POPULARITY
16 episodes with pediatric icu
10 episodes with pediatric icu
6 episodes with pediatric icu
5 episodes with pediatric icu
2 episodes with pediatric icu
2 episodes with pediatric icu
3 episodes with pediatric icu
3 episodes with pediatric icu
2 episodes with pediatric icu
In this episode of Compassion and Courage, host Marcus Engel speaks with nurse Hannah Fowler about her journey into nursing, the realities of bedside care, and the importance of compassion in healthcare. Hannah shares her personal experiences as a patient and how they shaped her approach to nursing. She discusses her work in pediatric nursing, the challenges and joys of caring for children, and her involvement with Victory Junction, a camp for kids with chronic illnesses. The conversation emphasizes the significance of building relationships with patients and their families, and the profound impact of compassionate care. Resources for you: More communication tips and resources for how to cultivate compassion: https://marcusengel.com/freeresources/Connect with Marcus on LinkedIn: https://www.linkedin.com/in/marcusengel/Learn more about Victory Junction: https://victoryjunction.orgLearn more about Marcus' Books: https://marcusengel.com/store/Subscribe to our podcast through Apple: https://bit.ly/MarcusEngelPodcastSubscribe to our podcast through YouTube: https://bit.ly/Youtube-MarcusEngelPodcast More about Hannah Fowler, RN:I am Hannah Fowler. I have been a registered nurse for almost 3 years! I work in a Pediatric ICU as well as a pediatric doctor's office. I also love spending time a Victory Junction, a camp for children with chronic illnesses! Date: 6/2/2025 Name of show: Compassion & Courage: Conversations in Healthcare Episode number and title: Episode 169 – The Heart of Nursing – With Hannah Fowler, RNkeywordsnursing, compassion, healthcare, pediatric nursing, patient care, personal stories, resilience, Victory Junction, healthcare communication, nursing journey
About our Guest: Dr. Omar Alibrahim is a professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. He completed his Pediatric Residency and Chief Residency at St. Joseph's Children's Hospital, followed by Pediatric Critical Care Fellowship at the University of Buffalo. He served as the Pediatric Critical Care Division chief, the PICU Medical Director, and the PCCM fellowship Director in Buffalo, NY, for more than 8 years, during which he worked with the pulmonology and respiratory therapy divisions to develop a negative pressure ventilation program for acute respiratory failure. In 2021 Dr. Alibrahim was recruited to Duke Children's Hospital and now serves as the PICU Medical Director and the program director for the Pediatric Critical Care Fellowship. Learning Objectives: By the end of this podcast series, listeners should be able to: Critique the physiologic rationale for negative pressure ventilation (NPV) in acute respiratory failure.Understand the experience of introducing a novel form of respiratory support in a PICU.Describe the stepwise escalation of NPV settings often used in acute respiratory failure.References:Derusso, M., Miller, A. G., Caccamise, M., & Alibrahim, O. (2024). Negative-Pressure Ventilation in the Pediatric ICU. Respiratory Care, 69(3), 354–365. https://doi.org/10.4187/RESPCARE.11193Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS. Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2017 Dec;62(12):1540-1549. doi: 10.4187/respcare.05531. Epub 2017 Aug 31. PMID: 28860332.Deshpande SR, Maher KO. Long term negative pressure ventilation: Rescue for the failing fontan? World J Cardiol. 2014 Aug 26;6(8):861-4. doi: 10.4330/wjc.v6.i8.861. PMID: 25228965; PMCID: PMC4163715.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.
About our Guest: Dr. Omar Alibrahim is a professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. He completed his Pediatric Residency and Chief Residency at St. Joseph's Children's Hospital, followed by Pediatric Critical Care Fellowship at the University of Buffalo. He served as the Pediatric Critical Care Division chief, the PICU Medical Director, and the PCCM fellowship Director in Buffalo, NY, for more than 8 years, during which he worked with the pulmonology and respiratory therapy divisions to develop a negative pressure ventilation program for acute respiratory failure. In 2021 Dr. Alibrahim was recruited to Duke Children's Hospital and now serves as the PICU Medical Director and the program director for the Pediatric Critical Care Fellowship. Learning Objectives: By the end of this podcast series, listeners should be able to: Critique the physiologic rationale for negative pressure ventilation (NPV) in acute respiratory failure.Understand the experience of introducing a novel form of respiratory support in a PICU.Describe the stepwise escalation of NPV settings often used in acute respiratory failure.References:Derusso, M., Miller, A. G., Caccamise, M., & Alibrahim, O. (2024). Negative-Pressure Ventilation in the Pediatric ICU. Respiratory Care, 69(3), 354–365. https://doi.org/10.4187/RESPCARE.11193Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS. Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2017 Dec;62(12):1540-1549. doi: 10.4187/respcare.05531. Epub 2017 Aug 31. PMID: 28860332.Deshpande SR, Maher KO. Long term negative pressure ventilation: Rescue for the failing fontan? World J Cardiol. 2014 Aug 26;6(8):861-4. doi: 10.4330/wjc.v6.i8.861. PMID: 25228965; PMCID: PMC4163715.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.
No parent ever wants to end up in the Pediatric ICU; but we know it happens and we want you to be informed and know what to expect. I invited my social media friend and Pediatric Critical Care Doctor, Dr. Anita Patel on the show to chat about the Pediatric ICU and what to expect. We discuss: The common reasons children end up in the Pediatric ICU and what to expect The questions to ask your care team in the ICU How we manage health anxiety as a pediatric ICU doctor and general pediatrician To connect with Dr. Anita Patel follow her on Instagram @anitakpatelmd and check out all her resources on https://linktr.ee/anitakpatelmd. 00:00 Introduction & Why This Conversation Matters 02:00 Meet Dr. Anita Patel 04:10 Common Reasons for Pediatric ICU Admissions 10:46 What Happens Inside the PICU? 14:23 Navigating the ICU Experience as a Parent 20:27 Key Questions Parents Should Ask the Care Team 24:46 The Emotional Toll on Parents & Doctors 31:14 Balancing Medical Knowledge with Parenting Anxiety 35:16 Final Thoughts & Words of Encouragement 37:59 Where to Follow Dr. Anita Patel & Closing Remarks We'd like to know who is listening! Please fill out our Listener Survey to help us improve the show and learn about you! Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website. Learn more about your ad choices. Visit megaphone.fm/adchoices
No parent ever wants to end up in the Pediatric ICU; but we know it happens and we want you to be informed and know what to expect. I invited my social media friend and Pediatric Critical Care Doctor, Dr. Anita Patel on the show to chat about the Pediatric ICU and what to expect. We discuss: The common reasons children end up in the Pediatric ICU and what to expect The questions to ask your care team in the ICU How we manage health anxiety as a pediatric ICU doctor and general pediatrician To connect with Dr. Anita Patel follow her on Instagram @anitakpatelmd and check out all her resources on https://linktr.ee/anitakpatelmd. 00:00 Introduction & Why This Conversation Matters 02:00 Meet Dr. Anita Patel 04:10 Common Reasons for Pediatric ICU Admissions 10:46 What Happens Inside the PICU? 14:23 Navigating the ICU Experience as a Parent 20:27 Key Questions Parents Should Ask the Care Team 24:46 The Emotional Toll on Parents & Doctors 31:14 Balancing Medical Knowledge with Parenting Anxiety 35:16 Final Thoughts & Words of Encouragement 37:59 Where to Follow Dr. Anita Patel & Closing Remarks We'd like to know who is listening! Please fill out our Listener Survey to help us improve the show and learn about you! Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website. Learn more about your ad choices. Visit megaphone.fm/adchoices
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.
In this episode of Life Sciences 360, host Harsh Thakkar sits down with Marc Sheetz, Associate Dean of Research at Midwestern University's College of Pharmacy, to discuss the growing concern of antimicrobial resistance and the field of pharmacometrics. Marc sheds light on how pharmacometrics is shaping the future of medicine by using predictive models to personalize dosing, making drug treatments more effective while reducing toxicity. This episode dives deep into the intersection of pharmacometrics, AI, and machine learning, revealing how the future of patient care and treatment is rapidly evolving. Marc also shares insights from his current research in the infectious disease space, including his work with pediatric ICU patients.Chapters:00:00 Introduction00:03 Antibiotic Toxicity and Population Models01:02 The Importance of Antibiotics and Public Health Challenges01:22 Introduction to Pharmacometric Science03:12 Using Data in Medicine for Future Predictions06:01 Tailoring Drug Dosages for Individuals09:36 The Global Variation in Drug Dosages and Challenges14:44 The Future of Personalized Medicine and Precision Dosing21:39 The Intersection of AI, Machine Learning, and Pharmacometrics26:35 The Role of Technology in Medicine30:01 How Dosing Software and AI Are Enhancing Patient Care36:54 Innovation and Research Trends in Medicine- Connect with Marc Sheetz on Twitter: (https://twitter.com/IDPharmacometrics) - Learn more about Midwestern University: (https://www.midwestern.edu) - Follow Life Sciences 360 on LinkedIn (https://www.linkedin.com/company/life-sciences-360)--- Subscribe to our podcast for more insights on life sciences:
Host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, is joined by Michael C. McCrory, MD, MS, FCCM, to discuss a multicenter retrospective study evaluating the impact of neighborhood, as categorized by the Child Opportunity Index, on pediatric intensive care unit (PICU) outcomes such as mortality, illness severity, and PICU length of stay. The study highlights the disparities in PICU admissions based on socioeconomic factors (McCrory MC, et al. Pediatr Crit Care Med. 2024 Apr;25:323-334). Michael C. McCrory, MD, MS, FCCM, is an associate professor in the departments of Anesthesiology and Pediatrics at Wake Forest University School of Medicine in Winston-Salem, North Carolina.
IntroductionWelcome to PICU Doc On Call, a podcast dedicated to current and aspiring pediatric intensivists. I'm Dr. Pradip Kamat from Children's Healthcare of Atlanta/Emory University School of Medicine, and I'm Dr. Rahul Damania from Cleveland Clinic Children's Hospital. We are two Pediatric ICU physicians passionate about medical education in the PICU. This podcast focuses on interesting PICU cases and their management in the acute care pediatric setting.Episode OverviewIn today's episode, we are excited to welcome Dr. Karen Zimowski, Assistant Professor of Pediatrics at Emory University School of Medicine and a practicing pediatric hematologist at Children's Healthcare of Atlanta at the Aflac Blood & Cancer Center. Dr. Zimowski specializes in pediatric bleeding and clotting disorders.Case PresentationA 16-year-old female with a complex medical history, including autoimmune thyroiditis and prior cerebral infarcts, was admitted to the PICU with acute chest pain and difficulty breathing. Despite being on low-dose aspirin, her oxygen saturation was 86% on room air. A CT angiography revealed a pulmonary embolism (PE) in the left lower lobe and signs of right heart strain. The patient was hemodynamically stable, and thrombolytic therapy was deferred in favor of anticoagulation. She was placed on BiPAP to improve her respiratory status. Her social history was negative for smoking, illicit drug use, or oral contraceptive use.Key Case PointsDiagnosis: Pulmonary embolism (PE)Hemodynamics: Stable with no right ventricular (RV) strain on echocardiogramManagement Focus: Anticoagulation and consultation with the hematology/thrombosis teamExpert Discussion with Dr. Karen ZimowskiRisk Factors and Epidemiology of VTE in PediatricsPathophysiology: Venous thromboembolism (VTE) in children involves components of Virchow's triad: stasis of blood flow, endothelial injury, and hypercoagulability.Incidence: VTE is rare in the general pediatric population but increases significantly in hospitalized children.Age Distribution: Bimodal peaks in infants and adolescents aged 15-17 years.Risk Factors: Central venous lines, infections, congenital heart disease, cancer, and autoimmune disorders.Clinical Manifestations of DVTSymptoms: Swelling, pain, warmth, and skin discoloration in the affected extremity.Specific Presentations:SVC syndrome from superior vena cava thrombosisAbdominal pain from portal vein thrombosisHematuria from renal vein thrombosisNeurological symptoms...
When a couple finds themselves aligned in values and begins to take care of themselves, often they're in the position to fulfill dreams and callings in a gorgeous new way. Today we get to talk to Raeanne Newquist who, along with her husband, left a predictable and safe life for a glorious adventure on Mercy Ships, where she and her family got to help save the lives of thousands who get free and life-saving surgeries that will both help them to live as well as prevent them from being ostracized in their communities. Today we get to talk about how Raeanne and her family climbed heights together to find their dreams, as well as to learn about the inspiring outreach of Mercy Ships, endorsed over the last forty years by global leadership, including Nelson Mandela, Tony Blair, and many US leaders as well. Join us as we chat about ways you too can launch to make life changes happen across your part of the world! Watch on YouTube: https://youtu.be/truqwhKM4iM Show Links: Hop aboard by giving, going, or praying for Mercy Ships and the crew! www.MercyShips.com Listen to New Mercies, Raeanne's pod! https://open.spotify.com/show/0f1ocgAAOg6kRNC3xJ1gvy?si=152b5d678cea4279 More info about today's guest plus ways you can help with Mercy Ships amazing mission!! Raeanne, her husband, and 3 children joined Mercy Ships in 2019. After leaving everything behind in Southern California, they boarded the Africa Mercy in Las Palmas and made their first sail down to Dakar, Senegal for their first field service. On board, Raeanne volunteered in the communications department and later in chaplaincy. Currently, Raeanne works in the Mercy Ships U.S. Marketing department. Raeanne is the host of the New Mercies podcast, is the voice of the Mercy Minute daily radio broadcast and serves as a staff writer. Volunteer Each year, more than 3,000 volunteer professionals from over 60 countries serve on board, including surgeons, dentists, nurses, teachers, cooks, engineers, and others who dedicate their time and skills to accelerate access to safe surgical, obstetric and anesthetic care. With the recent addition of the Global Mercy in the last few years, the need for volunteers has increased with immediate needs in Senior Biomed Technician, OR Clinical Supervisor, PACU Nurse + Team Lead, OR Nurse + Team Lead, Ward Nurse in the Adult, Adult ICU, Pediatric, + Pediatric ICU departments, Senior Infection Preventionist, and Wound Care Team Nurse. Volunteer commitments range from 2 weeks to 2+ years. Learn More: mercyships.org/serve Facebook Instagram X YouTube Dive deeper into your pairing and Enneagram & Marriage love!
Sirens, Slammers and Service - A podcast for Female First Responders
Send us a Text Message.Join us for an awe-inspiring episode of Sirens, Slammers, and Service as we sit down with the incredible Taylor Sullivan, a dedicated Registered Nurse working in the Pediatric ICU and a heroic flight transport nurse for pediatric patients. Taylor shares her compelling journey of providing life-saving care to children across western Canada, navigating challenging rescues, and ensuring her young patients receive the emergency treatment they desperately need.In this heartwarming and at times heart-wrenching episode, Taylor recounts some of her most memorable rescues, from remote northern extractions to high-stakes in-air emergencies and the challenges that arise working in a very small aircraft with limited space and room.Taylor also opens up about the emotional toll of her work, discussing the heartbreaking losses that can come with the job and the profound impact they leave on her. She shares her personal strategies for coping with these challenges, offering insights into the resilience and compassion that drive her every day.Tune in to hear Taylor's extraordinary stories of bravery, compassion, and unwavering dedication to saving young lives. This episode is a tribute to the strength and spirit of healthcare professionals who go above and beyond the call of duty.Don't miss this episode of Sirens, Slammers, and Service – available now on all major podcast platforms.
Dr. Jordan has over 12 years of experience caring for children, training the next generation of PNPs, and conducting research in pediatric injury. He is an Assistant Professor and Coordinator of the Acute Care PNP Track at the UAB School of Nursing and a practicing PNP in the Pediatric ICU at Children's of Alabama.Alexandra Armstrong is an Acute Care Pediatric Nurse Practitioner with over 10 years of experience working at Children's of Alabama in the inpatient and outpatient setting. She is a full-time instructor at the UAB School of Nursing. She is a current PhD student studying medically complex children in foster care, and a foster parent for Jefferson Country DHR. She has an interest in vulnerable and at-risk youth as well as youth with special health care needs.
Nurses Out Loud with Nurse Michele, RN – Mary is among the treasure of nurses with decades of experience who did their research and concluded the mantra of ‘safe and effective' did not outweigh the potential risks of the ‘mandated' EUA product being imposed upon the staff of her Georgia hospital. The Pediatric ICU, housing its fragile patients and parents who look to wise, experienced medical professionals, lost a...
Nurses Out Loud with Nurse Michele, RN – Mary is among the treasure of nurses with decades of experience who did their research and concluded the mantra of ‘safe and effective' did not outweigh the potential risks of the ‘mandated' EUA product being imposed upon the staff of her Georgia hospital. The Pediatric ICU, housing its fragile patients and parents who look to wise, experienced medical professionals, lost a...
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.
This week I had an informative and fun conversation about money with my guest, nurse, and finance coach, April Waddell. Yes, you heard me right, I said fun. Talking about money can create anxiety in some and I'm no different but April's positive and hopeful spirit helped me keep calm and carry on.After retiring from her work as a Pediatric ICU nurse, April founded Nurse Money Date, a financial coaching business and you'll love hearing the reason behind the name. I never considered seeking out a fellow nurse for financial advice but this may have been a mistake because April helps nurses feel comfortable with money through leveraging their experience in nursing and by using language they understand: the nursing process. And this is genius.April's goal is to uplift nurses financially so they can stay in the profession they love and feel in control of the work they do. In the five-minute snippet: it's a 1970s disco flashback. LinkedInApril's websiteApril's InstagramApril's FacebookMoney Personality QuizContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comGive me feedback! Leave me a review! https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast Email: theconversingnursepodcast@gmail.comThank you and I'll see you soon!
In today's episode of Talent Hub Talk, we're joined by Eduardo Ferrao. Eduardo is a Senior Salesforce Healthcare Consultant and has an incredible story from working as a Pediatric ICU Nurse to transitioning into systems and now delivering Salesforce Health Cloud transformations. It was fascinating to hear more about Eduardo and his journey and how he is able to make a difference in the healthcare space. Throughout the episode, Eduardo highlights the importance of soft skills and how his nursing background has been valuable in his consulting role. He explains the potential use cases for Health Cloud in healthcare and the complexities of healthcare projects. The conversation with Eduardo covers the challenges of displaying correct information in digital solutions, the stress and potential adverse outcomes in healthcare, and Eduardo's journey and ability to add value in a different career. Make sure you're following Eduardo on LinkedIn here, and we hope you enjoy the chat! https://www.linkedin.com/in/eduardo-ferrão-08050123b/ Episode takeaways: Transitioning to a new career is possible by leveraging existing knowledge and skills. Soft skills, such as communication, critical thinking, and adaptability, are transferable and valuable in different industries. Healthcare projects have unique complexities due to the industry's digital maturity, regulatory requirements, and specific integration protocols. Domain knowledge and understanding the language and requirements of healthcare are crucial for successful project implementation. Perspective is gained by comparing the stress and challenges of different roles, putting things into context. Displaying correct information in digital solutions is crucial, especially in healthcare where adverse outcomes can occur if the wrong information is presented. Eduardo Ferrao's journey showcases the ability to transition to a different career while still adding value in the health space. The conversation highlights the importance of sharing stories and experiences to inspire and educate others. Follow us: LinkedIn@ https://www.linkedin.com/company/talent-hub-global/ YouTube@ https://www.youtube.com/@talenthub1140 Facebook@ https://www.facebook.com/TalentHubGlobal/ Instagram @ https://www.instagram.com/talenthubglobal/ Twitter X @ https://twitter.com/TalentHubGlobal
Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children's. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.Recognize common risk factors of post-intensive care syndrome in children.Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.Recall key next steps in post-intensive care syndrome research.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.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.References:Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476 https://www.palisi.org/ Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. doi: 10.1111/pan.14460. Epub 2022 Apr 22. PMID: 35426458; PMCID: PMC9990726.Support the show
Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children's. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.Recognize common risk factors of post-intensive care syndrome in children.Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.Recall key next steps in post-intensive care syndrome research.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.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.References:Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476 https://www.palisi.org/ Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. doi: 10.1111/pan.14460. Epub 2022 Apr 22. PMID: 35426458; PMCID: PMC9990726.Support the show
Does this sound familiar? You're facing personal crises that are wreaking havoc on your well-being and your business. You've been told to tough it out and push through, but deep down, you know that approach isn't working. The pain of trying to handle it all alone is taking a toll on your mental and emotional health, leaving you feeling overwhelmed and burnt out. It's time to acknowledge the importance of seeking support during these difficult times and discover how it can empower you to navigate personal crises while maintaining success in your business. Meet Kristin: Kristin Bentley is the founder and CEO of Elisely Publishing, a boutique traditional publishing house that launches changemakers with bold, uninhibited stories into bestselling authors. She is also an award-winning USA Today bestselling author and International Books for Peace Ambassador who has been in the writing industry for over 20 years. Her background includes experience as a journalist, recognition as the award-winning Editor-in-Chief of the National Infantry Association's official magazine, a nonprofit founder that supported women of the military in the Pacific Northwest, a creative executive for a startup that provided services to companies such as Hilton and US Foods, and the creative director behind the creation and launch of six successful global publications—one distributed to nominees of the 2021 Oscars & Grammys. Connect with Kristin: https://www.elisely.com/ hello@elisely.com
In this episode of PICU Doc On Call, your hosts Pradip Kamat and Rahul Damania, experienced Pediatric ICU physicians, take you on an enlightening journey through the intricate landscape of lactic acidosis. Join us as we unravel the complexities, share clinical insights, and provide practical guidance on diagnosing and managing this critical condition in the acute care pediatric setting.You will hear:Case Presentation:4-year-old boy with hypotension, fatigue, rash, and respiratory distressRecent COVID-19 exposure, concerning respiratory symptomsHypotensive, tachycardic, tachypneic, low pulse oximetry readingSwollen red lips, erythematous rash, hepatomegalyHigh-flow nasal cannula, resuscitation, epinephrine infusionInitial arterial blood gas: pH 7.22, lactate 4.5 mMol/LDefinition of Lactic Acidosis:Hyperlactatemia and lactic acidosis criteriaCauses: impaired tissue oxygenation or mitochondrial dysfunctionTypes of Lactic Acidosis:Type A: Impaired O2 delivery, shock-relatedType B: Impaired O2 utilization, toxins, infectionsLactate Measurement:Comparability between POCT and central lab analysisRole of lactate measurement in pediatric sepsisLactic Washout:Rising lactate with re-established oxygen deliveryImpaired clearance in microcirculation, liver, kidneyMonitoring trends with clinical exams and lab surrogatesBicarbonate Therapy:Role in Type A lactic acidosisControversy, indications, and potential complicationsConclusion:PICU Doc On Call podcast explores the intriguing case of a 4-year-old boy with lactic acidosis, highlighting the clinical intricacies of diagnosing and managing this condition. The hosts, Pradip Kamat and Rahul Damania provide insightful discussions on the different types of lactic acidosis, the physiological mechanisms behind it, and the role of bicarbonate therapy. The episode emphasizes the importance of addressing underlying causes and offers valuable clinical pearls for managing pediatric patients with lactic acidosis.Stay tuned for more engaging episodes from PICU Doc On Call! Don't forget to subscribe, share your feedback, and review the podcast on your preferred platform. For more information and resources, visit picudoconcall.org.
