Beth Rymeski

370 statements · 17 topics · summaries given as host listed separately

Abdominal Wall Defects · guest expert Colorectal / ARM & Hirschsprung · guest expert Etiologies (Gastroschisis/NEC/Atresia/Volvulus) · guest expert Fetal Surgery · guest expert Intestinal Rehab · guest expert

Featured statements

▶ Ep 29 · 8:10
we had trialed a system of just ad-lib feeding um it was not successful i think there were a number of reasons for that part of it was that there was no standardized plan for when to get the ng tube out so there was i think we started feeding these babies too late
quote · Abdominal Wall Defects
▶ Ep 29 · 16:58
we did put in our protocol for our nursing college as well as our families that emesis is expected we put that within our written protocol to make that expectation known that it's okay it's okay they're going to throw up we'll just keep working through it
quote · Abdominal Wall Defects
▶ Ep 92 · 2:07
I think if they are constipated, that's like the easier patient to deal with, but every once in a while, you get a kid who is well managed on whatever their regimen is, and they're still prolapsing, and then I think the question is, what do you do?
quote · Colorectal / ARM & Hirschsprung
▶ Ep 92 · 1:54
If it's a patient that I've never met before, I typically will address, you know, concerns about the constipation first and sort of prove or disprove whether or not this patient is significantly constipated.
quote · Colorectal / ARM & Hirschsprung
▶ Ep 46 · 13:51
our rate of sending gastroschisis babies home with an ng or a g tube it's like two thirds of them go home with some sort of tube to help them continue feeding which is crazy
quote · Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
▶ Ep 15 · 2:24
Yeah, we've had a couple unrepaired CDH's valvulize their stomach and need to get fixed more urgently. It's not common, but it's happened.
quote · Congenital Diaphragmatic Hernia

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Beth's statements about Abdominal Wall Defects 10 statements

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Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 29 · 6:52
clinical Cincinnati Children's protocol includes standardized feed advancement and sham feeding to address poor oral feeding skills in gastroschisis patients. ↗
▶ Ep 29 · 7:40
quote we introduced sham feeding because what we realized is a lot of our gastroschesis babies have very poor oral feeding skills from you know delayed access to feeding ↗
▶ Ep 29 · 8:10
quote we had trialed a system of just ad-lib feeding um it was not successful i think there were a number of reasons for that part of it was that there was no standardized plan for when to get the ng tube out so there was i think we started feeding these babies too late ↗
▶ Ep 29 · 8:10
clinical Cincinnati Children's attempted ad-lib feeding for gastroschisis but abandoned it after one year due to poor results, including delayed NG tube removal and starting feeds too late. ↗
▶ Ep 29 · 8:40
clinical Cincinnati Children's current gastroschisis feeding protocol has been in place for approximately four years. ↗
▶ Ep 29 · 13:51
epidemiological Approximately two-thirds of Cincinnati Children's gastroschisis patients are discharged home with an NG tube or G-tube for continued feeding support. ↗
▶ Ep 29 · 13:51
quote our rate of sending gastroschisis babies home with an ng or a g tube it's like two thirds of them go home with some sort of tube to help them continue feeding which is crazy ↗
▶ Ep 29 · 13:51
clinical Cincinnati Children's protocol includes both intermittent feeds and sham feeds, with sham feeds implemented for approximately one year. ↗
▶ Ep 29 · 16:58
clinical Cincinnati Children's written protocol explicitly states that emesis is expected during gastroschisis feeding to set appropriate expectations for nursing staff and families. ↗
▶ Ep 29 · 16:58
quote we did put in our protocol for our nursing college as well as our families that emesis is expected we put that within our written protocol to make that expectation known that it's okay it's okay they're going to throw up we'll just keep working through it ↗
Beth's statements about Colorectal / ARM & Hirschsprung 13 statements

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Update Course Rewind: 2020 Colorectal Part 2

▶ Ep 92 · 1:34
quote I think this is like a nightmare in clinic, honestly, this is the patient that no one wants to see, right? I mean, rectal prolapses. I it's very distressing to the patient and the family, and we don't really have a lot of, of great options. ↗
▶ Ep 92 · 1:34
quote I think this is like a nightmare in clinic, honestly, this is the patient that no one wants to see, right? I mean, rectal prolapses. I it's very distressing to the patient and the family, and we don't really have a lot of, of great options. ↗
▶ Ep 92 · 1:54
quote If it's a patient that I've never met before, I typically will address, you know, concerns about the constipation first and sort of prove or disprove whether or not this patient is significantly constipated. ↗
▶ Ep 92 · 1:54
quote If it's a patient that I've never met before, I typically will address, you know, concerns about the constipation first and sort of prove or disprove whether or not this patient is significantly constipated. ↗
▶ Ep 92 · 2:07
quote I think if they are constipated, that's like the easier patient to deal with, but every once in a while, you get a kid who is well managed on whatever their regimen is, and they're still prolapsing, and then I think the question is, what do you do? ↗
▶ Ep 92 · 2:07
quote I think if they are constipated, that's like the easier patient to deal with, but every once in a while, you get a kid who is well managed on whatever their regimen is, and they're still prolapsing, and then I think the question is, what do you do? ↗

