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Last month I wrote a post about the four stages of a career, using the analogy of seasons. I was inspired by the wonderful fall weather I was experiencing while on a walk here in New England, but also by changes I have been experiencing in my life and how these have caused me to re-evaluate what's important in my career. The post got a good reaction, including from Nicole Fox, Associate Chief Medical Officer, Medical Director of Pediatric Trauma, Medical Director of CDI, at Cooper University Health Care. Which led to this show. Nicole and I are in the “fall-ish” of our careers. Which might sound like we're getting ready for pasture, but not really. I'm 51 and Nicole is 48, so we have many more years to work—but our priorities are changing. You might say, they are better aligning with the new people we are becoming, as human works in progress. Nicole has done a lot with career coaching, both as recipient and mentor, and we get into all that on today's show—and bare our souls a little bit about what is holding us back. This was a terrific conversation with an amazing person and I suspect you'll enjoy it, and maybe come away a bit more reflective about your own career and priorities. On this show we discuss: • An update on Nicole's work as a pediatric trauma surgeon and hospital executive—and the need for changes • Her experience with a career coach and what she learned about herself • Career “saboteurs”—how do you discover them, and what can you do to diminish them? I highly recommend taking the free assessment linked below (my top 3 saboteurs are avoider, hyper achiever, and pleaser) • Is it possible to shape your career, and how does that look in practice? • The “seasons” of a career and using it as a framework for discovering what is most important (with an emphasis on the fall season) • Nicole's forays into coaching and mentorship, and prioritizing health and work-life balance in a demanding clinical career Show notes Four stages of a career: https://www.linkedin.com/posts/brian-murphy-13800b11_i-love-the-fall-especially-here-in-new-england-activity-7253050994937212932-2QFY? Career saboteurs assessment: https://www.positiveintelligence.com/saboteurs/
Interview with Kim Wallenstein, MD, PhD, pediatric surgeon at Upstate
In this episode of "Providing Pediatrics," Charles Wooley sits down with Dr. Todd Maxon to explore pediatric trauma and the trauma systems in place throughout Arkansas.
Event Objectives:Compare and contrast current tools to determine field or hospital to hospital triage of the pediatric trauma patient.Review current image gently guidelines with respect to the pediatric trauma patient.Discuss current recommendations for management of solid organ injuries in the pediatric trauma patient. Claim CME credit here!
Get ready to be captivated as we sit down with COL Dr. John Horton, Chief of Pediatric Surgery at Madigan Army Medical Center and Deputy Consultant to the US Army Surgeon General for General Surgery. This episode is packed with insights, as Dr. Horton lifts the veil on the realities and complexities of pediatric trauma care within military confines. Embrace the opportunity to discover the unique curriculum designed by the American College of Surgeons specifically for the military, and examine how pediatric trauma cases accounted for 7% of US military hospital admissions during recent conflicts. Learn why treating these fragile young patients can induce a sense of guilt among the medical staff. Our conversation with Dr. Horton takes a fascinating turn as we delve into his experiences of telecommunication surgery using FaceTime, and the wisdom he shares during these crucial interactions. Listen closely as he narrates the intricate processes of an infant's complex surgery, highlighting the hurdles faced surgical care in maintaining the baby's airway and IV access. This episode underscores the central role of decisive action and confidence, particularly when one is operating outside of their comfort zone. At the heart of the discussion lies the invaluable advice for anyone preparing for deployment in pediatric trauma care. Join us for this illuminating episode that underscores the critical role of pediatric trauma care in military medicine. --------- EPISODE CHAPTERS --------- (0:00:00) - Pediatric Trauma Care in the Military Dr John Horton discusses pediatric trauma care in the military, the American College of Surgeons' curriculum, and his approach to pediatric patient care. (0:15:10) - Pediatric Trauma Surgery Challenges & Preparation Dr John Horton provides telecommunication surgery advice, discussing an infant's atresia, airway maintenance, ventilator removal, and decision-making in pediatric trauma care.
MedFlight Radio talks about pediatric trauma for the month of November. We sit down with Dr. Chelsea Kadish, Recent Graduate EMS Fellow and Current Emergency Room Physician at Nationwide Children's Hospital. The talk starts off with what we are doing well and what we can improve on in our pediatric trauma management in central Ohio. We discuss TXA in our pediatric trauma patient, blood administration and is permissible hypotension ok in kids in certain types of trauma. We answer these tough questions and so much more. This is some really cool stuff. Come listen in!
