Megan Durham
131 statements · 4 topics
Featured statements
he had HAPC, so he had these high amplitude contractions that were up pressures upwards of 400 millimeters of mercury all the way down to his anus, and I don't think anybody can control. That type of pressure coming down to your anus.
quote ·
Colorectal / ARM & Hirschsprung
The babies that are obstructed show up when they're a few months old or a couple of years old, because if they're not passing stool, it's a very easy sign for parents to see.
quote ·
Colorectal / ARM & Hirschsprung
I personally will bring you back about 2 weeks or, um, 2 weeks after surgery and I'll calibrate the anus to make sure that anastomosis is OK.
quote ·
Enterocolitis
we initially always start out with cardiac babies around a pressure of eight, if we can get away with it
quote ·
Anorectal Malformation
Obstructed Hirschsprung patients are easier to identify because not passing stool is an easy sign for parents to see, whereas hypermodal patients with fecal incontinence present a more difficult diagnostic challenge.
clinical ·
Enterocolitis
Dr. Durham would discharge a child after enterocolitis on Flagyl, laxatives, and rectal irrigations for some period of time, particularly for children who tend to dilate their colon.
clinical ·
Hirschsprung disease
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Megan's statements about Anorectal Malformation 13 statements
Open the Anorectal Malformation collection →
Colorectal Quiz Episode 32: Anorectal Malformations And Cardiac Anomalies
Statement
For ARM with external opening and no cardiac defect, primary repair in the neonatal period would be the optimal choice.
Open
Statement
White beads along the scrotal raphe with meconium smear indicate the anorectal malformation is one of the less complicated lesions with an opening somewhere along the perineal body.
Open
Quotation
you know the lesion that you're dealing with, the interrectal malformation lesion you're dealing with, is one of the less complicated lesions
Open
Quotation
every time that they would try to dilate, the baby would cry and then desat down to like the 60s
Open
Statement
For laparoscopy in cardiac babies, initial insufflation pressure should start around 8 mmHg if possible.
Open
Statement
Irrigating the distal rectum and evacuating stool helps keep laparoscopic pressures low in ARM patients.
Open
Quotation
we initially always start out with cardiac babies around a pressure of eight, if we can get away with it
Open
Quotation
Half of the perineal opening was anterior to the muscular complex. So, we did actually formally move the entire opening back into the center around the anal muscular complex
Open
Statement
When half of the perineal fistula opening is anterior to the muscular complex, the entire opening should be formally moved back into the center around the anal muscular complex.
Open
Megan's statements about Colorectal / ARM & Hirschsprung 55 statements
Open the Colorectal / ARM & Hirschsprung collection →
Update Course Rewind: 2020 Colorectal Part 1
Statement
After Hirschsprung pull-through, Dr. Durham brings patients back about 2 weeks after surgery to calibrate the anus and assess for cicatrix or narrowing at the anastomosis.
Open
Quotation
I personally will bring you back about 2 weeks or, um, 2 weeks after surgery and I'll calibrate the anus to make sure that anastomosis is OK.
Open
Quotation
I personally will bring you back about 2 weeks or, um, 2 weeks after surgery and I'll calibrate the anus to make sure that anastomosis is OK.
Open
Statement
After Hirschsprung pull-through, Dr. Durham brings patients back about 2 weeks after surgery to calibrate the anus and assess for cicatrix or narrowing at the anastomosis.
Open
Statement
Problems after Hirschsprung pull-through commonly occur later rather than very early on in the young child.
Open
Quotation
very commonly, very early on, there's not problems. It's usually a little bit later, like we'll see in this patient that problems start occurring in the, in the young child.
Open
Statement
Problems after Hirschsprung pull-through commonly occur later rather than very early on in the young child.
Open
Quotation
very commonly, very early on, there's not problems. It's usually a little bit later, like we'll see in this patient that problems start occurring in the, in the young child.