Journal of Pediatric Surgery Article Review: February 2023, BAPS issue

▶ Ep 135 · 7:09
quote That it does not seem reflective at all of the type of things that that we see in our practice here, and I think that would be seen in a lot of practices in the United States. ↗
▶ Ep 135 · 7:09
opinion The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States ↗
▶ Ep 135 · 7:20
clinical In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life ↗
▶ Ep 135 · 7:39
clinical In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies ↗
▶ Ep 135 · 10:41
clinical Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection ↗
▶ Ep 135 · 10:41
quote Yeah, I mean, the first year that we operated there, almost every kid got a wound infection, and then we started the next year we had the nurses do pre-op baths up on the floor the day before, and that year we had like 0 wound infections. ↗
▶ Ep 135 · 10:56
clinical After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero ↗
Beth's statements about Congenital Diaphragmatic Hernia 87 statements

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Neonatal Gastric Volvulus with Dr. Jason Frischer

▶ Ep 15 · 2:24
quote Yeah, we've had a couple unrepaired CDH's valvulize their stomach and need to get fixed more urgently. It's not common, but it's happened. ↗
▶ Ep 15 · 2:38
quote Had a weird looking sort of fixed bubble in the chest that was not able to be decompressed, couldn't advance the repogal. ↗
▶ Ep 15 · 2:38
clinical Key presentation findings in gastric volvulus include a weird looking fixed bubble in the chest that cannot be decompressed and inability to advance the NG tube. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 40 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 40 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the abdominal wall into the uterus. ↗
▶ Ep 40 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 40 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 40 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 40 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 40 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 40 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 40 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 40 · 1:58
clinical The epiglottis is a key landmark to locate when navigating to the trachea. ↗
▶ Ep 40 · 2:23
clinical Excessive torquing of the membranes should be avoided because the scope goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 40 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 40 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 40 · 2:36
clinical The scope should always be advanced until the carina is visualized, which confirms location in the trachea and not the esophagus. ↗
▶ Ep 40 · 2:39
quote That tells you both where you are in the trachea. ↗
▶ Ep 40 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 40 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
▶ Ep 40 · 3:29
clinical The balloon contains a little metal ball that can be visualized. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 41 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 41 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 41 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 41 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 41 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 41 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 41 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 41 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 41 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 41 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 41 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 41 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 41 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 41 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 41 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 41 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗

Fetoscopic Endoluminal Tracheal Occlusion (FETO) Procedure: Step-by-Step Guide with Dr. Beth Rymeski

▶ Ep 42 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 42 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 42 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 42 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 42 · 1:21
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 42 · 1:21
clinical The tongue is a very easy landmark when doing a FETO because it is bumpy. ↗
▶ Ep 42 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 42 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 42 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 42 · 1:58
clinical The epiglottis is sought as a landmark to guide navigation toward the trachea. ↗
▶ Ep 42 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal and uterine walls, and excessive turning can cause membrane damage. ↗
▶ Ep 42 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 42 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 42 · 2:36
clinical The scope is always advanced until the carina is seen, which confirms tracheal position and ensures the scope did not accidentally enter the esophagus. ↗
▶ Ep 42 · 2:39
quote That tells you both where you are in the trachea. ↗
▶ Ep 42 · 2:56
clinical The balloon should not be driven into one side of the trachea; it should inflate in the main trachea. ↗
▶ Ep 42 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗

Severe Congenital Diaphragmatic Hernia (CDH) Case: FETO Management & Unexpected Findings with Dr. Beth Rymeski