Each week, I usually find one main takeaway point from the podcast episode. After talking with Chris though, I learned two key things. As much as I tried to get it down to one point, I couldn't leave one out. They were both equally important. The first lesson Chris learned many years before she even had Becca, she was in the Pediatric ICU with one of the cardiac children that her family fostered from Korea. While there, Chris witnessed a family with a perfectly healthy child who went in for what was supposed to be a very simple medical procedure that resulted in many complications eventually leading to severe, irreversible brain damage. As Chris sat witnessing this horror, she found herself asking the question, 'Why?" As she pondered, Chris realized that she would never be able to answer that question and that it was not worth her time to even ask it. This was tremendously helpful to Chris later in life when raising many children with congenital heart disease, and even more so, after she lost her sweet daughter, Becca. The second lesson that Chris learned was much further into her grief journey. Chris found that in these last few years without Becca, she was becoming tired of her grief, and maybe even a little angry with grief. She felt like grief was her enemy, affecting her life negatively. She then had a profound thought. She had heard many people say over the years that grief is love. This definitely felt like a true statement. Certainly, the reason that she grieved her daughter so much was because of her overwhelming love for Becca. Chris thought, 'If grief is a manifestation of this love, then maybe grief misses Becca, too. Maybe grief shouldn't be my enemy. Maybe grief can be my friend.' What a life-changing realization. Now, the challenges that I am giving to myself are to: 1.) Stop asking 'why' all of this has happened to Andy and my family, and 2.) Think of my grief as a 'friend' to keep beside me, not an enemy to hold at bay.
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.In today's episode, we're bringing together some of the best content from our previous podcasts to present a comprehensive clinical case. We're also excited to share with you some of the most highly cited articles from the past year, presented in a practical, case-based format. This episode will offer you valuable insights into the latest research findings while also highlighting the real-world application of this knowledge in a clinical setting.We'll start by presenting an interesting case of a toddler who was transferred to the PICU due to increasing respiratory distress:A 2-year-old male was brought to the emergency department with a chief complaint of increased work of breathing and URI symptoms, including a cough and runny nose. The child had no significant past medical history, was not taking any medications, and had no known allergies. The child was up-to-date on immunizations, and there were no significant sick contacts.The family brought the child to the emergency department after noticing a significant increase in work of breathing, including the use of accessory muscles, nasal flaring, and chest retractions. The initial physical exam revealed tachypnea and decreased breath sounds on the right side. The child's vital signs were concerning for respiratory distress, with a heart rate of 170 beats per minute, respiratory rate of 50 breaths per minute, and oxygen saturation of 85% on room air. Chest X-ray revealed right lower lobe pneumonia.The child was started on supplemental oxygen, and broad-spectrum antibiotics, and trialed with albuterol. Despite initial treatment, the child's respiratory distress worsened, and the decision was made to transfer the child to the PICU and place the patient on HFNC 1.5 L/kg. Upon admission to the PICU, the child's vital signs were still concerning, he was afebrile, with a heart rate of 180 beats per minute, respiratory rate of 60 breaths per minute, and oxygen saturation of 85% on 1.5L/kg HFNC at 75% FiO2. Given the persistent respiratory distress, the decision was made to intubate the child in the PICU for acute hypoxemic respiratory failure. Shortly after intubation, a central line is placed in the R internal jugular vein.To summarize key elements from this case:2-year-old with a prodrome of URI symptomsIs otherwise previously healthy with no significant medical history or allergiesDeveloped respiratory distress and diagnosed with pneumoniaTransferred to PICU, intubated for respiratory failureLet's fast forward in the case and talk about a scenario that frequently arises in the PICU. It's hospital day 2, and the patient's RSV swab is positive, and we're seeing some improvement on the X-ray....
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. I'm Rahul Damania from Cleveland Clinic Children's Hospital and 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.Today, we are going to discuss the management of the postoperative patient admitted to the PICU. Our discussion will focus on the non-cardiac and non-transplant admission. Our objective in this episode is to create a framework on what areas of care to focus on when you have a patient admitted to the PICU post-operatively. Each surgery and patient is unique; however, we hope that you will garner a few pearls in this discussion so you can be proactive.in your management. Without any further delay, let's get started with today's case:We begin with a 13-year-old child, Alexa, with h/o of a genetic syndrome, who presents today with a history of thoracolumbar kyphoscoliosis. Over the years, Alexa's curvature has progressively worsened, resulting in difficulty breathing and chronic back pain. The decision was made to proceed with a complex spinal surgery, including posterior spinal fusion and instrumentation.In the weeks leading up to the surgery, Alexa underwent a thorough preoperative evaluation, including consultations with specialists and relevant imaging studies. Pulmonary function tests revealed a restrictive lung pattern, while the echocardiogram showed no significant cardiac abnormalities. Preoperative labs, including CBC, electrolytes, and coagulation profile, were within normal limits.During the surgery, Alexa was closely monitored by the anesthesia team, who administered general anesthesia with endotracheal intubation. The surgery was performed by the pediatric neurosurgery and orthopedics, with intra-operative neuromonitoring to assess spinal cord function. The surgical team encountered an unexpected dural tear, which was repaired using sutures and a dural graft. Due to the prolonged surgical time, a temporary intra-operative loss of somatosensory evoked potentials was noted. However, signals were restored after adjusting the patient's position and optimizing blood pressure. The posterior spinal fusion and instrumentation were completed successfully, but the surgery lasted 8 hours. Total intra-operative blood loss was 800 mL, and Alex received 2 units of packed red blood cells and was on NE for a little over half the case before weaning off.Alexa was admitted to the PICU intubated and sedated for postoperative care. The initial assessment showed stable vital signs, with a systolic blood pressure of 100 mmHg, heart rate of 90 bpm, and oxygen saturation of 99% on mechanical ventilation. Postoperative pain was managed with a continuous morphine infusion. The surgical team placed a closed suction drain near the surgical site and a Foley catheter for urinary output monitoring. You are now at the bedside for OR to PICU handoff…To summarize key components from this case:This is a patient with thoracolumbar kyphoscoliosis, underwent complex spinal surgery (posterior spinal fusion and instrumentation) due to progressive curvature, breathing difficulties, and chronic pain.
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.Here's the case of a 12-week-old girl old who is limp and seizing presented by Rahul.Chief Complaint: A 12-week-old previously healthy female infant was found limp in her crib and developed generalized tonic-clonic seizures on the way to the hospital.History of Present Illness: The mother returned from work on a Saturday to find her daughter unresponsive in her crib. The infant had been left in the care of her mother's boyfriend, who stated that the daughter had been sleeping all day and had a small spit up. As the patient continued to have low appetite throughout the day and continued to be unresponsive in her crib, mother called EMS to bring her to the emergency department. En route, the patient had tonic movement that did not resolve with intranasal benzodiazepines.ED Course: The infant presents to the ED being masked. Upon arrival at the ED, the infant was in respiratory distress, with a heart rate of 190 beats per minute, respiratory rate of 50 breaths per minute, and oxygen saturation of 85% with bagging. She was intubated for seizure control upon arrival at the ED. Physical examination in the ED revealed bruising on the right neck region but was otherwise unremarkable. A non-contrast head CT showed no acute intracranial abnormalities. The initial diagnostic workup revealed normal CBC, mildly elevated hepatic enzymes, and pancreatic enzymes which were within normal limits. The blood gas showed metabolic acidemia with PCO2 in the 60s.Admission to PICU: Upon admission to the PICU, neurosurgery and trauma teams were consulted. A skeletal survey and ophthalmology consult for a fundoscopic examination were ordered, as there were concerns of non-accidental trauma. Further investigation is underway to determine the cause of the infant's condition.To summarize key elements from this case, this patient has:Patient left with mother's boyfriendInfant found limp and had seizures requiring intubationNeck bruiseAll of these bring up a concern for Non-Accidental Trauma (NAT) the topic of our discussion.Let's start with a short multiple-choice question:Which imaging modality is the most appropriate for establishing a diagnosis of abusive head trauma (AHT) in a 12-week-old infant with an open fontanelle on the exam?A. CT scan of the brain without contrast B. MRI of the brain without contrast C. Skull X-ray D. Doppler ultrasound of the headRahul, the correct answer is A. Though
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 about a 14-year-old male who collapsed on the baseball field.Here's the case presented by Rahul:A 14-year-old male athlete was playing in a high school baseball tournament when he was hit in the chest with a pitched ball. The impact caused him to collapse on the field. Bystander CPR was begun given his unresponsiveness and emergency medical services were immediately called. The patient was transported to the hospital. Upon arrival, he was unresponsive and had no pulse. An electrocardiogram (ECG) showed ventricular fibrillation, and advanced cardiac life support was initiated. After several shocks and cardiac compressions, the patient regained a pulse and was transferred to the pediatric intensive care unit for further evaluation and management.To summarize key elements from this case, this patient has:Been struck by a high-velocity object in the chestSuffered a cardiac arrest, likely due to an arrhythmia from the blunt chest traumaThe presentation brings up a concern for Commotio Cordis, our topic of discussion today!We wanted to create this educational episode in light of the recent medical event experienced by the Buffalo Bill's safety Damar Hamlin. His blunt chest trauma, which led to cardiac arrest, has been postulated to be due to commotio cordis. At the date of this record, we are glad that Damar Hamlin is on the road to recovery.Absolutely, let's dive in more into this topic, Let's start with a short multiple-choice question:The 14-year-old described in our case suffered cardiac arrest after blunt chest trauma. Based on the working diagnosis of comottio cordis, what is the most likely EKG finding which may be seen in this patient?A. Ventricular fibrillationB. Ventricular tachycardiaC. Complete heart blockD. AsystoleThe correct answer is A. In a study published in JAMA (2002; 287(9):1142-1146) which used data from the US Commotio Cordis registry maintained by the Minneapolis Heart Institute Foundation, reported that the most common arrhythmia out of the 128 confirmed cases, 82 of which had EKGs which could be analyzed was ventricular fibrillation. Three patients had Vtach, 3 had Bradyarrhythmia and 1 had complete heart block. Although 40 patients had asystole, this was unlikely to be the initial rhythm after impact. Interestingly, the majority of these rhythms were recorded at the scene.Rahul, What is the definition of Commotio...
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
Dear Listeners & Peds ICU community, WE are back on air!Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists.I'm Pradip Kamat coming BACK to you from Children's Healthcare of Atlanta/Emory University School of Medicineand I'm Rahul Damania from Cleveland Clinic Children's Hospital and 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.As we turn into a new year, we would like to introduce Season 2 of PICU Doc on Call. Yes Pradip, I am super excited for this year & I want to take this moment to thank YOU all, our listener community for making PICU Doc on Call such a success as we share our passion for medical education thru this forum!This episode will give you a quick layout of how we will be organizing each episode of PICU doc on call this year. We will also highlight some tips and tricks on how to best learn from a medical podcast. Our goal in this episode is to provide you a framework on some best practices in medical podcasting and how to retain information from a podcast. Especially for our past & future episodes, we hope you can use this audio learning platform to assist you in applying the knowledge at the bedside when you are working in the acute care setting.Let's get into our first learning objective,Rahul, did you know that learning via podcasts can actually benefit your brain & change the neural chemistry.In fact, a 2016 med ed study published out of UC Berkeley concluded that listening to narrative stories from podcasts can stimulate multiple parts of your brain such as the limbic system and can enhance mood as it modulates dopamine and serotonin driven neural pathways. Think about listening to your favorite true-crime podcast — the suspense actually allows for you to stimulate centers in your medulla that increase the amount of endorphines, dopamine and serotonin that keep you on the edge of your seat.That is so unique, so based on this, I do want to highlight some of the key elements which will make our podcast or any medical podcast you listen to beneficial. These pearls will also help you if you are developing a medical podcast of your own!The first concept here is that many podcasts provide narratives.When it comes to medical podcasts, narratives are in the form of medical cases which allow for you to retain content knowledge as a patient case invokes emotion and this can help you remember information more robustly.When listening to a podcast, you have to use your imagination to picture what's going on. For example, if I painted a 2 yo M with a history of rhinorrhea at home for about a week who now presents to the ED with subcostal & intercostal retractions that then progresses to intubation in the PICU, you not only are envisioning a patient in front of you, but also are shifting your mind across settings. Our brain has to work at the pace of the audio, so hopefully your mind doesn't wander off like it does when reading a textbook page. And because you have to...
Casey is joined by pediatric ICU nurse, Kelsey Robison. Join them as they talk about the hardships, joys and hidden miracles working with kiddos in the ICU setting. The Lord can answer prayers and bring blessings in ways you might not realize. Plus you WON'T want to miss Kelsey's prescription for well being! Follow me on Instagram: @wellbeing.podcast @if.thats.the.case
On Friday's show: Hospitals in Texas and Greater Houston are facing a shortage of pediatric ICU beds. We learn why and discuss how family gatherings next week for Thanksgiving might exacerbate that. Also this hour: Columnist Dwight Silverman talks about recent developments in consumer technology. Then, we break down The Good, The Bad, and The Ugly of the week. And we talk with local chef and restauranteur Victoria Elizondo about her new taco cookbook, Taco-Tastic: Over 60 Recipes to Make Taco Tuesday Last All Week Long.
Pediatric ICU units are 125% over capacity in Ontario, so Doug Ford kindly asked people to mask up. Well, he didn't really make his top "doctor," Kieran Moore, tell us Covid isn't bad; it's just flu season. - Why won't Doug Ford mandate masks in schools? - Why Kieran Moore is disregarding desperate PHA's and Hospital CEO's demand for mask mandates - Who benefits and who loses. Former conservative fixer and Ford insider David Wallace joins us to tell us who really owns Doug's decision-making and why. https://deanblundell.com/news/breakin... Spenny from Kenny VS Spenny sent us a Tweet this morning, and Dean didn't believe it. Thomas Wedders still holds the record for the biggest nose in human history; I think Spenny sent it because Tom looks like he sewed a dick onto his face. And a new study has some great news for men with big noses - you also have the biggest wrenches. https://twitter.com/Spenny/status/159... Speaking of dick faces, former Olympian Jamie Sale probably murdered any chance she had at a normal life this weekend after mocking rape victims and Canada's military. First, she mocked Canadian soldiers and the war dead then begged them to rise up against the need to wear a mask. Then she compared getting vaccinated to being raped. No Bueno. We discuss Jamie's future employment options AFTER she gets out of the psych ward. https://deanblundell.com/news/if-jami...
Today's podcast: Danielle Smith won byelection in Brooks-Medicine Hat earlier in the week and now will sit in the Alberta legislature as premier. Plans and priorities between now and the May 29, 2023 provincial election. Guest: Danielle Smith. Premier. Alberta. In March of 2023, mental illness may qualify for medical assistance in dying (MAID). Increasingly Canadians are engaging or considering engaging MAID. Today the facts, the fallacies concerning MAID. Guest: Dr. Stefanie Green. Co-founder and president, Canadian Association of MAID Assessors and Providers (CAMAP). - Medical advisor to the BC Ministry of Health MAID oversight committed, moderator of CAMAP's national online forum. Clinical faculty, UBC and University of Victoria. Author: This Is Assisted Dying. Winter virus season. Covid and more. Pediatric ICU's over capacity in Ontario with rising numbers of viral respiratory infections. Ontario's Chief Medical Officer of Health will tomorrow call for masks to be worn indoors, but no mandate issued. Questions about vaccinations and booster shots. Combining vaccines (Covid, annual flu, shingles, etc). Guest: Dr. Isaac Bogoch. Infectious diseases specialist, Toronto General Hospital and associate professor of medicine, University of Toronto. Indigenous Nexus: Bringing Common Sense and Sensible Environmentalism to Natural Resouce Development. A Constructive Way Forward with Indigenous People. January 25, 2023, Indigenous leaders, the energy and mining industry and governments will gather in Calgary for af first-of-its-kind conference on responsible and inclusive resource development. 65% of Indigenous people support or strongly support natural resource development (polling) say the organizers. Guest: Calvin Helin. CEO of IndSight Advisers. Calvin Helin is the son of a British Columbia Hereditary Chief, was named to B.C's Top Forty, Under Forty, is a lawyer and international best-selling author. --------------------------------------------- Host/Content Producer – Roy Green Technical/Podcast Producer – Tom McKay Podcast Co-Producer – Matt Taylor If you enjoyed the podcast, tell a friend! For more of the Roy Green Show, subscribe to the podcast! https://globalnews.ca/roygreen/ Learn more about your ad choices. Visit megaphone.fm/adchoices
Winter virus season. Covid and more. Pediatric ICU's over capacity in Ontario with rising numbers of viral respiratory infections. Ontario's Chief Medical Officer of Health will tomorrow call for masks to be worn indoors, but no mandate issued. Questions about vaccinations and booster shots. Combining vaccines (Covid, annual flu, shingles, etc). Guest: Dr. Isaac Bogoch. Infectious diseases specialist, Toronto General Hospital and associate professor of medicine, University of Toronto. Learn more about your ad choices. Visit megaphone.fm/adchoices
Pediatric ICU capacity is at or beyond its limits, and parents aren't far behind. Why is illness on the rise for kids across the province? For insight we welcome: Dr. Rod Lim, Site-Chief of the Paediatric Emergency Department at the Children's Hospital at London Health Sciences Centre, and an associate professor at Western University; and former director of the COVID-19 Science Advisory Table, Dr. Fahad Razak, who is an internist at St Michael's Hospital and assistant professor at the University of Toronto.See omnystudio.com/listener for privacy information.
Mychal Pilia's educational background includes a bachelor's in nutrition, bachelor's in Nursing, and a Masters in Nursing Midwifery. She has worked as a chef in various settings, then had a career as a Pediatric ICU nurse for 6 years. For the past 7 years she was catching babies as a nurse midwife. Last September she closed her birth center practice to pursue what God has called her to be and to do as a mother, a healer of hearts, and a protector of the innocent. #midwife #doula #midwifery #birth #pregnancy #homebirth #pregnant #baby #naturalbirth #newborn #childbirth #nurse #breastfeeding #postpartum #birthwithoutfear #midwifelife #midwives #waterbirth #motherhood #childbirtheducation #studentmidwife #empoweredbirth #birthdoula #hypnobirthing #bidan #laboranddelivery #midwiferycare #love #prenatal #obgyn --- Send in a voice message: https://podcasters.spotify.com/pod/show/alex-maison-podcast/message
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 a three-year-old girl with altered mental status and acute respiratory failure Here's the case presented by Rahul— A three-year-old presents to the PICU with altered mental status and difficulty breathing. Per the mother, the patient was in the usual state of health on the day prior to admission when the mother left her in the care of her maternal grandmother. When mom arrived home later in the afternoon, mom was unable to wake her and reported that she seemed "stiff". She did not have any abnormal movements or shaking episodes. Mom called 911 and the patient was brought to our ED. No known head trauma, though the patient is in the care of MGM throughout the day. No emesis. Nhttp://emesis.no/ (o) recent sick symptoms. No witnessed ingestion, however, the patient's mother reports that MGM is on multiple medications (Xarelto, zolpidem, Buspar, gabapentin, and acetaminophen) and uses THC-containing products specifically THC gummies. In the ED: The patient had waxing and waning mentation with decreased respiratory effort. GCS was recorded at 7. Arterial blood gas was performed showing an initial pH of 7.26/61/31/0. The patient was intubated for airway protection in the setting of likely ingestion. The patient has no allergies, immunizations are UTD. BP 112/52 (67) | Pulse 106 | Temp 36.2 °C (Tympanic) | Resp (!) 14 | Ht 68.5 cm | Wt 14.2 kg | SpO2 100% | BMI 30.26 kg/m² Physical exam was unremarkable-pupils were 4-5mm and sluggish. There was no rash, no e/o of trauma Initial CMP was normal with AG of 12, CBC was unremarkable, and Respiratory viral panel was negative. Serum toxicology was negative for acetaminophen, salicylates, and alcohol. Basic Urine drug screen was positive for THC To summarize key elements from this case, this patient has: Altered mental status: - waxing and waning with GCS less than 8 suggestive of decreased ventilatory effort pre-intubation impending acute respiratory failure Dilated but reactive pupils All of which brings up a concern for possible ingestion such as THC (but cannot rule out other ingestion) This episode will be organized… Pharmacology of Cannabis Clinical presentation of Cannabis toxicity Workup & management of Cannabis toxicity The Cannabis sativa plant contains over 500 chemical components called cannabinoids, which exert their psychoactive effect on specific receptors in the central nervous system and immune system. The 2 best-described cannabinoids are THC and cannabidiol (CBD)—and are the most commonly used for medical purposes. Patients with intractable epilepsy or chronic cancer pain may be using these drugs. THC is the active ingredient of the cannabis plant that is responsible for most symptoms of central nervous system intoxication. The term cannabis and the common name, marijuana, are often used interchangeably). Rahul, can you shed some light on the pharmacokinetics/pharmacodynamics of cannabis? Cannabis exists in various forms: marijuana (dried, crushed flower heads, and leaves), hashish (resin), and hash oil (concentrated resin extract), which can be smoked, inhaled, or ingested. THC is the active ingredient of the cannabis plant that is responsible for most symptoms of central nervous system intoxication, in contrast to CBD, the main non-psychoactive component of cannabis. The potency of cannabis is usually based on the THC content of the preparation. The THC is lipid soluble and highly protein bound and has a volume of distribution of 2.5 to 3.5...
