perched on the kitchen table. His father had been cleaning a rifle when it unexpectedly discharged. The bullet ricocheted through the infant’s body.

The surgeon’s finger traces upward across his white coat, zig-zagging like a child’s pencil following the lines of a maze: through the abdomen, into the liver and out the back.

The baby survived, Wesson said, but the Texas Children’s Hospital trauma surgeon still remembers the bullet’s path three decades later – and it still bothers him.

“When you treat somebody for cancer, you really feel that there’s not much anybody could have done to prevent that,” Wesson said. But not so with a child who’s been shot.

“You’re always thinking that, well, that could easily have been prevented,” Wesson, now a grandfather of six, said during an interview in the emergency department’s exam room.

In the last six days of July, three Houston-area children – boys 5, 7 and 11 – accidentally shot themselves in separate incidents, authorities said. Two died. Doctors and gun-safety experts say these events are doubly tragic because they are avoidable.

Houston doctor gives inside look at trauma center

The boys joined the list of 139 children accidentally shot by themselves or by other children in the first seven months of 2016, figures show. In Harris County, accidental gunshot wounds kill more children than any type of accident except vehicle crashes, according to a Chronicle analysis of medical examiner’s records from 2011 to 2014 – an average of 27 children a year.

Authorities gave the following accounts of the most recent shootings:

On July 26, Edgar Padilla, 5, shot himself in the face at his grandfather’s home in Harris County. He died two days later when life support was removed. On July 27, a 7-year-old boy shot himself in the forehead in Alvin after finding the key to his grandfather’s gun cabinet; Brazoria County police said he was expected to survive, after the bullet traversed his scalp without entering his skull. And on July 31, an 11-year-old boy shot himself in the neck while playing with his uncle’s gun in east Houston. Police said he died August 9 when he was taken off life support.

These local incidents are typical of accidental shootings by children, according to data collected by Everytown for Gun Safety, an advocacy group. Most of the more than 100 children killed accidentally in 2013 were shot in family homes with legally owned guns. At least two-thirds could have been prevented by safe storage, the group found.

Gunshots stand out as causes of injury, Wesson said, because they are more likely to require surgery than car crashes or falls. Gunshots are more likely to be life-threatening and more likely to be fatal.

And while a bullet wound is a medical emergency regardless of age, gunshots are even more devastating to children’s small bodies. “Young children have a different sort of vulnerability,” Wesson said.

Gravitate to guns

A pediatrician in southwest Houston, Dr. Christina Propst, said children’s smaller abdomens raise the chance of a bullet hitting key organs, blood vessels or the spine.

Dr. Fernando Stein, a critical-care specialist at Texas Children’s, said children’s lower body weights mean that bullets’ kinetic energy disperses across less mass.

Military researchers have experimented by firing bullets into gelatin blocks of varying sizes, Stein said. A block weighing 250 pounds – the weight of a large adult – can absorb a bullet. A 50-pound block, the weight of a young child, explodes.

Stein is president-elect of the American Academy of Pediatrics, which has guidelines for gun safety.

“Firearms should be removed from the environments where children live and play, but if they are not, they must be stored locked and unloaded,” the policy reads. “Safe storage practices can reduce the risk of death or injury.”

Research shows that children gravitate toward guns and rarely handle them safely, Stein said. “When they see a gun, they take it and they hold it in the position of firing and usually the first thing they do is pull the trigger.”

If parents or relatives keep guns in homes where children live or visit, Stein said locks and safes are crucial. He pointed to fingerprint-activated safes that cost as little as $120 and allow quick access for self-defense.

Multiple safety systems

Paul Slogan, an employee at Lone Star Gun Safes in Houston, agreed that fingerprint-activated safes are more secure. However, he said, “with kids, anything’s better than nothing.” A simple gun lock, a cable that runs through the chamber and magazine, costs less than $20. A trigger lock’s price tag is about $10.

Stein recommends using multiple safety systems, such as locking ammunition and firearms separately while also keeping on a trigger lock.

However, the doctors said, locks are not foolproof. One of the Houston-area victims found the key to his grandfather’s locked gun cabinet.

“Kids are curious, and they will watch what you’re doing,” Propst said. If they can find a key, she said, “they will find their way, unfortunately, into locked cabinets.”

A National Rifle Association spokesman, Lars Dalseide, said the organization had no comment. The NRA’s “Eddie Eagle” safety website says children should be taught not to touch guns and to tell adults when they find them.

Federal statistics show that children are 25 times more likely to die in a car crash than by accidental gunshot. The Centers for Disease Control also reports that the rate of death by accidental shooting has steadily declined since 1970. That year, 1.6 children per 100,000 died by accidental shooting; by 2014 that number was 0.4 per 100,000.

However, Everytown for Gun Safety says it has found that the CDC vastly undercounts accidental shooting deaths – so many of which could be prevented by safe storage.

Learn to ‘respect gun’

Ken Stonebraker, a gun safety instructor in Dallas, agreed that hiding a gun or keeping it out of reach is not enough. For parents who want a gun handy in case of intruders, he suggested following his example: Keep one gun nearby in a fingerprint-activated safe and lock the rest in a complex gun safe.

Stonebraker said he believes familiarity with guns can diminish the risk. When his daughters turned 8, the Army veteran said, he took them out to shoot a .45 caliber gun at milk cartons. They felt the recoil and saw the damage done, he said. “They learned to respect a gun and they learned that a gun’s not a toy.”

In classes he teaches to parents and children, he tells kids always to assume a gun is loaded and to tell an adult whenever they find a weapon.

But training can’t eliminate risk, Stein said. “There is no education that can prevent a child from doing what they do because they are children, which is hold the gun and pull the trigger.”

Sitting in the emergency department at Texas Children’s, just yards from the trauma bay where he directs the treatment of pediatric gunshot victims, Wesson remembers how many drivers refused to use seat belts when they were introduced because they considered themselves safe drivers. They knew about the recommendation; it just didn’t apply to them.

In the same way, Wesson said, “it’s hard for individual people to accept the general rule” that guns in family homes are more of a danger than a safeguard.

“People think, well, it won’t happen in my family, in my home,” he said. “But the fact is that if you look across the whole population, people are much more likely to hurt themselves or other members of their family if they have a gun in the home than they are to injure or stop some intruder.”

Lack of awareness

Wesson can’t say whether he treated any of the three Houston-area boys who recently shot themselves by accident. So instead he talks about the month-old child he treated all those years ago as a young surgeon.

To me it sort of epitomizes the whole issue,” he said in the ER, where young patients’ artwork decorates the hallways. “It wasn’t because of anything but carelessness, and maybe a lack of awareness.”

A little girl walks by, holding her mother’s hand. Before exiting the emergency department, she turns and waves to a nearby cluster of adults that includes the surgeon.

“Bye,” Wesson says quietly, raising his hand and returning her wave.

He seems energized after interacting with this small patient.

Then he thinks back to that baby and the bullet that ricocheted through his tiny abdomen.

“Why’d that have to happen?” Wesson asks. “It didn’t have to happen. It didn’t.”