▶ Ep 43 · 0:29
clinical The patient was a 33-year-old G3P2 diagnosed with CDH on routine 20-week ultrasound and seen at around 24 weeks. ↗
▶ Ep 43 · 0:42
clinical The left lung was so small they couldn't even get a measurement (less than 1 mL). ↗
▶ Ep 43 · 0:46
quote So these are really bad lungs. ↗
▶ Ep 43 · 0:49
clinical The O/E by trace was 14%. ↗
▶ Ep 43 · 0:59
quote So this is severe, severe CDH. ↗
▶ Ep 43 · 0:59
clinical This case represents severe, severe CDH. ↗
▶ Ep 43 · 1:14
clinical While the balloon was in place, the lungs showed some growth but it was shy of 20%, making this a non-responder. ↗
▶ Ep 43 · 1:40
clinical There was some interval growth in the right lung, but overall still really poor numbers. ↗
▶ Ep 43 · 1:55
quote You don't need to be a pediatrician to know that that baby did not look well. ↗
▶ Ep 43 · 1:58
clinical The baby was immediately put on ECMO in the delivery room. ↗
▶ Ep 43 · 2:09
quote And we were shocked to find that this baby had 6 pairs of ribs at the time of birth, missing a lot of ribs. ↗
▶ Ep 43 · 2:09
clinical The baby had only 6 pairs of ribs at the time of birth, missing a lot of ribs. ↗
▶ Ep 43 · 2:17
clinical The baby had no anus (anorectal malformation). ↗
▶ Ep 43 · 2:17
clinical The baby had a spinal kyphosis. ↗
▶ Ep 43 · 2:29
clinical The cardiac anatomy was determined to be a right dominant double aortic arch with narrowing on the right and atresia on the left, after considerable back and forth about the actual anatomy. ↗
▶ Ep 43 · 2:48
clinical The baby remained on ECMO for several weeks. ↗
▶ Ep 43 · 2:52
clinical Multiple attempts were made to wean off ECMO; the team could get down to a certain point but could never get below that threshold. ↗
▶ Ep 43 · 3:06
clinical After discussion with the family, they decided to withdraw support, and the baby passed around 3 weeks of life, never making it off ECMO. ↗
▶ Ep 43 · 3:14
clinical Radiology reviewed the prenatal imaging retrospectively, knowing what was found postnatally, and still could not identify the rib, spinal, and cardiac anomalies. ↗
▶ Ep 43 · 3:22
opinion Despite advanced prenatal imaging, we still miss some pretty significant findings. ↗
▶ Ep 43 · 3:22
quote So, you know, we, we think that we're really good at picking up everything before babies are born, but unfortunately, we still miss some. ↗

FETO for Late-Diagnosed Severe Congenital Diaphragmatic Hernia (CDH) at Cincinnati Children's with Dr. Beth Rymeski

▶ Ep 44 · 0:50
clinical When the left lobe of the liver is touching the apex of the left chest in left-sided CDH, the entire hemi-liver has herniated into that side of the chest. ↗
▶ Ep 44 · 1:23
quote So this is a bad CDH. ↗
▶ Ep 44 · 1:44
guideline The cutoff for severe CDH O/E (observed to expected lung to head ratio) on ultrasound is 25%. ↗
▶ Ep 44 · 2:36
quote I don't want to pretend like there's still not a lot of liver in that chest, but significant improvement. ↗
▶ Ep 44 · 2:45
clinical In this case, there was a 42% increase in lung volume between balloon placement and removal (left lung volume increased from 1 mL to 23 mL). ↗
▶ Ep 44 · 3:05
clinical For a C-section delivery less than a week after FETO balloon removal, intubation on support and surfactant administration were performed. ↗
▶ Ep 44 · 3:25
clinical Initial respiratory management included Vyvent (APRV setting), then oscillator, with low dose fentanyl to support blood pressure, eventually returning to Vyvent vent settings. ↗
▶ Ep 44 · 3:43
opinion Extubation at 26 days old is pretty good for a severe CDH. ↗
▶ Ep 44 · 3:47
quote Unfortunately, he had a weird thing where a month after he had hemoptysis and we weren't really sure what was going on. ↗
▶ Ep 44 · 4:02
opinion Discharge at day of life 94 (about three months old) is pretty good for severe CDH. ↗
▶ Ep 44 · 4:15
clinical Tracheal dilation is a very common finding in babies who had tracheal occlusion because the trachea was stretched out during the course of the pregnancy. ↗
▶ Ep 44 · 4:24
clinical Tracheal dilation after FETO is not felt to be clinically impactful in the long run based on follow-up data from kids in Europe. ↗
Beth's statements about Congenital Diaphragmatic Hernia 37 statements

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Neonatal Gastric Volvulus with Dr. Jason Frischer

