Podcasts about pediatric critical care

In this episode of "PICU Doc on Call," pediatric intensivists Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray discuss a critical case involving a 16-year-old male who experienced severe carbon monoxide poisoning after being found unresponsive in a garage. They chat about the pathophysiology, clinical manifestations, diagnostic workup, and management of carbon monoxide toxicity. Furthermore, they cover the importance of early oxygen administration, recognizing potential delayed neurological sequelae, and keeping an eye out for cardiac complications. Tune in and hear more about a comprehensive approach to treatment and the significance of multidisciplinary support for achieving the best patient outcomes.Show Highlights:Case presentation of a 16-year-old male with severe carbon monoxide poisoningPathophysiology of carbon monoxide toxicity and its effects on hemoglobinClinical manifestations and symptoms associated with carbon monoxide poisoningDiagnostic workup for suspected carbon monoxide exposureManagement principles for treating carbon monoxide poisoning in pediatric patientsSources and scenarios leading to carbon monoxide poisoningComplications arising from carbon monoxide exposure including neurological injuriesImportance of early oxygen administration and monitoring in treatmentDiscussion of hyperbaric oxygen therapy and its indicationsKey takeaways for clinicians regarding the management and follow-up of carbon monoxide poisoning casesWe welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.References:Tapking, C., et al. (2021). Burn and inhalation injury. In J. J. Zimmerman & A. T. Rotta (Eds.), Fuhrman and Zimmerman's Pediatric Critical Care (6th ed., pp. 1347–1362). Elsevier.Nañagas KA, Penfound SJ, Kao LW. Carbon Monoxide Toxicity. Emerg Med Clin North Am. 2022 May;40(2):283-312. doi: 10.1016/j.emc.2022.01.005. Epub 2022 Apr 5. PMID: 35461624.Smollin C, Olson K. Carbon monoxide poisoning (acute). BMJ Clin Evid. 2010 Oct 12;2010:2103. PMID: 21418677; PMCID: PMC3217756.Palmeri R, Gupta V. Carboxyhemoglobin Toxicity. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

This episode of the AARC Perspectives podcast discusses AARC's newest Clinical Practice Guideline on pediatric critical asthma with Lynda Goodfellow, EdD, RRT, FAARC, AARC Director of CPGs, and lead author Benjamin White, MD, MA, Assistant Professor of Pediatrics, Division of Pediatric Critical Care at the University of Utah. They discuss how this CPG was developed and summarize its recommendations, limitations, and why more research is needed. Additional ResourcesPediatric Critical Asthma CPGSend us a textSupport the show

Welcome to another exciting episode of PICU Doc on Call! Today, we're diving deep into the world of pediatric critical care with our expert hosts, Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray. Get ready to unravel the mysteries of the oxygen extraction ratio (O2ER) and its pivotal role in managing pediatric acute respiratory distress syndrome (ARDS) and multi-organ dysfunction.Picture this: a seven-year-old girl battling severe pneumonia that spirals into ARDS and septic shock. Our hosts walk you through this gripping case, shedding light on calculating O2ER and why central venous oxygen saturation (ScvO2) is a game-changer. They'll share their top strategies for optimizing oxygen delivery and cutting down on oxygen demand.But that's not all! This episode is all about the holistic approach to managing critically ill pediatric patients. Tune in to discover how these insights can lead to better outcomes for our youngest and most vulnerable patients. Don't miss out on this vital conversation!Show Highlights:Clinical significance of the oxygen extraction ratio (O2ER) in pediatric critical careImportance of understanding oxygen delivery and consumption in critically ill patientsCalculation and interpretation of O2ER and its relationship to central venous oxygen saturation (ScvO2)Physiological concepts related to oxygenation, including intrapulmonary shunting and ventilation-perfusion mismatchManagement strategies for increasing oxygen delivery and reducing oxygen demand in ARDS and septic shockInterventions such as blood transfusions, sedation, and optimization of cardiac outputImplications of lactic acidosis and anaerobic metabolism in the context of inadequate oxygen deliveryHolistic approach to patient management, focusing on both numerical values and overall metabolic needsWe welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.References:Fuhrman B.P. & Zimmerman J.J. (Eds.). Pediatric Critical Care, 6th ed. Elsevier; 2021. (Key concepts of oxygen delivery, consumption, and extraction in shock states are discussed in Chapter 13) .Nichols D.G. (Ed.). Roger's Textbook of Pediatric Intensive Care, 5th ed. Wolters Kluwer; 2016. (Comprehensive review of oxygen transport and utilization in critically ill children, including ARDS and shock).Lucking S.E., Williams T.M., Chaten F.C., et al. Dependence of oxygen consumption on oxygen delivery in children with hyperdynamic septic shock and low oxygen extraction. Crit Care Med. 1990;18(12):1316–1319. doi:10.1097/00003246-199012000-00002.Ronco J.J., Fenwick J.C., Tweeddale M.G., et al. Pathologic dependence of oxygen consumption on oxygen delivery in acute respiratory failure. Chest. 1990;98(6):1463–1466. doi:10.1378/chest.98.6.1463 .Carcillo J.A., Davis A.L., Zaritsky A. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock. Crit Care Med. 2002;30(6):1365–1378. (ACCM guidelines emphasizing ScvO₂ targets in shock) .Emeriaud G, López-Fernández YM, Iyer NP, et al; PALICC-2 Group; PALISI Network. Executive summary of the second international guidelines for the diagnosis and management of pediatric ARDS (PALICC-2). Pediatr Crit Care Med. 2023;24(2):143–168. doi:10.1097/PCC.0000000000003147.

The World Federation of Pediatric Intensive & Critical Care Societies (WFPICCS), in collaboration with OPENPediatrics, recognizes World PICU Awareness Week 2025. This initiative aims to raise global awareness about the importance of PICUs and critical care wards worldwide, emphasizing how healthcare professionals in these units, regardless of resource setting, are driving change. From frugal innovations to digital transformation, this episode highlights how pediatric intensive care is evolving across Asia. Hear from experts in Bangladesh, India, and Indonesia as they share how low-cost technologies, telemedicine, and integrated referral systems are improving outcomes for critically ill children even in the most remote settings. Discover how resilience and resourcefulness are driving change across the region. HOST Arun Bansal, MD, FCCM, FRCPCH Professor in Pediatric Critical Care at PGIMER Chandigarh, India and Chairperson of Pediatric Intensive Care Chapter of India GUESTS Mohammod Joyaber Chisti, MBBS, MMed (Paediatrics), PhD Professor of Pediatrics at icddr,b, Bangladesh Renowned for pioneering low-cost respiratory support technologies like bubble CPAP. Jayashree Muralidharan, MBBS MD Pediatrics FIAP FICCM Head of Pediatric Critical Care at PGIMER, Chandigarh, India A leader in intensive care in India. She had helped in developing and integrating digital health systems into PICU workflows using TelePICU. She also helped in developing a PICU Referral App Kurniawan Taufiq Kadafi, Sp.A(K) Chief of Pediatric Emergency Services, Indonesia, An expert on remote and interfacility pediatric transport across Indonesia's archipelago. DATE Initial publication date: May 7, 2025. TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/at/k7x72vx63hnbvwx6wpwc4xnt/WPAW-25_Asia_Final_English.pdf Spanish - https://cdn.bfldr.com/D6LGWP8S/at/qxkcv5b23xs49tj6z6w6np/WPAW-25_Asia_Final_Spanish.pdf French - https://cdn.bfldr.com/D6LGWP8S/at/v463w7zbhbbpfbbmj8qf8b/WPAW-25_Asia_Final_French.pdf Portuguese - https://cdn.bfldr.com/D6LGWP8S/at/p377fk7m84xmppk9hx6bbq6/WPAW-25_Asia_Final_Portuguese.pdf Italian - https://cdn.bfldr.com/D6LGWP8S/at/gxbshfgg7xcm7rfpx3p5n4vm/WPAW-25_Asia_Final_Italian.pdf German - https://cdn.bfldr.com/D6LGWP8S/at/4px7mgpbf65rbb8n8vv2sjr/WPAW-25_Asia_Final_German.pdf Arabic - https://cdn.bfldr.com/D6LGWP8S/at/64vtqntqj7v99j4ztc2pk5n3/WPAW-25_Asia_Final_Arabic.pdf Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