Neelofar K. Butt, MD, MPH, FAAP Dr. Neelofar K. Butt is a first generation Pakistani-American cis-female Muslim, born and raised in New York. She received her Bachelor of Arts degree magna cum laude from Wellesley College, and was awarded her medical degree from Icahn School of Medicine at Mount Sinai in New York, NY. She subsequently earned a Master of Public Health degree in Maternal and Child Health from New York Medical College. Dr. Butt completed her internship and residency training in Pediatrics at Maria Fareri Children's Hospital at Westchester Medical Center in Valhalla, NY. This was followed by a fellowship in Child Abuse Pediatrics at the Children's Advocacy Center at the Westchester Institute for Human Development, also in Valhalla, NY. Dr. Butt combined her passion for trauma-informed care and promoting resilience with her work as a full-time pediatrician at Hudson River Health Care in Yonkers, NY. There, she spearheaded the Pediatric Integrated Trauma Team as the lead pediatrician of this innovative approach to integrate primary pediatric care and behavioral health in order to improve patient care and well- being. For the past four and a half years, she has been working as a full-time pediatrician at Westmed, now a Summit Health Company, in Westchester County, NY. Dr. Butt is passionate about collaborating with others who seek to improve the health, safety, education and well-being of all children and is committed to engaging with community partners to advocate for these goals and ensure a hopeful future for today's youth.
On this week's show we explore the synchronized teamwork required to save a child's life in the most critical moments.
In this episode of EMSCast, hosts Ross Orpet and Will Berry discuss a lecture given by Dr. David Bliss on taking care of pediatric trauma patients. Dr. Bliss emphasizes the importance of supporting the psychosocial needs of pediatric patients, as they may not have the same coping skills as adults. He also discusses the unique challenges of treating pediatric trauma patients, including the need for specialized equipment, medication errors, and issues with diagnosis and communication. Listeners are encouraged to follow EMSCast on Instagram and visit their website emspodcast.com for more educational content. https://emspodcast.com/taking-care-of-pediatric-trauma-patients-with-dr-david-bliss/
Enjoy another episode from our board review series featuring Dr. Cole and Dr. Woolwine. This Episode is sponsored by St. John Associates St. John Associates is a physician recruiting firm that was recommended to us by one of our listeners- they have an orthopedic surgery team who has over 16 years and hundreds of matches in the ortho market, at no cost to the physician. Get started with your job search today at www.StJohnJobs.com/Ortho. Following that link will let them know that you found them through us.
In this month's EM Quick Hits: Heather Cary on the use and misuse of abdominal FAST in pediatric trauma, Hans Rosenberg and Arleigh McCurdy on the diagnosis and management of Multiple Myeloma in the ED, David Jerome on practice tips for managing the drowning patient, Brit Long and Michael Gottlieb on the diagnosis and management of Alcohol-Induced Ketoacidosis, Navpreet Sahsi on his journey to becoming a humanitarian and global EM doctor... The post EM Quick Hits 48 – FAST in Pediatric Trauma, Multiple Myeloma, Drowning, AKA, Global EM appeared first on Emergency Medicine Cases.
My guest is Pediatric Surgeon Dr. Julie Long who and our topic is pediatric trauma resuscitation.
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
Each month, EMedHome.com presents EMCast, the 90-minute podcast hosted by Dr. Amal Mattu, the premier educator in Emergency Medicine. Subscribe to EMedHome.com for an array of clinical content that will impact every shift. This month's EMCast covers:(1) Massive Hemorrhage Protocol (MHP) in Trauma(2) Alcoholic Ketoacidosis (AKA)(3) Pediatric Trauma
As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren't sure what we can do in our daily clinical practice to make a difference. That's why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention. We've covered how to APPROACH patients about gun safety and ASSESS risk, now we learn how to ACT. In the final episode of our series, Dr. Barnhorst explains what we can do as physicians to help mitigate risk. We'll talk about options, including temporary transfer of firearms to a safe party, psychiatric holds when appropriate, and “red flag” laws that allow for emergent removal of firearms in extremely high risk situations. Have you ever had a patient you felt was high risk intentional to accidental injury due to firearms? How did you act to reduce that risk? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED Guest: Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project Resources: The BulletPoints Project - Interventions EM Pulse: Wraparound California Firearm Violence Research Center (CA FVRC) *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.
As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren't sure what we can do in our daily clinical practice to make a difference. That's why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention. In the third episode of our gun violence prevention series, we delve into the second step of BulletPoints: ASSESS. Do you talk to your patients about guns? What's your approach? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED Guest: Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project Resources: The BulletPoints Project - The Basics Guns and Suicide: the Hidden Toll a Special Report by Madeline Drexler, Editor, Harvard Public Health California Firearm Violence Research Center (CA FVRC) Gifford Law Center *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.