▶ Ep 12 · 2:24
quote Yeah, we've had a couple unrepaired CDH's valvulize their stomach and need to get fixed more urgently. It's not common, but it's happened. ↗
▶ Ep 12 · 2:38
quote Had a weird looking sort of fixed bubble in the chest that was not able to be decompressed, couldn't advance the repogal. ↗
▶ Ep 12 · 2:38
clinical Key presentation findings in gastric volvulus include a weird looking fixed bubble in the chest that cannot be decompressed and inability to advance the NG tube. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 17 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 17 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the abdominal wall into the uterus. ↗
▶ Ep 17 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 17 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 17 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 17 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 17 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 17 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 17 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 17 · 1:58
clinical The epiglottis is a key landmark to locate when navigating to the trachea. ↗
▶ Ep 17 · 2:23
clinical Excessive torquing of the membranes should be avoided because the scope goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 17 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 17 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 17 · 2:36
clinical The scope should always be advanced until the carina is visualized, which confirms location in the trachea and not the esophagus. ↗
▶ Ep 17 · 2:39
quote That tells you both where you are in the trachea. ↗
▶ Ep 17 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 17 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
▶ Ep 17 · 3:29
clinical The balloon contains a little metal ball that can be visualized. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 18 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 18 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 18 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 18 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 18 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 18 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 18 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 18 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 18 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 18 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 18 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 18 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 18 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 18 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 18 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 18 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
Beth's statements about Congenital Diaphragmatic Hernia 34 statements

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Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 11 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 11 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the abdominal wall into the uterus. ↗
▶ Ep 11 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 11 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 11 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 11 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 11 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 11 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 11 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 11 · 1:58
clinical The epiglottis is a key landmark to locate when navigating to the trachea. ↗
▶ Ep 11 · 2:23
clinical Excessive torquing of the membranes should be avoided because the scope goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 11 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 11 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 11 · 2:36
clinical The scope should always be advanced until the carina is visualized, which confirms location in the trachea and not the esophagus. ↗
▶ Ep 11 · 2:39
quote That tells you both where you are in the trachea. ↗
▶ Ep 11 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 11 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
▶ Ep 11 · 3:29
clinical The balloon contains a little metal ball that can be visualized. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 12 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 12 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 12 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 12 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 12 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 12 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 12 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 12 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 12 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 12 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 12 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 12 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 12 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 12 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 12 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 12 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
Beth's statements about Esophageal Atresia 7 statements

Open the Esophageal Atresia collection →

Journal of Pediatric Surgery Article Review: February 2023, BAPS issue

▶ Ep 23 · 7:09
quote That it does not seem reflective at all of the type of things that that we see in our practice here, and I think that would be seen in a lot of practices in the United States. ↗
▶ Ep 23 · 7:09
opinion The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States ↗
▶ Ep 23 · 7:20
clinical In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life ↗
▶ Ep 23 · 7:39
clinical In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies ↗
▶ Ep 23 · 10:41
clinical Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection ↗
▶ Ep 23 · 10:41
quote Yeah, I mean, the first year that we operated there, almost every kid got a wound infection, and then we started the next year we had the nurses do pre-op baths up on the floor the day before, and that year we had like 0 wound infections. ↗
▶ Ep 23 · 10:56
clinical After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero ↗
Beth's statements about Esophageal Atresia 7 statements

Open the Esophageal Atresia collection →

Journal of Pediatric Surgery Article Review: February 2023, BAPS issue

▶ Ep 35 · 7:09
opinion The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States ↗
▶ Ep 35 · 7:09
quote That it does not seem reflective at all of the type of things that that we see in our practice here, and I think that would be seen in a lot of practices in the United States. ↗
▶ Ep 35 · 7:20
clinical In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life ↗
▶ Ep 35 · 7:39
clinical In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies ↗
▶ Ep 35 · 10:41
clinical Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection ↗
▶ Ep 35 · 10:41
quote Yeah, I mean, the first year that we operated there, almost every kid got a wound infection, and then we started the next year we had the nurses do pre-op baths up on the floor the day before, and that year we had like 0 wound infections. ↗
▶ Ep 35 · 10:56
clinical After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero ↗
Beth's statements about Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 13 statements

Open the Etiologies (Gastroschisis/NEC/Atresia/Volvulus) collection →

Neonatal Gastric Volvulus with Dr. Jason Frischer

▶ Ep 43 · 2:24
quote Yeah, we've had a couple unrepaired CDH's valvulize their stomach and need to get fixed more urgently. It's not common, but it's happened. ↗
▶ Ep 43 · 2:38
clinical Key presentation findings in gastric volvulus include a weird looking fixed bubble in the chest that cannot be decompressed and inability to advance the NG tube. ↗
▶ Ep 43 · 2:38
quote Had a weird looking sort of fixed bubble in the chest that was not able to be decompressed, couldn't advance the repogal. ↗

Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 46 · 6:52
clinical Cincinnati Children's protocol includes standardized feed advancement and sham feeding to address poor oral feeding skills in gastroschisis patients. ↗
▶ Ep 46 · 7:40
quote we introduced sham feeding because what we realized is a lot of our gastroschesis babies have very poor oral feeding skills from you know delayed access to feeding ↗
▶ Ep 46 · 8:10
clinical Cincinnati Children's attempted ad-lib feeding for gastroschisis but abandoned it after one year due to poor results, including delayed NG tube removal and starting feeds too late. ↗
▶ Ep 46 · 8:10
quote we had trialed a system of just ad-lib feeding um it was not successful i think there were a number of reasons for that part of it was that there was no standardized plan for when to get the ng tube out so there was i think we started feeding these babies too late ↗
▶ Ep 46 · 8:40
clinical Cincinnati Children's current gastroschisis feeding protocol has been in place for approximately four years. ↗
▶ Ep 46 · 13:51
quote our rate of sending gastroschisis babies home with an ng or a g tube it's like two thirds of them go home with some sort of tube to help them continue feeding which is crazy ↗
▶ Ep 46 · 13:51
clinical Cincinnati Children's protocol includes both intermittent feeds and sham feeds, with sham feeds implemented for approximately one year. ↗
▶ Ep 46 · 13:51
epidemiological Approximately two-thirds of Cincinnati Children's gastroschisis patients are discharged home with an NG tube or G-tube for continued feeding support. ↗
▶ Ep 46 · 16:58
quote we did put in our protocol for our nursing college as well as our families that emesis is expected we put that within our written protocol to make that expectation known that it's okay it's okay they're going to throw up we'll just keep working through it ↗
▶ Ep 46 · 16:58
clinical Cincinnati Children's written protocol explicitly states that emesis is expected during gastroschisis feeding to set appropriate expectations for nursing staff and families. ↗
Beth's statements about Fetal Surgery 50 statements

Open the Fetal Surgery collection →

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 28 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 28 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the abdominal wall into the uterus. ↗
▶ Ep 28 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 28 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 28 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 28 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 28 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 28 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 28 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 28 · 1:58
clinical The epiglottis is a key landmark to locate when navigating to the trachea. ↗
▶ Ep 28 · 2:23
clinical Excessive torquing of the membranes should be avoided because the scope goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 28 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 28 · 2:36
clinical The scope should always be advanced until the carina is visualized, which confirms location in the trachea and not the esophagus. ↗
▶ Ep 28 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 28 · 2:39
quote That tells you both where you are in the trachea. ↗
▶ Ep 28 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 28 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
▶ Ep 28 · 3:29
clinical The balloon contains a little metal ball that can be visualized. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 30 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 30 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 30 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 30 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 30 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 30 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 30 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 30 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 30 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 30 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 30 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 30 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 30 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 30 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 30 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 30 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 30 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 30 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 30 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 30 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 30 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 30 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 30 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 30 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 30 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 30 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 30 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 30 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 30 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 30 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 30 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
▶ Ep 30 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
Beth's statements about Gastroschisis 10 statements

Open the Gastroschisis collection →

Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 17 · 6:52
clinical Cincinnati Children's protocol includes standardized feed advancement and sham feeding to address poor oral feeding skills in gastroschisis patients. ↗
▶ Ep 17 · 7:40
quote we introduced sham feeding because what we realized is a lot of our gastroschesis babies have very poor oral feeding skills from you know delayed access to feeding ↗
▶ Ep 17 · 8:10
quote we had trialed a system of just ad-lib feeding um it was not successful i think there were a number of reasons for that part of it was that there was no standardized plan for when to get the ng tube out so there was i think we started feeding these babies too late ↗
▶ Ep 17 · 8:10
clinical Cincinnati Children's attempted ad-lib feeding for gastroschisis but abandoned it after one year due to poor results, including delayed NG tube removal and starting feeds too late. ↗
▶ Ep 17 · 8:40
clinical Cincinnati Children's current gastroschisis feeding protocol has been in place for approximately four years. ↗
▶ Ep 17 · 13:51
quote our rate of sending gastroschisis babies home with an ng or a g tube it's like two thirds of them go home with some sort of tube to help them continue feeding which is crazy ↗
▶ Ep 17 · 13:51
clinical Cincinnati Children's protocol includes both intermittent feeds and sham feeds, with sham feeds implemented for approximately one year. ↗
▶ Ep 17 · 13:51
epidemiological Approximately two-thirds of Cincinnati Children's gastroschisis patients are discharged home with an NG tube or G-tube for continued feeding support. ↗
▶ Ep 17 · 16:58
clinical Cincinnati Children's written protocol explicitly states that emesis is expected during gastroschisis feeding to set appropriate expectations for nursing staff and families. ↗
▶ Ep 17 · 16:58
quote we did put in our protocol for our nursing college as well as our families that emesis is expected we put that within our written protocol to make that expectation known that it's okay it's okay they're going to throw up we'll just keep working through it ↗
Beth's statements about Gastroschisis 10 statements