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: A Somnolent Toddler. Here's the case: A 2 yo M presents to the PICU after being found increasingly sleepy throughout the day. The toddler is otherwise previously healthy and was noted to be in his normal state of health prior to today. The mother dropped the toddler off at his Grandmother's home early this morning. Grandmother states that he was playing throughout the day, and she noticed around lunchtime the toddler stumbles around and acts more sleepy. She states that this was around his nap time so she did not feel it was too out of the ordinary. The toddler 1 hr later was still very sleepy, and the grandmother noticed that the toddler had some shallow breathing. She called mother very concerned as she also found her purse open where she typically keeps her pills. The grandmother has a history of MI and afib as well as hypertension. She is prescribed a multitude of medications. Given the child's increased lethargy, the grandmother presents the patient to the ED. In the ED, the child is noted to be afebrile with HR 55 & RR of 18. His blood pressure is 78/40. On exam he has minimal reactivity to his pupils, he has shallow breathing and laying still on the bed. A POC glucose is 68 mg/dL. Acute resuscitation is begun and the patient presents to the PICU. To summarize key elements from this case, this patient has: Drowsiness Bradycardia Normotension This is in the setting of being at grandma's home and having access to many medications Given the hemodynamic findings and CNS obtundation, this patient's presentation brings up concern for a clonidine or beta-blocker ingestion. This episode will be organized: Beta-Blocker poisoning We will also examine other medications that potentially can be toxic to a toddler (one pill can kill) present in Grandma's purse which include: TCA, CCB, Opioids, oral anti-diabetic agents, digoxin, etc. The presence of a grandparent is a risk factor for unintentional pediatric exposure to pharmaceuticals commonly referred to as the Granny Syndrome. Grandparents' medications account for 10% to 20% of unintentional pediatric intoxications in the United States. To kids, all pills look like candy. Let's start with a multiple choice. An overdose of which of the following medications may mimic the presentation of Metoprolol overdose? A. Verapamil toxicity B. Ketamine toxicity C. Valium toxicity D. Lithium toxicity The correct answer is A, verapamil toxicity. Verapamil is a non DHP CCB. It acts at the level of the SA and AV node similar to Metoprolol, a beta-1-specific antagonist. Both cause bradycardia and AV node block. Valium though a CNS depressant, can cause CV depression as well, however, would have fewer changes on the conduction system compared to a non-DHP CCB. What is the mechanism of toxicity with beta-blockers? Beta-blockers are competitive inhibitors at beta-adrenergic binding sites, which results in decreased production of intracellular cyclic adenosine monophosphate (cAMP) with a resultant blunting of multiple metabolic and cardiovascular effects of circulating catecholamines. They attenuate the effect of adrenergic catecholamines on the heart Decrease inotropic and chronotropic response. Some drugs like Propranolol can act as Na channel blockers (myocyte membrane stabilizing activity) at high doses resulting in arrhythmias and seizures. Toxic doses of drugs like Sotalol can result in K channel blockade giving rise to prolonged QT and risk for...
Mychal Pilia's educational background includes a bachelor's in nutrition, bachelor's in Nursing, and a Masters in Nursing Midwifery. She has worked as a chef in various settings, then had a career as a Pediatric ICU nurse for 6 years. For the past 7 years she was catching babies as a nurse midwife. Last September she closed her birth center practice to pursue what God has called her to be and to do as a mother, a healer of hearts, and a protector of the innocent. #midwife #doula #midwifery #birth #pregnancy #homebirth #pregnant #baby #naturalbirth #newborn #childbirth #nurse #breastfeeding #postpartum #birthwithoutfear #midwifelife #midwives #waterbirth #motherhood #childbirtheducation #studentmidwife #empoweredbirth #birthdoula #hypnobirthing #bidan #laboranddelivery #midwiferycare #love #prenatal #obgyn --- Send in a voice message: https://podcasters.spotify.com/pod/show/alex-maison-podcast/message
Mychal Pilia's educational background includes a bachelor's in nutrition, bachelor's in Nursing, and a Masters in Nursing Midwifery. She has worked as a chef in various settings, then had a career as a Pediatric ICU nurse for 6 years. For the past 7 years she was catching babies as a nurse midwife. Last September she closed her birth center practice to pursue what God has called her to be and to do as a mother, a healer of hearts, and a protector of the innocent. #midwife #doula #midwifery #birth #pregnancy #homebirth #pregnant #baby #naturalbirth #newborn #childbirth #nurse #breastfeeding #postpartum #birthwithoutfear #midwifelife #midwives #waterbirth #motherhood #childbirtheducation #studentmidwife #empoweredbirth #birthdoula #hypnobirthing #bidan #laboranddelivery #midwiferycare #love #prenatal #obgyn --- Send in a voice message: https://podcasters.spotify.com/pod/show/alex-maison-podcast/message
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 and 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 of a 4-day-old with jaundice and vomiting. Here's the case presented by Rahul: A full-term 4-day-old boy presents to the ED after recently being discharged from the newborn nursery. Per mom, the patient "look yellow" and was having difficulty with feeding. The mother states that the patient would be increasingly sleepy, and will only latch to the breast for five minutes. The patient has been having decreased wet diapers, and the stool is loose and non-bloody. Mother was concerned today as the child continue to look yellow, especially in the eyes, had four episodes of vomiting, and overall was acting lethargic. The patient presented to the emergency room afebrile, tachypneic, and tachycardic. The patient was noted to have initial serum glucose of 70. As the patient was increasingly dehydrated, laboratory testing was difficult to obtain. The infant was fussy for the caregivers. The patient was resuscitated with 2 x 10 per kilo boluses and responded well. Point of care ultrasound noted normal four-chamber cardiac anatomy and squeeze. Given the instability of the patient, a RAM cannula was initiated, and the patient presented to the PICU. To summarize key elements from this case, this 4-day-old infant has: an acute presentation of jaundice and poor feeding Prominent GI symptoms and dehydration A sepsis-like presentation with hemodynamic instability responsive to fluids All of which brings up a concern for inborn error of metabolism, likely galactosemia. This episode will be organized… Clinical Presentation Laboratory Findings & Biochemistry Management of Galactosemia Rahul, let's start with a short multiple choice question: Of the following biochemical enzymes, which of the following is deficient in classic galactosemia? A. UDP Glucoronyl Transferase B. Aldolase B C. Galactose 1 Uridyl Transferase D. Galactokinase The correct answer is C. Galactose 1 Uridyl Transferase aka GALT. Classic galactosemia is caused by a complete deficiency of galactose-1-phosphate uridyl transferase (GALT). We should contrast this with galactokinase deficiency. These two present quite differently — GALT deficiency presents like our patient with jaundice, vomiting, hepatomegaly, renal dysfunction, and sepsis. Galactokinase deficiency has less of systemic symptoms and these patients similar to GALT deficiency have cataracts that are usually bilateral and resolved with dietary therapy. To go through our other answer choices, remember that Aldolase B is the rate-limiting enzyme in fructose metabolism, thus a deficiency in this enzyme would cause hereditary fructose intolerance. With this lead in question, let's pivot into the biochemistry of galactose and review key lab findings in our patient with galactosemia. Rahul, can you give us a quick summary of how galactose is metabolized in our body? Galactose is a sugar found primarily in human milk and milk products as part of the disaccharide lactose. Lactose is hydrolyzed to glucose and galactose by the intestinal enzyme lactase. The galactose then is converted to glucose for use as an energy source, however it needs a series of reactions: Galactokinase → which catalyzes the rxn galactose to galactose 1 PO4 Our rate limiting enzyme Galactose-1-phosphate uridyl transferase (GALT). GALT helps place a sugar moiety on galactose 1 PO4 to turn it into glucose 1 Phos which can then be utilized in glycolysis or glycogenesis. A complete deficiency in GALT is known as classic...
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. I'm Rahul Damania from Cleveland Clinic Children's Hospital and 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: Here's the case presented by Rahul: A 21-month-old girl was brought to an OSH ED for somnolence and difficulty breathing, which developed after she accidentally ingested an unknown amount of liquid medicine that was used by her grandfather. Per the mother, the patient's grandfather was given the liquid medication for the treatment of his opioid addiction. The patient took some unknown amount from the open bottle that was left on the counter by the grandfather. Immediately after ingestion of the medicine, the patient initially became irritable and had some generalized pruritus. The patient subsequently became sleepy followed by difficulty breathing and her lips turned grey. The patient was rushed to an outside hospital ED for evaluation. OSH ED: The patient arrived unresponsive and blue, she was noted to be sleepy and difficult to arouse on arrival, with pinpoint pupils and hypoxic to 88%. , but After receiving Naloxone, however, she became awake and interactive. Her glucose on presentation was 58 mg/dL and Her initial VBG resulted 7.3/49.6/+2. She continued to have intermittent episodes of somnolence without apnea. Poison control called and recommend starting a naloxone infusion; she was also given dextrose bolus. The patient was admitted to the PICU. To summarize key elements from this case, this patient has: Accidental ingestion of an unknown medication Altered mental status Difficulty breathing—with grey lips suggestive of hypoventilation/hypoxia All of which brings up a concern for a toxidrome which is our topic of discussion for today The typical symptoms seen in our patient of pinpoint pupils, respiratory depression, and a decreased level of consciousness is known as the “opioid overdose triad” Given the history of opioid addiction in the grandfather, the liquid medicine given to him is most likely methadone.In fact, in this case, the mother brought the bottle of medicine, which was subsequently confirmed to be prescription methadone given to prevent opioid withdrawal in the grandfather. To dive deeper into this episode, let's start with a multiple choice question: Which of the following opioids carries the greatest risk of QTc prolongation? A. Methadone B. Morphine C. Fentanyl D. Dilaudid The correct answer is methadone. Methadone prolongs QT interval due to its interactions with the cardiac potassium channel (KCNH2) and increases the risk for Torsades in a dose-dependent manner. Besides the effect on cardiac repolarization, methadone is also associated with the development of bradycardia mediated via its anticholinesterase properties and through its action as a calcium channel antagonist. Hypokalemia, hypocalcemia, hypomagnesemia, and concomitant use of other drugs belonging to the family of CYP3A4 system inhibitors such as erythromycin can prolong Qtc. Even in absence of these risk factors, methadone alone can prolong QTc. Thanks for that, I think it is very important to involve your Pediatric Pharmacy team to also help with management as children may be concurrent qt prolonging meds. Rahul, what are some of the pharmacological and clinical features of methadone poisoning? Methadone is a synthetic opioid analgesic made of a racemic mixture of two enantiomers d-methadone and l-methadone. besides its action on mu and kappa receptors, it is also an NMDA receptor antagonist. Due to its long action, methadone is useful as an analgesic and to suppress opioid withdrawal symptoms (hence used for opioid...
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 about a 4-year-old girl with a chief complaint of headache and vomiting Here's the case: A 4-year-old presents to the PICU with headaches + vomiting and abnormal CT scan findings. The patient presented to the ED with h/o abdominal pain X 5 days with nonbilious, non-bloody emesis. Initial CBC, UA was normal. The patient was given some pain meds and IV fluids. Further history revealed that the patient has been having severe headaches for the last 5 days and had emesis secondary to the headaches resulting in generalized, non-specific abdominal pain. No h/o of trauma or seizures, no h/o of fever or diarrhea, no h/o toxic ingestions h/o recent travel, exposure to sick contacts, COVID test negative. No family h/o migraines, her immunizations are UTD. Besides the normal UA and CBC, her CMP was also normal. A CT scan of the head revealed right frontoparietal mass with moderate surrounding edema, 6 mm leftward midline shift, diffuse sulcal narrowing, and right cisternal narrowing. Imaging of the abdomen (US and CT w/ contrast) was unremarkable. An MRI done revealed: Right parietal diffusion restricting lesion, most compatible with abscess. Moderate surrounding vasogenic edema. Given her abdominal pain- Abdominal KUB as well as contrast CT scan of abdomen and pelvis were performed and revealed no abdominopelvic pathology. In the ED her vitals were normal and the patient was afebrile. On her PE: the patient appeared sleepy but woke up and answered questions appropriately. No focal deficits, PERRL, normal tone and strength. The rest of her physical exam was completely normal. She now is transferred to the PICU for serial neurological exams. To summarize key elements from this case, this patient has: Headache with altered mental status No focal deficits Vomiting surprisingly no fever Imaging showing right frontoparietal mass. All of which brings up a concern for brain abscess This episode will be organized… Epidemiology and pathogenesis Diagnosis Management Rahul, can you inform our listeners about the epidemiology of brain abscesses? Only about 25% of brain abscesses occur in children. Incidence in developed countries is about 1-2% while in developing countries it's about 8%. Peak incidence in children is seen between the ages of 4-7 years and is more common in males. Brain abscess in the neonatal age group is rare but are associated with a higher risk of complications and mortality. Risk factors for brain abscess include Otologic infections (ear, sinus, and dental infections), Congenital heart disease (30% of patients with BA have an underlying heart defect) with intra-cardiac or intrapulmonary shunting (pulmonary AV malformations in hemorrhagic telangiectasis), immunodeficiencies (solid organ transplantation, HIV, etc), prolonged steroid use, diabetes, alcoholism neurosurgical procedures, trauma. Other rare causes can be airway foreign bodies, congenital dermal sinuses, and esophageal procedures (such as dilatations). Brain abscess typically begins with a localized area of cerebritis which evolves through various stages (typically 10-14 days) to develop into an encapsulated collection of purulent material with peripheral gliosis or fibrosis. 40-50% of the spread of infection is via a contiguous site of infection such as otitis, sinusitis or mastoiditis or from head trauma or neurosurgical procedure. 30-40% is spread through the hematogenous route from endocarditis, pulmonary infections, or dental abscess. 90% of brain...
In this Fight Back episode, we welcome Dr. Howard Zucker, former New York State Public Health Commissioner who led New York through the initial impact of COVID-19. He has held public health positions at the state, federal, and international levels and academic appointments at the Yale, Columbia, and Albert Einstein medical schools. He served as head of the Pediatric ICU at New York Presbyterian Hospital and was a research affiliate at MIT.Dr. Zucker shares New York's experience as the first hot spot for COVID-19, dealing with shutdowns, masks, vaccines, and overrun emergency rooms. Join us as we look back at the start of COVID-19 in New York and how local, state, and federal governments interfaced with the healthcare system.
This week on the podcast we have Tammi Boswell, MSN, NNP-BC. She graduated from East Carolina University 1992-BSN, at that time she worked one year in Pediatric ICU, then four years NICU RN, followed by six years NICU FLIGHT RN (1yr co director). During her graduate program at SUNY-STONYBROOK she finished her MSN-NNP in 2002 while giving birth to three of her own babies. She has worked for 15 years as staff NNP Level III/IV NICU and currently has worked for the last six years as a LOCUMS and Local PRN NNP! Neonatal NP's are advanced practice registered nurses (APRN) that help provide care to high-risk newborn infants who require postnatal care due to low birth weights, heart abnormalities, infections and other complications. Doctor Nurse Links: https://linktr.ee/DoctorNursePodcast Wanna start a side hustle? Subscribe to the Doctor Nurse Podcast and I will show you how to start: https://view.flodesk.com/pages/625318... Networth Nurse Course: https://networthnurse.co/courses/ Tammi's Links: Follow Tammi on Instagram @nurse2nnp https://www.linkedin.com/in/tammi-boswell-msn-aprn-nnp-bc-4b93b229/
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 and 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 an 18 -year old with sore throat, and unilateral L-sided neck pain for ~2 weeks. Here's the case presented by Rahul: An 18-year-old female presents to the ED with cough, fever, fatigue, sore throat, and unilateral L-sided neck pain for ~2 weeks. The patient also has been having non-specific chest pain, weight loss, and decreased appetite for ~ 1 month. Patient has no recent travel h/o, no h/o of vaping or illicit drug use, and there were no sick contacts at home. Vitals revealed an HR 105, BP 116/66, Temp 38.3, and respiratory rate 35, She was 65 Kg and SPO2 on 2L NC was 100%. Physical exam was negative except (L) neck tender to palpation. There was no goiter, lymphadenopathy or hepatosplenomegaly. An initial chest x-ray was significant for possible multi-lobar pneumonia versus metastases. A Chest CT revealed multifocal septic emboli in the lungs. Echo did not show any gross vegetation. She has no rash or any trauma to the neck or difficulty swallowing, no oral ulcers, joint pain, or diarrhea. She had no recent dental work or drinking of unpasteurized milk or eating raw fish or meat. She was admitted to the PICU as she had hypotension requiring fluid boluses, and lab works significant for hyponatremia, rhabdomyolysis, worsening AKI, elevated ferritin, and elevated D-dimer. Her serum uric acid was 9.9, LDH = 230 (normal) ,ESR 78 (normal = 20 or less). Her serum lactate and serum troponin and BNP were all normal. Pertinently, US neck revealed an occlusive thrombus in the (L) IJ vein (done so as to avoid contrast in face of AKI), and blood cultures sent. To summarize key elements from this case, this 18-year-old female presents with fever +cough+sore throat Fatigue + Weight loss (L) neck pain Hypotension with abnormal labs including a concerning WBC with (L) shift, anemia, AKI, elevated uric acid, and ESR Chest CT with possible pulmonary emboli US showing occlusion. All of which brings up a concern for possible malignancy or pulmonary emboli from a septic focus in the neck and a possible diagnosis of Lemierre syndrome This episode will be organized… Definition Diagnosis (physical, laboratory) Management Rahul: What is the definition of Lemierre's syndrome? Lemierre's syndrome, also known as post-anginal septicemia or necrobacillosis, is characterized by bacteremia, internal jugular vein thrombophlebitis, and metastatic septic emboli secondary to acute pharyngeal infections. All of which are seen in our above case presentation. Previously called as the forgotten disease as its incidence was decreasing due to the increasing use of antibiotics especially penicillin for URI. However, recently there is an increase in Lemierre's disease cases with decreased use of antibiotics due to antibiotic stewardship. The recent increase in Lemierre disease due to decreased antibiotic use has not been proven and remain controversial. Rahul what are some of the causative organisms of Lemierre syndrome? The most common causative agent of Lemierre's syndrome is Fusobacterium necrophorum, followed by Fusobacterium nucleatum and anaerobic bacteria such as streptococci, staphylococci, and Klebsiella pneumoniae. Rahul: Can you tell our listeners about the pathophysiology of Lemierre's syndrome? Lemierre syndrome can occur in health adults (more common in males in the age group of 14-24 years). Risk factors include immunocompromised patients, organisms, and environmental conditions. Lipopolysaccharides in F. necrophorum have endotoxic...
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: In today's episode, we discuss about a 12-year-old male with lethargy after ingestion. Here's the case presented by Rahul: A 12-year-old male is found unresponsive at home. He was previously well and has no relevant past medical history. The mother states that he was recently in an argument with his sister and thought he was going into his room to “have some space.” The mother noticed the patient was in his room for about 1 hour. After coming into the room she noticed him drooling, minimally responsive, and cold to the touch. The patient was noted to be moaning in pain pointing to his abdomen and breathing fast. Dark red vomitus was surrounding the patient. The mother called 911 as she was concerned about his neurological state. With 911 on the way, the mother noticed a set of empty vitamins next to the patient. She noted that these were the iron pills the patient's sister was on for anemia. EMS arrives for acute stabilization, and the patient is brought to the ED. En route, serum glucose was normal. The patient presents to the ED with hypothermia, tachycardia, tachypnea, and hypertension. His GCS is 8, he has poor peripheral perfusion and a diffusely tender abdomen. He continues to have hematemesis and is intubated for airway protection along with declining neurological status. After resuscitation, he presents to the Pediatric ICU. Upon intubation, an arterial blood gas is drawn. His pH is 7.22/34/110/-6 — serum HCO3 is 16, and his AG is elevated. To summarize key elements from this case, this patient has: Lethargy and unresponsiveness after acute ingestion. His hematemesis is most likely related to his acute ingestion. And finally, he has an anion gap metabolic acidosis, as evidenced by his low pH and low HCO3. All of these salient factors bring up the concern for acute iron ingestion! In today's episode, we will not only go through acute management pearls for iron poisoning, but also go back to the fundamentals, and cover ACID BASE disorders. We will break this episode down into giving a broad overview of acid base, build a stepwise approach, and apply our knowledge with integrated cases. We will use a physiologic approach to cover this topic! Pradip, can you give us a quick overview of some general principles when it comes to tackling this high-yield critical care topic? Absolutely, internal acid base homeostasis is paramount for maintaining life. Moreover, we know that accurate and timely interpretation of an acid–base disorder can be lifesaving. When we conceptualize acid base today, we will focus on pH, HCO3, and CO2. As we go into each disorder keep in mind to always correlate your interpretation of blood gasses to the clinical status of the patient. Going back to basic chemistry, can you comment on the relationship between CO2 and HCO3? Yes, now this is a throwback. However, we have to review the Henderson–Hasselbalch equation. The equation has constants & logs involved, however in general this equation shows that the pH is determined by the ratio of the serum bicarbonate (HCO3) concentration and the PCO2, not by the value of either one alone. In general, an acid–base disorder is called “respiratory” when it is caused by a primary abnormality in respiratory function (i.e., a change in the PaCO2) and “metabolic” when the primary change is attributed to a variation in the bicarbonate concentration. Now that we have some fundamentals down, let's move into definitions. Can you define acidemia and alkalemia and comment on how...