Behind the Scenes of Pediatric Critical Care with Dr. Rana ShamiIn this episode of The Pediatric Lounge, hosts Herb and George bring on Dr. Rana Shami, the medical director of the pediatric intensive care unit at Inova Children's Hospital. Dr. Shami discusses her journey from the American University of Beirut to leading a premier PICU in Fairfax, Virginia. She shares insights into the challenges and innovations in pediatric critical care, such as the use of high-flow oxygen and bedside ultrasound, as well as the critical importance of multidisciplinary teamwork. Dr. Shami also talks about the growth of their PICU fellowship program and her advocacy for early diabetes screening to prevent DKA. The episode illuminates how pediatric ICU care has evolved and the ongoing efforts to improve patient outcomes through simulation education and data-driven approaches.00:00 Introduction to The Pediatric Lounge00:28 Sponsor Message: Hippo Education01:08 Meet Dr. Rana Shami: From Beirut to Fairfax01:30 Dr. Rana Shami's Journey in Pediatric Critical Care05:46 Legacy of Dr. Steve Keller in Pediatric Critical Care11:26 Advancements in Pediatric Intensive Care15:36 Challenges and Innovations in Pediatric Care21:42 The Role of Technology in Modern Pediatric Care30:06 Personal Stories and Reflections in Pediatric Care31:48 Using Data to Improve Healthcare33:25 The Power of Tableau in Data Visualization35:48 Leadership Style in the PICU39:25 The Role of Simulation in Medical Training42:35 Launching a PICU Fellowship Program47:18 Telehealth and Remote ICU Work51:16 Advocating for Pediatric Health56:27 The Parent Wise NGO59:19 Concluding Thoughts and FarewellSupport the show

Pediatric critical care physician Kyle Willsey discusses his article, "When every second counts: the evolving challenges of pediatric transport." He shares the high-stakes realities of transporting critically ill children, from his experience stabilizing a severely injured toddler during fellowship to his current role in building a pediatric transport team from the ground up. Kyle highlights the lack of standardization in pediatric transport medicine, the financial barriers to maintaining specialized teams, and the need for high-fidelity simulation training. He also explores how shrinking pediatric inpatient resources make efficient transport systems more essential than ever. Tune in for a deep dive into the evolving challenges of pediatric transport and what it takes to save lives when every second counts. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

In this episode of PICU DOC on Call, Dr. Rahul Damania and Dr. Pradip Kamat discuss the resurgence of measles in the United States. They explore the virus's pathophysiology, clinical features, diagnostic methods, treatment options, and complications. They emphasize the critical role of vaccination in preventing measles outbreaks and address the historical context and public health challenges related to vaccine hesitancy. The speakers highlight the severe complications of measles, especially in immunocompromised patients, and advocate for robust vaccination efforts to protect vulnerable populations and prevent the spread of this preventable disease. Tune in to hear more!Show Highlights:Resurgence of measles in the United StatesHistorical context of measles outbreaks and vaccination impactCurrent statistics and recent cases of measlesPathophysiology of the measles virusClinical features and progression of measles infectionDiagnostic approaches for confirming measlesDifferential diagnosis considerations for fever and rashTreatment options and the role of vaccinationComplications associated with measles, including severe outcomesPublic health challenges related to vaccine hesitancy and advocacy for immunizationResources:CDC Measles Info PageWHO Measles Global SurveillanceReferences:Fuhrman & Zimmerman. Textbook of Pediatric Critical Care, Ch. 52Long S et al. Principles and Practice of Pediatric Infectious Diseases, Ch. 227Moss WJ. Measles. Lancet. 2017;390(10111):2490-2502Paules CI, Marston HD, Fauci AS. NEJM. 2019;380(23):2185-2187

Rapid City Hospital's Kyle Lemley, M.D., Pediatric Critical Care, Amy Morrill, RN, Nurse Educator and Amanda Horsley, RN, Manager Nurse, join Mark Houston to tuck into pediatric sedation (or sleepy time as they refer to it) and how it's evolved to be less traumatic for children. They share the innovative sedation techniques they use, including an intranasal medication to minimize pain and anxiety for kids undergoing procedures like MRIs and CT scans. Not all procedures are the same and the team discusses how they emphasize the importance of creating a calm, comforting environment for both children and their parents. They also highlight how these advancements help local families avoid the stress of traveling far for treatments, making health care a little easier for everyone. Hosted on Acast. See acast.com/privacy for more information.

Host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, sits down with Christina L. Cifra, MD, MS, to discuss communication strategies for interfacility transfers to the pediatric intensive care unit (PICU). Dr. Cifra shares insights from her recent study on verbal handoffs during transfers, examining the challenges and vital elements of communication during these high-stakes situations (Thirnbeck CK, et al. Pediatr Crit Care Med. 2024;52:162-171). Dr. Cifra is an attending physician in the Division of Medical Critical Care at Boston Children's Hospital and assistant professor of pediatrics at Harvard Medical School in Boston, Massachusetts.

Send us a textIn this conversation, Dr. Kyle Willse, a pediatric intensivist, shares insights on the Pediatric Intensive Care Unit (PICU).  The discussion is meant to provide a basic understanding as to how the  PICU operates and to help parents be an advocate for their children.   A must listen for anybody who has a child or a loved one in the PICU.Kyle Willse, DO, is board certified in Pediatrics and in Pediatric Critical Care.  For the past 5 years, he has worked at Cedars-Sinai hospital as an attending in the pediatric and congenital cardiac intensive care unit.  His comments in the podcast are his individual thoughts and opinions and do not represent Cedars Sinai.    Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. For more content from Dr Jessica Hochman:Instagram: @AskDrJessicaYouTube channel: Ask Dr JessicaWebsite: www.askdrjessicamd.com-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20-To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Bradley A. Kuch, STAT MedEvac's Director of Medical Operations, discusses the usage of CPAP in the field and transport settings.  It's a great tool to help the patient and the provider! Brad brings his practical experience as a respiratory therapist and transport clinician to the podcast to help us understand why it's not something by which to be intimidated.

Matthew A. Borgman, M.D. is a Professor of Pediatrics in the Division of Pediatric Critical Care at the University of Texas Southwestern.  Dr. Borgman graduated from Uniformed Services University (USU), he completed Pediatric Residency at Brooke Army Medical Center in 2007, followed by a fellowship in Critical Care at Boston Children's Hospital.  He is a prolific author in pediatric trauma management which has helped redefine the care of injured children. He is also the former national chair of the Pediatric Trauma Society Research Committee and has co-authored the 2022 Pediatric Traumatic Hemorrhagic Shock Consensus Conference Recommendations. Learning Objectives:By the end of this podcast, listeners should be able to:Define pediatric hemorrhagic shock and massive transfusion.Develop a guideline-based clinical approach to managing a child with hemorrhagic shock.Explore an expert's approach to managing a child with hemorrhagic shock where the evidence might not be clear. References:Russell et al. Pediatric traumatic hemorrhagic shock consensus conference recommendations. J Trauma Acute Care Surg. 2023 Jan 1;94(1S Suppl 1):S2-S10. Spinella et al. Transfusion Ratios and Deficits in Injured Children With Life-Threatening Bleeding. Pediatr Crit Care Med. 2022 Apr 1;23(4):235-244. Gaines et al. Low Titer Group O Whole Blood In Injured Children Requiring Massive Transfusion. Ann Surg. 2023 Apr 1;277(4):e919-e924. Moore et al. Fibrinolysis Shutdown in Trauma: Historical Review and Clinical Implications. Anesth Analg. 2019 Sep;129(3):762-773.Roberts et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013 Mar;17(10):1-79. Dewan et al. CRASH-3 - tranexamic acid for the treatment of significant traumatic brain injury: study protocol for an international randomized, double-blind, placebo-controlled trial. Trials. 2012 Jun 21;13:87.Spinella et al. Survey of transfusion policies at US and Canadian children's hospitals in 2008 and 2009. Transfusion. 2010 Nov;50(11):2328-35.Whitton TP, Healy WJ. Clinical Use and Interpretation of Thromboelastography. ATS Sch. 2023 Jan 9;4(1):96-97. MATIC-2: Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Listener discretion is advised. References: CHOP Croup Clincial Pathway: https://pathways.chop.edu/clinical-pathway/croup-emergency-department-and-inpatient-clinical-pathway General Peds Reference: Lucking, S. Maffei, F., Tamburro, R., &  Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide. Pediatric Fluid Maintenance: Somers, Michael. (2022). Maintenance intravenous fluid therapy in children. Up-to-Date. Racemic vs. Standard Epi: PMID: 1734400

Joseph Carcillo, MD, a physician scientist in Critical Care Medicine at UPMC Children's Hospital of Pittsburgh, discusses the intersection of precision medicine and pediatric critical care medicine research.