As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren't sure what we can do in our daily clinical practice to make a difference. That's why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention. In the second episode of our series, we delve into the first step of BulletPoints: approach. Dr. Barnhorst takes us through how to start some of these challenging conversations. Hint: it starts with checking your own beliefs and biases. Do you talk to your patients about guns? What's your approach? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED Guest: Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project Resources: The BulletPoints Project - The Basics Guns and Suicide: the Hidden Toll a Special Report by Madeline Drexler, Editor, Harvard Public Health California Firearm Violence Research Center (CA FVRC) Gifford Law Center *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.
Objectives: Understand trauma resuscitation differences in children and adults. Understand management of solid organ injury in children and need for angio/embolization. Understand the indications for REBOA in the adolescent population. Presenter: Alexis Smith, MD Pediatric Trauma Surgeon & TMD at CHOA
As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren't sure what we can do in our daily clinical practice to make a difference. That's why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention. In the first episode of our series, Dr. Barnhorst provides the background information we need to understand the scope of firearm violence in the US, and to begin to tackle the issue with practical solutions. Do you talk to your patients about guns? What's your approach? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED Guest: Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project Resources: The BulletPoints Project - Epidemiology CDC firearm related death statistics California Firearm Violence Research Center (CA FVRC) Stop Handgun Violence *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.
We have a great show for you this week which will provide all of the answers you have come to expect from The Word on Medicine. Today we will discuss trauma in little kids – or as we say in medicine, Pediatric Trauma. Drs. Jean Pearce and Jennifer Zaspel, Maria Traska (RN), and Emily Stone (Child Life) will be joined by a patient and her parents. For all of you that are parents or grandparents - - you need to hear this program!
You are working at *rural* Clerkship General when you receive a radio call from EMS – 7yo male from a severe bus accident with a large scalp laceration, unable to control the hemorrhage. Initial Vitals HR: 136 RR: 22 BP: 80/35 O2%: 100% Temp: 98F Critical Actions: Perform ATLS Algorithm Control Hemorrhage Transfuse pRBCs Replete […]
Massive transfusion protocols have become vital tools used within trauma centers across the country. Appropriately so, as many emergency providers know that hemorrhage is the most common cause of death within the first hour of arrival to a trauma center. Most recently, a medication called Tranexamic Acid or TXA has been found to assist in life-saving measures for trauma victims in both the pre-hospital setting and the emergency department. But is TXA a recommended medication for kids? This podcast segment highlights the safe use of TXA in pediatric traumas and beyond.
If you're a racing fan, then you know Richard Childress. Richard is a former NASCAR driver, the current owner of Richard Childress Racing, the owner of Childress Wineries, a wildlife conservationist, and advocate for child trauma with The Childress Institute of Pediatric Trauma. Ethan and Richard talk about the people that helped steer them in the right direction after losing their fathers at a young age. Richard also talks about guiding his grandsons through the world of social media and giving them traditional values. They then discuss how John Wayne's films impact the younger generations and give them a positive role model to look up to. Richard's grandson, Austin Dillon, is not only the driver of the RCR Cowboy Channel/John Wayne car but he is also a huge John Wayne fan who grew up looking up to Duke. Richard also talks about the different moments in his life that made an impact and how believing in the American dream got him to where he is now. Hunting is a passion of Richards. That passion started out when he was a young kid and was born out of necessity. That passion has taken him all over the world and also brought him into funding nature conservation. His other passions include the Childress Winery, his Wildlife conservation museum, Auto Racing museum with 43 Dale Earnhardt cars, and The Childress Institute for Pediatric Trauma. Trauma is the number 1 killer of children in America and The Childress Institute for Pediatric Trauma discovers and shares the best way to prevent and treat severe injuries in children. The Institute funds research, education and advocacy to help improve the care and treatment injured kids receive across the US. He also talks about losing his friend, Dale Earnhardt, and how that has changed the racing industry and how they changed the approach to safety in racing. Listen to the end of podcast to hear Richard tell a story about how he protected his family from intruders. If you like John Wayne and his values, we think you will really enjoy this episode with Richard Childress! More information on Richard Childress Racing: https://www.rcrracing.com/ Follow Richard Childress Racing here: https://www.instagram.com/rcrracing/ More information on Childress Winery: https://childressvineyards.com/ Follow Childress Winery here: https://www.instagram.com/childresswines/ More information on The Childress Institute for Pediatric Trauma: https://saveinjuredkids.org/ More information about John Wayne on JohnWayne.com Shop our official store on JWStockandSupply.com Follow us on Social Media Instagram.com/johnwayneofficial Facebook.com/johnwayne Twitter.com/johndukewayne TikTok.com/johndukewayne
We're back with Dr. David Greenky, a pediatric emergency medicine fellow who will walk us through the first steps in management of a pediatric trauma patient. This is a great episode for medical students and residents who want to learn how to get their hands dirty in a high acuity setting.