Open
Statement
At Children's Healthcare of Atlanta, acute Hirschsprung-associated enterocolitis management does not include fixed NPO time or immediate TPN initiation.
Open
Statement
At Children's Healthcare of Atlanta, acute Hirschsprung-associated enterocolitis management does not include fixed NPO time or immediate TPN initiation.
Open
Statement
Children's Healthcare of Atlanta protocol for enterocolitis includes rectal irrigations with about 10 cc/kg normal saline every 8 hours for at least the first 24 to 48 hours.
Open
Statement
Children's Healthcare of Atlanta protocol for enterocolitis includes rectal irrigations with about 10 cc/kg normal saline every 8 hours for at least the first 24 to 48 hours.
Open
Statement
IV Flagyl is typically started for Hirschsprung-associated enterocolitis at Children's Healthcare of Atlanta.
Open
Statement
IV Flagyl is typically started for Hirschsprung-associated enterocolitis at Children's Healthcare of Atlanta.
Open
Statement
Dr. Durham would discharge a child after enterocolitis on Flagyl, laxatives, and rectal irrigations for some period of time, particularly for children who tend to dilate their colon.
Open
Statement
Dr. Durham would discharge a child after enterocolitis on Flagyl, laxatives, and rectal irrigations for some period of time, particularly for children who tend to dilate their colon.
Open
Quotation
we here have recently come up with a very standardized teaching regimen for our different campuses.
Open
Statement
Children's Healthcare of Atlanta has developed a standardized teaching regimen for rectal irrigations across different campuses and a regular education process for floor nurses.
Open
Statement
Children's Healthcare of Atlanta has developed a standardized teaching regimen for rectal irrigations across different campuses and a regular education process for floor nurses.
Open
Quotation
we here have recently come up with a very standardized teaching regimen for our different campuses.
Open
Quotation
there was a lot of education that needs to be done on the floor while they are inpatients, and there's, because this is not an everyday common occurrence, the nursing staff very commonly will have a different level of, of education based on. Rectal irrigations, rectal enemas
Open
Statement
Nursing staff commonly have different levels of education regarding rectal irrigations and enemas because this is not an everyday common occurrence.
Open
Statement
Nursing staff commonly have different levels of education regarding rectal irrigations and enemas because this is not an everyday common occurrence.
Open
Quotation
there was a lot of education that needs to be done on the floor while they are inpatients, and there's, because this is not an everyday common occurrence, the nursing staff very commonly will have a different level of, of education based on. Rectal irrigations, rectal enemas
Open
Quotation
we, we, we do have a regular education process that we do to the floor nurses to make sure they understand. And we also have come up with a standardized order form now so that it's much more clear for the nurses about types of tubes, how it's supposed to be done with a, with links to, um, policy.
Open
Quotation
we, we, we do have a regular education process that we do to the floor nurses to make sure they understand. And we also have come up with a standardized order form now so that it's much more clear for the nurses about types of tubes, how it's supposed to be done with a, with links to, um, policy.
Open
Statement
A standardized order form with links to policy has been implemented to make rectal irrigation procedures clearer for nurses.
Open
Statement
A standardized order form with links to policy has been implemented to make rectal irrigation procedures clearer for nurses.
Open
Statement
Dr. Langer published a guideline with the APSA Hirschsprung Disease Research Interest Group for diagnosis and management of obstructive symptoms after Hirschsprung pull-through.
Open
Statement
Dr. Langer published a guideline with the APSA Hirschsprung Disease Research Interest Group for diagnosis and management of obstructive symptoms after Hirschsprung pull-through.
Open
Statement
Obstructed Hirschsprung patients are easier to identify because not passing stool is an easy sign for parents to see, whereas hypermodal patients with fecal incontinence present a more difficult diagnostic challenge.
Open
Quotation
The babies that are obstructed show up when they're a few months old or a couple of years old, because if they're not passing stool, it's a very easy sign for parents to see.
Open
Quotation
The babies that are obstructed show up when they're a few months old or a couple of years old, because if they're not passing stool, it's a very easy sign for parents to see.