Alexander Rotta, MD is a Professor of Pediatrics and the Division Chief of Pediatric Critical Care at Duke University School of Medicine. He is an accomplished intensivist, educator and physician scientist with well over 100 publications with a focus on respiratory care in critically ill children. He authored a review on high-frequency jet ventilation that served as the foundation for today's episode. Learning Objectives:By the end of this podcast, listeners should be able to discuss:The physiologic rationale supporting the use of high frequency jet ventilation (HFJV).Patient populations most likely to benefit from HFJV.Key published evidence that informs our use of HFJV in pediatric critical care.An expert approach to managing a patient with HFJV.References:Cheifetz IM, Rotta AT. High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2021 Feb;66(2):191-198. doi: 10.4187/respcare.08241. Epub 2020 Oct 2. PMID: 33008841.Miller AG, Scott BL, Gates RM, Haynes KE, Lopez Domowicz DA, Rotta AT. High-Frequency Jet Ventilation in Infants With Congenital Heart Disease. Respir Care. 2021 Nov;66(11):1684-1690. doi: 10.4187/respcare.09186. Epub 2021 Jun 9. PMID: 34108137.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

In this episode of The Luke Coutinho Show, join me in welcoming Dr. Natwar Sharma, an Associate Professor in Pediatrics and Pediatric Critical Care and a regression therapy expert trained through TASSO International. He's a certified member of the Earth Association for Regression Therapy (EARTh) and author of Metaphors of Memory: Healing Through Past and Current Life Regression. Tune in to gain valuable insights on: Dr. Natwar's journey into regression therapy: How pediatric cancer patients sparked his curiosity about the soul and karma in health Regression therapy: Healing emotional and psychological wounds by exploring past life experiences Emotional release: Addressing root causes of physical, emotional, and spiritual imbalances The mindset towards medications: Embracing them with gratitude can significantly reduce side effects Four phases of healing: Thoughts, emotions, energy, physical body Energy contamination or attachment: Manifestations like possession and energy transfer, and how to handle them And much more…

Alexander Rotta, MD is a Professor of Pediatrics and the Division Chief of Pediatric Critical Care at Duke University School of Medicine. He is an accomplished intensivist, educator and physician scientist with well over 100 publications with a focus on respiratory care in critically ill children. He authored a review on high-frequency jet ventilation that served as the foundation for today's episode. Learning Objectives:By the end of this podcast, listeners should be able to discuss:The physiologic rationale supporting the use of high frequency jet ventilation (HFJV).Patient populations most likely to benefit from HFJV.Key published evidence that informs our use of HFJV in pediatric critical care.An expert approach to managing a patient with HFJV.References:Cheifetz IM, Rotta AT. High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2021 Feb;66(2):191-198. doi: 10.4187/respcare.08241. Epub 2020 Oct 2. PMID: 33008841.Miller AG, Scott BL, Gates RM, Haynes KE, Lopez Domowicz DA, Rotta AT. High-Frequency Jet Ventilation in Infants With Congenital Heart Disease. Respir Care. 2021 Nov;66(11):1684-1690. doi: 10.4187/respcare.09186. Epub 2021 Jun 9. PMID: 34108137.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Host Elizabeth H. Mack, MD, MS, FCCM, is joined by John Lin, MD, to discuss the transformative impact of the ICU Liberation Bundle (ABCDEF) on caring for critically ill children. This episode delves into the Pediatric Critical Care Medicine article, "Caring for Critically Ill Children With the ICU Liberation Bundle (ABCDEF): Results of the Pediatric Collaborative," exploring the implementation, outcomes, and the potential for enhancing pediatric ICU care (Pedtr Crit Care Med. August 2023; 24(8):636-651). Dr. Lin is Associate Professor of Pediatrics, Critical Care Medicine, and Service Chief for Respiratory Failure and Sepsis in the PICU, as well as the Medical Director of Respiratory Care at St. Louis Children's Hospital in St. Louis, Missouri.

Happiness Solved with Sandee Sgarlata. In this episode, Sandee interviews Dr. Greg Hammer. Greg Hammer, MD is a Professor at Stanford University School of Medicine, pediatric intensive care physician, pediatric anesthesiologist, mindfulness expert, and the author of GAIN without Pain: The Happiness Handbook for Health Care Professionals (May 15, 2020). Connect with Dr. Greg: www.GregHammerMD.com  Instagram: https://www.instagram.com/greghammermd/   Facebook: https://www.facebook.com/greghammermd/  LinkedIn: https://www.linkedin.com/in/greg-hammer-02b20422/  Connect with Sandee www.sandeesgarlata.com Podcast: www.happinesssolved.com www.facebook.com/coachsandeesgarlata www.twitter.com/sandeesgarlata www.instagram.com/coachsandeesgarlata  

Birthrates in the United States have been on a relatively constant and significant downward trajectory since the 1950s. While medicine has improved in the field of infertility, many still struggle with the issue. Jenna Miller, MD, is an associate professor of Pediatrics-University of Missouri-Kansas City and the program director for Pediatric Critical Care at Children's Mercy Hospital. She is also the author of a new book, Navigating Your Fertility as a Woman in Medicine. In her book, Miller shares her infertility journey to help others who might face this journey themselves. It is a roadmap for how physicians deal with fertility and infertility and the options available when family planning is put off until after training. This is a critical topic that doesn't receive enough attention from physician leaders. From deans of medical schools to editors of medical journals, from residency directors to those working in HR, understanding, supporting, and reducing the barriers for women physicians to achieve fertility is needed. For woman physicians to achieve full gender equity, an understanding of the physiologic changes happening for women physicians in the midst of their training is needed. @JennaMillerKC Learn more about the American Association for Physician Leadership at www.physicianleaders.org

James D. Fortenberry MD, MCCM, FAAP is a Professor Pediatrics in the Division of Pediatric Critical Care at Emory University School of Medicine. He is the Chief Medical Officer of Children's Healthcare of Atlanta & the interim Chief of Critical Care Medicine. He is a past Chair of Critical Care sub-board of the American Board of Pediatrics and on SCCM and AAP critical care committees  He is also a past president of Extracorporeal Life Support Organization (ELSO). Objective:By the end of this podcast, listeners should be able to identify key leadership skills across the spectrum of an academic career and apply these to their own professional development.How to support PedsCritPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Support the show

Dr. Catherine G. Caronia is a highly accomplished and dedicated professional in the field of pediatrics and medical education. Based in Syosset, New York, she has a wealth of experience and expertise in various roles, including Senior Vice President of Academic Affairs and Chief Academic Officer at Catholic Health, Editor of the Academic Journal of Pediatrics and Neonatology, and Designated Institutional Officer at Good Samaritan Hospital.Dr. Caronia is a board-certified pediatrician with a subspecialty in Pediatric Critical Care. Her commitment to medical education is evident through her role as Associate Dean of the Clinical Affiliate Site of the Icahn School of Medicine at Mount Sinai and her positions as Clinical Professor and Associate Dean at various medical institutions.With a diverse educational background, including an M.D. from New York Medical College and an M.B.A. from Adelphi University, Dr. Caronia brings a unique blend of medical and business acumen to her leadership roles in healthcare. Her passion for research and continuous improvement is reflected in the numerous grants and studies she has undertaken, particularly in the field of pediatrics.Dr. Caronia is a Fellow of the College of Chest Physicians and the American Academy of Pediatrics, and she has received various awards for her contributions to healthcare, including the Catholic Health Good Samaritan University Hospital Physician of the Year.Beyond her professional roles, Dr. Caronia actively engages in committee work and community involvement, emphasizing her dedication to enhancing the quality of healthcare and education. Her work is widely recognized and respected within the medical community, making her a valuable asset to healthcare organizations and institutions.Support the show

On this week's episode, we are joined by Nurse Tori BSN RNC-NIC. Tori is a NICU nurse who shares openly on social media. Tori went directly from graduation into a level 4 NICU and has worked in NICUs for 10 years. Things you will hear about on this episode:- Differences between NICU levels.- The importance of getting to know your team in the NICU.- Communication in the NICU.- Personalizing your space in the NICU to help make it feel more comfortable.- Good preemie clothing brands.- Journaling to your baby .- Coping with an intense work environment.- The importance of self-care as a NICU parent.Guest Bio: Nurse Tori Meskin is a Registered Nurse with over 8 years of nursing experience specializing in neonatal and pediatric critical care and has served as a specialty NICU & Pediatric Critical Care trained nurse serving patients in the Los Angles and Orange County areas providing direct patient care, leadership, consultation, education and patient care management expertise for the complex neonatal & pediatric patient populations. She has worked for Children's Hospitals and University Hospitals in Level IV NICU, Trauma I centers, and consulting centers. As a new nurse, she completed a 20-week RN Versant Residency Program. She is trained to work in specialized areas; Small Baby Unit, Body Cooling Team, & Surgical NICU (Cardiothoracic, Gastrointestinal, Neurosurgical, & Congenital anomalies etc.)Tori graduated from The University of Arizona (beardown) with a dual major in Nursing and Psychology. Currently, Tori is obtaining a Master's Degree in Nursing Leadership sharpening leadership skills, enhancing research expertise, driving evidence-based research forward, and becoming a true leader in this space.You can find Nurse Tori on Instagram: @nurse.tori_For more birth trauma content and a community full of love and support, head to my Instagram at @birthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.