Caroline Delongchamp's son became a pediatric trauma patient at MUSC after a terrible accident. That experience ultimately drove her to change careers. Today, Caroline is Manager of Patient- and Family-Centered Care at MUSC Health. Listen to MUSC's approach of involving patients as partners in care and how they made shifts during COVID-19.
Hand Surgeons Dr. Alexia Soria and Dr. Marshall Kuremsky discuss a sports medicine case and provide tips on speaking with anxious families.
Emergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies at a local Denver brewery for our latest Brewcast. Pediatric patients require special considerations compared to adults when receiving medical care, and that remains true for traumatic injuries dealt with in the ED and pre-hospital settings. Dr. Christine Darr, Pediatric Emergency Medicine Physician, discusses a range of traumatic injuries in pediatric patients and how to appropriately perform a physical exam, order radiographic diagnostics to further assess and identify injuries and key steps for management. She reviews growth plate injuries as well as considerations at different developmental stages that can mask the presence of more serious injuries like blunt internal organ trauma without rib fractures and SCIWORA (spinal cord injury without radiographic abnormality). Common injuries associated with abuse at different ages are also addressed to help you identify concerning signs of maltreatment of pediatric patients. Listen for a deep dive into the intricacies of pediatric trauma!
Here is the JournalFeed Podcast for the week of August 17-21, 2020. We cover TIA, CT in pediatric trauma, steroid bursts and harm, RECOVERY trial - dexamethasone for COVID-19, and a top ten list of what we wish we had known about COVID-19 early on.
AFR Podcast Episode 34: Pediatric Trauma Welcome to the Albuquerque Fire Rescue Podcast! This podcast is the thirty-fourth broadcast of the AFR training team for Albuquerque Fire and Rescue. Each broadcast will cover various training discussions and bring interviews with professionals in order to provide best practices for all members of AFR. In this episode, Captain Andrew West interviews Captain Kevin Ferando about responding to various calls with multiple pediatric traumas.
Dr. David Notrica (@surgery4kids on Twitter: https://twitter.com/surgery4kids) is a native of Atlanta, Georgia. He graduated Cum Laude from Duke University in 1988 and Emory University School of Medicine in 1992 where he was class president and a member of the Alpha Omega Alpha National Medical Honor Society. He completed his General Surgery residency training at Emory University in 1997 and his Pediatric Surgery Fellowship training at Texas Children's Hospital in Houston in 1999. He is an Associate Professor of Surgery at Mayo Clinic Medical School, Associate Professor at the University of Arizona College of Medicine Phoenix, and Associate Program Director for the Pediatric Surgery Fellowship at Phoenix Children's Hospital. He was one of the founding members of the ATOMAC pediatric research network. He Co-founded and co-chairs the Western Pediatric Trauma Conference, the Southwest Trauma and Acute Care Symposium, and Trauma Conference International. Dr. Notrica developed and continues to direct the Level 1 Trauma Center for Phoenix Children's Hospital. We discuss all things pediatric surgery with Dr. Notrica, both on a clinical level but also on a systems-level. Links: 1. ATOMAC guidelines: https://surgery4children.com/diagnoses-and-treatment/trauma/atomac-guideline/ 2. Non-op management of blunt abdominal trauma in children: https://pubmed.ncbi.nlm.nih.gov/26402546/?from_term=notrica%2C+david&from_pos=2 3. Shock Index: https://journals.lww.com/jtrauma/Citation/2012/09000/Shock_Index___A_simple_clinical_parameter_for.45.aspx 4.
Dr. DuBose interviews current Shock Trauma surgical critical care fellow, Navy veteran and pediatric surgeon Dr. Howard Pryor. The relatively unaccomplished Dr. Pryor discusses the basics of trauma in the child, which is both qualitatively and quantitatively different from trauma care in the adult. They conclude with a discussion about Caps Lock, which both mistakenly believe is unnecessary.
Join David as he discusses the basics of pediatric trauma with Dr. Landman, pediatric trauma surgeon at Riley Hospital for Children.