TeamPeds Talks is a podcast series from the National Association of Pediatric Nurse Practitioners (NAPNAP) and features NAPNAP experts and stakeholders addressing key issues in pediatric health. Join us for pediatric-focused conversations about dermatology, Lyme disease, disaster preparedness, injuries, immunizations and more as we discuss the importance of summer and outdoor wellness. This series will focus on summer health and wellness. In this podcast series, our host, Dr. Andrea Kline-Tilford, NAPNAP's Executive Board President, will explore different aspects of children and teen health and wellness through conversations with NAPNAP member experts and special interest group leaders. Andrea Kline-Tilford, PhD, CPNP-AC is an Acute Care Pediatric Nurse Practitioner with significant clinical experience in pediatric critical care and pediatric cardiac surgery. She is the NAPNAP Executive Board President and the Professional Issues Department Editor of the Journal of Pediatric Health Care. She is the co-editor of two books: Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner and Cases in Pediatric Acute Care: Strengthening Clinical Decision Making. She has presented internationally on topics of pediatric acute care and pediatric advanced practice nursing, with many publications in these areas. She is an advocate for children and proud mother of two. This episode's guests are Jeremy Jordan and Hilary Baxter. Dr. Jeremy Jordan is an Assistant Professor and Coordinator of the Acute Care Pediatric Nurse Practitioner Track at the University of Alabama at Birmingham as well as a practicing NP in the Pediatric ICU at Children's of Alabama. He has been an RN for 10 years and a PNP for 7 years. Dr. Jordan's practice focus is on the care of pediatric patients and their families during acute and critical injury and illness. Dr. Jordan is also an active researcher in pediatric brain injury. Outside of work, Jeremy and his husband Patrick, who is a pediatric CRNA, enjoy traveling and anything outdoors. Hilary W Baxter is dual certified nurse practitioner at the Emergency Department of The Children's Hospital of Philadelphia. She is starting her 10th year of practice. She currently is the co-chair of the Pediatric Emergency Care SIG. She resides in NJ with her husband, 3 kids and 2 dogs. Hilary has presented at several NAPNAP conferences with a focus on providing supportive care during emergent procedures as well teaching suturing at this year's Reconnect Symposium. Her focus is on identifying health literacy deficits in the population and assisting families with learning to help manage wellness and health concerns.
Introducing Avery...you see Avery's name used to be Heather! Heather was working as an RN and was working loooong shifts. Christmas morning of 2018, the Charge Nurse, of the pediatric ICU, "commanded" her to go home saying she didn't look too well. Heather would find herself so sick that she was bedridden. Heather was newly married and "In sickness and in health" came a lot soon than either of them had expected! Heather officially had a chronic illness and disability overnight. Heather mourned the loss of who she used to be. She decided two years later to make a fresh start and changing her name felt right. After sifting through baby names, the one that stood out to her was Avery. Fast forward to current day Avery is going through the legal process to be Avery officially and feels as though she has truly found herself! Avery now helps highly sensitive people prevent and reverse the negative health effects of stress. Full Show Notes
Genene Jones. Angel of death. Angel no, death yes. She chose the most helpless of victims. Children and infants that could not tell her secrets. She wanted the attention caring for the helpless babies in the Pediatric ICU, and she craved the chance to look like the most caring and grieving nurse, but like any true psychopath, it was all just a play.Sources for this episode: “Ohio Doctor is Acquitted of Killing Patients with Fentanyl” By Alyssa Lukpat and Michael Levenson April, 20, 2022. https://www.nytimes.com/2022/04/20/us/william-husel-ohio-doctor-murder-trial.html https://www.nytimes.com/2022/04/20/us/william-husel-ohio-doctor-murder-trial.htmlGenene Jones: Baby Killer by Katherine RamslandThe Death Shift by Peter Elkind, August 1983 https://www.texasmonthly.com/news-politics/the-death-shift-2/Convicted nurse's former boss continues her Kerrville practice by Kristin Gazlay The Galveston Daily News, February 26, 1984Genene Jones paints portrait of confidence by Ken Herman Fort Worth Star-Telegram, February 26, 1984Infant death probe broadens by Michael Pearson San Angelo Standard Times, March 3, 1983Judge relocates child killing trial by Michael Pearson San Angelo Standard Times August 4, 1983 For details, show notes, and pictures please visit Thearchivistpodcast.com
Extubation Readiness with Alyssa Stoner and Gina Patel--Part 3: Cardiovascular and Gastrointestinal Considerations + Practical Tips for ExtubationAbout our guests:Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo or support us by becoming a Patreon. 100% of all funds will go to supporting the show to keep this project going. Objectives for this episode:The participant will be able to describe 3 factors that influence a patient's readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient's clinical picture. The participant will be able to develop and execute a patient's extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for 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 pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updatesSupport the show
It's always alarming and jarring when our world's state reflects the true reality of the fallen place we live in. When the groans and moaning of the need for redemption are so loud, we are yet again reminded that this is not our home. This episode is a tough one. What we're talking about is a topic that is close to all of us; today we are talking about suffering and trials. We'll discuss why suffering occurs, where is God in all of it, how can we know and love God through suffering and trials, and, lastly, how can we respond when we face trials and sufferings of many kinds? __________________________ This is episode 50 – FIFTY episodes! We launched Momma Theologians- this podcast and our website- on November 1st 2021, so we- the team of writers and I- have been stewarding this ministry for nearly five months. If this ministry has been a gift to you, would you take a few minutes to leave a rating and review on Apple Podcasts? Those truly help make this podcast more accessible to mothers like you! __________________________ On Momma Theologians this past week, we released two episodes and essays by our Momma Theologians, Amber Thiessen and Kyleigh Dunn, that I encourage you to go back through and listen to or download. Amber is finishing her seminary master's degree to become a Christian therapist, and in her essay, ”Where I Never Thought I'd Be: A Momma's Theology of Suffering” she encourages us to deepen our faith through spiritual disciplines and to build the foundation of our faith by developing habits to give you a footing on which to stand when the storms of life come raging. Kyleigh Dunn provides a wonderful explanation of another practical thing we can do in the midst of suffering- cry and pray out to the Lord in lament. Her podcast episode and essay is called “Learning the Language of Lament.” ________________________ Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life, and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence). Don't hesitate to reach out to her via email at rachel@mommatheologians.com
Extubation Readiness with Alyssa Stoner and Gina Patel--Part 2: Upper Airway and Pulmonary ConsiderationsAbout our guests:Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo or support us by becoming a Patreon. 100% of all funds will go to supporting the show to keep this project going. Objectives for this episode:The participant will be able to describe 3 factors that influence a patient's readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient's clinical picture. The participant will be able to develop and execute a patient's extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for 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 pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updatesSupport the show
Extubation Readiness with Alyssa Stoner and Gina Patel--Part 1: Introduction and Sedation ManagementAbout our guests:Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo or support us by becoming a Patreon. 100% of all funds will go to supporting the show to keep this project going. Objectives for this episode:The participant will be able to describe 3 factors that influence a patient's readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient's clinical picture. The participant will be able to develop and execute a patient's extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for 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 pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updatesSupport the show
On the next episode of the Amplify Nursing podcast, we talk with Ravenne Aponte. Ravenne is a doctoral student at the University of Pennsylvania School of Nursing in the Barbara Bates Center for the Study of the History of Nursing focusing her research on the history of black nurses. Ravenne started her educational career with a Bachelor of Arts in African American Studies with a minor in Health Disparities and then received a Bachelor of Science in Nursing, working as a Pediatric ICU nurse. It was the combination of these experiences that lead to her interest in nursing history and workforce diversity that ultimately lead her to co-create the Nurses You Should Know (NYSK) project. Nurses You Should Know, is a social media and digital campaign whose goal is to elevate the stories of nurses of color and to make their impact more widely known. We talk with Ravenne about how her educational, clinical, and life experiences contributed to the work she does today, the disconnect between nursing history and practice, and how she is using the NYSK project to highlight the work nurses of color have done - and are doing - to contribute to the nursing profession.
So, you don't want to begin reading or studying the Bible... Can I be honest? I haven't always desired to, either. Join me today to talk about why you probably don't want to begin reading and studying the Bible. SUBSCRIBE TO OUR DEVOTIONAL NEWSLETTER TO STAY CONNECTED WITH OUR MINISTRY Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Connect with Rachel on Instagram @rachellynnlawrence ___________ If this episode resonated with you in any way, would you share it with a friend? This is our FIRST EPISODE in SEASON THREE: A Lamp Unto my Feet | Abiding in the Light of God's Word to Illuminate our Lives ------------------- Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
So, you want to begin reading and studying the Bible... But maybe you're unsure how or even where to start. Maybe you're a ten-times-over Bible Reading Plan dropout and you need some encouragement to restart again. Maybe you've read the Bible numerous times before and you just want a little boost to begin reading it again. Join me today as we talk about reading and studying the Bible: 1. What the Bible is 2. Reasons why we should read and study it 3. How to begin reading and studying God's Word SUBSCRIBE TO OUR DEVOTIONAL NEWSLETTER TO STAY CONNECTED WITH OUR MINISTRY Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Connect with Rachel on Instagram @rachellynnlawrence ___________ If this episode resonated with you in any way, would you share it with a friend? This is our Second Episode in SEASON THREE: A Lamp Unto my Feet | Abiding in the Light of God's Word to Illuminate our Lives ------------------- Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
We, Christians, are to be ready. We are to be ready for His return- which will be beautiful and glorious for those who love Him- we are to be a light that shines for Jesus- that illuminates our dark world. Our lives are to be the very testimony for God's mercy and grace and love and hope- We are to display this good news to our children, our families, our friends, our neighbors, and beyond. He is coming- may our lives reflect that truth today. JOIN OUR FREE MOMMA THEOLOGIANS ADVENT STUDY HERE RECEIVE YOUR FREE ADVENT STUDY GUIDE ---------------------------------------- Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Join our monthly devotional newsletter here. Our instrumental music in the background of our Advent and Podcast episodes has been composed and played by our talented Momma Theologian, Kyleigh Dunn @kyleighrdunn ______________________ Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
Let's discuss the incarnation of Jesus. Our study is called “O Come O Come Emanuel | Marvel at the Magnitude of the incarnation.” I named it as such because I can often find myself not marveling at the incarnation of Jesus. Personally, I find that it is all too easy for the awe- this wonder- to become plain. Also, I've found it easy to simply fall into a lackluster of lukewarm belief in Jesus that can become numb to this awe or wonder that we should rightly have at our Holy God and at His miraculous plan for salvation- Jesus. JOIN OUR FREE MOMMA THEOLOGIANS ADVENT STUDY HERE RECEIVE YOUR FREE ADVENT STUDY GUIDE ---------------------------------------- Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Our instrumental music in the background of our Advent and Podcast episodes has been composed and played by our talented Momma Theologian, Kyleigh Dunn @kyleighrdunn ______________________ Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
Christian Advent 2021 O Come O Come Emmanuel | Marvel at the Magnitude of the Incarnation Week Two Recap | Anticipating the Savior On our podcast episode today we discuss our study's second week of Advent theme, “Anticipation of the Savior.” This week, we shift from our discussion about the creation, fall, and the necessity of our Savior, and reflect upon the biblical accounts we have of others' anticipation of Jesus. JOIN OUR FREE MOMMA THEOLOGIANS ADVENT STUDY HERE RECEIVE YOUR FREE ADVENT STUDY GUIDE We have the revealed, unfolded perspective that: Jesus always was. Jesus created. Jesus was needed for salvation. Jesus was promised. Jesus was born as fully man yet stayed fully God. Jesus lived perfectly. Jesus died for our sins. Jesus rose again. Jesus ascended to the Father. Jesus sent His Holy Spirit. Jesus will return to consummate all things. Jesus will return… ---------------------------------------- Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Our instrumental music in the background of our Advent and Podcast episodes has been composed and played by our talented Momma Theologian, Kyleigh Dunn @kyleighrdunn ______________________ Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
Week One Recap | The Promise of a Savior| From our free Advent Study, "O Come O Come Emmanuel | Marvel at the Magnitude of the Incarnation." To join our study, sign up today at mommatheologians.com/advent and your free study guide will be sent to your inbox. *** Our Advent Study Began November 28th- December 26th When you sign up, you can expect to receive: * A five-day per week reading plan for the duration of the Advent season, where we will be reading from a Bible Reading Plan curated by Blue Letter Bible and the classic Christian 4th Century work by Saint Athanasius, On The Incarnation. * Our Advent Study Guide, which includes reflection questions, theological insights, daily Scripture passages, excerpts from the daily readings, and space to record your notes, thoughts, and prayers. * Weekly Advent emails to provide accountability and support. * Weekly Devotional Podcast Episodes (That's this!) to expound and reflect on the Advent Study. ___________ If this episode resonated with you in any way, would you share it with a friend? We would be delighted if you took a few minutes to leave a rating and review. These truly help to make the podcast more searchable and accessible so that other mothers like you can be encouraged to deepen their relationship with Christ in the midst of motherhood. We cherish and appreciate every single one. Our instrumental music in the background of our Advent and Podcast episodes has been composed and played by our talented Momma Theologian, Kyleigh Dunn @kyleighrdunn ------------------ Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence). *** Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Connect with Rachel on Instagram @rachellynnlawrence
On the next episode of the Amplify Nursing podcast, we talk with Ravenne Aponte. Ravenne is a doctoral student at the University of Pennsylvania School of Nursing in the Barbara Bates Center for the Study of the History of Nursing focusing her research on the history of black nurses. Ravenne started her educational career with a Bachelor of Arts in African American Studies with a minor in Health Disparities and then received a Bachelor of Science in Nursing, working as a Pediatric ICU nurse. It was the combination of these experiences that lead to her interest in nursing history and workforce diversity that ultimately lead her to co-create the Nurses You Should Know (NYSK) project. Nurses You Should Know, is a social media and digital campaign whose goal is to elevate the stories of nurses of color and to make their impact more widely known. We talk with Ravenne about how her educational, clinical, and life experiences contributed to the work she does today, the disconnect between nursing history and practice, and how she is using the NYSK project to highlight the work nurses of color have done - and are doing - to contribute to the nursing profession.
Introduction Episode for our free Advent Study, "O Come O Come Emmanuel | Marvel at the Magnitude of the Incarnation." To join our study, sign up today at mommatheologians.com/advent and your free study guide will be sent to your inbox. "We feel this groaning. We feel this tension of the 'already but not yet' reality that we live in as Christians. We are in a season of waiting. Much like the Israelites in the Old Testament who were longing for the Savior to come, we are also longing for our Savior- who we know to be Jesus- to return again. We are waiting. And we are called to wait well and diligently. Therefore, this season of Advent should amplify our hearts to acknowledge that we are awaiting our Savior. To Acknowledge and rejoice that He has already come- and that He will come again. It is also a season to reflect upon the darkness of sin that our world is under and to celebrate the Light- Jesus- and to compel us to bring that light to others." *** Our Advent Study Begins November 28th- December 26th When you sign up, you can expect to receive: * A five-day per week reading plan for the duration of the Advent season, where we will be reading from a Bible Reading Plan curated by Blue Letter Bible and the classic Christian 4th Century work, On The Incarnation. * Our Advent Study Guide, which includes reflection questions, theological insights, daily Scripture passages, excerpts from the daily readings, and space to record your notes, thoughts, and prayers. * Weekly Advent emails to provide accountability and support. * Weekly Devotional Podcast Episodes (That's this!) to expound and reflect on the Advent Study. *** ___________ If this episode resonated with you in any way, would you share it with a friend? We would be delighted if you took a few minutes to leave a rating and review. These truly help to make the podcast more searchable and accessible so that other mothers like you can be encouraged to deepen their relationship with Christ in the midst of motherhood. We cherish and appreciate every single one. ------------------ Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence). *** Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Connect with Rachel on Instagram @rachellynnlawrence
Welcome to PICU Doc On Call, a podcast dedicated to current and aspiring intensivists. My name is Pradip Kamat. And my name is Rahul Damania, we come to you from Children's Healthcare of Atlanta/Emory University School of Medicine. Today's episode is dedicated to Noninvasive and Invasive ventilation in children post-hematopoietic cell transplantation. We are delighted to be joined by Dr. Courtney Rowan, MD, MSCR, Associate Professor of Pediatrics, and the Director of the Pediatric Critical care Fellowship at Indiana University School of Medicine/Riley Children's Health. Dr. Rowan's research interest is in improving the outcomes of immunocompromised children with respiratory failure. She is active in this field of research and has led and participated in multi-centered studies. She is the co-chair of the committee of the hematopoietic cell transplantation subgroup of the Pediatric acute lung injury and sepsis investigators network. In our podcast today we will be asking Dr. Rowan about the findings of her recent study published in the journal-Frontiers in Oncology reporting on the risk factors for noninvasive ventilation failure in children post hematopoietic cell transplant. She is on twitter @CmRowan. Patient CaseI will turn it over to Rahul to start with our patient case... A 15-year-old female with a history of AML s/p Allogeneic hematopoietic stem cell transplantation T+15 days presents with tachypnea and a new O2 requirement. She has been on the BMT floor for 48 hrs after being admitted for respiratory distress and fevers. Her blood cultures are negative but she is febrile intermittently. Her CXR shows nonspecific haziness, no focal opacity, and underinflation. Her weight is up 2KG in the last 48 hours. She is found to have increased work of breathing and mild desaturations to 88%. She is placed on HFNC and continued on broad-spectrum antibiotics. A respiratory viral panel and Sars-CoV-2 PCR is sent. Transfer to the Pediatric ICU is initiated. Episode DialogueDr. Rowan, welcome to our PICU Doc on-call podcast. Dr. Rowan: Thanks Rahul & Pradip for having me. I am delighted to be here to discuss one of my favorite topics. I have no conflicts of interest but I have funding from the NHLBI. Today we will be discussing the up-to-date evidence for NIV (HFNC and NIPPV) use in children who have had BMT. Additionally, we will also be discussing the use of invasive MV strategies including HFOV in the pediatric BMT population. To start us off, Dr. Rowan, why is the BMT cohort different from other patients admitted to the PICU? There is an increase in the # of patients undergoing BMT as indications for BMT are being expanded to different disease processes. The Etiologies for lung disease in BMT patients can be infectious (common organisms as well as opportunistic organisms). They can have lung disease from non-infectious causes and even fluid overload from renal dysfunction/medications given and there is a constant threat of alloreactivity which can manifest as GVHD or engraftment syndrome. 75% of PICU admits of immunocompromised children come from the heme-onc inpatient services. BMT patients have a higher risk to progress to ARDS. Recent reports show the incidence of ARDS in the intubated BMT population reaching upwards of 92%. These patients are also at high risk for MODS and can have a mortality rate close to 60%.
O Come O Come Emmanuel An Advent Reading Plan to Marvel at the Magnitude of the Incarnation Do you long for this Christmas Season to feel different this year? Do you long for your heart to be tender, receptive to Jesus, and in awe of the magnitude of His birth? Perhaps you desire to learn more about what Christmas and Advent are really about, and you desire a theological and Scriptural foundation to strengthen your heart, mind, and soul in knowledge and love of God. Instead of being swept away by the rush and consumerism of the Holiday season, may we marvel at the magnitude of the incarnation, may we marvel at Jesus this year. O come, o come Emmanuel. Join Our Free Advent Study Join us as we read On the Incarnation by Saint Athanasius and “Advent Readings: From Genesis to Revelation,” a Bible Reading Plan curated by Blue Letter Bible during this Advent Season. Our Free Study Begins November 28th When you sign up, you can expect to receive: A five-day per week reading plan for the duration of the Advent season. Our Advent Study Guide, which includes reflection questions, theological insights, daily Scripture passages, excerpts from the daily readings, and space to record your notes, thoughts, and prayers. Weekly Advent emails to provide accountability and support. Weekly Devotional Podcast Episodes to expound and reflect on the Advent Study. *Advent Study to be sent by email on or after Monday, November 22nd Our instrumental background music for this Episode and for our upcoming Advent Devotionals has been played and recorded by one of our talented Momma Theologian Contributors, Kyleigh Dunn. ____________________________________________________ Our study will be led by Rachel Lynn Lawrence, Founder of Momma Theologians. Rachel Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life, and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
Momma, can our heart posture today become one of abiding, resting, and marveling at our God of the Gospel? We welcome you, whether you've heard the Gospel one thousand times before or if you haven't heard anything about it- to hear and absorb it today. If you've felt as we have before- that the Gospel has become something that feels common, familiar, and plain- This is especially for you. Join us for our first devotional and intro episode today; where we will prayerfully discuss and reflect upon the Gospel. DOWNLOAD YOUR FREE WORKSHEET TO GO ALONG WITH THIS EPISODE Go to www.mommatheologians.com Find articles and essays written by mothers just like you as they share stories and reflections about how they grow spiritually in Christ in the midst of motherhood. Join our community on Instagram @mommatheologians Connect with Rachel on Instagram @rachellynnlawrence Receive our monthly devotional ___________ If this episode resonated with you in any way, would you share it with a friend? We would be delighted if you took a few minutes to leave a rating and review. These truly help to make the podcast more searchable and accessible so that other mothers like you can be encouraged to deepen their relationship with Christ in the midst of motherhood. We cherish and appreciate every single one. The Commentary that I referenced earlier in the episode is the Commentary Critical and Explanatory on the Whole Bible, which can be found for free in the Logos Bible App. ------------------- Rachel Lynn Lawrence Founder of Momma Theologians Rachel delights in each day with her husband, Steve, and their three children, Isaiah, Elijah, and Ruth. She enjoys early morning quiet times, being home in their “Northwoods Eden” and deep theological study of God. She has been in Seminary her entire motherhood life and will be completing her MDiv in 2021, with plans to pursue a DMin proceeding that. Prior to becoming a stay-at-home mom, she worked as a Pediatric ICU nurse and specialized in bereavement and end-of-life care. Rachel has a passion for equipping fellow mothers to grow in relationship with God and believes spiritual growth can be revived in the midst of motherhood. Rachel enjoys connecting with others on Instagram (@rachellynnlawrence).