About our Guest: Bradley Fuhrman, MD completed his training in pediatrics followed by fellowships in cardiology and neonatology at the University of Minnesota where he went on to found the first PICU and serve as the Chief of critical care at that institution. He has also served as the associate director of the PICU at Children's Hospital of Pittsburgh, Division Chief of Critical Care at Children's Hospital Buffalo and Physician-in-Chief at El Paso Children's Hospital. His career in pediatric critical care exceeds 40 years. He has many peer-reviewed publications with a research career that is focused in cardiac and respiratory physiology. He is also the co-author of Fuhrman and Zimmerman's Pediatric Critical Care.Learning Objectives:By the end of listening to this 2-part series, learners should be able to discuss clinically relevant cardiopulmonary interactions and a fundamental clinical approach to optimizing cardiopulmonary mechanics in patients with:Spontaneous (negative pressure) respirations with severe work of breathing Septic shockMechanical (positive pressure) ventilationPulmonary hypertension with right ventricular systolic dysfunctionLeft ventricular systolic dysfunctionRight ventricular diastolic dysfunctionSingle ventricle Fontan circulationReferences:Bronicki RA, Penny DJ, Anas NG, Fuhrman B. Cardiopulmonary Interactions. Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S182-93. doi: 10.1097/PCC.0000000000000829. PMID: 27490598.Fuhrman and Zimmerman's Pediatric Critical Care 6th EditionHow to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please complete our Listener Feedback Survey (

About our Guest: Bradley Fuhrman, MD completed his training in pediatrics followed by fellowships in cardiology and neonatology at the University of Minnesota where he went on to found the first PICU and serve as the Chief of critical care at that institution. He has also served as the associate director of the PICU at Children's Hospital of Pittsburgh, Division Chief of Critical Care at Children's Hospital Buffalo and Physician-in-Chief at El Paso Children's Hospital. His career in pediatric critical care exceeds 40 years. He has many peer-reviewed publications with a research career that is focused in cardiac and respiratory physiology. He is also the co-author of Fuhrman and Zimmerman's Pediatric Critical Care.Learning Objectives:By the end of listening to this 2-part series, learners should be able to discuss clinically relevant cardiopulmonary interactions and a fundamental clinical approach to optimizing cardiopulmonary mechanics in patients with:Spontaneous (negative pressure) respirations with severe work of breathing Septic shockMechanical (positive pressure) ventilationPulmonary hypertension with right ventricular systolic dysfunctionLeft ventricular systolic dysfunctionRight ventricular diastolic dysfunctionSingle ventricle Fontan circulationReferences:Bronicki RA, Penny DJ, Anas NG, Fuhrman B. Cardiopulmonary Interactions. Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S182-93. doi: 10.1097/PCC.0000000000000829. PMID: 27490598.Fuhrman and Zimmerman's Pediatric Critical Care 6th EditionHow to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please complete our Listener Feedback Survey (

About our Guest: Jerry Zimmerman, M.D, PhD, FCCM is a Professor of Pediatrics at the University of Washington and the former Chief of the Division of Critical Care Medicine and the Director of the Pediatric Intensive Care Unit at Seattle Children's Hospital. He is a past president of the Society of Critical Care Medicine. Dr. Zimmerman is the co-editor of the textbook Pediatric Critical Care and is an accomplished researcher. He was a charter principal investigator in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network and is a co-principal investigator for the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) trial that we will discuss later in this episode. Learning Objectives:By the end of this podcast, listeners should be able to discuss:The physiologic rationale supporting and opposing the use of corticosteroids in septic shock.The high-quality clinical evidence supporting and opposing the use of corticosteroids in septic shock.The current practice patterns among pediatric intensivists in prescribing corticosteroids in septic shock.The clinically relevant side effects associated with corticosteroids in septic shock.Future research of corticosteroids in septic shock with emphasis on the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) study.How to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Key reference:Zimmerman, Jerry J. MD, PhD, FCCM. A history of adjunctive glucocorticoid treatment for pediatric sepsis: Moving beyond steroid pulp fiction toward evidence-based medicine. Pediatric Critical Care Medicine: November 2007 - Volume 8 - Issue 6 - p 530-539Other references:  PMID: 32058370  PMID: 20228689  PMID: 29979221  PMID: 29490185  PMID: 29347874  PMID: 27695824  PMID: 18184957  PMID: 12186604 Support the show

About our Guest: Jerry Zimmerman, M.D, PhD, FCCM is a Professor of Pediatrics at the University of Washington and the former Chief of the Division of Critical Care Medicine and the Director of the Pediatric Intensive Care Unit at Seattle Children's Hospital. He is a past president of the Society of Critical Care Medicine. Dr. Zimmerman is the co-editor of the textbook Pediatric Critical Care and is an accomplished researcher. He was a charter principal investigator in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network and is a co-principal investigator for the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) trial that we will discuss later in this episode. Learning Objectives:By the end of this podcast, listeners should be able to discuss:The physiologic rationale supporting and opposing the use of corticosteroids in septic shock.The high-quality clinical evidence supporting and opposing the use of corticosteroids in septic shock.The current practice patterns among pediatric intensivists in prescribing corticosteroids in septic shock.The clinically relevant side effects associated with corticosteroids in septic shock.Future research of corticosteroids in septic shock with emphasis on the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) study.How to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Key reference:Zimmerman, Jerry J. MD, PhD, FCCM. A history of adjunctive glucocorticoid treatment for pediatric sepsis: Moving beyond steroid pulp fiction toward evidence-based medicine. Pediatric Critical Care Medicine: November 2007 - Volume 8 - Issue 6 - p 530-539Other references:  PMID: 32058370  PMID: 20228689  PMID: 29979221  PMID: 29490185  PMID: 29347874  PMID: 27695824  PMID: 18184957  PMID: 12186604 Support the show

Joining us on Well Said is Dr. Jose Prince and Dr. Chethan Sathya. Dr. Prince is the Vice Chair of Surgery and the System Chief of Pediatric Surgery and Acute Care Surgery for Northwell Health, Surgeon in Chief at Cohen Children's Medical Center and a professor of Surgery and Pediatrics at the Zucker School of Medicine at Hofstra/Northwell. Dr. Sathya is a Pediatric General and Thoracic Surgeon, Associate Medical Director for Trauma and the Surgical Director for Pediatric Critical Care at Cohen Children's Medical Center, assistant professor of Surgery and Pediatrics at the Zucker School of Medicine at Hofstra/Northwell and director of the Northwell Health Gun Violence Prevention Center. They will be discussing how gun violence causes physical injury to its victims, increases strain on our health systems, and reshapes entire communities.

Gwenny and Ashley came on the podcast to talk about dealing with sick pediatric patients. References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/. Lucking, S. Maffei, F., Tamburro, R., &  Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide. Nagler, Joshua. Cheifetz, Ira. (2021). Initiating Mechanical Ventilation in Children. Up-to-Date.

