Virtual Curbside

Latest Episodes:

Episode 372: #86-4 NOWS: Q & A Feb 24, 2026

Show notes

In this Q&A episode of our neonatal opioid withdrawal syndrome (NOWS) series, we address challenging and nuanced clinical questions surrounding withdrawal, toxicology testing, and newborn exposures. Our host, Paul Wirkus, MD, FAAP, and guest Camille Fung, MD, review the early signs of withdrawal and discuss the process of obtaining consent for neonatal toxicology screening, clarifying when testing is considered diagnostic and how results may have reporting implications.

We also explore common clinical scenarios, including the impact of maternal fentanyl administered via epidural on newborn toxicology results, and how in utero SSRI exposure may present with symptoms such as apnea, posturing, or seizure-like activity. The conversation further examines the effects of prenatal THC exposure, addressing common misconceptions, potential neonatal impacts, and the persistence of THC in breastmilk.

Throughout the discussion, the emphasis remains on careful clinical assessment, clear communication with families, and a nonjudgmental, evidence-based approach to care.
Have a question? Email questions@vcurb.com.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 371: #86-3 NOWS: Management and Discharge Protocols Feb 17, 2026

Show notes

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.

We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.
Have a question? Email questions@vcurb.com. They will be answered in week four.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 371: #86-2 NOWS: Management and Discharge Protocols Feb 17, 2026

Show notes

Episode 370: #86-2 NOWS: Clinical Features of NOWS Feb 10, 2026

Show notes

In this episode, we continue our discussion of neonatal opioid withdrawal syndrome (NOWS), focusing on clinical features, treatment, and care after discharge. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the signs and symptoms clinicians use to recognize and assess withdrawal, along with current approaches to medication management and supportive care in the hospital setting. The conversation also addresses discharge planning, including criteria for safe transition home and coordination with caregivers. Finally, we explore the important role of the primary care pediatrician in follow-up—monitoring growth and development, supporting families, and coordinating ongoing services to promote the best possible outcomes for these infants.
Have a question? Email questions@vcurb.com. They will be answered in week four.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 369: #86-1 NOWS: Scope, Features and Clinical Presentation Feb 03, 2026

Show notes

This month we are focusing on neonatal opioid withdrawal syndrome (NOWS), with an emphasis on the underlying physiology and clinical presentation. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the mechanisms of opioid exposure and withdrawal, including neuroexcitability and the gastrointestinal and autonomic manifestations commonly seen in affected newborns. The discussion also highlights the role of specialized clinics and coordinated care models that support mothers during pregnancy and the postpartum period. Together, this episode provides a foundational understanding of NOWS to help clinicians recognize symptoms early and deliver informed, compassionate care to both infants and their families.
Have a question? Email questions@vcurb.com. They will be answered in week four.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 368: #85-4 Common Eye Issues: Q & A Jan 27, 2026

Show notes

In this Q&A episode, Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD address common clinical questions related to pediatric red eye presentations. The discussion covers key elements of the differential diagnosis, including how to approach cloudy corneas and other concerning findings. We also review practical questions pediatricians frequently encounter, such as whether massage is effective for clearing duct obstruction and important considerations for contact lens use in children and adolescents. This episode offers clear, practical guidance to support safe evaluation, counseling, and management of pediatric eye concerns.
Have a question? Email questions@vcurb.com. We will have a new topic next week.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 367: #85-3 Common Eye Issues: Allergic Conjunctivitis Jan 20, 2026

Show notes

In this episode, we turn our focus to allergic conjunctivitis. Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD guests review the clinical features of ocular allergy and discuss how characteristics such as discharge and symptom patterns can help distinguish allergic conjunctivitis from viral, bacterial, and other etiologies. The conversation also covers important mimics and red flags, including chemical conjunctivitis, corneal abrasions, and foreign bodies, with guidance on evaluation and management. This episode equips pediatricians with practical tools to accurately assess red eye complaints and determine when further intervention is needed.
Have a question? Email questions@vcurb.com. They will be answered next week.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 366: #85-2 Common Eye Issues: Bacterial Conjunctivitis Jan 13, 2026

Show notes

This week’s episode focuses on bacterial conjunctivitis and practical considerations for pediatric care. Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD discuss key principles of infection control, how to recognize concerning findings and distinguish uncomplicated conjunctivitis from more serious conditions such as orbital cellulitis, and when escalation of care is necessary. We also review the appropriate use of antibiotics, including selection, administration, and common pitfalls—highlighting how improper dosing or technique can limit effectiveness. This discussion is designed to support evidence-based decision-making and safe, effective management of bacterial conjunctivitis in children.
Have a question? Email questions@vcurb.com. They will be answered in week four.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 365: #85-1 Common Eye Issues: Viral Conjunctivitis Jan 06, 2026

Show notes

This month we begin a new series on common pediatric eye issues, starting with viral conjunctivitis. In this episode, host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD review the clinical features that help distinguish viral conjunctivitis from other causes of red and pink eye, discuss typical disease course, and address common misconceptions around treatment and contagion. They also explore practical counseling points for families, including symptom management, infection control, and guidance on school and daycare attendance. This discussion is designed to help pediatricians confidently diagnose viral conjunctivitis and provide clear, evidence-based reassurance to families.
Have a question? Email questions@vcurb.com. They will be answered in week four.
For more information about available credit, visit vCurb.com.
ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.
AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Episode 363: #84 Angelo's Book Club Dec 30, 2025

Show notes

In months with five weeks, The Virtual Curbside steps away from clinical topics for a pediatric book club discussion. This month, we explore The Self-Driven Child: The Science and Sense of Giving Your Kids More Control Over Their Lives by Ned Johnson and William Stixrud.

Our hosts Paul Wirkus, MD, FAAP and Angelo Giardino, MD, FAAP, reflect on the science behind autonomy, stress, and motivation, and discuss how the book’s core themes intersect with pediatric care, parenting, and adolescent development. The conversation examines how well-intentioned adult control can sometimes undermine resilience, and how supporting a child’s sense of agency can improve mental health, learning, and long-term well-being. Listeners will gain practical insights into how pediatricians can reinforce these principles in conversations with families—and how clinicians themselves can think differently about success, pressure, and development in children and teens.

No credit available for this episode. See vcurb.com for additional episodes.

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