My first guest for season 3 of Still a Nurse podcast is my lovely friend and neighbor Mary. I am so glad that she was willing to be on the show and share with us her journey through nursing over the past 43 years. This episode really shows just how varied your nursing career can be! Tune in to hear about Mary's experiences as a nurse on a pediatric ICU and watching early open heart surgeries, working on a reservation in Arizona with Hope and Navajo tribes, and on to high risk antepartum nursing, and finally finishing out in home health care. This is an episode you don't want to miss!-Mary was educated as a nurse at the Oregon Health Sciences University.-She has nursed in several different states.-Throughout her career she has had several drastic changes in the types of nursing she has done. Her advice to those facing a new nursing job or role is to remember that "The fundamental basis of all nursing is assessing" As long as you have strong assessment skills, are humble and willing to learn and ask questions, in her opinion you can quickly adapt to just about any nursing position.Links:-https://www.ohsu.edu/school-of-nursing Click here to learn more about the program Mary graduated from and speaks so highly of.-https://www.ihs.gov/nursing/Click here if you want to learn more about nursing on reservations.-Do you have nursing stories you want to share? We want to hear them! Email me at soelberg90@gmail.com or go to http://www.stillanurse.co and leave a comment under the "Let's Connect" tab.
In this episode I sit down with Dr. Toni Petrillo who's the Medical Director of the Pediatric ICU at Egleston Children's Hospital part of Children's Healthcare of Atlanta. In this episode we talk about how she spent the last 5 years dropping 123 pounds while still managing a 100+ hour work week. Listen to Dr. Petrillo's incredible story in this short episode and then try to tell me you don't have time to focus on your nutrition ... As always, thanks for listening and use the link below to apply for your NBS membership! Click the link below
I'm as guilty as anyone else of saying that I value creativity, but then as soon as life gets busy, it's the first thing I throw on the backburner. It doesn't help that many of us got the message (from our parents, from society at large, from wherever) that creativity in adulthood is kind of frivolous and should, at best, be relegated to a side hobby. Whenever I find myself ignoring my creative side in favor of more “productive” things, I try to remember this quote from Brené Brown: “Creativity has to be cultivated. Unused creativity is not benign. It metastasizes. It turns into grief, rage, judgment, sorrow, shame. We are by nature creative. It gets lost along the way.” Kara Guilfoyle can attest to just how true this is! After years of working herself into exhaustion in the intense, fast-paced, emotionally exhausting medical world, she finally realized that the best way to heal her burnout and make her feel whole again was to reignite her artistic side. Listen in as I ask Kara about her evolving relationship with her creativity, including... How and why her creative side got shut down when she “grew up,” Her view of the healing power of creativity (you'll want to hear her description — it's beautiful!), Her struggles with procrastination and the many ways she's learned to overcome it, How the “menu approach” opened up a whole new world of creative freedom for her, And her advice for anyone who's craving more creativity, but is feeling stuck on how to prioritize it. After you've listened, leave us a comment to share how Kara's story resonated with you! MORE ABOUT KARA GUILFOYLE Kara Guilfoyle is a reformed workaholic, former Pediatric ICU nurse and Sexual Assault Forensic Examiner who sought healing and refuge in art. She is on a journey of tapping into her divine feminine and expanding her creative self. She is a highly sensitive, INFJ, Thriver and Side-Hustler fascinated with cultural anthropology, horticulture, and a love of all things witchy and woo. She has been informed by her nursing students that she is a Ravenclaw. She is currently working as a Nurse Practitioner in a primary care clinic serving uninsured adults in Los Angeles and is considering getting a dog. LISTEN TO THESE EPISODES NEXT I can't believe this is my life with Solange Luftman Making space in your life (when you don't believe it's possible) with Anna Gore Stop regretting & start creating with Todd Searle Bonus Book Club! Big Magic by Elizabeth Gilbert Bonus Book Club! The Artist's Way by Julia Cameron LINKS Leave us a comment on this episode Take the Passion Profile Quiz Submit your question for a future episode of Dear Krachel Join our Patreon community Check out our YouTube channel
Guts, Grit & Ironman. Ironman Class 101 shared by Janie Bowen and Taylor Cannon. War stories. Podiums. Training. Balance. In this episode you will be introduced to two Mi Duole team mates who are filled with guts, grit and passion. That passion took them into the world of Ironman. Both have completed multiple full length Ironman events. Taylor grew up very active in sports. He played high school football, basketball and Rugby at the University of Utah. He then turned to running after he got married. He ran his first marathon in 2006 and has since then run over 20 marathons. He has qualified for the Boston marathon a multiple times and ran Boston in 2015. His fastest marathon time was 2:52 in St. George in 2016. He ran 2- ultras (50 milers) and then decided to move onto different goals. He turned to the ironman world in 2011 with St George Full ironman. He has done 4 full Ironman's, 9 half-Ironman's, and a few other triathlons. Since learning to love cycling through Ironman he has done the Ultimate challenge, multiple centuries, and LOTOJA 3x. Meet Janie Bowen...At the age of 5 Janie was diagnosed with a vision robbing autoimmune eye disease that has led to ~6 eye surgery including a lens replacement in her right eye. She has received steroid injections straight into her eyes more than 100 times. At the age of 13 she was involved in a terrible boating accident requiring her to be life flighted from Lake Powell. She had pins put in her hip to fix a spiral fracture of her femur. She had her hip replaced at the age of 20 because of necrosis from her femur fracture. Janie didn't allow health struggles to define her life. In high school she excelled in swimming winning the 200 IM 5A state championship. Janie started doing triathlon in 2017 starting with 1/2 Ironman in Santa Cruz. She had since completed 3 full Ironman races as well as countless 1/2 Ironman races. She raced and got on the podium in her first LOTOJA after joining the team in 2019. She worked for 6 years as a nurse primarily in the pediatric ER, adult ER, Pediatric ICU, and NICU. She then went back to school and became a Women's Health Nurse Practitioner and Nurse Midwife. In September she gave birth to her beautiful baby (Blue). Step in and get ready to be inspired by these two incredible athletes. This episode and team are gratefully brought to you by our friends at Hanagar 15 Cycles. All our thanks go out to Mike Hanseen (master bike fitter) and his crew for taking care of the Mi Duole team.
In this episode we are joined by Tracy Webb a pediatric ICU Nurse. Any choice in the end of life care is difficult. We had a conversation with someone who deals with it often. Oh... did we mention Tracey is GI Jane?!
Episode 005: Marisol Adewunmi, pediatric ICU nurse, and Jeff Watson, TNA Past President On this episode of the #NurseLife podcast, we wanted to continue our conversation regarding mental health and why it is SO important that we continue to have these conversations and offer each other support. 2020 has not been easy. To say the least. And while nurses tend to be painted as strong and heroic figures, the fact of the matter is that we are tired. This pandemic will definitely leave an impact on our profession and will require some recovery. And so that’s what we are going to focus on today. What does that recovery look like and how do we use this pandemic as an opportunity for nurses and organizations to flip the script on burnout.
BUZZARDSKORNER OF LOVE RADIO presents......Pandemic Health For Children, Angels we here have focused so much on Adults and Adult Well-Being that sometimes our Childern can be forgotten which is why we here at BUZZARDSKORNER OF LOVE are dedicating this show to Kids! Tuesday 9/22/20 4pmPAC right here @http://www.blogtalkradio.com/buzzardskorner-of-love Reverand Herracia Brewer is a native Angeleno who has the loving distiction of being one of the first Nurses to be hired at Martin Luther KIng Jr. Hospital in the Pediatric ICU. Following that she transitioned to Los Angels Unified School District as a Counselor of Crenshaw High School. During her encounter ther the graduation rate increased by 3% each year. Additionally during her years of service at Guidance Church she has served as Director of Youth and Family Ministries. After Graduating from Earnest Holmes School of New Thought she became the Minister of The Light and Truth Church of Science. Reverand Herracia published her first book Sheter In A Storm in 2016 and her 2nd book Restoration Now which appeals to a larger Audiene to Inspire, Restore, and Motivate the Divine Aspirations of her readers. Angels, Reverand Herracia Brewer will be with us as this will be geared toward Childern and staying safe in this COVID19 experience. Join us Tuesday 9/22/20 at 4pmPAC right here @http://www.buzzardskorner.com Check out our Coaching Packages, Sign up for our FREE monthly Newsletter, download our latest E-Book, join our Community on FBK, Instagram, Twitter. BUZZARDSKORNER OF LOVE RADIO bringing people back to themselves
Full of motivational advice and tips, this episode is a must listen with Vibha Sreenivasa, a pediatric ICU registered nurse! Learn more about the world of nursing and receive beneficial advice that will assist your journey into a desired career. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this week's episode we are once again blessed with the presence of my wife. To be honest as a dad who has done absolutely zero preparation for a baby, I feel as though I'm as prepared as anyone else could be.My wife works at one of the top children hospitals in the country in the Pediatric ICU. She is constantly taking care of the sickest children who range in age all the way from newborns to teenagers. She might be the most prepared person on the planet for this. So there are a lot of helpful and useful tips on how to prepare.We talk about getting ready for the baby, packing hospital bags, getting in parenting mode and preparing for when the little one comes home.Follow Dads Being Dudes on social media:Instagram: https://www.instagram.com/dads_being_dudes/Facebook: https://www.facebook.com/Dads-Being-Dudes-114969293480201Twitter: https://twitter.com/_dadsbeingdudes
A local hospital helps its teen patients forget about their illnesses for a night. Then, #OscarsSoWhite is back. We'll hear a high schooler's take on Asian representation in Hollywood. And, we've got a love story from the StoryCorps booth.
Leah Bodenbach is a registered nurse, mom, wife & lover of: natural living + functional medicine + preventive wellness. She’s worked in the extremes of the Pediatric ICU and a birthing center with the most amazing midwives. She loves straying from recipes and involving her toddler in preparing all the meals (even though it takes twice as long), and hates to enjoy a meal alone. Her brand and coaching practice Blooming Motherhood seeks to cultivate a nourished family, by integrating holistic living + ancient wisdom, and bring all this goodness into the hands of the modern mother. Follow her journey on Instagram:https://www.instagram.com/bloomingmotherhood/And find out more about her practice at:https://www.bloomingmotherhood.co/SHOW LINKSNourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and Diet Dictocrats:https://www.amazon.com/Nourishing-Traditions-Challenges-Politically-Dictocrats/dp/0967089735The Nourishing Traditions Book of Baby & Child Care:https://www.amazon.com/Nourishing-Traditions-Book-Baby-Child/dp/0982338317The Vaccine-Friendly Plan: Dr. Paul's Safe and Effective Approach to Immunity and Health-from Pregnancy Through Your Child's Teen Years:https://www.amazon.com/Vaccine-Friendly-Plan-Effective-Health-Pregnancy/dp/1101884231
In an effort to educate the "whole child" as many schools do, we are grateful for the opportunity to consider students' physical, social-emotional, and spiritual well-being through the efforts of two amazing staff members: Amanda Robert, RN, our Director of Health & Wellness and also Valerie Hubbard, PLPC, our School Counselor. Together, they empower our faculty members to care for our children's needs while giving students a challenging education and meaningful community. This two-part series will give you a window into how we seek to care for all of God's image-bearers. In Part 1, you'll hear about Nurse Robert's journey from the Pediatric ICU of Children's Hospital to Central Christian School, her passion for good communication, and ways parents can partner with her for the good of your children and the school at-large. RESOURCES:A letter from Amanda Robert, RN, to the Central community
Interested to know what working as a pharmacist in a pediatric hospital is like? Well, listen up! On this the first segment of Work-it Wednesday, Jake Luke gives us an insight into that world, and you won't be disappointed!
Carolyn Koppel founded Aaron's Coffee Corner while sitting with her son Aaron in his hospital room. Her mission is to provide 24/7 access to free Keurig coffee to the family, friends and caregivers admitted to the Pediatric Intensive Care Unit of Ann & Robert Lurie's Children's Hospital of Chicago. Find out more at AaronsCoffeeCorner.org. Read more about The Passionistas Project. FULL TRANSCRIPT: Passionistas: Hi and welcome to The Passionistas Project Podcast. We're Amy and Nancy Harrington. Today we're talking with Carolyn Koppel, the founder of Aaron's Coffee Corner. Carolyn left a career in Hollywood to return to the Midwest where she worked at the Shoah Foundation and Oprah Winfrey's Harpo Studios. Most recently she founded Aaron's Coffee Corner, while sitting with her son, Aaron, in his hospital room. Her mission is to provide 24/7 access to free Keurig coffee to the family, friends and caregivers of patients in the pediatric intensive care unit of Ann and Robert Laurie's Children's Hospital of Chicago. So please welcome to the show, Carolyn Koppel. Carolyn: Hello. Thank you. Passionistas: What's the one thing you're most passionate about? Carolyn: I feel that of course, right now I'm passionate about this project and getting coffee to people that really could use it, but I think in general, as I look back on my adult life, I've tried to work with organizations and people that do good, which I didn't really think about, but it turns out that it's a running theme in my life and I'm pretty proud of it. Passionistas: Why do you think you're drawn to projects that help other people? Carolyn: I think it's just my upbringing. I think I grew up pretty happily and my parents were always very kind to people and I think that my family has nurtured that. And as I went through middle school and high school and college, it's something that I carried with me. I think it's just my upbringing. I'll give that credit to my parents. Passionistas: How does that translate into what you do in your day to day life? Carolyn: Well, right now my day to day life is nothing that I thought it would be like 14 years ago when my child Aaron was born. So over the last few years I've thought about what can I do? Should I get a job? How can I get a job? Because there's a lot of medical appointments and there's a lot of time off if parent gets sick, how do I tell people that I need a really flexible job that can allow me to care for my globally delayed and medically fragile child? So it's been a journey to try and find something that I can do. And along the way I've volunteered on a parent board, um, for a local organization here called North suburban special education district, which my son is a part of and has been a part of. And I slowly got back into the idea of filling my time, trying to help somebody else because after you're in a situation like I am, it takes a long time to kind of settle into your life. And I think that just over the last few years we've had a little more regularity so you can kind of look outside of what your craziness is and say, Oh, other people have it worse than me. And I think that when I started going to the hospital, I think that played a big role in how I was going to handle life with Aaron. And that I always looked around when I was in the pediatric intensive care unit and thought, Oh my God, look at these people. They have it so much worse than we do. And I think that always rang true that no matter how frustrating and how difficult and how ludicrous you feel your life is, somebody has always got it worse. So it took a long time to kind of get to the point where I'm like, okay, well it's always going to be like this. Let's see how we can help other people because now I have things a little under control and let's open it up and see what we can do for others. And that started to happen about four or five years ago, but I couldn't really find what I needed until I was so frustrated in the middle of the night in a hospital room that I couldn't find some coffee. And that's really how we got here. Passionistas: Let's back up a step. Tell everybody about Aaron and why you're in the hospital so much. Carolyn: So my son has something called dihydro perimeter ING dehydrogenase deficiency. And it's not necessarily uncommon to have this disorder, but it is to have it from birth. So his symptoms started showing very early and at about 18 weeks he had a seizure and then we knew something wasn't right. And we took ourselves to that hospital and we needed to get transferred down to Lurie's children's because they didn't know what was going on and they had to get the seizures under control. So this disorder was known to people. And when Aaron was admitted to the hospital, he was there for about, I think the first time, about eight days. And they just did a battery of tests and they were trying to figure out what was wrong. And they did EKGs to see about his seizure activity. And they took all kinds of blood tests and one test from that very admission kept coming back positive. And I remember that genetics factor coming in and saying, well this is something we're going to have to test again because I've never seen it in my career. So we're gonna send it to the Mayo clinic and have the, his blood tested it and then we're going to see what they say. And then it came back from the Mayo clinic and they said there's one man in the Netherlands that's doing research on this particular disorder. You did test positive for it and can we have blood samples from your whole family and urine samples and send them to him? And when that was confirmed, we knew what his diagnosis was. So a lot of kids that are medically fragile and globally delay, they don't have any kind of diagnosis. So we were lucky right there that we had something to hold on to. And the way that we knew that this was what he had was because there was a drug called five plural are soul, that men in their forties when they get prostate cancer, sometimes we're treated with this drug and it had horrible side effects including death. So this man in the Netherlands had created a urine test that could test before they had this treatment to make sure that they can get it. And that's the test that Aaron kept coming back positive for. So they pulled it back around and they said, we don't have very much information on this disorder, but we know that children haven't lived past the age of three. So that was his diagnosis and his prognosis very early on, at around under a year. And that's a shock. Let me tell you what he suffers from I guess. So he has epilepsy. He suffers from unmanageable seizures. He's globally delayed. He is not verbal and he is non-ambulatory, which means he is confined to a wheelchair. He doesn't really have the use of his limbs. So I guess he would technically be classified as a quadriplegic. And he has excellent hearing and a really good sense of spell. So he's fed through a G tube. He's on a number of medications, which he also takes through his G-tube. And as a result of the disorder, besides the epilepsy, he has lot of pulmonary issues, breathing issues. He's had pneumonia a few times. And one of the many reasons we've been in the hospital so often is that it doesn't take very much for him to get. And when he does, he has a really hard time recovering from it. So he's just a really sick, handsome little guy, you know, and, and he's just a love. He recognizes voices, he smiles when he's happy, whether you know why he's happy or not. It's always good to have him smile. And I think that he is surrounded by so much love that he emanates it back. He really is a lucky kid and we're lucky to have him. Passionistas: We're sorry that you've had to deal with all that. Carolyn: Oh, it's okay. It's all right. It's turned out to be a pretty good life unexpectedly. Passionistas: Let's go back and talk about your path to getting to here. So you studied journalism at the university of Wisconsin Madison, and what were your goals at that point when you graduated and what did you do? Carolyn: Well, my goal at the university of Wisconsin was to get out of the cold when I graduated. And my parents had already had that idea and they deserted me while I was living while I was in college. So they took off or Arizona and I went and shacked up with them for a year and I worked as a stringer producer. So there was a company in Arizona and we would do work for the Phoenix suns and for lifestyles of the rich and famous and for ESPN and all those kinds of stringer things. That was anything that was happening in entertainment tonight. Anything that was happening in Phoenix, we would run out and do a little bit and I would be the person holding the little microphone and asking the questions off camera. And a friend of mine had already moved out to California and she's like, well why don't you come out here? And I'm like, okay. And I had another friend from Arizona that happened to be going to California for a summer program and she and I ended up being roommates with a couple of other girls and I got a job. I was, the first thing I did is I went to limited express to make sure I could work for them while I was there cause I had to have a job. And I had done that on and off. Like through school I had worked at limited express. So that was my first thing. And another friend of mine said, well why don't you come in and interview and see if we have a job for you at Viacom? And it was via con television. And at the time it was Dean Hargrove and Fred Silverman and they were doing all of these shows that old people like “Jake and the Fatman” and “Matlock” and “Perry Mason” “Diagnosis, Murder.” It was awesome. And I ended up working for a woman who was the script production office manager, Donna and I was a script coordinator. So the first thing she had me do was learn how to type better because my typing skills were not up to par because I thought I'd be a broadcast journalist. From then on I was in a pretty good place. I was like, this is cool. I have a great group of friends, we're all in it together, we're all starting out. And it was a really great experience and I had done that for about four years. And I remember a friend of mine asked me to go see a movie and the movie was Schindler's list and I remembered that at the end of the movie we were on the universal lot and we had seen it in a screening room. And at the end of the movie it said that Steven Spielberg was starting a foundation to interview Holocaust survivors. And I was like, Oh well, if I remember correctly, he's my neighbor on