The third national conference call of APDIS, the Association of Pediatric Documentation Improvement Specialists, was held on Thursday, June 28th at 2 PM Eastern, sponsored by Valerie Bica, RN of DuPont Children's Hospital in Wilmington, Delaware.

Dr. Gold discussed one of the more vexing issues in Pediatric CDI, heart failure in neonates and children. He emphasized that there were three periods of life in which specific causes of heart failure required understanding in order to properly communicate with the physicians: newborns, early in life with either congenital or acquired structural defects and later in life with congenital or acquired structural defects. It is important for the CDI specialist to recognize that left to right shunting can lead to pulmonary edema from forward overload whereas acquired structural issues lead to retrograde pulmonary edema, like the adult model.

Here are a few of the slides that he presented and discussed so that the Pediatric CDI specialist could gain an understanding of the clinical circumstances, and recognize when to ask about specificity of left ventricular failure and when it is inappropriate to do so.