Open the Gastroschisis collection →

Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 18 · 6:52
clinical Cincinnati Children's protocol includes standardized feed advancement and sham feeding to address poor oral feeding skills in gastroschisis patients. ↗
▶ Ep 18 · 7:40
quote we introduced sham feeding because what we realized is a lot of our gastroschesis babies have very poor oral feeding skills from you know delayed access to feeding ↗
▶ Ep 18 · 8:10
quote we had trialed a system of just ad-lib feeding um it was not successful i think there were a number of reasons for that part of it was that there was no standardized plan for when to get the ng tube out so there was i think we started feeding these babies too late ↗
▶ Ep 18 · 8:10
clinical Cincinnati Children's attempted ad-lib feeding for gastroschisis but abandoned it after one year due to poor results, including delayed NG tube removal and starting feeds too late. ↗
▶ Ep 18 · 8:40
clinical Cincinnati Children's current gastroschisis feeding protocol has been in place for approximately four years. ↗
▶ Ep 18 · 13:51
quote our rate of sending gastroschisis babies home with an ng or a g tube it's like two thirds of them go home with some sort of tube to help them continue feeding which is crazy ↗
▶ Ep 18 · 13:51
epidemiological Approximately two-thirds of Cincinnati Children's gastroschisis patients are discharged home with an NG tube or G-tube for continued feeding support. ↗
▶ Ep 18 · 13:51
clinical Cincinnati Children's protocol includes both intermittent feeds and sham feeds, with sham feeds implemented for approximately one year. ↗
▶ Ep 18 · 16:58
quote we did put in our protocol for our nursing college as well as our families that emesis is expected we put that within our written protocol to make that expectation known that it's okay it's okay they're going to throw up we'll just keep working through it ↗
▶ Ep 18 · 16:58
clinical Cincinnati Children's written protocol explicitly states that emesis is expected during gastroschisis feeding to set appropriate expectations for nursing staff and families. ↗
Beth's statements about Hirschsprung disease 13 statements

Open the Hirschsprung disease collection →

Update Course Rewind: 2020 Colorectal Part 2

▶ Ep 40 · 1:34
quote I think this is like a nightmare in clinic, honestly, this is the patient that no one wants to see, right? I mean, rectal prolapses. I it's very distressing to the patient and the family, and we don't really have a lot of, of great options. ↗
▶ Ep 40 · 1:34
quote I think this is like a nightmare in clinic, honestly, this is the patient that no one wants to see, right? I mean, rectal prolapses. I it's very distressing to the patient and the family, and we don't really have a lot of, of great options. ↗
▶ Ep 40 · 1:54
quote If it's a patient that I've never met before, I typically will address, you know, concerns about the constipation first and sort of prove or disprove whether or not this patient is significantly constipated. ↗
▶ Ep 40 · 1:54
quote If it's a patient that I've never met before, I typically will address, you know, concerns about the constipation first and sort of prove or disprove whether or not this patient is significantly constipated. ↗
▶ Ep 40 · 2:07
quote I think if they are constipated, that's like the easier patient to deal with, but every once in a while, you get a kid who is well managed on whatever their regimen is, and they're still prolapsing, and then I think the question is, what do you do? ↗
▶ Ep 40 · 2:07
quote I think if they are constipated, that's like the easier patient to deal with, but every once in a while, you get a kid who is well managed on whatever their regimen is, and they're still prolapsing, and then I think the question is, what do you do? ↗

Journal of Pediatric Surgery Article Review: February 2023, BAPS issue

▶ Ep 55 · 7:09
quote That it does not seem reflective at all of the type of things that that we see in our practice here, and I think that would be seen in a lot of practices in the United States. ↗
▶ Ep 55 · 7:09
opinion The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States ↗
▶ Ep 55 · 7:20
clinical In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life ↗
▶ Ep 55 · 7:39
clinical In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies ↗
▶ Ep 55 · 10:41
clinical Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection ↗
▶ Ep 55 · 10:41
quote Yeah, I mean, the first year that we operated there, almost every kid got a wound infection, and then we started the next year we had the nurses do pre-op baths up on the floor the day before, and that year we had like 0 wound infections. ↗
▶ Ep 55 · 10:56
clinical After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero ↗
Beth's statements about Intestinal Rehab 13 statements

Open the Intestinal Rehab collection →

Neonatal Gastric Volvulus with Dr. Jason Frischer

▶ Ep 59 · 2:24
quote Yeah, we've had a couple unrepaired CDH's valvulize their stomach and need to get fixed more urgently. It's not common, but it's happened. ↗
▶ Ep 59 · 2:38
clinical Key presentation findings in gastric volvulus include a weird looking fixed bubble in the chest that cannot be decompressed and inability to advance the NG tube. ↗
▶ Ep 59 · 2:38
quote Had a weird looking sort of fixed bubble in the chest that was not able to be decompressed, couldn't advance the repogal. ↗

Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 62 · 6:52
clinical Cincinnati Children's protocol includes standardized feed advancement and sham feeding to address poor oral feeding skills in gastroschisis patients. ↗
▶ Ep 62 · 7:40
quote we introduced sham feeding because what we realized is a lot of our gastroschesis babies have very poor oral feeding skills from you know delayed access to feeding ↗
▶ Ep 62 · 8:10
quote we had trialed a system of just ad-lib feeding um it was not successful i think there were a number of reasons for that part of it was that there was no standardized plan for when to get the ng tube out so there was i think we started feeding these babies too late ↗
▶ Ep 62 · 8:10
clinical Cincinnati Children's attempted ad-lib feeding for gastroschisis but abandoned it after one year due to poor results, including delayed NG tube removal and starting feeds too late. ↗
▶ Ep 62 · 8:40
clinical Cincinnati Children's current gastroschisis feeding protocol has been in place for approximately four years. ↗
▶ Ep 62 · 13:51
clinical Cincinnati Children's protocol includes both intermittent feeds and sham feeds, with sham feeds implemented for approximately one year. ↗
▶ Ep 62 · 13:51
epidemiological Approximately two-thirds of Cincinnati Children's gastroschisis patients are discharged home with an NG tube or G-tube for continued feeding support. ↗
▶ Ep 62 · 13:51
quote our rate of sending gastroschisis babies home with an ng or a g tube it's like two thirds of them go home with some sort of tube to help them continue feeding which is crazy ↗
▶ Ep 62 · 16:58
clinical Cincinnati Children's written protocol explicitly states that emesis is expected during gastroschisis feeding to set appropriate expectations for nursing staff and families. ↗
▶ Ep 62 · 16:58
quote we did put in our protocol for our nursing college as well as our families that emesis is expected we put that within our written protocol to make that expectation known that it's okay it's okay they're going to throw up we'll just keep working through it ↗
Beth's statements about Long-gap Esophageal Atresia 7 statements

Open the Long-gap Esophageal Atresia collection →

Journal of Pediatric Surgery Article Review: February 2023, BAPS issue

▶ Ep 4 · 7:09
opinion The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States ↗
▶ Ep 4 · 7:09
quote That it does not seem reflective at all of the type of things that that we see in our practice here, and I think that would be seen in a lot of practices in the United States. ↗
▶ Ep 4 · 7:20
clinical In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life ↗
▶ Ep 4 · 7:39
clinical In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies ↗
▶ Ep 4 · 10:41
clinical Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection ↗
▶ Ep 4 · 10:41
quote Yeah, I mean, the first year that we operated there, almost every kid got a wound infection, and then we started the next year we had the nurses do pre-op baths up on the floor the day before, and that year we had like 0 wound infections. ↗
▶ Ep 4 · 10:56
clinical After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero ↗
Beth's statements about Long Gap Esophageal Atresia 7 statements

Open the Long Gap Esophageal Atresia collection →

Journal of Pediatric Surgery Article Review: February 2023, BAPS issue

▶ Ep 5 · 7:09
opinion The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States ↗
▶ Ep 5 · 7:09
quote That it does not seem reflective at all of the type of things that that we see in our practice here, and I think that would be seen in a lot of practices in the United States. ↗
▶ Ep 5 · 7:20
clinical In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life ↗
▶ Ep 5 · 7:39
clinical In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies ↗
▶ Ep 5 · 10:41
clinical Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection ↗
▶ Ep 5 · 10:41
quote Yeah, I mean, the first year that we operated there, almost every kid got a wound infection, and then we started the next year we had the nurses do pre-op baths up on the floor the day before, and that year we had like 0 wound infections. ↗
▶ Ep 5 · 10:56
clinical After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero ↗
Beth's statements about Pulmonary Hypoplasia 49 statements

Open the Pulmonary Hypoplasia collection →

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 6 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 6 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 6 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 6 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 6 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 6 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 6 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 6 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 6 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 6 · 1:21
clinical The tongue is an easy landmark to identify during FETO because it is bumpy in appearance. ↗
▶ Ep 6 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 6 · 1:24
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 6 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 6 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 6 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 6 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 6 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 6 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 6 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 6 · 1:58
clinical The epiglottis is a key landmark to identify when navigating toward the trachea. ↗
▶ Ep 6 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 6 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 6 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 6 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage. ↗
▶ Ep 6 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 6 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 6 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 6 · 2:36
clinical The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea. ↗
▶ Ep 6 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 6 · 2:56
clinical The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea. ↗
▶ Ep 6 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
▶ Ep 6 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗

Fetoscopic Endoluminal Tracheal Occlusion (FETO) Procedure: Step-by-Step Guide with Dr. Beth Rymeski