the universe a lot. So let me send him some universal mail with my resume in it and a letter. And that got me introduced to the show foundation. And by then I was in California for five years and I was known as the crazy aunt from California. All my nieces and nephews were being born. It was like a machine out West out East. And I was like, I should see if I can give them an idea and see if they'll give me a job. So when I sent them a letter, I said, I really do believe that you're going to be wanting to locate in Chicago, Illinois and I'm from the Midwest and I'd be more than happy to run your production office from Chicago. And they said, well that's a little far off because you know, we're in one trailer in the back of Amblin entertainment right now and we have to get set up here. And I said, well, I'm happy to volunteer or whatever you need. And so eventually I volunteered there and they offered me the job in Chicago. So I became the Midwest regional coordinator for the show foundation. And that brought me back here. After that project was over, I went on to Harpo and an interviewer that was working for me on the show foundation said, Oh, you should meet my friend at the Oprah Winfrey show. She's a producer. And I said, okay. And I had coffee with her and I told her what I did and she went back to the office and told her, her boss, one of the producers and said, you know, you're starting up this new project, maybe she's the one for you. And I went in and I interviewed for that job and I got it. And it was the very beginning of Oprah's angel network, the original version of it where we raised money for kids to go to college and we built houses with habitat for humanity. So between the Shoah foundation and recording these visual histories of what had happened to these people during the most horrific period of time in their lives, and to show at the end how they've survived and how they've created new families and continue to do good in the world. Then to go top Harpo and give back to communities. It was just kind of a theme I was on and it was great and I was like, okay, what's the next thing? And I had been at Harpo for a little while and the angel network had kind of morphed into something else and they were opening up Oprah online, they creating their own website. So I moved over to that website and I helped them start that website. And I learned a lot about things that I never thought I would know about, like HTML and all that kind of stuff and how to create a website. But it wasn't really hitting the Mark for me. And I enjoyed my time there, but I had met my husband by then and he's like, well go look for a different job. And I think he found out about my next job, which was for adventure, which was an educational technology company right in the middle of the bubble. It was all very exciting and I was the operations manager and it was great. And then the bubble burst and I was four months pregnant and I look like I was eight months pregnant and one of those people that as soon as I got pregnant I looked like I had been pregnant for 17 years because I looked so pregnant at the beginning and I was like, I can interview for jobs because who's going to take a pregnant woman? And then I had my first child and everything was working out all right, we bought a house, my husband was working, did I really need to go back to work? Not really. I was lucky and I did some work here and there and a little production work and then Aaron was born and that's when things kind of took a little different path. And so I became the primary caregiver and I think all of those lessons that I learned from all of those jobs, I think that's the secret to really getting through life is to remember what you've learned and bring a little of that to your next project and bring all of that to your next project and to build upon it. And I think that by the time Aaron came, I kind of knew this was going to be okay and it's not horrible, but we don't know what's going to happen. And once he hit three years old, we started having a birthday party every year. We just had his 14th birthday party and my backyard this weekend. And I'm telling you, there's tons of people that come in there, his therapists and doctors and nurses and our family and friends that have supported us for 14 years, you know, that have gone through the highs and the lows and the hospitals, hospital visits. And I mean it just makes you realize how lucky you are. I think that they always say maybe a Maya Angelo says it. If you find it in your heart to care for somebody, then you've succeeded. So if you keep your heart open and you try and do the best you can for somebody else, you're going to get through the next door. And that's kind of how I got to where I am. I just, I love being in broadcast journalism, but I really loved helping other people and being a part of a bigger project and I think that's just the path I took, which turned out to work well for me. And I'm using all those skills now. So it's pretty remarkable. Passionistas: We're Amy and Nancy Harrington and you're listening The Passionistas Project Podcast and our interview with Carolyn Koppel. To learn more about her mission to provide 24/7 access to free curd coffee to the family, friends and caregivers admitted to the pediatric intensive care unit of Ann and Robert Laurie's Children's Hospital of Chicago, visit AaronsCoffeeCorner.org. Now here's more of our interview with Carolyn. Passionistas: How did the day to day skills you learned when you were in production apply to your life now? Carolyn: We're going to take a little downturn for, for a minute. And I say that with as light of an attitude as I can, but when you're told that your child is not gonna live past three, so for those first few years, you're not sleeping, you're listening for him to breathe and not to have a seizure every night. And then when you wake up in the morning you're like, Oh my God, we made it through the night. You know, cause you always think it's going to be nighttime when something happens and you're gonna walk into that room and something horrible will have happened and there goes on for many, many years. And once he hits three, you're like, how long is it going to go on? How do you plan for it? So you're going to be here one year and then gone the next. It's like when you get classified, you get the hanging sticker that says you're driving a car that has a handicap ramp or something, that little hang or the blue one. And then they're like, you know, well maybe you should have a license plate. And I'm like, no, because if I get the license play, maybe that's like superstitious and then something horrible is gonna happen. So there was a lot of that year after year, like I didn't want to think too far ahead, but here I am with a ramp van with a license plate that says we're handicapped. So you have to jump over those hoops to get where you are. And I think that's just a positive attitude. If you let go of what you think you're supposed to be doing with your life and then you're going, okay, well what am I supposed to be doing with it? Every time you do that you get a little further down the line. And I think I took that from all of my experiences in working with people and just volunteering and stuff like that. So I think I might date today. It really played a role in just moving forward everyday move forward and see what happens. And here we are. I mean it's kind of worked, you know, we have these moments where he gets RSV or he gets pneumonia and we're in the hospital and we are at that point where people are talking about do not resuscitate letters and what do we have in place to move ahead with his treatment? Or do we put a breathing tube in so he can recover from his illness? Or is the breathing tube something that's keeping him alive? Like is it because of his underlying disorder that he needs some breathing tube? So you're making those distinctions and you're looking at your child who's on all kinds of machines in a hospital and you're like, okay, what if we have to bury him next week? And those are not the kind of thoughts you want going around your head. But it's very practical and I'm a Capricorn and that's how I think. So I think the first thing that we did when those things kind of started happening, we were concerned about my older son Eli, who's 17 now and terrific and I was like, who is he going to talk to if something happens to Aaron? Because he's not gonna wanna talk to me or, or my husband stuck. I don't want to touch him. My sister, he needs like a third party. And I remember doing that early on, he was probably eight or nine and I thought, okay, we have that taken care of. We have a place for Eli to kind of process his feelings, but we have to, um, plan for things that you just don't think you need to plan for. And there are things that people don't want to talk about. Like you just have to, uh, compart mentally maybe and say this is where he'll be buried and when it happens, this is how we'd like it to happen. But those change, all those things change as you go through the process. I think that just understanding that it's going to be okay. You don't have a lot to do with it. Right? And you just have to understand it and not accept it, but understand it and move through it because it sucks. Don't get me wrong. So I think that's what gets us true to this situation where I was like having a little self pity party and I was really upset that I couldn't find some coffee at 10 o'clock at night. What's wrong with that? And it was really frustrating and that's at one of those times when you have a sick child, you kind of know that something's happening, right? Like he was not his normal self and he was having seizures that he didn't usually have and he was having some seizures that he hadn't had for a long time. So things were changing and you know that it could be growth, you know, it could be diet, it could be age, they have all these reasons for all these changes to happen and you end up going into the hospital a couple of times a year to have things checked out and that's where we end up. We end up in the hospital because everybody wants to help and the best possible way, except when you go for an EEG and people don't realize that there's a lot of times when you go into the hospital and you don't have full nursing care, you're on a floor and you're there and he's having all of these electrodes attached to his head and you're responsible for hitting this little alarm when you think he's having a seizure. So they can watch the video and look at the EEG printout and kind of determine if it's a seizure, if it's neurological, if they can say that it's a seizure or not and how to treat it, but you're the one for three days. In Aaron's case, we were there for three days this last time so we could be sure to catch what was happening and you're the one that's for doing it. You give him his meds, you are awake, you're watching the activity as it goes through, and then when you go to bed, there's somebody that comes into the room and watches it on the camera so you can't leave the room. You can't go down to elevators to get a cup of coffee or one elevator to go to the cafeteria because it's not open and room service is closed and then you just getting pissed, right? You're like, I have to stay up until midnight to turn him his last time. So Aaron, since he doesn't move, has to get moved every few hours. And the longest time that he sleeps on one side is from midnight to about six in the morning depending on when my husband wakes up. So I always have to stay up until midnight. And I was really frustrated and I'm like, why isn't there coffee ever in the hospital when I need it in the mornings before the rounds happen or the doctor start check again at seven o'clock in the morning and I've been up since five, why do I not have little more access to that? And I started thinking about it and I thought, well let's ask Keurig to help. And so that night, I think it was 10 45 I wrote them a letter and I said, it's 10 45 at night and I can't get a cup of coffee and how can we work together to make that happen in the hospital. And I had big visions of every floor having a Keurig machine for the families and it would be great and super easy. It seems so simple. And the rest of our stay happened. I wrote the letter, I put it aside, I went back to my job as seizure alarmist and couple of days later we went home and I'm like, Oh I wrote that letter, I should go read that letter. Maybe I'll send that letter. So I went back and I read it and I told my husband that I had written this letter and that I'm going to mail it out to the CEO of Keurig. So I did and I didn't hear from anybody and I was like, maybe I should send it to like the whole board of Keurig. So, cause it was Christmas time and who's really reading their mail and they're probably all off on vacation. And so in January, I think I sent it to all the board members listed on the cure USA website. And in February I got a phone call from this man, so I'm looking for Carolyn capital. I said, does this Carolyn? And he said, this is John Barrett from Keurig. And I'm like, it is not John Barrett from curate. And he's like, yes it is. And I was like, I was just trying to figure out how to start a fundraiser at Lurie's and how much a pure coffee machine would really cost. I'm doing all the research right now. And he's like, well, we'd like to help you out with that and as like you are kidding me. And he's like, no, whatever you need, figure it out, we'll help you. And so from that point I was like, I had already been complaining to people for two weeks and making sure that I was in the right. Nobody was going to disagree, that I don't deserve coffee when I want coffee. And I was getting a lot of really good feedback. I could have been because I was a little aggressive, but I knew that I was right. So I got in touch with Lurie's and I said, listen, I have this offer from Keurig and wouldn't it be great if we could get a machine on all the floors? And they're like, hold on there we are a huge hospital and we got to figure out if we can do it. And I, I got a few notes and this is when you learn that no is just the wrong answer. And if you keep complaining and keep talking about it, somebody is going to hear you and say, Oh well why can't we just try that on one floor? Because I had already gotten it down to that. My big dream had come in like how about a pilot program for three months? Can you give me that? And they're like, I don't know why we can't. That's a really reasonable thought and let me explore what we can do. So when this was all happening, it was my son's 13th year and in September I knew we were having a bar mitzvah. So in my mind, without telling a lot of people when I was up to, I was like, Oh, that would be a great way to kick off Aaron's bar mitzvah. You know, if people want to give money, we've always given money to make a wish. When I think Aaron was five, so Eli must've been around 11 we went on a Make-A-Wish trip and it was to this day, the best trip we've ever taken, I'm very grateful for that organization. And at every birthday for Aaron, we've always asked people to donate to make a wish. And I thought they've gotten enough money from us. We've paid that trip back. We sent a few kids on their own. We are all good with them. Let's see if we can switch directions and put our energies into this project. And so I had all of this formulating in my head and I kept getting no. So there were a few more phone calls and then one woman, Barbara Burke from the founders board. I think at Lori's called me up to give me the final no, and I kept her on the phone and she's like, I'm going to find out why we can't do this. I have a Keurig machine in my own house. It's very easy. I'm like, I know. So what's more? He got on board, it moved really quickly and we were able to set up a website through Lurie's about what we were doing and we were able to get it all done before labor day weekend in September and at his bar mitzvah I got up and told people what I was going to do and all of a sudden people were donating and people were sending me pictures of how they were using their mugs because everybody got a mug at the bar mitzvah and they'd fill up with pants or they'd show me their copy and I had an enormous help from, she's down my social media coordinator, but she's been Aaron's babysitters since he was one years old. She just said, we should put it online and this is a social media thing and you need an Instagram and a Facebook and a Twitter. And I'm like, I don't know how to use any of that. She's like, I'll teach you. And from that moment on, we've really snowballed when I was first formulating, and in my mind, people are going to give you money to give coffee to people. It's not for research or it's not for, you know, blankets or something for the kids. And I'm like, I'm done with the kids. Kids get tons of stuff. I don't think people realize that it's the whole family is part of the experience. And if you can bring a little comfort to the family in the smallest of ways, it's gonna make the biggest difference. And I always felt like if we could help the families, we were helping the child because you create less stress, you create a little peace of mind and it makes you better at navigating all of this unfamiliar stuff. All of the machines. Your child is all of a sudden hooked up to the medicine that I V bags, the noises in the hospital, the family that wants to desperately do something for you and they don't know what to do. You know, these are all ways you can help the whole community that supports you to make it a little easier. And I, I think it's a great idea and I just wish, you know, we can take it to a second floor and then a third floor and eventually as we continue, we can create grants for smaller hospitals. Set could use a Keurig machine, maybe don't know, pick you because they aren't big enough to have a pediatric intensive care unit, but maybe in their emergency room, you know, maybe we can spread a little bit of the comfort and help a lot of people. It doesn't take much. And I think the simplicity of it is really what's people are like, wait, what? You're just going to give them some coffee? I'm like, yeah, yes please. I think that people don't realize one in the hospital, it's expensive. So let's say that all of these years, until about two years ago, we got a Illinois medical waiver. So it helps us with everything. Like the 20% the deductibles, it goes through our insurance and then it goes to this waiver program and they help pay for it. So for the first 12 years we paid to have our house redone so we could have a wheelchair in the house. We had paid for diapers for 12 years. Those are big diapers and they're not like little Pampers. You can run to the store for wipes, gloves, you know, Chuck's for the bed, we have a really nice laundry machine because we do it all the time. We've spent all this money that people think, Oh that's like everyday kinds of stuff. But I don't think everybody has like a $700 a month bill for one medicine every month. Right. And they think, Oh well you have insurance and that's with insurance. So it's like paying for college but not saving for college for all of those years. And you're trying to save and you're trying to move money around. And that is stressful on its own. So these people that find themselves in the hospital in an emergency that we're counting on that. Like I been doing this for a long time. I know that when I used to go into the hospital and I got up $536,000 bill, I needed to pay 10% of that to the hospital. And that's a lot of money. So for years I was on a constant payment plan and I think that people, one, they need to know about those payment plans. Any hospital will take a payment plan and you should ask about it and get on it and only give them what you can afford. If anything anybody hears today, that should be it. But it's stressful. Money is stressful, sickness is stressful. So when you have those things mixed together and you find yourself in a hospital and you're like, can I really afford a $4 cup of coffee at Starbucks down the way? Maybe not. Maybe I could get a free cup of coffee down the hall and be back in time to talk to the nutritionist or the doctor. That's coming around. And if I'm gone for a couple of seconds, the nurse can say, Oh, she just went to get a cup of coffee. She'll be back in moments instead of finding out where the doctor is on the floor and what time rounds usually are, and then to rush out, get your copy and something to eat and then get back to your room so you don't miss anything. It's a whole different like universe inside a hospital. And it's even more difficult and unnerving to be in a PICU because a pediatric intensive care unit, just like when adults go to an intensive care unit, things are not good. So the best day, and I've said this before in the PICU, is the day you leave the pick queue and you want to leave the PICU. So it's just a different way of thinking of it and really simplifying it and saying, we appreciate what you're going through. We been there, we're a family that has experienced it, and we want you to know that it's going to be okay. It might take a little while. The journey is a long one and you just gotta stick with it. Passionistas: Is there one lesson you've learned so far on this journey that sticks with you the most? If you have a good idea and you hear no a lot, that you should take a risk and just keep trying for yes. Carolyn: I think that's a really big lesson to learn and that these things take time. You know, it takes a long time for somebody to say yes and it's worth it at the end when you hear yes, just don't give up. It's not anything great, but it's hard to do in practice is to not give up and just not take no for an answer. Because when you don't stop, there's going to be a door that opens up and somebody's gonna say, Hey, I'm there with you. And I think that's important to keep in mind and, and learn about yourself. Stick to it. If miss, I don't know. It's been a good journey. Hard, difficult, sad, glorious, fun. I mean all of those things. But it's still a journey. And at the end, we're all going to meet our end and the Aaron's going to meet it in its own time surrounded by people he love living a life that has been glorious because the people around him are glorious. What more could you ask for really? Right. So it's all gonna be good in the end. Passionistas: Thanks for listening to The Passionistas Project Podcast and our interview with Carolyn Koppel. To learn more about her mission, to provide 24/7 access to free Keurig coffee to the family, friends and caregivers of patients in the pediatric intensive care unit of Ann and Robert Laurie's Children's Hospital of Chicago, visit AaronsCoffeeCorner.org. And be sure to subscribe to the passion Eustace project podcast so you don't miss any of our upcoming inspiring guests.
Pediatric ICU nurse Carter Todd RN, MS, CCRN, switched from athletics to nursing and this changed his life completely. On graduation he realized he could help both his community and the nursing profession by advocating for greater workforce diversity. Carter went on to start his local NBNA chapter and create a barbershop outreach program. In California, health access is the number 1 issue, like most other states. But uniquely, California has the highest number of undocumented or uninsured agricultural workers, all deserving and needing care. Carter discusses the importance of health literacy and integrating an understanding of social determinants into day to day care decision making and talks about a collaboration with the African American Health Legacy initiative to bring preventive health to the community. With Carla Harwell, MD.
Pediatric ICU nurse Carter Todd RN, MS, CCRN, switched from athletics to nursing and this changed his life completely. On graduation he realized he could help both his community and the nursing profession by advocating for greater workforce diversity.