What is the most common missed injury? Whats the most common cause of mortality? Why are they so hard to intubate? All of these questions and more. #trauma #ICU #SURGERY #ER #Resuscitation #PALS #injury #criticalcare #foamed #meded #pediatrics #pediatricsurgery
This is a guest podcast and collaboration with the EAST Traumacast, which highlights the Sixth Annual Pediatric Trauma Society Meeting in November 2019. Dr. Ian Mitchell from Children's Hospital San Antonio, Dr. Alexander Gibbons from Akron Children's Hospital, and Dr. Alejandra Casar Berazaluce from Cincinnati Children's Hospital hosted several interviews to discuss some of the main topics from the meeting. EAST Traumacast focuses on bringing the leaders of the trauma community together to address upcoming research and its application to the injured patient, education efforts related to trauma, and novel methods in the management of injury. Find more at https://www.east.org/education/online/traumacasts.
In this episode, we review the high-yield topic of Pediatric Trauma Evaluation & Management from the Pediatrics section. --- Send in a voice message: https://anchor.fm/orthobullets/message
In this EAST Traumacast, Drs. Ian Mitchell (@ianmitchellMD), Alexander Gibbons (@AlexGibbonsMD), and Alejandra Casar Berazaluce (@alejandracasar) present highlights from the 2019 Pediatric Trauma Society Annual Meeting (@PediTraumaSoc). Great stuff on head injury risk calculation, whole blood and viscoelastic assays in pediatric resuscitation, Pediatric Trauma Research, and firearm violence prevention.
So you think you know how to handle pediatric solid organ injuries? In this Traumacast, we hear from Drs. Ian Mitchell, Regan Williams, Judith Hagedorn, and Bindi Naik-Mathuria from the Pediatric Trauma Society (PTS) about updates to practice management guidelines for pediatric solid organ injury. The discussion is geared toward those that might initially manage a pediatric patient but also those "adult” hospitals caring for kids ages 15 and up. Links mentioned in the podcast:Pediatric Trauma Society Guidelines Liver/Spleen Guideline - J Pediatr Surg. 2000 Feb;35(2):164-7; discussion 167-9EAST Pediatric Blunt Renal Trauma GuidelinePancreas Guideline - J Trauma Acute Care Surg. 2017 Oct;83(4):589-596. doi: 10.1097/TA.0000000000001576.
In this AHEC Original Live Webinar Lesa Mohr, BSRS, RT(R)(QM)(BD) describes how different imaging modalities are used to demonstrate pediatric trauma, immobilization and sedation techniques for pediatrics, and understanding how optimization of each step in the imaging process can reduce patient exposure.
This episode reviews the Top Educational Content sessions from the APSA 50th Anniversary meeting. It is part of our collaboration with the Behind the Knife podcast. -Dr. Aaron Jensen discusses Cervical Spine Clearance in Pediatric Trauma. -Dr. Shawn Rangel covers Antibiotic Stewardship in Pediatric Surgery. -Dr. Samir Gadepalli addresses Sepsis as a Surgical Problem. (Tweetorial at https://twitter.com/alejandracasar/status/1130466960943267840) Remember to review the 2018 Pediatric Surgery Practice Gaps by the APSA Professional Development Committee. (Available in the StayCurrentApp Video Library and at https://twitter.com/StayCurrentApp/status/1141048992782069761) Edited by Alejandra M. Casar Berazaluce, MD. Music tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626
TOTAL EM - Tools Of the Trade and Academic Learning in Emergency Medicine
We have started partnering with EB Medicine to provide you with some great content. For our first post, we will cover the use of point of care ultrasound (POCUS) for the pediatric trauma patient.
Case study of pediatric patient v. auto
St. Luke's has opened the first dedicated pediatric trauma program in Idaho and we speak with Dr. Kathryn Beattie and Dr. Kendra Bowman on filling this medical niche in a growing community.
In this video, Dr. Michelle Niescierenko discusses the leading causes of pediatric trauma, explains the steps of the trauma assessment, and reviews 3 case studies involving pediatric trauma. Initial publication: April 2, 2019. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu
Former Arizona Senator Jeff Flake on toxic politics in Washington. Jason Strickland of Clemson University on the mysterious venom of Mojave rattlesnake. Charles Nelson of Harvard Medical School on the effects of pediatric trauma. Dava Newman of MIT and former NASA Deputy Administrator on spacesuits for Mars. Deirde Clemente of University of Nevada Las Vegas on athleisure as business dress. Anita Kozyrskyj of the University of Alberta on household disinfectant and childhood weight gain.
Episode 59: Dr, Mark Slidell Mark Slidell, MD, MPH, is an Assistant Professor of Surgery at the University of Chicago. He specializes in pediatric surgery and is the Director of Pediatric Trauma at Comer’s Children Hospital.