▶ Ep 7 · 0:27
quote So this is just a little schematic of what this looks like. ↗
▶ Ep 7 · 0:33
clinical FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus. ↗
▶ Ep 7 · 0:33
quote For it's a percutaneous intervention on mom. ↗
▶ Ep 7 · 0:36
clinical A standard fetoscope with a side channel is used, and the balloon is worked through the side channel. ↗
▶ Ep 7 · 1:21
quote So the tongue is a very easy landmark when you're doing a feto. ↗
▶ Ep 7 · 1:21
clinical The tongue is a very easy landmark when doing a FETO because it is bumpy. ↗
▶ Ep 7 · 1:29
clinical Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement. ↗
▶ Ep 7 · 1:38
clinical If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth. ↗
▶ Ep 7 · 1:48
quote In this particular case, the first thing we saw was the esophagus, and we're like, OK, that's the wrong hole, right? ↗
▶ Ep 7 · 1:58
clinical The epiglottis is sought as a landmark to guide navigation toward the trachea. ↗
▶ Ep 7 · 2:23
clinical Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal and uterine walls, and excessive turning can cause membrane damage. ↗
▶ Ep 7 · 2:23
quote You also don't want to be torquing the membranes too much, right? ↗
▶ Ep 7 · 2:36
quote You always advance the scope till you see the carina, right? ↗
▶ Ep 7 · 2:36
clinical The scope is always advanced until the carina is seen, which confirms tracheal position and ensures the scope did not accidentally enter the esophagus. ↗
▶ Ep 7 · 2:39
quote That tells you both where you are in the trachea. ↗
▶ Ep 7 · 2:56
clinical The balloon should not be driven into one side of the trachea; it should inflate in the main trachea. ↗
▶ Ep 7 · 3:03
clinical The scope is backed up as the balloon is inflated so that balloon inflation can be watched. ↗
Beth's statements about Rectal Prolapse 3 statements

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Update Course Rewind: 2020 Colorectal Part 2

▶ Ep 3 · 1:34
quote I think this is like a nightmare in clinic, honestly, this is the patient that no one wants to see, right? I mean, rectal prolapses. I it's very distressing to the patient and the family, and we don't really have a lot of, of great options. ↗
▶ Ep 3 · 1:54
quote If it's a patient that I've never met before, I typically will address, you know, concerns about the constipation first and sort of prove or disprove whether or not this patient is significantly constipated. ↗
▶ Ep 3 · 2:07
quote I think if they are constipated, that's like the easier patient to deal with, but every once in a while, you get a kid who is well managed on whatever their regimen is, and they're still prolapsing, and then I think the question is, what do you do? ↗

Summaries Beth gave as host · 10 summaries

Recaps of other experts' statements, not Beth's own clinical position.

Summaries Beth gave as host · Abdominal Wall Defects 2 summaries

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Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 29 · 10:01
host summary Beth Rymeski summarizing the discussion: the protocol fed infants had fewer surgical site infections ↗
▶ Ep 29 · 10:01
host summary Beth Rymeski summarizing the discussion: In a multi-institutional study, protocol-fed gastroschisis infants had fewer surgical site infections compared to non-protocol-fed infants. ↗
Summaries Beth gave as host · Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 2 summaries

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Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 46 · 10:01
host summary Beth Rymeski summarizing the discussion: In a multi-institutional study, protocol-fed gastroschisis infants had fewer surgical site infections compared to non-protocol-fed infants. ↗
▶ Ep 46 · 10:01
host summary Beth Rymeski summarizing the discussion: the protocol fed infants had fewer surgical site infections ↗
Summaries Beth gave as host · Gastroschisis 2 summaries

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Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 17 · 10:01
host summary Beth Rymeski summarizing the discussion: In a multi-institutional study, protocol-fed gastroschisis infants had fewer surgical site infections compared to non-protocol-fed infants. ↗
▶ Ep 17 · 10:01
host summary Beth Rymeski summarizing the discussion: the protocol fed infants had fewer surgical site infections ↗
Summaries Beth gave as host · Gastroschisis 2 summaries

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Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 18 · 10:01
host summary Beth Rymeski summarizing the discussion: In a multi-institutional study, protocol-fed gastroschisis infants had fewer surgical site infections compared to non-protocol-fed infants. ↗
▶ Ep 18 · 10:01
host summary Beth Rymeski summarizing the discussion: the protocol fed infants had fewer surgical site infections ↗
Summaries Beth gave as host · Intestinal Rehab 2 summaries

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Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee

▶ Ep 62 · 10:01
host summary Beth Rymeski summarizing the discussion: In a multi-institutional study, protocol-fed gastroschisis infants had fewer surgical site infections compared to non-protocol-fed infants. ↗
▶ Ep 62 · 10:01
host summary Beth Rymeski summarizing the discussion: the protocol fed infants had fewer surgical site infections ↗