FULL EPISODE EPISODE SUMMARY Conversation with Dr. Mardi Steere about Mission, Leadership, Emergency Medicine and Ebenezer Moments from her 8+ years at Kijabe Hospital. EPISODE NOTES David - So today, I'm talking with Mardi Steere. This is a conversation that I don't want to have. It's about leaving about memories, and about Kijabe.And I don't want to have it because I don't want you guys ever to leave. That is the hardest part of life in Kijabe. But amazing people come and amazing people go and you're gonna do amazing things and stay in touch. First, why don't you give the introduction you gave at the medical team the other day. Mardi - So this is bittersweet for me as well. We came to Kijabe in 2011 and planned to stay for two years and here we are eight and a half years later, taking our leave. And in some ways, it's inevitable. You can't stay in a place forever. It's been a real opportunity for me to reflect. David - Let me pause you real quick there. So when you first came, who is we? And then what did you come to do? Mardi - In 2011, I was a young pediatric emergency physician with an engineering husband looking for a place where we felt like God had said "To whom much is given, much is required," and we knew our next step was to go in somewhere with the gifts and the passions and the exposure and education that we've been given. And so I came as a Pediatrician, and the hospital hadn't had a long-term pediatrician in quite a while. Jennifer Myhre had just joined the team in 2010 and my husband Andy is a civil engineer and project manager, and now, theological educator as well.We moved here with our then two-year-old and four-year-old to do whatever seemed to be next. David - That's amazing. So give the theological introduction to the Ebenezer. Mardi - It comes from first Samuel Chapter 7 verse 7-12, where there's a battle between the Philistines and the Israelites and Samuel lays a stone to God for being faithful and to remember what God has done. When Andy and I got married in 1998, actually, it was a scripture that was read at our wedding. And we were encouraged when these Ebenezer moments come, take stock of them, step back, and acknowledge what God has done . Those moments will be key moments in your marriage. As I was talking to the medical division the other day, I felt like it was just another reminder that, as we have our professional lives and we work in a place like Kijabe and we serve, it's really easy to get caught up day-to-day in the daily struggles that we all have - with life and death and bureaucracy and not enough money and not enough equipment and team dynamics and conflict. But there are these moments when we take a step back and we see what God has done. This hospital has been around for 100 years, and I've only been here for a little over eight of them, but there are so many moments where I look back on where we've come from - and the journey that we've been on - and I see these landmark moments of God intervening. David - How do you see the balance here between medical excellence and spiritual - I don't know if excellence is the right word - between medical excellence and spiritual excellence. I think the origins of medicine were very intertwined with the spiritual, but at least in Western medicine, it's very divorced and I feel like in some ways, what I see happening here is not taught in classrooms anywhere else. Mardi - This is one of those things that I am going to be taking with me for the rest of my life. I don't know who's listening to this, but Americans have a cultural Christianity where it's acceptable in medicine, I think, to ask medical questions and maybe you ask a spiritual question and saying God bless you and bless her heart, and praying for people is somewhat accepted but still it's a parallel track to medicine. In Australia, it's completely divorced. There's almost a cultural fear of discussing the spiritual in Australia, a very agnostic country. So to be a Christian in Australia, you have to make a choice. But then when you go to medical school, it's taught to you almost don't bring that in. This is a science, and one of the things that I love about Kijabe is that they are inextricably intertwined. There isn't a meeting that we start here without prayer. When I'm covering pediatrics, as a clinician, we start with team prayer and depending how busy things are, if you're trying to see 30 patients on rounds, you might pray for the room, as you start. We ask the parents how they're doing, and then we pray for the mom with her permission, and for the baby or the dad or whichever caregiver is there. We ask God to intervene, we ask God to give us wisdom, we ask him to be a part of the science. We ask him to be a part of the conversations. When it comes to the even bigger picture, when it comes to strategically planning the hospital, and our core values again - they're inextricably intertwined, and it's a gift. One thing that I'm gonna take with me as a leader and as a clinician, is that it is not difficult to ask anyone, "What is your world view and what is your spiritual worldview? Because all of us have one in Australia. That world view might be... "I don't believe there's a spiritual realm." That's so important to know. But what if the answer to that question is," I believe in God, but I don't see him doing anything." What an opportunity we miss. What if we have immigrants in our population in our community, and we don't ask them "What is your spiritual and cultural world view? What do you think is happening beneath the surface?" and we don't give someone an opportunity to say without derision, "I think I've been cursed" or "There is a generational problem in my family," and we don't open up the opportunity to intervene in a way that's holistic, much we miss by not intertwining the spiritual and the physical? The fact is every one of our communities has a spiritual world view, and shame on us if we don't explore it with them. David - Amen. It's fascinating here because before coming here, I thought of missions as giving. The longer I'm here, the more I think of it as receiving. When you stop and pray for a family, the encouragement received from those family members is huge. The trust and the love, and you do see people who come in the halls and you ask, "Why are you here?" "Because my doctor will pray for me." Mardi - So what's interesting to me is there are some conversations going on in medicine around the world right now about this "innovative new concept of Compassionomics." And really it's exactly what you're saying, it's not new and it's not innovative. I think that Compassionomics is our fearful way of re-exploring the spiritual. It's taking the time on rounds to say, "How are you doing as a family, how are we doing as a team," and to take the opportunity to draw comfort from each other. It comes from a spiritual foundation, that I think that we've lost, and I think a lot of it comes from burnout and from the way that medicine has become a business and a commodity. We're starting to re-explore through Compassionomics, and I pray through exploring the spiritual, the deeper side of medicine that around the world I think people really miss. David - Right on. Mardi - And if that's not reverse innovation, I don't know what is. David - It's fascinating, this space that Kijabe fills and how we think about it and how we talk about it. I use a phrase - World class healthcare in the developing world - but when I use that, I don't mean that I want Kijabe to be the big hospital in the big city in the West, because there are certain aspects that we don't want to lose. Yes, absolutely, it would be super-cool to be doing robotic surgery, and some of these wild technological things, but really I feel like what Kijabe excels at is not fancy and not glamorous. It fundamentals of medicine. I remember Evelyn Mbugua telling me this one time. I asked her, "What do you think about medicine in general?" "When I have a challenge or when I'm stuck on a patient, I go back to their history." It's fascinating that that's fascinating! Some of the basic fundamentals of medicine are practiced here, just looking at your patient and laying your hands on them and touching them and talking to them. A conversation is both a diagnostic tool and it's actually medicine. If the numbers are true, I know it's different from orthopedic surgery than for outpatient, but, if half of medicine is actually placebo, this stuff is really important to healing. And it's not anti-science. It actually is science to care about people. Mardi - It's interesting when you mentioned the placebo effect. I think that the placebo effect is considered as nothing, but it's not the placebo effect, is actually a real effect. It's that time and conversation and compassion, truly do bring healing and the point of a control trial is to see in a drug-do better than that. But the thing we're doing, already makes sense. It's interesting to me that medicine around the world is getting faster and faster and more and more advanced. Time is money. I think that around the world, we wanna save money in medicine, we wanna do more with what we have, but we're willing to sacrifice time, to make that happen. And why is that the first thing that goes? Burned-out physicians in high income countries, the thing that they love, is when they have to see more and more patients in less and less time because they know what they have to offer is beyond a drug, and beyond a diagnosis and beyond a referral and beyond a surgery. The one of my favorite phrases in medicine that I truly don't understand but want to spend the rest of my life working on it, is a "value-based care." I think to define value you have to define what we're offering. If value is time, then one of the things I think that Kijabe and mission hospitals can continue to pioneer the way in is, "how do we cut costs in other areas but refuse to sacrifice the cost of time and make sure that our impact is helpful for our patients but that also helps our team members and our clinicians receive the value that comes from being a part of a meaningful conversation. I think that's what patients want too. They don't want the robotics, they come to us because they're helpless vulnerable and afraid, and those are the things that we're treating. They trust what we tell them and if we don't have the time to build up that trust, we've lost a lot of the value that we offer. David - What have you seen change about team? You guys have been part of this big culture change process, but I think it's something that's started long before long before either of us. What do you see is the arc of Kijabe and the archive teamwork and the arc of culture? Mardi - So, Kenya is an incredibly multicultural and diverse country and Nairobi is high-powered and it's fast and it's a lot of white-collar and highly educated people and Kijabe is not so far from that. I think we operate more in a Nairobi mindset than a rural, small town mindset, but that's actually been a huge transition, I think, is going from presenting ourselves as a rural distant place to a part of a busy growing rapidly advancing system, and so that comes with leadership styles that become more open and more I guess, more modern in style. And so that's been the first big thing that I've just seen a huge jar over the part of the decade that I have been here is that leadership is no longer just top-down, enforced. It's participational leadership and I'm a massive fan of that. Leaders do have to make hard decisions and make things happen, but the input of the team has become a much, much higher priority in the last decade. And that's huge because our young highly-educated, highly-aspirational team members have got some great ideas and shame on us as leaders, if we don't take the time to listen to their approach to things. So that inclusive style of leadership has has been a huge arc. And then I think the other thing is just our changing generations, millennials are not confined to high-income countries. We have a young generation of people here who aren't gonna stay in the same job for 40 years like their parents or their grandparents did, and that's the same globally. And so we've had to question, over the last decade, how do you approach team members who are only gonna be here for a little while? Do you see that is, they're just gonna go, or do you get the maximum investment into them and benefit out of them in the time that they're gonna be here and then release them with your blessing? And so that's been something that's been huge for me is when we've got these new graduate nurses or lab staff radiographers, to not be on the fact that three years after they come to us, they go it's to say, "You know what, we've got these guys for three years, let's sow into them, let's get the most we can out of their recent education... Let's do what we can to up skill them with the people that we've got here and then let's release them all over Kenya to be great resources for health care across the country and across the region. David - I would say, for healthcare and for the gospel. I've been wrestling a lot with what does it mean for Kijabe is to be a mission hospital. I think the classic definition - I don't know if we define it as such, I don't often hear people say it out loud, but I think it's an unwritten thing - that what makes a Mission hospital a Mission Hospital, is that it cares for the poor. Hopefully on some level, or on a lot of levels, that will always be true at Kijabe. But I'm really excited about the possibility of what you just described, that if these guys are here for three or four years and we are to training them with the attitude that they are going out as Christian leaders and as missionaries to these parts of Kenya that honestly, you and I will never touch. And a lot of the places I've never even heard of. But if we're equipping them to be the light that's the huge opportunity that Kijabe has to be missional. Mardi - This is a much, much longer podcast, but defining mission is really really important, isn't it? I think that there's a couple of things that stick out to me as you're talking and one is that, I think mission has a history that can be associated with colonialism. And one thing I love about my time in Kenya is seeing that we are a globe of missionaries. The church that we attended in Nairobi, Mamlaka Hill Chapel, these guys would send mission teams to New Zealand, which is fabulous. It's not that lower middle income countries are receiving missionaries anymore. All of us need the gospel, all of us need the full word of Jesus and when you're spreading the gospel, what are you spreading? I think that this is a much longer conversation, but I believe that we are called to go and make disciples we are called to serve the sick, we are called to serve the poor, we are called to serve those in prison. I focus on the parable of the sheep and the goats, it is one of my life scriptures, "when you are poor and sick and needy whatever you did for the least of these, you did for me." And what I hope for Kijabe does is that for whoever passes through our doors, whether it be patient, whether it be staff member, this is who we are, we love Jesus and we want you to know this incredible King who gave so much for us and who has an eternal life for us that starts now. And eternal life starting now means making an impact and restoring that which is broken, and it means restoring it now, wherever you are. As our team members go out to work in other hospitals, I would hope that one of the indicators of success for us would be a lack of brain drain, because it would show that we've shown people, "You know what there are people here that need you in healthcare. And this is why I'm here." If I had wanted to be an evangelist rather than a health care missionary, I should have stayed in Australia, for less people in Australia know Jesus that in Kenya. But I felt like my call in mission was to serve the sick in a place where I could help other people do the same. That's been my passion here, but I'm called to go back to Australia now. Does that mean my mission life is over? Absolutely not. It means that I'm going back to Australia to love Jesus and serve sick there and to do it in a different way. And I think that understanding that all of us, whoever is listening to this podcast right now, wherever you you have a call to mission, it's that sphere of influence that God's put you in. It's to take care of the poor or the sick, or to love the wealthy, who are lost around you that are never gonna step foot in a church but need a love of Jesus every bit as much as one of our nursing students here in the college. David - Amen again, that's fantastic. So back to Ebenezers, back to the the stones. What are things come to mind as you look back over on your time at Kijabe that were hallmarks or turning points? Mardi - There's a few of them. One evening sticks out to me because it's so indicative of the bigger picture and what we've been working towards. I'd been here for about nine months or so. . . One of the things that Jennifer Myhre and I noticed is we started out on pediatrics was that our nursing staff were incredibly passionate about their kids, but no one had really had the time to teach them about sick kids and how to resuscitate them, just basic life support, because they were so overwhelmed. You know, there was one nurse who was taking care of 12-15 patients at a time. That ratio is now one to eight, so it's much easier. But they just hadn't had the opportunity to learn some of the basic life-saving assessment in resuscitation skills, and so we started doing just weekly mock resuscitations with the nurses and as we got to know each other and they got to trust me and to know that I wasn't there to, to judge them, but to try and help them, we would do mock recesses every week, and people would stop being scared of coming and would come with by interested and actually came to test their knowledge. When I started in 2011, about once a week I would get called in, in the middle of the night to find a baby blue and not breathing, who was dead, and there was nothing that I could do. But what we worked together on was setting up a resuscitation room, and setting up the right equipment. And so after about nine months of this, I was called in for yet another resuscitation in the middle of the night, and by the time I got there, the baby was just screaming and pink, and I asked the nurse is what had happened and it was the same story as always, this baby choked on milk, they had turned on the oxygen given the baby oxygen done some CPR and they resuscitated that baby before I got there, they didn't need me at all. And the Ebenezer for me was the was the pride on their faces. "We are experts at this and we know what we're doing." That has just escalated leaps and bounds. Now we've got outstanding nursing leadership and they're being equipped and taught and up-skilled every day. But that was an Ebenezer moment for me that the time taken to build relationship and team and invest doesn't just bring a resuscitated baby and life is important, but it builds team and it builds ownership and pride in "this is what I've been called to do, and I'm good at it." It's interesting because it's what you would do is individual doctors with your teams and doing the mock code. But it's also very much a systems process for Kijabe hospital, right? A big part of solving that challenge was getting the right nursing ratios, but also setting up high dependency units to where children you're concerned about could be escalated. Did that happened during your time here? Mardi - So when we started here in 2011, children weren't really admitted to the ICU at all unless they were surgical patients who just had an operation, and then the surgeons would take care of them and transfer them down to the ward. So the pediatrics team wasn't really involved in any ICU care, extremely rarely. We didn't have a high dependency unit. And our definition of high dependency unit, here, is a baby that can be monitored on a machine 24-7. This is something that shows you how reliant we are on partnerships, David. So for example, the nursing and the medical team together decided, "Look, we think we need a three-bed unit, where at least the babies who were the more sick ones can be monitored on machines." And so, Bethany kids were the ones who equipped... We turned one of our words into a three-bed HDU in the old Bethany kids wing, and that was the first time we could put some higher risk babies on monitoring so that if they deteriorated we knew about it sooner. And we saw deaths start to drop, just with that simple thing. The other thing was that pediatricians who worked here in the past weren't necessarily equipped in how to do... ICU care. And so Jennifer and I said, "Well I'm a Peds-emergency physician, and she is an expert in resource-poor medicine, between the two of us, we can probably figure this out." We started putting some babies in ICU who we knew had a condition that would be reversible if we could just hook them up for 24 hours to ventilator. So we started ventilating babies with just pneumonia or bronchiolitis. Or sepsis, that was the other big one, something that if you can help their heart beats more strongly for a day or two, you can turn the tide. And so we just started working with the ICU team to say, "Look, can we choose some babies to start bringing up here? And four years later we were overtaking the ICU at the time and that's why we had to build a new Pediatric ICU, which opened in 2016. All of these things are incremental, and we stand on the shoulders of giants. The Paeds ward existed because a surgeon said "I don't want babies with hydrocephalus and spina bifida to not get care." And then we came along and said "We think that's great, but we think that babies with hydrocephalus spina bifida, who also have kidney problems and malnutrition, should probably have a pediatrician care for them." And over time, that degree of care, that we've been able to offer has just grown and grown. And we had Dr. Sara Muma as a pediatrician join us in 2012 then Dr. Ima Barasa - she was sponsored into pediatric residency long before I got here. That was the foresight of the medical director back then, to say "We are gonna need some better pediatric care". And then I stepped into the medical director role and people like Ima and Ariana came along and they've just pushed it further and further and further. None of us are satisfied with what we walk into, and we keep saying we can do better because these kids deserve more. David - That's fantastic, I think that's another way when you think about the influence and the impact of Kijabe, it's that refusing to settle. It's to say, "Yeah this is possible. Let's figure it out." And for all the team members to say that and commit to it, and for the leadership to support that I think that's what makes Kijabe special. I read something that the other day, it was just an interesting take, someone said [to a visiting doctor] "Why are you going to that place? It has so much." But Kijabe only has “so much” because the immense sacrifice of so many people over so much time. None of this showed up without the hours and the donations and years and years and years of work. I remember you saying that about Patrick with his ophthalmology laser? How did you phrase that? Mardi - Patrick, he's such a wonderful example of the kind of person that doesn't look for reward, but sees a need and just walks to the finish line. He started out, I believe, on the housekeeping team in the hospital. He's been here for 20 years at least, I think, and then went through clinical office or training, which is a physician assistant level training, and then received higher training in cataract surgery. He started our ophthalmology service in 2012. Since then he had nurses trained around him. He's been doing cataract surgery, and then he said, "We've got these diabetic patients and the care we offer isn't good enough, we need a laser." He went to Tanzania, and got laser training, and now he's going to start doing laser surgery on patients with diabetic retinopathy. He refuses to be satisfied with the status quo. And that's the heritage that we have here. You know, talking about even a moment I feel them enormously privileged to have been here in 2015 as we as a hospital celebrated our centennial. It took us a year to prepare for that, and I know you were a part of that process, David. David's job was find all of the stories and all of the photos and interview all of the people and make sure to document everything that might be lost if we lose these stories now. Being a part of that process... I was in tears so many times when we would hear one more story about somebody's commitment and sacrifice. We've been able to write down that story from 2015, with the Theodora Hospital as we were known then. The stories of not just these missionaries but these extraordinary early nurses, like Wairegi and Salome who worked here for decades, who were initially trained informally, because we didn't even have accreditation for the nursing program. David - We didn't even exist as a country. Mardi - That's a really good point! To hear those stories and to see our very first lab technician was just amazing. And then when these 80 and 90-year-olds came over and saw the scope of the hospital as it exists now, it just gave me a glimpse into whatever we do today, we have no concept of 100 years from now, the fruit that that will bear. And I think a missional life, is like that, isn't it? It's being okay with not seeing fruit. There's foundations positive and negative, that all of us lay in the interactions and the work that we do and I think all of us, our prayer is that those seeds that we plant would bear fruit. We have to be okay with not seeing the fruit with saying this has been my contribution. I've stood on the shoulders of giants and now I hand over the baton to you, who will come after me. Make of it what you will. It's not my dream and it's not my goal, I've done my part, and let's see where God takes it through you. David - And so, very shortly, you're about to become a giant. [laughter] I really appreciate you, I appreciate you bringing that up. That was one of the most important things that could have ever happened. It was in the 2015. It was before we started Friends of Kijabe. The realization for me I always come back to how long life is. It's both amazingly short and amazingly long. Watching Dr. Barnett and realizing that he worked here for 30 years, and then went back to the states, so now he's... I think he just hit 102 years old. It really does bring in a clear view what is legacy, what does it mean and what are we building? But also that this is very much outside of us. We get to pour everything we have into it for a time, but then others will take up that work. And it's both humbling, and amazing and... Mardi - And I think it's helpful to as many of us have a sense of calling on our lives, I think that this is what God has for me now. But we have to hold that with open hands because our view and our understanding of what God is doing is so small and what he is doing is so large. I think sometimes in this kind of setting, you come in with a dream and a passion and a goal, but you see that path shift and change during the time that you're here and that is good and that is okay. I think a danger is when we come in and think that we have the answers or we know exactly where God is going, and then things don't work out, and we burn out or are bitter or disappointed. To come into a sense of mission and calling... Saying "not my will but yours be done," and to just obey in the day-to-day and to see where it goes and to be okay with the direction being different at the end than it was at the beginning - I think that's how we lead a life led by the Spirit. We hold these things with open hands and say, "God take it where you will" and if it's a different place, let me just play my part in that. David - Okay, I gotta dig into that cause. How do you balance that? I would frame it as vision. I feel like a good example to look at, I don't know if it's the right one, so, you can choose a different one if you want to, but the balance between vision and practicality and reality. Because you say that, and you are walking in the day-to-day, but I just think of the Organogram that has been on your wall, which was on Rich's, wall, which is now your's again, which is about to be Evelyn's wall. And you had this vision back in, "this is how I think the organization should work to function well." But there's a four-year process in making that come to pass. How do the day-to-day and the long-term balance? Mardi - I think we're talking about spiritual and practical things combined aren't we? I think that anyone who's in organizational leadership knows that you, your organization as a whole needs a trajectory and a long-term plan. We make these five-year strategic plans which are based on the assumptions of today and every strategic plan. You need to go back every couple of years and say, Were those assumptions right? And just to be a super business nerd for a minute, you base things on SWOT analyses and you base things on the current politics and economics. David - What does SWOT stand for? Mardi - Strengths, Weaknesses, Opportunities and Threats. Then you do a PESTLE analysis, you look at the politics, you look at the economy, you look at the social environment of the day, etcetera etcetera. In technology everything is changing quicker than we can keep up with. And so I think that when you're looking at a place like a happy, which is large and complex, you set yourself some goals, and you work with them, but, you know, so something's going to change. Politics are gonna change, the economy's gonna tank, maybe there's gonna be a war on the other side of the world and we’re the only source of this, that, or the other?Maybe India falls into the sea and we start doing all of the surgeries that India was doing? I just don't even know. One thing for me, I've been enormously privileged to have been the medical director for two different terms that were separated by two years. And so I think I have a slightly unique perspective because from 2013 to 2016, I set the way I thought that our division would work and I came back into the role, two years later and already it had changed, but Rich had made it a better. It's funny, I when I came into the role, my predecessor. Steve Letchford said, "Look, you're gonna need a deputy, you can't do this by yourself." And I looked at my team and said "Um, No, I need four deputies, four sub-divisional heads because this is too much for one or two people and I can't keep my ear to the ground without it. I came back after two years away and there were five deputies and my initial gut reaction was, "You changed my structure!" And then I realized that Rich and Ken had made a really wise call. It did have to be five deputies for lots of really good reasons and that team of five has been my absolute rock this year. David - Who is the team of five? So the team of five, I've got a head of inpatient medicine and pediatrics, and specialties and this George Otieno. There's a head of Outpatient Department, and Community Health and Satellite clinics, and that's Miriam Miima. I've got ahead of Surgery and Anesthesia, and that's Jack Barasa. There's a head of Pharmacy, and that's Elizabeth Irungu. Then there's a head of what we call Allied and Diagnostic that incorporates the Lab and Pathology, Radiology, Physiotherapy, Nutrition and Audiology, and the head of that, it is Jeffrey Mashiya who is a radiographer. What's amazing to me about that is when I instituted this framework in 2014, there were four people and they were all missionaries. And I've come back in 2018 and there are five people and they're all our Kenyan senior staff and they're extraordinarily talented and any one of them can stand in for the medical director, when the medical director is away. What a gift that has been. David - I can't imagine how important this is for continuity. Because you think right now, you're handing off your responsibilities to Evelyn, but she has five people that...those are the executors and they actually get to groom her in leadership. That's amazing and for the strength of Kijabe and the stability, it's indispensable. I don't think there's another way to build a strong, stable system other than to build that. Mardi - Yeah, that's actually one of the things that brings me so much joy as I leave is the team isn't going to notice too much the change in senior leadership because that level of day-to-day practical strategic and operational leadership is just so strong. I think it made Ken as my CEO, I think it made his job easier to say, "Look, who should fill the position that Mardi is vacating?" He was able to say, "Who's got institutional memory and who's got leadership expertise and wisdom, and who knows how the senior leadership team works?" Whoever that person is, they're gonna have a team around them that will mean that no voices get lost in the transition. When I took the job in 2013, hearing the voices of specifically missionaries and surgeons can be really noisy and you hear their voices, but who's listening to the head of palliative care and who's listening to the head of laboratory who's listening to the head of nutrition, which is a tiny team of four people, those voices are well represented by wise people who all listen to each other and make the system work around them. It's a tremendous gift and there's no way to do this job without a team of people like that around you. And you know what, that's one of my other Ebenezers, David. Thursday, we installed Evelyn as the incoming medical director. Seeing those five sub-divisional heads praying for Evelyn and as that took off, I will never forget that. David - Absolutely. I wasn't here the first time, but I remember I should print out a series of those [pictures] because I remember you handing the hat to Rich and I remember it going back to you and then watching you give Evelyn the hat and stethoscope. There's this legacy of people that care. It's interesting to think about... 