If you have wondered how to make asynchronous, cross-disciplinary teaching between physicians and nurses really work, this podcast provides a great model for you to consider. Listen as Dr. Becky Gesler from the School of Nursing and Dr. Natalie Henderson from the Department of Pediatrics Critical Care Division discuss an innovative way that they solved this problem using a collaborative, opportunistic approach to learning. Do you have any questions or comments about Faculty Feed? Please contact us at FacFeed@louisville.edu

In this World Shared Practice Forum podcast, Dr. Michael Dean discusses the potential impact of ChatGPT on pediatric critical care. Dr. Dean gives background as to what ChatGPT is, how it was developed, and how it is currently being used in the medical community at large. He discusses his experiences using ChatGPT, describing its promising features and the issues involved with it as well. Lastly, Dr. Dean speculates on the potential impact it will have on patients, clinicians, and medical students moving forward. Upon listening to this presentation, learners should be able to: - Explain what ChatGPT is and how it is trained - Discuss potential use cases of ChatGPT in the medical community - Identify potential issues with the use of ChatGPT and the importance of integrating accurate data sets into future versions Publication date: April 20, 2023. References: • https://openai.com/blog/chatgpt Citation: Dean JM, O'Hara JE, Burns JP. The Potential Impact of ChatGPT on Pediatric Critical Care. 04/2023. OPENPediatrics. Online Podcast. Links: https://youtu.be/FpWGxK0aFi8. Podcast: Podcast: https://soundcloud.com/openpediatrics/the-potential-impact-of-chatgpt-on-pediatric-critical-care-by-dr-j-michael-dean-for-openpediatrics. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

Noninvasive respiratory support is an important modality utilized in the pediatric critical care setting to treat respiratory failure without the use of an artificial airway. On today's discussion, pediatric critical care fellow, Dr. John-David Bruce joins pediatric hospitalist, Dr. Brynn Ehlers and Dr. Gene Fisher who is a pediatric intensivist that serves as the division chief of Pediatric Critical Care unit at the Children's Hospital of Georgia. After listening to this podcast, learners should be able to:  1. Recognize different types of noninvasive respiratory support 2. Have an understanding of basic settings involved in the different modes of noninvasive respiratory support 3. Discuss conditions that are most ideal for noninvasive respiratory support  4. Recognize when it is necessary to escalate to a higher mode of respiratory support 5. Common complications of noninvasive respiratory support and how do you treat them. FREE CME Credit (requires free sign-up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19507  References: Amin, R, & Arca, MJ. Feasibility of non-invasive neurally adjusted ventilator assist after congenital diaphragmatic hernia repair. Journal of Pediatric Surgery, 2019;54(3):434-438. Coletti, KD, Bagdure, DN, Walker, LK, Remy, KE, & Custer, JW. High-flow nasal cannula utilization in pediatric critical care. Respiratory Care, 2017;62(8):1023-1029. Desai, JP, & Moustarah, F. Pulmonary Compliance. StatPearls Publishing. 2021.  https://www.ncbi.nlm.nih.gov/books/NBK538324/ Fedor, KL. Noninvasive respiratory support in infants and children. Respiratory Care, 2017;62(6):699-717. Franklin, D, Babl, FE, & Schlapbach, LJ, et al. A randomized trial of high-flow oxygen therapy in infants with bronchiolitis. The New England Journal of Medicine, 2018;378:1121-1131. Intagliata, S, Rizzo, A, & Gossman, WG. Physiology, Lung Dead Space. StatPearls Publishing. 2020. https://www.ncbi.nlm.nih.gov/books/NBK482501/ Morrison, WE, Nelson McMillan, KL, & Shaffner, DH. (Eds.). Roger's Handbook of Pediatric Intensive Care (5th ed.). 2017. Wolters Kluwer. Najaf-Zadeh A, & Leclerc F. Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review. Ann Intensive Care. 2011;1(1):15. doi:10.1186/2110-5820-1-15 Oymar, K, & Bardsen, K. Continuous positive airway pressure for bronchiolitis in a general paediatric ward; a feasibility study. BMC Pediatrics. 2014;14:122. Pope, JF, & Birnkrant, DJ. Noninvasive ventilation to facilitate extubation in a pediatric intensive care unit. Journal of Intensive Care Medicine. 2000;15(2):99-103.  Storre, JH, Bohm, P, Dreher, M, & Windisch, W. Clinical impact of leak compensation during non-invasive ventilation. Respiratory Medicine. 2009;103(10):1477-1483.  Silver AH, Nazif JM. Bronchiolitis. Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260

Listener Feedback SurveyAbout our guest:Dr. Whyte-Nesfield is a Critical Care attending at Children's National Hospital in Washington, DC. She completed her medical degree in her home country of Grenada at St. George's University, and her fellowship in Pediatric Critical Care at Penn State Health Children's Hospital, PA. Mekela's research interest is the role of parent and child traumatic stress management in improving long term outcomes of children in the PICU; she ran a multi-center prevalence study during her fellowship. She is also interested in advanced ventilator modes and educating the next generation of intensivists about pulmonary physiology.Objectives:After listening to this episode, listeners should be able to:Define indications for intubation in a patient with asthma.Review adjunct therapies, including high-dose steroids, mag, epi, terbutaline, isoproterenol, aminophylline, isoflurane, and manual decompression of the chest.Identify the physiologic and logistic rationale supporting each mode of mechanical ventilation in asthma (PRVC vs PCPS).Identify the benefits and risks of paralyzing an intubated asthmatic. Discuss the relationshiop between static compliance, dynamic compliance, and reversible bronchoconstriction.  Describe the complications of mechanical ventilation in asthma, including indications for ECMO.References:Manual external chest compression reverses respiratory failure in children with severe air trapping. Pediatric Pulmonology, 56(12), 3887–3890. https://doi.org/10.1002/ppul.25689 Mechanical ventilation of the intubated asthmatic: How much do we really know? *. Pediatric Critical Care Medicine, 5(2), 191–192. https://doi.org/10.1097/01.CCM.0000113929.14813.51Volatile Anesthetic Rescue Therapy in Children With Acute Asthma. Pediatric Critical Care Medicine, 14(4), 343–350. https://doi.org/10.1097/PCC.0b013e3182772e29Pressure-controlled ventilation in children with severe status asthmaticus*. Pediatric Critical Care Medicine, 5(2), 133–138. https://doi.org/10.1097/01.PCC.0000112374.68746.E8Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*. Pediatric Critical Care Medicine, 8(2), 91–95. https://doi.org/10.1097/01.PCC.0000257115.02573.FCHow to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Support the showSupport the show

Approach to Pediatric Trauma Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists.I'm Pradip Kamat coming to you from Children's Healthcare of Atlanta/Emory University School of Medicine and I'm Rahul Damania, from Cleveland Clinic Children's Hospital. We are two Pediatric ICU physicians passionate about all things MED-ED in the PICU. PICU Doc on Call focuses on interesting PICU cases & management in the acute care pediatric setting so let's get into our episode.Welcome to our Episode today of a 7 yo M who presents to the PICU after a severe Motor Vehicle Accident.Here is the case presented by RahulA 7-year-old male child is admitted to the PICU after sustaining severe trauma. The patient was brought to the emergency department after a motor vehicle accident that involved an 18-wheeler truck & the family's car; in this severe accident the 7 yo was noted to be restrained however upon impact was ejected from the vehicle. He was unconscious and had multiple injuries, including a laceration on the head and bruising on the chest. The EMS was activated and the patient presented to the ED for acute stabilization. Upon examination, the patient was found to have a Glasgow Coma Scale score of 8, indicating a serious head injury. He had multiple bruises and abrasions on the chest and arms, and his pulse was rapid and weak. The patient was resuscitated with colloid and blood products, intubated, and transferred to the pediatric intensive care unit for further management.Notably, a CT scan of the head showed a skull fracture and a subdural hematoma. A chest X-ray showed multiple rib fractures and bilateral pulmonary opacities with no evidence of pneumothorax. The patient was also found to have a grade 2 liver laceration and a splenic injury. Pelvic x-ray and cardiac FAST exam were unrevealing.To summarize key elements from this case, this patient has:A traumatic brain injuryPulmonary contusions and is at risk for PARDSLiver and spleen injuryAnemiaPertinent negative includes: No pelvic injuries or injuries to great vessels in the chestRahul, let's approach the PICU medical management of this case based on a culmination of various guidelines published in the Pediatric Critical Care literature. Namely, let's use this case to dive deep into guidelines for:Traumatic brain injury (TBI)****Transfusion and Anemia Expertise Initiative (****TAXI)pediatric blunt liver and spleen injury management, are also known as the ATOMAC protocol, as well as general PICU management of acute trauma.As we take the management of this pediatric trauma patient in a systems-based fashion let's first go into the Management of Pediatric Traumatic Brain Injuries, can you start us off with some key management considerations?Based on the March 2019 TBI guidelines published in Pediatric Critical Care Medicine in 2019 (PCCM20(3S):p S1-S82, March 2019)This patient should have an ICP monitor or even an EVD placed for CSF diversion in consultation with the NS and trauma team. A CPP of at least >50 in our 7 yo patient and ICP < 20 mm Hg has been shown to improve outcomes and reduce mortality.Just as a quick review, CPP stands for cerebral perfusion pressure, which is the pressure that maintains blood flow to the brain. The formula for CPP is:CPP = MAP (mean arterial pressure) - ICP (intracranial pressure)Monitoring does not affect outcomes directly; rather the information from monitoring can be used to direct treatment decisions. Treatment informed by data from monitoring may result in better outcomes than treatment informed solely by data from clinical assessment. In short, it is important to have qualitative and quantitative data to optimize your decision-making.As we talked about ICP control is so crucial for

Episode 4 Pediatric Critical Care, Sedation, and AnalgesiaIn this podcast, we review some of the basics of analgesia and sedation with Dr. Fajer.