Pediatric Grand Rounds for Wednesday, May 30, 2018 Sarah Bingham, MD. Children’s Hospital at Dartmouth-Hitchcock
This podcast is an interactive discussion about pediatric trauma between Dr. Todd Ponsky, Dr. Mark McCollum, and Dr. David Notrica. Dr. David Notrica is the trauma medical director at Phoenix Children's Hospital and is associate professor of surgery at the Mayo Clinic College of Medicine and Associate Professor of Surgery at the University of Arizona College of Medicine in Phoenix. 00:01:30 Dr. David Notrica 00:02:28 Can you tell us a little bit more about what ATOMIC is and what you guys did about it? 00:05:12 In patient with blunt solid organ injury, what is the evidence to support non-operative management based on hemodynamic status as opposed to a grade of injury? 00:07:45 Can you describe some of the other factors that we would use to define hemodynamic stability? 00:10:22 Do you use that in your center? Are the vital signs indexes like the shock index or laboratory values like serum lactate in addition to physical exam findings? 00:12:44 From a crystalloid infusion standpoint, what are your thoughts as far as limiting crystalloid infusion and patients that you know are actively bleeding not crystalloid, but bleeding blood? 00:15:57 What about the complications of transfusion short term and long term and how do we know that that is now not going up because we're giving more blood? 00:19:08 It seems like now real viscoelastic assays TEG and Rotem are getting a lot more traction so that we're directing component therapy specifically as opposed to shot gunning a transfusion. I would love your thoughts on that? 00:19:11 In a patient who has ongoing bleeding is he hemodynamically unstable and you're in the process of resuscitating them with blood products. What are your thoughts on angioembolization its safety and efficacy in pediatric of blunt liver and spleen injury? 00:22:05 So once we have these patients resuscitated and stable in kids with solid organ injury should ICU admission be determined then by injury grade, hemodynamics or a combination of both? 00:23:18 Do you have a threshold of volume of transfusion that would then indicate failure or is it a case by case? 00:24:33 What are your thoughts as far as time frame for bedrest? How long and what are the parameters that help you decide? 00:26:15 In hemodynamically stable patients, do you use a timeframe for observation or are they able to be fast tracked and may be discharged within 24 hours? 00:27:47 Do you have criteria or a threshold, Hematocrit or hemoglobin point that indicates lab variability versus actual continued bleeding? 00:29:31 So, whenever these kids are ready to go home, do you have a standard follow up regimen of a week, two weeks, four weeks. The rest issue I'll let you discuss as well, as far as time frame where they really stay off of activities until you see them back? 00:31:05 is there a type of injury a finding on imaging or a symptom that would then maybe move you to schedule additional imaging in follow up to avoid a complication like a pseudoaneurysm or AV fistula or something along those lines? 00:33:00 So, then it even in a grade 4 or a grade 5 injury with an active extravasation there's no real utility van and scheduling a post or a follow up ultrasound or additional imaging? 00:34:52 For a patient who is stabilized to the point that he is ready for discharge, what criteria do you use then for timeframe of follow up? 00:37:07 Review 00:41:23 Resources 00:43:11 Final comment
Today on ACEP's Frontline, host Dr. Ryan Stanton talks to Dr. Sean Fox about significant traumatic events in the pediatric patient.
This podcast provides listeners with an overview of pediatric trauma. Components of the initial hospital assessment will be discussed, including triage, primary, and secondary surveys. This episode was developed by Breanne Paul with the help of Dr. Melissa Chan. Breanne is a medical student at the University of Alberta, and Dr. Chan is a pediatric emergency physician and Assistant Professor at the University of Alberta and Stollery Children’s Hospital in Edmonton, Alberta, Canada.
Management of the pediatric trauma patient is challenging regardless of where you work. In this EM Cases episode, with the help of two leading pediatric trauma experts, Dr. Sue Beno from Hospital for Sick Children in Toronto and Dr. Faud Alnaji from Children's Hospital of Eastern Ontario in Ottawa we answer such questions as: what are the most important physiologic and anatomic differences between children and adults that are key to managing the trauma patient? How much fluid should be given prior to blood products? What is the role of POCUS in abdominal trauma? Which patients require abdominal CT? How do you clear the pediatric c-spine? Are atropine and fentanyl recommended as pre-induction agents in the pediatric trauma patient? How can the BIG score help us prognosticate? Is tranexamic acid recommended in early pediatric trauma like it is in adults? Is the Pediatric Trauma Score helpful in deciding which patients should be transferred to a trauma center? and many more... The post Episode 95 Pediatric Trauma appeared first on Emergency Medicine Cases.