Open
Statement
Obstructed Hirschsprung patients are easier to identify because not passing stool is an easy sign for parents to see, whereas hypermodal patients with fecal incontinence present a more difficult diagnostic challenge.
Open
Statement
The patient in Case 2 had high-amplitude propagating contractions (HAPCs) on manometry with pressures upwards of 400 mmHg all the way down to the anus.
Open
Statement
The patient in Case 2 had high-amplitude propagating contractions (HAPCs) on manometry with pressures upwards of 400 mmHg all the way down to the anus.
Open
Quotation
he had HAPC, so he had these high amplitude contractions that were up pressures upwards of 400 millimeters of mercury all the way down to his anus, and I don't think anybody can control. That type of pressure coming down to your anus.
Open
Quotation
he had HAPC, so he had these high amplitude contractions that were up pressures upwards of 400 millimeters of mercury all the way down to his anus, and I don't think anybody can control. That type of pressure coming down to your anus.
Open
Colorectal Quiz Episode 32: Anorectal Malformations And Cardiac Anomalies
Quotation
you know the lesion that you're dealing with, the interrectal malformation lesion you're dealing with, is one of the less complicated lesions
Open
Statement
White beads along the scrotal raphe with meconium smear indicate the anorectal malformation is one of the less complicated lesions with an opening somewhere along the perineal body.
Open
Statement
For ARM with external opening and no cardiac defect, primary repair in the neonatal period would be the optimal choice.
Open
Quotation
every time that they would try to dilate, the baby would cry and then desat down to like the 60s
Open
Statement
Irrigating the distal rectum and evacuating stool helps keep laparoscopic pressures low in ARM patients.
Open
Quotation
we initially always start out with cardiac babies around a pressure of eight, if we can get away with it
Open
Statement
For laparoscopy in cardiac babies, initial insufflation pressure should start around 8 mmHg if possible.
Open
Statement
When half of the perineal fistula opening is anterior to the muscular complex, the entire opening should be formally moved back into the center around the anal muscular complex.
Open
Quotation
Half of the perineal opening was anterior to the muscular complex. So, we did actually formally move the entire opening back into the center around the anal muscular complex
Open
Megan's statements about Enterocolitis 21 statements
Open the Enterocolitis collection →
Update Course Rewind: 2020 Colorectal Part 1
Quotation
I personally will bring you back about 2 weeks or, um, 2 weeks after surgery and I'll calibrate the anus to make sure that anastomosis is OK.
Open
Statement
After Hirschsprung pull-through, Dr. Durham brings patients back about 2 weeks after surgery to calibrate the anus and assess for cicatrix or narrowing at the anastomosis.
Open
Statement
Problems after Hirschsprung pull-through commonly occur later rather than very early on in the young child.
Open
Quotation
very commonly, very early on, there's not problems. It's usually a little bit later, like we'll see in this patient that problems start occurring in the, in the young child.
Open
Statement
At Children's Healthcare of Atlanta, acute Hirschsprung-associated enterocolitis management does not include fixed NPO time or immediate TPN initiation.
Open
Statement
Children's Healthcare of Atlanta protocol for enterocolitis includes rectal irrigations with about 10 cc/kg normal saline every 8 hours for at least the first 24 to 48 hours.
Open
Statement
IV Flagyl is typically started for Hirschsprung-associated enterocolitis at Children's Healthcare of Atlanta.
Open
Statement
Dr. Durham would discharge a child after enterocolitis on Flagyl, laxatives, and rectal irrigations for some period of time, particularly for children who tend to dilate their colon.
Open
Statement
Children's Healthcare of Atlanta has developed a standardized teaching regimen for rectal irrigations across different campuses and a regular education process for floor nurses.
Open
Quotation
we here have recently come up with a very standardized teaching regimen for our different campuses.