'cause you are, I mean you’re building this remarkable team and your system and things that operate independently of you. But at the same time, you're unbelievably special, and have given a ton over the past years and you. As Rich phrased it, you walked in shoes that not many other people will get to walk in. It's special. I imagine is what it's like when the former presidents get together for their picture. There's things that only only you guys will know and only you guys will have experienced. Mardi - You know, one thing that is really special is I think a lot of leadership transitions come through pain, brutality and war. And one thing that I noticed on Thursday, is that in the room as I handed over leadership to evil and were Steve Letchford and Peter Bird, who have both been here for decades and who've previously been the medical directors. I think there's a beauty about the transition of leadership here in the clinical division that it hasn't come through attrition, war and burnout. I'm leaving with a lot of sadness, and I'm not cutting ties with this place to see. . . there has been a cost. Rich. I know, I would still love to be here in this position as the person who is my predecessor…but to see such strength of leadership that is here and sowing into the next generation rather than leaving when they died. They've stepped down and gone into leading other areas to ensure that the team that follows them is strong, I think that's a tremendous gift and something unique about Kijabe. People love this place and they love this team and they wanna be a part of its ongoing success in its broader mission. David - And they love and they love that above their own glory and their own desires. I think it's what makes an organization great, it’s what makes a country great. I think it's probably gonna be easier in a place of faith, honestly, that this is God's ministry, not our own, not any one persons's. FPECC What is FPECC? I think it's important for people to know a little bit about how hard is it to create a training program or anything new in Kenya? Mardi - So FPECC is the fellowship program in pediatric emergency and critical care. Ariana [Shirk] and I are pediatric emergency physicians, we trained in pediatrics, and then we did specially training in how to take care of emergencies and resuscitation. And were the only two formally trained pediatric emergency doctors in Kenya. Critical Care is taking care of kids in ICUs and currently in the country, there are four pediatric ICU doctors for 55 million people. I don't have the stats that my finger tips, but it's extraordinarily low. I think of the city where you live and how many ICU beds there are, and how many children's hospitals you have just in your own city if you're based in a high income country. For 55 million people, there's kids just can’t access that care. David - Recently, I'm sure it's gone up, but two years ago, it was 100 beds for the country. Mardi - For adults and kids. . . In the country, there are a 12 pediatric ICU beds. Actually no, that's not true, there are 16 and eight of them came into existence, when we opened up our Peds ICU here three years ago. David - And keep in mind, this is East Africa, of the 56 million people. . .33 million of those are under age 18. So 16 beds. Mardi - That's right. Think of anything that can cause a critical illness. Trauma, illness, cancer, you name it, that's not enough beds. So when I came to Kenyo, I had no dream of starting a training program that wasn't even remotely on my radar. But sometimes things just come together at the right time. It was actually University of Nairobi, where they have the only other Peds ICU, they had been working with University of Washington in Seattle to say, “Look, can you help us start some training?” This is really important, because in East Africa there is nowhere that a pediatrician can learn how to run an ICU. Think of the US, where every state has got multiple training programs, where pediatricians will spend three years to learn to be an ICU doctor. There is nowhere for 360 million people in this region to learn how to do ICU care for children. Just think about that for a second. 360 million people... No training program. There's one in Cairo, and there's one in Cape Town, but that's for 600 million people. So I'm just taking a few of them where there's nowhere to go. University of Nairobi was talking to Seattle. They've got two Peds ICU doctors in Nairobi and they were thinking of starting a program. Then just through several contacts, actually through the Christian mission network, one of University of Washington's ICU doctors grew up in Nigeria but she's involved with the Christian Medical and Dental Association, and so she knew about Kijabe. The University of Washington team came out to Kenya for a visit, and they said, "Hey we heard you doing some ICU care caring Kijabe. Can we come out and see what's happening?" That was in 2013. They came out and said "Hey what are you guys doing here?" And we showed them around, and their minds were blown, they didn't know there was any peds ICU happening outside of Nairobi at all. And so, we rapidly started some conversations and said "Look, why don't we start a training program in Pediatric Emergency Care and Critical Care and our trainees can train at both Kijabe hospital and Kenyatta hospital in Nairobi and they can get an exposure to two different types of ICUs. They can also take advantage of the fact that Ariana and I are here as Peds Emergency faculty, and we can split the training load. Training programs in the US have dozens of faculty for something like this, to rely on just two doctors in Nairobi was an incredible risk even though University of Washington is supporting with visiting faculty. So we said, "Look, we've got all these people in the country at the same time, let's just try and do it." So we started that process in 2013. We took our first fellows at the beginning of this year. It's taken us six years. That's how things work here. You've got to form relationships. University of Nairobi didn't know us real well when it came to our pediatric care. We had to get to know each other, we had to develop a curriculum. We had to let the Ministry of Health know. We had to get the Kenya pediatrics Association on side. The Kenya Medical Practitioners and Dentists Board, had to approve the program. The University Senate had to approve the program. We had to try and get some funding in place. None of that happens quickly. It's all relationship that's all a lot of chai. That's all a lot of back and forth and making sure that you don't try and skip anything to get through the hoops, any quicker than you need to, because if you try to go to quick it falls apart. And if University of Nairobi and Kenya doesn't own this program, it's not gonna last. And I think that's probably the first thing to take away for me is this program exists because University of Nairobi and Kenya wanted it I didn't come in here and say, "We need this.” University of Nairobi wanted it, and we said, "How can we support it?" And so Arianna showing up here for a short-term visit - which we rapidly recruited you guys as long-term - it was God's timing because Ariana and I couldn't have done this independently from each other. It's taken both of us to build those relationships over the last six years. Arianna and I are so proud of this program. Our first two graduates will finish this training at end of December 2020, and we hope and pray that we can recruit them to stay at Kijabe and University of Nairobi as our first home-grown faculty. What's been lovely about that, too, is that we've connected with people all over the world who want to support this kind of thing, they just didn't know how. David - Not did they not know how, there wasn’t a way. It literally did not exist until February 2019. Mardi - So now, we're actually talking to colleagues in Uganda and Tanzania, and colleagues in Sudan and other places about... “Hey, is this a good model for you?” I've got some contacts in Nigeria, they've got how many million people, 30 million people or something ridiculous? And there's no way to get this training there either. And people all over the world want to be able to support what a country wants to start in its own strategy. So that's something that I'm just thrilled to be leaving. Even as we leave next month, I'm hoping and planning to come back at least once a year to teach in the program for the forseeable future and to support Arianna from a distance in continuing to connect people all over the world to say, "Here's a way that your global health desires can interface with a local country's needs." David - You two are the only Peds Emergency Medicine doctors in the country and there's a realization. . .What actually is Emergency Medicine here and what is the difference between what it looks like here versus America? Mardi - Yeah, it's a really great question. First of all, Ariana and I trained in a country where there are multiple children's hospitals per city. So, Pediatric Emergency Medicine is the Emergency Department attached to a children's hospital. There are less than 10 children's hospitals on this entire continent, I think. So there are no Pediatric Emergency departments. What is really great is that Emergency Medicine combined adult and pediatric is a growing specialty here. There's been so much great work that's going on in so many countries around the region. Rwanda last year, just graduated their first class of emergency residents. Uganda just on the cusp, the great advocate there, Annette Allenyo is leading the charge for emergency medicine. Ben Wachira is an Emergency Medicine trained doctor here at Agha University, and they're on the cusp of starting an emergency medicine residency training program. You know Emergency Medicine's a funny thing. Emergency medicine in a high-income country, is a part of a functioning system. Emergency medicine in the US means that you've got ambulances that get your people to you and you've got an ICU at the other end that you send sick people to. Emergency medicine here is. . . people showing up on our door step, we don't know how to get them here and then where do we send them? I think that Emergency Medicine training here is so much more broad. We're training people not only how to provide Emergency Medicine, but how to be advocates in a broader system. And I think if you live in a high income country, you can't understand how much medical training is not about medical training. It's about advocacy and building access to care for people, no matter where they're at. What I see emerging here is…from the start, it's collaborative. Emergency Medicine training here isn't just training a doctor in a specialty to give you a certificate and leave you there. It's connecting you with people who are trying to get paramedic systems going and people trying to build ICU care. That's one of the reasons we realized that our Pediatric Emergency and Critical Care program had to be both. There's not enough places to work where you've got the luxury of staying in the ICU. Our graduates are gonna go out and work in hospitals where they will be expert trainers for the pediatricians running the ICU and the family medicine doctors running the emergency department and the surgeons who are doing pediatric surgery with just general training. Our graduates are gonna be those advocates drawing teams together asking "How can we improve the system from arrival at our doorstep till the day we send them home." It's a different focus in our training. Yes, the skills are necessary. You need to know how to run a ventilator and keep a heart pumping when it's not. But it's about building a team and being a part of solving systems issues and hopefully in a way that is affordable and sustainable. David - I love that word, systems. For me, this is the year of systems. Thinking broadly about each of these individual parts because it’s another way that healthcare here is very different from healthcare in the US. The US is just sub-specialization, that's what it's all about. And here, there's not a fine line between. . .for an Emergency Medicine doctor, you're not sitting out in casualty waiting for a kid to come in, right? If you want to find the emergency, you just walk around and lay eyes on every kid and there's gonna be one out of 70 children in that building, who is in trouble. So it really is a bigger and broader way of thinking about things. Mardi - I think another thing that's interesting to me just as we come back to the missional aspect of who we are... I think 00 years ago, a missionary was someone who would go into deepest, darkest wherever and be whoever they wanted to be. I think as we consider what is global mission, our question needs to be, “What is that country looking for, what systems are they trying to develop and how do we help them in it?" And that comes down to health…if you're a missionary, what does the local church want to do? What is their mission and how can we assist them? I think we need to ask better, what system is someone trying to build and how can we be a part of it. Because that's the key, isn't it? We're here to serve God who is restoring creation and he's doing it in lots of different ways already. We don't need to necessarily think we've got the answer, but to say "God, where are you working and how can I be a part of it, and what does it look like?" I think Mary Adam in her community health project, is a really lovely example of that. Community Health growth is a priority of Kenya. So she's gotten grant funding and she is just sowing in it, she knows every county Governor in the country, I'm suspecting. She knows how to get into the system, but how to be salt and light, and how to be the love of Jesus in making things functional and making all things new. I think that's one thing that I think Kijabe is doing well. We are looking at health strategy and saying How can we be a part of it and love that our FPECC program is in partnership with University of Nairobi. I love that our clinical offices have a program that we got accredited for called the Emergency Critical Care Clinical Officer program, that actually wasn't a part of hell strategy, but we did see a gap, and as soon as we trained people in that we went to the Clinical Officer of Council and said, "Hey you want to accredit this? This is a really good program. And they did, and now the Kenya Medical training training college has taken that program and they're doing their own program. I think those are lovely examples of saying “We're here to bring restoration but we don't want to be separate from the system. Where are you going and how can we help” David - What does that mean for friends of Kijabe? How do you see that working with Friends of Kijabe as an organization? Mardi - What's been really lovely, about Friends of Kijabe in the last year, and I know you're excited about this, David, is in what the core the Friends of Kijabe vision and mission. I think a core part of Friends of Kijabe that we've got the CEO, the CFO and the Director of Clinical Services on the Friends of Kijabe board. One question that I've heard you ask so many times in the last year is "Where are you going and how can we help, what are your priorities? Friends of Kijabe exists to help the hospital further its strategy, but also exists as a bit of a connector between people in high-income countries who really want to contribute and who have passions. Where does that intersect with the hospital strategy? So Friends of Kijabe is not going to take the whole hospital strategy and try and piecemeal help every part of it. They're gonna say, "Hey you're a part of your strategy that are happy resonates with and that's become very clear. A lot of Friends of Kijabe funding currently goes towards whatever the hospital thinks is important. The hospital has prioritized the theater expansion project this year and that's great. But, at its core, Friends of Kijabe also says, "We support the needy. We support education. We support sustainability. How can we get there?" And so [FoK] has prioritized putting money towards each of those areas which happened to align with the core values of Kijabe Hospital. So a large proportion of what Friends of Kijabe hospital is doing this year is helping us with an infrastructure project. But every year we're going re-ask "What are your priorities, and how can we help that?" But we're also going to say, "Here is where our heart beats. Can we help with this too?" I think one of the things about Friends of Kijabe is the trust that's developed since its inception. As Friends of Kijabe, we trust that the hospital leadership is following a strategy that is meaningful, that is sustainable, and that is in line with where Kenya is going and where the African Inland Church is going because that's who we're owned and operated by. As long as our missions intersect, I think Friends of Kijabe can trust that at the hospital is taking us in a good direction. David - Awesome, anything else I should ask you? Anything you'd like to add? Mardi - No. It's been an extraordinary eight years and it's been such a privilege to be here, and it's lovely to leave with joy, even as there's associated sadness. I really can't wait to see what the next few decades bring, and I'm gonna be watching both from a distance and also up close, when I come back to visit. David - Thank you Mardi.
Healing Hearts: Empowering Pediatric Critical Care Providers
In part one of Pediatric ICU Delirium, pediatric intensivist, Dr. Alison Miller, describes the basic definition of pediatric delirium and its clinical characteristics, risk factors, and outcomes. The information provided in this podcast is general in nature and is intended as a training tool for Children's Hospital & Medical Center personnel. This podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. Each patient is unique and information provided in any educational forum must be tailored to each patient's unique situation. By recording this podcast, neither Children's, nor any provider, is engaged in the practice of medicine, nursing or any other health care service. Medical professionals and individual patient families should not attempt to use or rely upon any of the information provided to make medical decisions or to provide health care services. If you are a Children's employee and you have any questions about the content of this podcast, please discuss these with your supervisor. By listening to the podcast, you are agreeing with the terms of this disclaimer. All rights to this podcast are reserved. Copyright Children's Hospital & Medical Center 2019.
Today we are going to meet Rebecca Harman DNP, RN, APRN, CPNP-AC. Becca is a Nurse Practitioner in the Pediatric ICU and she is the epitome of a lifetime learner and nursing excellence. In this weeks episode she shares her journey into the nursing profession and provides insight into the advanced practice role. Join us as she shares her journey and her wisdom. Enjoying The Nightingal Podcast? Join us for more content at TheNightingalPodcast.com and make sure to subscribe to our email list to join our Nightingal tribe!
In Episode 3, I talk with Katieri Thielke, a pediatric intensive care nurse. Katieri was one of the first people I shared my vision to start a podcast with, and through great conversation with her the idea to build a podcast centered around 'sharing life' came to be. Given that, her interview just had to be one of the launching episodes! We chat about: - Discerning what field of medicine to enter when you feel a call to be a provider - Navigating the loss of pediatric patients - Advice for new grads We mention: - Pope Francis' apostolic exhortation, Gaudete et Exsultate - Chiara Corbella Petrillo: A Witness to Joy, by Simone Troisi, Christian Paccini Enjoy! **The usual boring disclaimer: The views expressed in this podcast by myself and my guest are our own and do not necessarily represent those of our employer. This podcast is not intended to be a substitute for medical care. Please see your healthcare provider for any medical needs.**
Rory Bosio is a mountain athlete for The North Face, specifically a mountain-ultra-trail runner from the Tahoe area in Northern California. She also spends her time as a Pediatric ICU nurse when she's not in the mountains or traveling somewhere for an international race. She was featured in a reality show called "Boundless" for the Esquire Network. >"Curiosity": https://youtu.be/GNWkehVuO84 >Rory Bosio on Instagram: https://www.instagram.com/rorybosio/ >"Boundless" clip: https://youtu.be/E9Rp-Gx6SG8 _____ Facebook.com/BillyYangPodcast Twitter.com/BillyYang Instagram.com/BillyYangPod
https://www.youtube.com/watch?v=YMaP_zPXzdg&feature=youtu.be Sam Renfrow is a 49 year old father of three from Ripley, Mississippi. He has been married to his wife, Pamela, for 25 years, and they have three sons. Tyler (21 years old) is a junior at Mississippi State, Braeden (18 years old) is a freshman at Northwest Community College, and Landon (16 years old) is a sophomore at DeSoto Central High School. Pamela is a Pediatric ICU nurse at St. Jude. She stayed home with their three boys for most of their lives, and then went back to nursing school, and is currently pursuing her Masters degree. The Renfrows live in Nesbit. Sam's favorite activities are Crossfit, running (working on the Run Long part), college football, but most importantly, spending time with family. Sam attained his degree in Industrial Engineering from Mississippi State, and works as an Area Sales Manager for ChemTreat. His job primarily involves working as a consultant to help his customers protect their industrial water systems. Sam's was in the Navy for 20 years. When he retired, his family moved to Ripley. He worked in various jobs, including driving a milk delivery truck. His mom was stay at home mom. Sam is an only child, and grew up spending most of my time outside playing in the woods beside his house. When he was young, he got involved in activities like Boy Scouts and band. He played some sports, but was not as involved as youth are today. When Sam was in 7th grade, he decided he wanted to play football. Because he was going through puberty, and his voice had changed, they decided he should play quarterback. Boy, was that a major disaster. He had watched football, and was a huge Steelers fan, but had not played much football. Sam had no clue what he was doing. As he got older, the pressure got more intense to be a “jock”. He gave up Boy Scouts and band, and tried his best to be a great athlete. God did not bless him with great coordination or natural athletic ability, but he was willing to work hard. He gave it his best shot, and became a starter his junior year in high school. Just before his senior year, Sam decided that football just wasn’t his passion. He focused more on school, but really lost his identity and fell into some bad behavior. Now that he wasn’t a “jock” wanna be any more, what would he do? Sam was bullied some in Junior high into high school. That destroyed his self-confidence, and made it tough to be himself. Prior to 7th grade, He was very confident, and lived life “his way”. From 7th grade all the way through high school, he tried to be what he thought other people wanted him to be. As a father, Sam tries to teach his sons to be true to themselves, even when it is not “popular”. He is blessed to be married to a woman that truly an awesome mother. Pamela has a strong personality (in a good way), and has taught their boys to take up for themselves. Sam never knew how to handle the bullying, so he really never stood up for myself. When Sam got to college, he felt like he had a clean slate. He asked a good friend of his that was really popular at college how he got to know so many people. He told Sam to smile and say hello to everybody he passed walking around campus. He did, and it worked. He was finally able to be the person that he really was. At Northeast Mississippi Community College, he became a college mascot. Being in the mascot suit was one of the best things that ever happened to him. He could get away with anything, so he did. It helped him become much more confident and learn to be himself. He had a great college experience, and it transformed his life. As Sam has shared before, he thinks the biggest question we face in our fitness journey is our “why”. “Why” do we get up at 4:15 in the morning to go get physically beat up for an hour. He thinks the question of “why” is much deeper than our initial answer. Sam's parents both passed away within a two year span ...
Episode 10 features an interview with Roxanne, a mom of three from San Antonio, Texas. Just after entering high school and an outstanding performance in a football game, Roxanne’s eldest child, Rueben, began having high fevers and flu-like symptoms. After about a week, his parents found him having a seizure and rushed him to the emergency room. They would soon learn that Rueben was diagnosed with viral encephalitis. Roxanne tells the story of their stay in the Pediatric ICU, what it was like balancing being there for Rueben in the hospital while having a newborn and another child at home, and how family played a major role in getting through some of their darkest times. Rueben’s seizures continue after he returned home from the hospital, and during his sophomore year he was diagnosed with epilepsy which led to four invasive brain surgeries. Roxanne talks about what a critical role basketball was in Rueben’s life prior to acquiring viral encephalitis and how he continues to show his determination in finding purpose while dealing with his illness. Roxanne wants parents to know that it is ok to vent, it is ok to ask questions and know that you are not alone. Roxanne and Rueben are advocates and aim to bring awareness to the rare disease that is encephalitis. Roxanne is currently in the works to bring an encephalitis walk to raise awareness in San Antonio. Roxanne says that Chris Maxwell has been instrumental in helping Rueben cope with his illness. She also suggests that families visit EncephalitisGlobal.org. If you would like to connect to Roxanne and follow along with Rueben’s Journey, you can do so here on Facebook or Instagram. If you’d like more information or to share your own story, please email info@childlifepodcast.com.
Todd Fraser, MD, speaks with Jenny Tcharmtchi, BSN, RN, CCRN, about the article, "Family Experience in the PICU," published in Critical Connections, the Society of Critical Care Medicine's newsletter.
Todd Fraser, MD, speaks with Jenny Tcharmtchi, BSN, RN, CCRN, about the article, "Family Experience in the PICU," published in Critical Connections, the Society of Critical Care Medicine's newsletter.
Starting her career as a clinical nurse in the Pediatric ICU at Yale New Haven Health System, MPRO’S Vice President of Clinical Operations, Jacqueline Rosenblatt, emphasizes both her educational achievements (Masters and PhD) and her circuitous journey into information technology in this podcast. She discusses how challenges given to her by the CIO of a major health system spurred her subsequent lifelong love affair with health information technology and informatics. Jacquie shares insight on: Her journey outside and inside the technology field Overcoming discriminatory preconceptions of stereotypical nurse roles The importance of being a lifelong learner and egalitarian leader How to be, and stay, positive as a leader MPRO can be found at www.mpro.org and Jacqueline can be contacted at jrosen@mpro.org. Make sure to check us out on online at www.divatechtalk.com, on Twitter @divatechtalks, and on Facebook at https://www.facebook.com/divatechalk.
Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases' partners who's mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering - why was DKA singled out in this needs assessment? It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment - cerebral edema being the big bad one. The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum ketones are in the diagnosis of DKA, how to assess the severity of DKA to guide management, how to avoid the dreaded cerebral edema that all too often complicates DKA, how to best adjust fluids and insulin during treatment, which kids can go home, which kids can go to the floor and which kids need to be transferred to a Pediatric ICU. The post Episode 63 – Pediatric DKA appeared first on Emergency Medicine Cases.
Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases’ partners who’s mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering - why was DKA singled out in this needs assessment? It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment - cerebral edema being the big bad one. The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum ketones are in the diagnosis of DKA, how to assess the severity of DKA to guide management, how to avoid the dreaded cerebral edema that all too often complicates DKA, how to best adjust fluids and insulin during treatment, which kids can go home, which kids can go to the floor and which kids need to be transferred to a Pediatric ICU. The post Episode 63 – Pediatric DKA appeared first on Emergency Medicine Cases.
Margaret Parker, MD, MCCM, speaks with Kyle Rehder, MD, assistant professor of pediatrics in the division of pediatric critical care medicine at Duke Children Hospital.
Margaret Parker, MD, MCCM, speaks with Kyle Rehder, MD, assistant professor of pediatrics in the division of pediatric critical care medicine at Duke Children Hospital.
Margaret Parker, MD, FCCM, speaks with MD, MPH, Angela S. Czaja, MD, MSc, lead author on an article published in the July Pediatric Critical Care Medicine.
Margaret Parker, MD, FCCM, speaks with MD, MPH, Angela S. Czaja, MD, MSc, lead author on an article published in the July Pediatric Critical Care Medicine.
Elaine Meyer, RN, PhD, discuss a paper published recently in Pediatric Critical Care Medicine.
Elaine Meyer, RN, PhD, discuss a paper published recently in Pediatric Critical Care Medicine.
© 2020-2025 Ivy Podcast Discovery LLC