Join a panel of speakers in a “20 by 20” tour through the hottest topics in pediatric trauma. Clinical pearls and how to avoid pitfalls will be discussed during this non-stop course.
In this episode we discuss two issues highlighted in the August 2016 EAST Literature review concerning Pediatric Trauma: the meaning and definition of pediatric traumatic coagulopathy and what to do with an injured child with a tender c-spine and negative imaging. Drs. Barbara Gaines, David Mooney, and John Petty joing moderators Dave Morris and Matt Martin for a thought-provoking discussion that will be interesting to anyone who cares for injured children -- even providers who don't normally treat pediatric patients. Supplemental MaterialsAcute traumatic coagulopathy in a critically injured pediatric population: Definition, trend over time, and outcomes. Outcomes of pediatric patients with persistent midline cervical spine tenderness and negative imaging result after trauma.
This episode covers Chapter 38 of Rosen's Emergency Medicine. Episode Overview List 5 relevant anatomic/physiologic differences between children and adults in relation to trauma management List 8 airway differences between pediatrics and adults with their relevant implications List potential fluid therapies for hemorrhagic shock and their doses List 3 ideal IO sites in pediatrics and describe the procedure Describe the pediatric GCS List 6 indications for laparotomy List 6 signs of elevated ICP in infants and children What is an impact seizure? List the 5 layers of the scalp and describe 3 types of extra cranial bleeding in pediatrics What is the difference between a linear and a diastatic skull fracture Describe the typical presentation and etiologic cause of an epidural hematoma and a subdural hematoma Describe the management of elevated ICP List 10 anatomical differences between the pediatric and adult cervical spine How can you discern between true subluxation and pseudosubluxation at C2/C3 List 2 ways to choose the size of chest tube in pediatrics What are indications for ER resuscitative thoracotomy in chest trauma? List pediatric specific cardiovascular and abdominal injury patterns
This episode covers Chapter 38 of Rosen's Emergency Medicine. Episode Overview List 5 relevant anatomic/physiologic differences between children and adults in relation to trauma management List 8 airway differences between pediatrics and adults with their relevant implications List potential fluid therapies for hemorrhagic shock and their doses List 3 ideal IO sites in pediatrics and describe the procedure Describe the pediatric GCS List 6 indications for laparotomy List 6 signs of elevated ICP in infants and children What is an impact seizure? List the 5 layers of the scalp and describe 3 types of extra cranial bleeding in pediatrics What is the difference between a linear and a diastatic skull fracture Describe the typical presentation and etiologic cause of an epidural hematoma and a subdural hematoma Describe the management of elevated ICP List 10 anatomical differences between the pediatric and adult cervical spine How can you discern between true subluxation and pseudosubluxation at C2/C3 List 2 ways to choose the size of chest tube in pediatrics What are indications for ER resuscitative thoracotomy in chest trauma? List pediatric specific cardiovascular and abdominal injury patterns
Traumatized children need your full attention. Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. Two main reasons: Children have specific injury patterns Their physiologic response to trauma is unique. Crash course in pediatric anatomy and physiology in trauma When you think of trauma in children, think of Charlie Brown. Large head, no neck, his chest and abdomen form an underdeveloped, amorphous shape. Alternatively, think of children as apples – they are rounder than they are tall, with a large increased surface area. Apples don’t have a hard shell or thick rind to protect them. If you drop them, you may not see any evidence of damage to the outside, but there can be considerable bruising just under the surface. A child has thin skin, less subcutaneous deposits than an adult, and a non-calcified, pliable thorax that deforms more than it protects or shields. The child’s abdominal muscles are not yet developed. There is less peritoneal fat to cushion a blow, and so traumatic forces transmit readily into internal organs, often without external bruising. The child’s large surface area also causes him to dissipate heat more quickly. He may be wet from urine or blood, and in a major trauma, this faster cool-down predisposes him to coagulopathy. Case A 5-year-old boy who was playing with his older brother in front of their home when the ball rolled into the street. He ran after it, and was struck by a sedan going approximately 30 mph. This is the so-called Wadell’s triad that occurs in a collision of auto versus pedestrian or auto versus bicycle. The initial impact is the greatest, and will vary depending on the child’s height and what part of his body reaches up to the bumper of the car. Depending on the height of the child and the height of the car, the initial impact will cause a femur fracture, a pelvic fracture, or direct abdominal trauma. The