Listener Feedback SurveyAbout our guest:Dr. Whyte-Nesfield is a Critical Care attending at Children's National Hospital in Washington, DC. She completed her medical degree in her home country of Grenada at St. George's University, and her fellowship in Pediatric Critical Care at Penn State Health Children's Hospital, PA. Mekela's research interest is the role of parent and child traumatic stress management in improving long term outcomes of children in the PICU; she ran a multi-center prevalence study during her fellowship. She is also interested in advanced ventilator modes and educating the next generation of intensivists about pulmonary physiology.Objectives: After listening to this episode, listeners should be able to:Define indications for intubation in a patient with asthma.Review adjunct therapies, including high-dose steroids, mag, epi, terbutaline, isoproterenol, aminophylline, isoflurane, and manual decompression of the chest.Identify the physiologic and logistic rationale supporting each mode of mechanical ventilation in asthma (PRVC vs PCPS).Identify the benefits and risks of paralyzing an intubated asthmatic. Discuss the relationshiop between static compliance, dynamic compliance, and reversible bronchoconstriction.  Describe the complications of mechanical ventilation in asthma, including indications for ECMO.References:Manual external chest compression reverses respiratory failure in children with severe air trapping. Pediatric Pulmonology, 56(12), 3887–3890. https://doi.org/10.1002/ppul.25689 Mechanical ventilation of the intubated asthmatic: How much do we really know? *. Pediatric Critical Care Medicine, 5(2), 191–192. https://doi.org/10.1097/01.CCM.0000113929.14813.51Volatile Anesthetic Rescue Therapy in Children With Acute Asthma. Pediatric Critical Care Medicine, 14(4), 343–350. https://doi.org/10.1097/PCC.0b013e3182772e29Pressure-controlled ventilation in children with severe status asthmaticus*. Pediatric Critical Care Medicine, 5(2), 133–138. https://doi.org/10.1097/01.PCC.0000112374.68746.E8Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*. Pediatric Critical Care Medicine, 8(2), 91–95. https://doi.org/10.1097/01.PCC.0000257115.02573.FCHow to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Support the show

In this World Shared Practice Forum podcast, Dr. Robert Tasker discusses trends in research over the past year from his position as Editor-in-Chief of the Pediatric Critical Care Medicine Journal. Dr. Tasker shares his views on some of the most active areas of research in the field of pediatric critical care medicine in 2022 and provides an insider's look at many metrics relating to the PCCM Journal itself, including impact factors, subscribership numbers, and Altmetric scores. Upon listening to this presentation, learners should be able to: -Identify diverse areas of active research interest within the field of pediatric critical care medicine -Describe the reach and impact of the journal Pediatric Critical Care Medicine within the field of pediatrics, and within medicine more generally -Interpret Altmetric scores to better understand the global reach of a published work Publication date: November 18, 2022. Citation: Tasker R, Daniel D, Burns JP. Research Trends in Pediatric Critical Care Medicine: Editor's Perspective. 11/2022. Online Podcast. OPENPediatrics. https://youtu.be/EnOz15CTiEI. Articles referenced: Jonat B, Gorelik M, Boneparth A, et al. Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019 in a Children's Hospital in New York City: Patient Characteristics and an Institutional Protocol for Evaluation, Management, and Follow-Up. Pediatr Crit Care Med. 2021;22(3):e178-e191. (11:39) Capasso L, De Bernardo M, Vitiello L, Rosa N. Ultrasound Options for Measuring Optic Nerve Sheath Diameter in Children. Pediatr Crit Care Med. 2021;22(5):e329-e330. (12:40) Staveski SL, Pickler RH, Khoury PR, et al. Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery Patients. Pediatr Crit Care Med. 2021;22(1):68-78. (13:42) Ozment CP, Scott BL, Bembea MM, Spinella PC; Pediatric ECMO (PediECMO) subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and the Extracorporeal Life Support Organization (ELSO). Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Survey of Medical Directors in the United States. Pediatr Crit Care Med. 2021;22(6):530-541 (14:05) Rimensberger PC, Kneyber MCJ, Deep A, et al. Caring for Critically Ill Children With Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections' Collaborative of the European Society of Pediatric and Neonatal Intensive Care. Pediatr Crit Care Med. 2021;22(1):56-67. (14:47) Additional references: Pediatric Critical Care Medicine journal: https://journals.lww.com/pccmjournal (06:42) Pediatric Critical Care section of Frontiers in Pediatrics journal: https://www.frontiersin.org/journals/pediatrics/sections/pediatric-critical-care (06:59) Journal of Pediatric Critical Care: https://www.jpcc.org.in (07:06) Critical Care Medicine journal: https://journals.lww.com/ccmjournal/pages/default.aspx (07:20) Pediatric Pulmonology journal: https://onlinelibrary.wiley.com/journal/10990496 (07:28) Atlmetric: https://www.altmetric.com/ (16:42) Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

LISTEN ​Show Notes: In his From the Heart segment, Dr. Paul talks about how we can be a light in the darkness for those who have experienced significant loss. We have an opportunity to bring love, peace, and presence to those who are alone. Don’t underestimate the power of what love can do in this world. Dr. Monique Robles, a pediatric critical care physician and bioethicist, joins this week to discuss the weaponization of the medical establishment and the serious con [...]

This weeks Ask Dr Jessica episode is all about coughs! Coughs are often so difficult for families; they can be so uncomfortable and persistent, and many families don't know how to best help their children.  In this episode, with pediatric pulmonologist, Dr Cesar Chavarria, we discuss what is a normal length of time for coughs to last, what medications can be offered, and also when to see a doctor.  We also talk about asthma (starting @18:55). We discuss common signs of asthma, how to know the difference between asthma and a regular cold virus cough, how to treat asthma and what demographic it typically affects. Dr. Chavarria is a pediatric pulmonologist with more than 30 years of experience in treating pediatric respiratory conditions. He attended undergraduate school at Madrid College and medical school at the National Autonomous University of Mexico, both in Mexico City. He completed his pediatric internship at the University of Colorado Health Sciences Center in Denver, and his residency in pediatrics and fellowship in pediatric pulmonology and critical care at the Long Beach Memorial Medical Center.  Dr. Chavarria is board certified in Pediatrics and in Pediatric Critical Care.Cesar Chavarria, M.D., is a third-generation physician. Outside of his work, Dr  Chavarria likes to spend his time with his wife and daughter. His wife is a psychiatrist, and his daughter is completing her psychiatry residency. To schedule an appointment, call 818-342-0793. He can also be found on his website: https://www.brthez.com/Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children.  Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. Do you have a future topic you'd like Dr Jessica Hochman to discuss?  Email your suggestion to: askdrjessicamd@gmail.com. Dr Jessica Hochman is also on social media:Follow her on Instagram: @AskDrJessicaFollow her on TikTok: @AskDrJessicaSubscribe to her YouTube channel! Ask Dr JessicaSubscribe to this podcast: Ask Dr JessicaSubscribe to her mailing list: www.askdrjessicamd.comThe information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.