Open
Quotation
there was a lot of education that needs to be done on the floor while they are inpatients, and there's, because this is not an everyday common occurrence, the nursing staff very commonly will have a different level of, of education based on. Rectal irrigations, rectal enemas
Open
Statement
Nursing staff commonly have different levels of education regarding rectal irrigations and enemas because this is not an everyday common occurrence.
Open
Quotation
we, we, we do have a regular education process that we do to the floor nurses to make sure they understand. And we also have come up with a standardized order form now so that it's much more clear for the nurses about types of tubes, how it's supposed to be done with a, with links to, um, policy.
Open
Statement
A standardized order form with links to policy has been implemented to make rectal irrigation procedures clearer for nurses.
Open
Statement
Dr. Langer published a guideline with the APSA Hirschsprung Disease Research Interest Group for diagnosis and management of obstructive symptoms after Hirschsprung pull-through.
Open
Statement
Obstructed Hirschsprung patients are easier to identify because not passing stool is an easy sign for parents to see, whereas hypermodal patients with fecal incontinence present a more difficult diagnostic challenge.
Open
Quotation
The babies that are obstructed show up when they're a few months old or a couple of years old, because if they're not passing stool, it's a very easy sign for parents to see.
Open
Statement
The patient in Case 2 had high-amplitude propagating contractions (HAPCs) on manometry with pressures upwards of 400 mmHg all the way down to the anus.
Open
Quotation
he had HAPC, so he had these high amplitude contractions that were up pressures upwards of 400 millimeters of mercury all the way down to his anus, and I don't think anybody can control. That type of pressure coming down to your anus.
Open
Megan's statements about Hirschsprung disease 42 statements
Open the Hirschsprung disease collection →
Update Course Rewind: 2020 Colorectal Part 1
Statement
After Hirschsprung pull-through, Dr. Durham brings patients back about 2 weeks after surgery to calibrate the anus and assess for cicatrix or narrowing at the anastomosis.
Open
Statement
After Hirschsprung pull-through, Dr. Durham brings patients back about 2 weeks after surgery to calibrate the anus and assess for cicatrix or narrowing at the anastomosis.
Open
Quotation
I personally will bring you back about 2 weeks or, um, 2 weeks after surgery and I'll calibrate the anus to make sure that anastomosis is OK.
Open
Quotation
I personally will bring you back about 2 weeks or, um, 2 weeks after surgery and I'll calibrate the anus to make sure that anastomosis is OK.
Open
Quotation
very commonly, very early on, there's not problems. It's usually a little bit later, like we'll see in this patient that problems start occurring in the, in the young child.
Open
Quotation
very commonly, very early on, there's not problems. It's usually a little bit later, like we'll see in this patient that problems start occurring in the, in the young child.
Open
Statement
Problems after Hirschsprung pull-through commonly occur later rather than very early on in the young child.
Open
Statement
Problems after Hirschsprung pull-through commonly occur later rather than very early on in the young child.
Open
Statement
At Children's Healthcare of Atlanta, acute Hirschsprung-associated enterocolitis management does not include fixed NPO time or immediate TPN initiation.
Open
Statement
At Children's Healthcare of Atlanta, acute Hirschsprung-associated enterocolitis management does not include fixed NPO time or immediate TPN initiation.
Open
Statement
Children's Healthcare of Atlanta protocol for enterocolitis includes rectal irrigations with about 10 cc/kg normal saline every 8 hours for at least the first 24 to 48 hours.
Open
Statement
Children's Healthcare of Atlanta protocol for enterocolitis includes rectal irrigations with about 10 cc/kg normal saline every 8 hours for at least the first 24 to 48 hours.
Open
Statement
IV Flagyl is typically started for Hirschsprung-associated enterocolitis at Children's Healthcare of Atlanta.
Open
Statement
IV Flagyl is typically started for Hirschsprung-associated enterocolitis at Children's Healthcare of Atlanta.
Open
Statement
Dr. Durham would discharge a child after enterocolitis on Flagyl, laxatives, and rectal irrigations for some period of time, particularly for children who tend to dilate their colon.
