Podcasts about pediatric icu

  You may love or hate medical TV shows. They seem to come in waves on TV. Right now, one of the best medical TV shows that I've seen, in my opinion, is “The Pitt.” We are taking a dive into this show talking about the themes it covers in medicine and sharing experiences my guest and I have that are so relatable. Who's ready for more of “The Pitt?” We are, so let's get started.    Connect with The Host! Subscribe to This Podcast Now!     The ultimate success for every podcaster – is FEEDBACK! Be sure to take just a few minutes to tell the hosts of this podcast what YOU think over at Apple Podcasts! It takes only a few minutes but helps the hosts of this program pave the way to future greatness! Not an Apple Podcasts user? No problem! Be sure to check out any of the other many growing podcast directories online to find this and many other podcasts via The Podcaster Matrix!     Housekeeping -- Get the whole story about Dr. Mark and his launch into this program, by listing to his "101" episode that'll get you educated, caught up and in tune with the Doctor that's in the podcast house! Listen Now! -- Interested in being a Guest on The Pediatric Sports Medicine Podcast? Connect with Mark today!   Links from this Episode: -- Dr. Mark Halstead: On the Web -- On X  -- American Sirens Book https://www.amazon.com/dp/0306926091?ref=ppx_yo2ov_dt_b_fed_asin_title   Calls to the Audience Inside this Episode: -- Be sure to interact with the host, send detailed feedback via our customized form and connect via ALL of our social media platforms! Do that over here now! -- Interested in being a guest inside The Pediatric Sports Medicine Podcast with Dr. Mark? Tell us now! -- Ready to share your business, organization or efforts message with Dr. Mark's focused audience? Let's have a chat! -- Do you have feedback you'd like to share with Dr. Mark from this episode? Share YOUR perspective!   Be an Advertiser/Sponsor for This Program!   Tell Us What You Think! Feedback is the cornerstone and engine of all great podcast. Be sure to chime in with your thoughts, perspective sand more.  Share your insight and experiences with Dr. Mark by clicking here!   The Host of this Program: Mark Halstead:  Dr. Mark Halstead received his medical degree from the University of Wisconsin Medical School. He stayed at the University of Wisconsin for his pediatric residency, followed by a year as the chief resident. Following residency, he completed a pediatric and adult sports medicine fellowship at Vanderbilt University. He has been an elected member to the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness and the Board of Directors of the American Medical Society for Sports Medicine (AMSSM). He has served as a team physician or medical consultant to numerous high schools, Vanderbilt University, Belmont University, Washington University, St. Louis Cardinals, St. Louis Blues, St. Louis Athletica, and St. Louis Rams. He serves and has served on many local, regional and national committees as an advisor for sports medicine and concussions. Dr. Halstead is a national recognized expert in sport-related concussions and pediatric sports medicine. — Dr. Mark Halstead on Facebook — Dr. Mark Halstead on LinkedIn — Dr. Mark Halstead on X — Learn Why The Pediatric Sports Medicine Podcast Exists...   The Co-Host of this Program: Nicole Halstead:  Nicole Halstead received her bachelors degree in Nursing from the University of Wisconsin-Oshkosh. She worked in the Emergency Department, Pediatric ICU, and Adult ICU, and the Burn Unit while at the University of Wisconsin, Vanderbilt Children's Hospital and Barnes-Jewish Hospital. She currently works at a substitute school nurse in the Francis Howell School Distr...

Get ready for an insightful conversation with Dr. K. Amer Khan, Consultant Intensivist and General Pediatrician, as he takes us behind the scenes of pediatric critical care. With an MBBS, MD in Pediatrics, and a Fellowship in Pediatric Critical Care (IDPCCM), Dr. Khan brings over 6 years of hands-on experience from the Pediatric ICU. In this special interview hosted by Suhasini, we explore the clinical challenges, ethical decisions, and emotional resilience required in saving young lives. Catch this insightful episode on TALRadio English on Spotify and Apple Podcast!Host : SuhasiniGuest : Dr.K.Amer Khan#TALRadioEnglish #TALHospitals #DrAmerKhan #PediatricCare #PICUInsights #CriticalCareHeroes #InsideThePICU #ChildHealthMatters #MedicalStories #HealthcareWithHeart #PediatricIntensivist #DoctorDiaries #EthicsInMedicine #TouchALife #TALRadio

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!

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 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

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