You only live once, so why not live it to the fullest? A full life doesn't necessarily mean going out to eat fast food everyday, or going out for drinks every weekend. It's about living a healthy and purposeful life! But how do you do that? Lifestyle medicine physician, Dr. Jennifer David, saw how our choices, especially on the food we eat can greatly affect our lifestyle and its longevity. After receiving her certificate on Plant Based Nutrition, she now shares her discovery on how a plant-powered lifestyle produces a long, healthy and productive life. Living a healthy lifestyle herself, she will share with you today the power of plant-based nutrition and the 6 pillars of lifestyle medicine that will help you live a longer life. You only live once, so live it with purpose!   Episode Highlights: Dr. Jennifer on living her own healthy lifestyle The best diet to live longer How plant-based nutrition can help reverse chronic diseases  How to incorporate plant-food into your diet How to begin plant predominant diet for the meat lovers The ultra processed foods Checking the label Entering the plant-based diet The 6 Pillars of Lifestyle Medicine    About Dr. Jennifer David  Dr. Jennifer David is board certified in Pediatrics, Pediatric Critical Care and Lifestyle Medicine. She recently transitioned from full time hospital medicine to a telehealth practice focused on Lifestyle Medicine. She developed a passion for plant based diets after becoming vegan about 12 years ago and discovering how much better she felt. She then obtained her Plant Based Nutrition Certificate where she discovered the true power plant based diets and other lifestyle interventions in preventing and reversing disease. In her spare time, she loves to run and cook. She also loves trying to convert traditional recipes to healthier plant based alternatives. Her children are great food critics!   Ways to Connect with Dr. Jennifer David: Website | www.healthylivingwithdrjenn.com LinkedIn | www.linkedin.com/in/jennifer-davis  Email | healthylivingwithdrjenn@gmail.com  Facebook | www.facebook.com/healthylivingwithdrjenn  Instagram  | @healthylivingwithdrjenn    Free Resources: Book a Free Discovery Call with Dr. Jennifer David: (954) 861-0778   Discover the 5 Reasons Your Weight-Loss Journey Has Gotten Derailed (And How To Get Back On Track!)

LISTEN ​Show Notes: ​In his From the Heart segment, Dr. Paul talks about how we need to surrender to become free and have gratitude to overcome resentment because what we resist persists. He encourages us to break through the world’s endless crazy cycle by choosing to love others, looking for the goodness within them. This week features a dynamite interview with Monique Robles, M.D., a board-certified pediatric critical care physician and bioethicist. She talks [...]

Sersie and Gigi sit down with Dr. Jenn to unpack the pillars of healthy living.  Jennifer Davis is a physician. She is board certified in Pediatrics, Pediatric Critical Care, and Lifestyle Medicine.  She recently transitioned from full time hospital medicine to a telehealth practice focused on Lifestyle Medicine. She developed a passion for plant-based diets after becoming vegan about 12 years ago and discovering how much better she felt.  She then obtained her Plant-Based Nutrition Certificate where she discovered the true power of plant-based diets and other lifestyle interventions in preventing and reversing disease. In her spare time, she loves to run and cook.  She loves trying to convert traditional recipes to healthier plant-based alternatives.  Her children are great critics. You can find her on Instagram @healthylivingwithdrjenn or on her website healthylivingwithdrjenn.com. And her practice is accepting patients in Vermont and Florida.

Season 2 | Episode 31 | August 3, 2022Jennifer Davis, MD, a critical care pediatrician, and a lifestyle medicine physician, is the guest on Medical Matters Weekly on Wednesday, August 3. Known as Dr. Jenn, Davis completed her undergraduate studies at Wellesley College where she majored in Philosophy. She earned her medical doctorate at New York Medical College and completed one year of General Surgery at Indiana University Medical Center before discovering a love of pediatrics. She completed a Pediatric Residency at Westchester Medical Center and fellowship training in Pediatric Critical Care at Montefiore Medical Center, both in New York.In addition, Davis earned a Plant-Based Nutrition Certificate at the T. Colin Campbell Center for Nutrition Studies and became board certified in Lifestyle Medicine. She enjoys cooking and running long-distance races.Medical Matters Weekly features the innovative personalities who drive positive change within health care and related professions. The show addresses all aspects of creating and maintaining a healthy lifestyle for all, including food and nutrition, housing, diversity and inclusion, groundbreaking medical care, exercise, mental health, the environment, research, and government. The show is produced with cooperation from Catamount Access Television (CAT-TV). Viewers can see Medical Matters Weekly on Facebook at facebook.com/svmedicalcenter and facebook.com/CATTVBennington. The show is also available to view or download a podcast on www.svhealthcare.org/medicalmatters.Underwriter: Mack Molding

Joseph Carcillo, MD, a physician scientist in Critical Care Medicine at UPMC Children's Hospital of Pittsburgh, discusses the intersection of precision medicine and pediatric critical care medicine research.

In this World Shared Practice Forum podcast, Dr. Akash Deep, Director of the Pediatric Intensive Care Unit, Staff Governor, and Professor in Pediatric Critical Care at King's College Hospital, discusses his recent publication on non-transplant options in pediatric acute liver failure. He describes important considerations for the management of acute liver failure and commonly associated toxicities, and offers insights into the paradigm shift currently evolving in the field and what we can expect in the trends of future treatment pathways. Upon listening to this presentation, learners should be able to: - Apply strategies for management of acutely ill children with acute liver failure - Describe various forms of toxicity commonly associated with acute liver failure Publication date: June 28, 2022. Articles Referenced: • Deep A, Nagakawa S, Tissieres P. Non-transplant options in paediatric acute liver failure-what is new?. Intensive Care Med. 2022;48(1):114-117. (00:49) • Habib M, Roberts LN, Patel RK, Wendon J, Bernal W, Arya R. Evidence of rebalanced coagulation in acute liver injury and acute liver failure as measured by thrombin generation. Liver Int. 2014;34(5):672-678. (7:03) • Slack AJ, Auzinger G, Willars C, et al. Ammonia clearance with haemofiltration in adults with liver disease. Liver Int. 2014;34(1):42-48. (13:27) • Hunt A, Tasker RC, Deep A. Neurocritical care monitoring of encephalopathic children with acute liver failure: A systematic review. Pediatr Transplant. 2019;23(7):e13556. (17:39) • Kochanek PM, Adelson PD, Rosario BL, et al. Comparison of Intracranial Pressure Measurements Before and After Hypertonic Saline or Mannitol Treatment in Children With Severe Traumatic Brain Injury. JAMA Netw Open. 2022;5(3):e220891. (19:51) Citation: Deep A, Daniel D, Burns JP. Non-transplant Options in Pediatric Acute Liver Failure. 6/2022. Online Podcast. OPENPediatrics. https://youtu.be/iSvZ26drzy0. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause.

In the hustle and bustle of 21st-century life in the U.S., pausing for a moment feels like a luxurious indulgence. However, pausing to reflect on the life of a child who has recently died is proving to be an effective coping moment for direct care staff involved. That's what PAUSE - sometimes referred to as "The Pause"- is all about. PAUSE is currently being piloted in the Delaware Pediatric Intensive Care Unit  (PICU), and we talk about its fundamentals with Pastor Patricia Weichart, LCSW Elizabeth Wood, and Dr. Mindy Dickerman, from both the Divisions of Pediatric Critical Care, Palliative Care