Open
Statement
Dr. Durham would discharge a child after enterocolitis on Flagyl, laxatives, and rectal irrigations for some period of time, particularly for children who tend to dilate their colon.
Open
Quotation
we here have recently come up with a very standardized teaching regimen for our different campuses.
Open
Quotation
we here have recently come up with a very standardized teaching regimen for our different campuses.
Open
Statement
Children's Healthcare of Atlanta has developed a standardized teaching regimen for rectal irrigations across different campuses and a regular education process for floor nurses.
Open
Statement
Children's Healthcare of Atlanta has developed a standardized teaching regimen for rectal irrigations across different campuses and a regular education process for floor nurses.
Open
Quotation
there was a lot of education that needs to be done on the floor while they are inpatients, and there's, because this is not an everyday common occurrence, the nursing staff very commonly will have a different level of, of education based on. Rectal irrigations, rectal enemas
Open
Statement
Nursing staff commonly have different levels of education regarding rectal irrigations and enemas because this is not an everyday common occurrence.
Open
Statement
Nursing staff commonly have different levels of education regarding rectal irrigations and enemas because this is not an everyday common occurrence.
Open
Quotation
there was a lot of education that needs to be done on the floor while they are inpatients, and there's, because this is not an everyday common occurrence, the nursing staff very commonly will have a different level of, of education based on. Rectal irrigations, rectal enemas
Open
Quotation
we, we, we do have a regular education process that we do to the floor nurses to make sure they understand. And we also have come up with a standardized order form now so that it's much more clear for the nurses about types of tubes, how it's supposed to be done with a, with links to, um, policy.
Open
Quotation
we, we, we do have a regular education process that we do to the floor nurses to make sure they understand. And we also have come up with a standardized order form now so that it's much more clear for the nurses about types of tubes, how it's supposed to be done with a, with links to, um, policy.
Open
Statement
A standardized order form with links to policy has been implemented to make rectal irrigation procedures clearer for nurses.
Open
Statement
A standardized order form with links to policy has been implemented to make rectal irrigation procedures clearer for nurses.
Open
Statement
Dr. Langer published a guideline with the APSA Hirschsprung Disease Research Interest Group for diagnosis and management of obstructive symptoms after Hirschsprung pull-through.
Open
Statement
Dr. Langer published a guideline with the APSA Hirschsprung Disease Research Interest Group for diagnosis and management of obstructive symptoms after Hirschsprung pull-through.
Open
Statement
Obstructed Hirschsprung patients are easier to identify because not passing stool is an easy sign for parents to see, whereas hypermodal patients with fecal incontinence present a more difficult diagnostic challenge.
Open
Quotation
The babies that are obstructed show up when they're a few months old or a couple of years old, because if they're not passing stool, it's a very easy sign for parents to see.
Open
Statement
Obstructed Hirschsprung patients are easier to identify because not passing stool is an easy sign for parents to see, whereas hypermodal patients with fecal incontinence present a more difficult diagnostic challenge.
Open
Quotation
The babies that are obstructed show up when they're a few months old or a couple of years old, because if they're not passing stool, it's a very easy sign for parents to see.
Open
Statement
The patient in Case 2 had high-amplitude propagating contractions (HAPCs) on manometry with pressures upwards of 400 mmHg all the way down to the anus.
Open
Statement
The patient in Case 2 had high-amplitude propagating contractions (HAPCs) on manometry with pressures upwards of 400 mmHg all the way down to the anus.
Open
Quotation
he had HAPC, so he had these high amplitude contractions that were up pressures upwards of 400 millimeters of mercury all the way down to his anus, and I don't think anybody can control. That type of pressure coming down to your anus.
Open
Quotation
he had HAPC, so he had these high amplitude contractions that were up pressures upwards of 400 millimeters of mercury all the way down to his anus, and I don't think anybody can control. That type of pressure coming down to your anus.
Open