Update From the Chair of the Section on Anesthesiology, the American Academy of Pediatrics
By Anita Honkanen, MD
Clinical Professor
Stanford University
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Dr. Honkanen |
When last I wrote, I hoped that we would be in a stronger position related to the pandemic, which continues to ravage our world and wreak havoc on global economies. Since that time, our nation has been rocked by the blatant exposure of deep long-standing racism, putting so many at even far greater risk. Our children and families struggle with isolation, home schooling, loss of income, and for many, loss of habitation and medical coverage.
Despite all challenges, I see our colleagues continue to forge ahead, caring for our patients, in all circumstances, with empathy and grace. I admire all of our physicians, nurses, techs, cleaning crews, and the many other members of our staff who put themselves at increased risk to care for our patients. I wish all of you and your families well as you work through many of these challenges.
The AAP has developed many resources for both providers and the public about the novel coronavirus. Critical updates for clinicians, including clinical guidance, physician wellness tips, advocacy resources, information for families, etc., have been collected on a central AAP COVID-19 Website. As the world responds to the pandemic, the AAP is committed to fast-tracking COVID-19 research articles and publishing them free to read in a special Pediatrics COVID-19 Collection.
On another front, using humor and real-world conversations, the AAP has launched the #CallYourPediatrician campaign, which aims to reach parents with timely reminders that going to the pediatrician, even during COVID-19, is important and safe. Encourage your own networks to take their children to the pediatrician for sick and well care; the #CallYourPediatrician Resource Page includes sample texts, videos and photos sized for Facebook, Instagram, Twitter, LinkedIn and Pinterest.
In addition, AAP leaders have recently stepped up to urge the importance of science in guiding safe school reopening and of increased funding to schools to support new safety measures. The AAP’s most recent Guidance for School Re-Entry addresses various planning considerations and serves as a resource for districts across the country struggling with challenging new conditions in which to educate our nation’s children.
The AAP remains the leading child health advocacy organization in the US, working tirelessly on behalf of our patients. As a healthcare advocacy leader, the Academy recently endorsed a Senate resolution declaring racism a public health crisis. The resolution recognizes the role of race in health disparities, only underscored by the COVID-19 pandemic. For more on this topic, see this press release.
In addition, the AAP recently responded to reports of children being detained in hotels. An Associated Press report showed that immigrant children as young as one year old are being detained in hotels for weeks at a time in Arizona and Texas. AAP issued this statement calling it a "dangerous, traumatizing practice." Also, in early July, the Trump administration announced the official withdrawal of the United States from the World Health Organization. Another Senate resolution - S. Res. 653 - condemns the decision. If you are an AAP member, you can urge your senators to support this resolution by going to federaladvocacy.aap.org and "Support the World Health Organization" under Our Issues.
Several policy statements remain “under-construction” by our section, including statements addressing Oxymetazoline (Afrin) use in pediatrics, the care of children with chronic pain, the assessment and management of acute pain in pediatrics, and the perioperative management of children with obstructive sleep apnea. Shared statements on topics in collaboration with other AAP sections include pain management in the neonate and premedication for neonatal intubation, the recognition and management of opioid dependence in children, the preoperative approach to pediatric patients with congenital heart disease, the approach to DNR orders for children coming for anesthesia and surgery, oral health care for developmentally disabled children, and the relief of anxiety and pain in children presenting to the emergency room.
As most upcoming medical society meetings shift to a virtual platform, the American Academy of Pediatrics has followed suit and will host its 2020 National Conference and Exhibition online for the first time. This presents a unique opportunity for those of us who would not typically travel to a non-SPA/ASA meeting to attend the largest and most comprehensive meeting of the US pediatric medical community. You may be surprised at what you will find! More information is to come as the AAP plans for its transition from an in-person meeting to a digital experience. Visit https://aapexperience.org/ for up-to-date information over the coming weeks.
Meanwhile, save the dates of October 2-6, 2020. For general pediatricians, our section will offer two useful sessions, one on “Integrating Acupuncture in Pediatric Practice” and one titled, “We Have Clearance Clarence: Ensuring Safe Anesthesia Through Pre-anesthetic Medical Evaluation.”
Lastly, the AAP is celebrating its 90th anniversary this year and is taking a look back at the dedicated pediatricians who paved the way for its founding and the amazing fruits of their labor. AAP News has been publishing one historical article per month throughout 2020 in honor of this milestone, collecting the articles for perusal here.
Thus far, the articles have examined societal factors in the late 19th and early 20th centuries that led to the establishment of the AAP; the growth of pediatrics in the 1930s; the activities of the AAP in the 1940s; AAP’s injury prevention efforts in the 1950s; the ushering in of Head Start in the 1960s as well as new vaccines to fight measles, rubella and mumps and the first American neonatal intensive care unit; the doubling of AAP membership in the 1970s and the opening of its DC office to jumpstart advocacy efforts; and its achievements in the 1980s, which include taking on pediatric AIDS, introducing Neonatal Resuscitation Program (NRP) training, establishing the Pediatric Research in Office Settings program and launching AAP News. Stay tuned for more to come.
It is important to note that, as the AAP is celebrating its legacy, it has also entered into the record where the organization has fallen short. To that end, the Academy has published a statement titled Truth, Reconciliation, and Transformation: Continuing on the Path to Equity, in the September 2020 issue of Pediatrics and the August 2020 issue of AAP News. The statement acknowledges that the AAP has not always lived up to its founding ideals and apologizes to those it has wronged. The apology is long overdue — and a precondition for a better future.
The experience of the AAP’s first Black members, Dr. Alonzo deGrate Smith and Dr. Roland Boyd Scott, reveals an AAP Executive Board that was not immune to racist attitudes and beliefs. From their initial rejection in 1939 to their eventual acceptance in 1945, Drs. Smith and Scott were made to bear numerous indignities and clear many hurdles, despite being successful clinicians and established leaders in the pediatric academic community. In fact, Dr. Scott would go on to receive the Abraham Jacobi Award, the Academy’s highest honor.
I appreciate that the AAP is vocalizing what for so long has gone unsaid and is turning those painful epiphanies into plans of action. If you are reading this and are not yet a member of the AAP Section on Anesthesiology and Pain Medicine, now is the time to get involved! We need your ideas and your energy, with everyone working together to create a better world for every child - the one they deserve.
May you and your loved ones all stay well.