About our Guest:Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care and a practicing pediatric intensivist at the University of Florida. How to support PedsCrit:Please share, like, rate and review on Apple Podcasts or Spotify!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Objectives for this series:The participant will be able to discuss unique physiology of the neuromuscular patient and how it relates to work of breathingThe participant will be able to define obstacles to effective ventilation in patients with neuromuscular diseaseThe participant will be able to describe ventilation strategies to utilize in patients with neuromuscular diseaseFor a deeper dive on Disability Studies, check out Alice Wong's Disability Visibility Podcast: https://podcasts.apple.com/us/podcast/disability-visibility/id1282878324References1.Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177-89.2.Mercuri E, Finkel RS, Muntoni F, Wirth B, Montes J, Main M, et al. Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscul Disord. 2018;28(2):103-15.3.Finkel RS, Mercuri E, Meyer OH, Simonds AK, Schroth MK, Graham RJ, et al. Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscul Disord. 2018;28(3):197-207.4.Marino PL SK. The ICU Book. Wilkins LW, editor. Philadelphia: Lippincott Williams & Wilkins; 2007.5.Machado DL, Silva EC, Resende MB, Carvalho CR, Zanoteli E, Reed UC. Lung function monitoring in patients with duchenne muscular dystrophy on steroid therapy. BMC Res Notes. 2012;5:435.6.Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: "Children are not small adults!". Open Inflamm J. 2011;4:4-15.7.Lo Mauro A, Aliverti A. Physiology of respiratory disturbances in muscular dystrophies. Breathe (Sheff). 2016;12(4):318-27.8.Diaz CE, Deoras KS, Allen JL. Chest wall motion before and during mechanical ventilation in children with neuromuscular disease. Pediatr Pulmonol. 1993;16(2):89-95.9.Perez A, Mulot R, Vardon G, Barois A, Gallego J. Thoracoabdominal pattern of breathing in neuromuscular disorders. Chest. 1996;110(2):454-61.10.Testa MB, Pavone M, Bertini E, Petrone A, Pagani M, Cutrera R. Sleep-disordered breathing in spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2005;84(9):666-70.11.Aboussouan LS. Sleep-disordered Breathing in Neuromuscular Disease. Am J Respir Crit Care Med. 2015;191(9):979-89.12.Hull J, Aniapravan R, Chan E, Chatwin M, Forton J, Gallagher J, et al. British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax. 2012;67 Suppl 1:i1-40.13.Mayer O PH, Rhodes H, Dominick C, Wolfe H,  Martin K, Craig N,  Waxler M. . PICU Pathway for SMA Patient Admitted with Acute Respiratory Failure https://www.chop.edu/clinical-pathway/spinal-muscular-atrophy-sma-acute-respiratory-failure-clinical-pathway201914.Petrone A, Pavone M, Testa MB, Petreschi F, Bertini E, Cutrera R. Noninvasive ventilation in children with spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2007;86(3)Support the show

I'm super excited for you all to hear this highly educated, but so humble provider. Dr. Lisa discussed how practicing in Jamaica is so different than in the States. She mentioned that life can be tough, but we are tougher. Tune into Motivate with KO as she encourages us not to quit, but keep pressing. Dr. Lisa is an assistant professor of pediatrics in the department of Pediatric Critical Care at the University of Mississippi Medical Center. Dr. Lisa also is Medical Director of Pediatric services here at NMMC.
She's Jamaican and went to medical school at University of the West Indies, Mona in Jamaica and then worked as a pediatric Hospitalist in the Bahamas for 4yrs. From there she went to Wayne State University/Children's Hospital of Michigan to do residency and then University of Miami/Holtz Children's Hospital for my fellowship in Pediatric Critical Care. She has lived in Tupelo for the last 5 years with my Husband and two children.

Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists. I'm Pradip Kamat and I'm Kate Phelps, a second-year pediatric critical care fellow joining Pradip and Rahul today! I'm Rahul Damania and we are coming to you from Children's Healthcare of Atlanta - Emory University School of Medicine. Today we are honored to have Dr. John Berkenbosch- senior author of the Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients with consideration of the ICU Environment and Early Mobility (PANDEM) guidelines recently published in February 2022 issue of the Pediatric Critical Care journal. Dr. Berkenbosch is a Professor of Pediatrics and Pediatric Critical Care at the University of Louisville School of Medicine, and continues to be nationally recognized as an expert in pediatric procedural sedation with multiple publications relating to sedation practices, particularly novel uses of procedural sedation medications and regimens. He currently also serves as co-chair for the American College of Critical Care Medicine's Task Force guidelines for sedation and analgesia in critically ill children which we will be discussing in today's episode. Dr. Berkenbosch's research interests have primarily focused on pediatric procedural sedation and implementation of technology advances in Pediatric Critical Care and have resulted in 57 publications as well as several book chapters Rahul: Dr. Berkenbosch welcome to the PICU Doc ON call podcast. I would also like to point out that the free full access to the PANDEM guidelines is available online athttp://pccmjournal.org ( pccmjournal.org) Dr. Berkenbosch: Thanks Rahul and Pradip. I am excited to be on the PICU Doc on Call Podcast to discuss the PANDEM guidelines. I want to first start by giving a huge shout-out to all the team members who contributed to these guidelines' development. This is a topic about which I am quite passionate but also one that provides much-needed guidance regarding pain/agitation/delirium to our entire pediatric critical care community! KATE: Dr. Berkenbosch, the rationale for the development of the PANDEM guidelines was the high variability in pediatric sedation and analgesia. Can you speak to this variability and why it was important to address that variability? That is a great question, the variability has been one of the key motivators in the creation of these guidelines. We also wanted to develop a guideline that was broader in scope than what was currently available. The ICU Liberation bundle provided a paradigm for liberating critically ill patients from mechanical ventilation and the ICU environment and as we delved into developing these guidelines, we realized that many elements of the ICU liberation bundle aligned very closely with PICU sedation and analgesia so it made imminent sense to incorporate all of these topics into the guidelines, an acknowledgment if you will, that PICU liberation & sedation go hand in hand! Absolutely, as we have stated in our prior episodes, the paradigm is: intubate → ventilate → liberate, and sedation/analgesia is intertwined in each of these processes. Dr. Berkenbosch, as we get into the guidelines, can you please highlight how the search strategy for these guidelines were derived? Of course, this was a remarkable group effort solicited by the Society of Critical Care Medicine. We were initially modeled after the adult PAD (pain, agitation, and delirium) guidelines task force but, as described already, extended beyond that to include Pediatric Pain, Agitation, Neuromuscular Blockade, and Delirium in addition to the PICU Environment and Early Mobility. It was comprised of 29 national experts who collaborated over a ten-year period. The full task force gathered annually in person during the Society of Critical Care Medicine Congress for progress reports and further strategizing with the final face-to-face meeting occurring in...

Ventilation of the Neuromuscular Patient with Dr. Bill Bortcosh--Part 1: physiology and noninvasive ventilationAbout our Guest:Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care and a practicing pediatric intensivist at the University of Florida. How to support PedsCrit:Please share, like, rate and review on Apple Podcasts or Spotify!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Objectives for this series:The participant will be able to discuss unique physiology of the neuromuscular patient and how it relates to work of breathingThe participant will be able to define obstacles to effective ventilation in patients with neuromuscular diseaseThe participant will be able to describe ventilation strategies to utilize in patients with neuromuscular diseaseReferences1.Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177-89.2.Mercuri E, Finkel RS, Muntoni F, Wirth B, Montes J, Main M, et al. Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscul Disord. 2018;28(2):103-15.3.Finkel RS, Mercuri E, Meyer OH, Simonds AK, Schroth MK, Graham RJ, et al. Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscul Disord. 2018;28(3):197-207.4.Marino PL SK. The ICU Book. Wilkins LW, editor. Philadelphia: Lippincott Williams & Wilkins; 2007.5.Machado DL, Silva EC, Resende MB, Carvalho CR, Zanoteli E, Reed UC. Lung function monitoring in patients with duchenne muscular dystrophy on steroid therapy. BMC Res Notes. 2012;5:435.6.Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: "Children are not small adults!". Open Inflamm J. 2011;4:4-15.7.Lo Mauro A, Aliverti A. Physiology of respiratory disturbances in muscular dystrophies. Breathe (Sheff). 2016;12(4):318-27.8.Diaz CE, Deoras KS, Allen JL. Chest wall motion before and during mechanical ventilation in children with neuromuscular disease. Pediatr Pulmonol. 1993;16(2):89-95.9.Perez A, Mulot R, Vardon G, Barois A, Gallego J. Thoracoabdominal pattern of breathing in neuromuscular disorders. Chest. 1996;110(2):454-61.10.Testa MB, Pavone M, Bertini E, Petrone A, Pagani M, Cutrera R. Sleep-disordered breathing in spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2005;84(9):666-70.11.Aboussouan LS. Sleep-disordered Breathing in Neuromuscular Disease. Am J Respir Crit Care Med. 2015;191(9):979-89.12.Hull J, Aniapravan R, Chan E, Chatwin M, Forton J, Gallagher J, et al. British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax. 2012;67 Suppl 1:i1-40.13.Mayer O PH, Rhodes H, Dominick C, Wolfe H,  Martin K, Craig N,  Waxler M. . PICU Pathway for SMA Patient Admitted with Acute Respiratory Failure https://www.chop.edu/clinical-pathway/spinal-muscular-atrophy-sma-acute-respiratory-failure-clinical-pathway2019 [updated Feb 2019.]14.Petrone A, Pavone M, Testa MB, Petreschi F, Bertini E, Cutrera R. Noninvasive ventilation in children with spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2007;86(3):216-21.Support the show