second impact happens as the child is flung onto the grill or the hood of the car, causing usually thoracic trauma. The third impact can be the coup de grace – to add insult to major injury, the child is then propelled forward, worsening the two previous impacts’ injuries and adding a third – severe blunt head trauma. Intubation Pearl #1: If your patient has any subtle change in mental status, intubate early. In pediatric trauma, we need to be proactive. Hypoxia is our enemy. Intubation Pearl #2: Thankfully cervical spine injuries in children are uncommon, and when they do occur, they typically occur at the child’s fulcrum, which is at C2. Compare this with an adult’s injury pattern with our fulcrum at C7. Be careful and minimize manipulation of the cervical spine, but do what you must to visualize the chords and place the tube. Keep the neck midline, and realize that the child’s usual decrease respiratory reserve is even more affected by trauma. Preoxygenate and pass that tube quickly. Chest Tube Pearl #1: Chest tube sizing in pediatrics is straightforward if we remember that the traditional chest tube size is 4 x the ETT size. Chest Tube Pearl #2: Try using a pigtail catheter. Safety Triangle Lateral edge of the pectoral muscle Lateral edge of the latisimus dorsi Line along the fifth intercostal space at the level of the nipple. It’s roughly where you would put on a generous dose of deodorant. Insertion here minimizes the risk of damage to nerves, vessels and organs. Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. analyzed 1,691 patients who received ED thoracotomy. Overall all-cause adult survival was 6.1%. In children ? 15 years of age, overall all-cause survival was considerably less, at 3.4%. In a large case series and review of the literature for pediatric ED thoracotomy, Allen et al. found a survival rate in penetrating trauma of 10.2%, with a much lower survival rate in blunt pediatric arrest, at 1.6%. Adolescents had more penetrating injuries, and younger children had more blunt trauma. To synthesize, the rarity of ED thoracotomy in children is due to the fact that: Traumatic full arrest in children is uncommon. It is most often blunt trauma. Blunt traumatic arrest in children is mostly non-survivable. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. REBOA involves accessing the common femoral artery, passing a vascular sheath, floating a balloon catheter to the appropriate section of the aorta, and inflating the balloon to occlude blood flow. Brenner et al. described a case series of 6 patients from two Level I trauma centers. They used REBOA for refractory hemorrhagic shock due to either blunt or penetrating injury. After balloon occlusion, blood pressure improved sufficiently to take the patient either to interventional radiology or to the OR. Four patients lived, two died. The AORTA trial is underway to investigate its use in trauma. Summary: Children are like Charlie Brown – large head, no neck, amorphous, underdeveloped and unprotected thorax and abdomen. Or, if you like, they’re like, apples – they have a large surface area and are easily internally bruised, often without overt signs of external bruising. Chest tubes for children are very similar to the adult procedure – the traditional chest tube size is 4 x the child’s ETT size. Try to use smaller pigtail catheters, available in commercial kits, whenever possible. They’re easy, safe, and effective. Resuscitative thoracotomy is for penetrating trauma with signs of life wthin 10-15 minutes of arrival. Find the correctable surgical cause of the arrest. Resuscitative thoracotomy for blunt trauma has a dismal prognosis in children. Selected References Allen CJ, Valle EJ, Thorson CM, Hogan AR, Perez EA, Namias N, Zakrison TL, Neville HL, Sola JE. Pediatric emergency department thoracotomy: a large case series and systematic review. J Pediatr Surg. 2015 Jan;50(1):177-81. American College of Surgeons Committee on Trauma; American College of Emergency Physicians Pediatric Emergency Medicine Committee; National Association of Ems Physicians; American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Fallat ME. Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest. Pediatrics. 2014 Apr;133(4):e1104-16. Holscher CM, Faulk LW, Moore EE, Cothren Burlew C, Moore HB, Stewart CL, Pieracci FM, Barnett CC, Bensard DD. Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. J Surg Res. 2013 Sep;184(1):352-7. Moore HB, Moore EE, Bensard DD. Pediatric emergency department thoracotomy: A 40-year review. J Pediatr Surg. 2015 Oct 19. Scaife ER, Rollins MD, Barnhart DC, Downey EC, Black RE, Meyers RL, Stevens MH, Gordon S, Prince JS, Battaglia D, Fenton SJ, Plumb J, Metzger RR. The role of focused abdominal sonography for trauma (FAST) in pediatric trauma evaluation. J Pediatr Surg. 2013 Jun;48(6):1377-83. Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. J Trauma. 2011 Dec;71(6):1869-72. Pediatric Trauma on WikEM This post and podcast are dedicated to Dr Al Sacchetti, MD, FACEP. Thank you for promoting the emergency care of children and for spreading the message that you don’t need subspecialty training to take good care of acutely ill and injured children. Powered by #FOAMed — Tim Horeczko, MD, MSCR, FACEP, FAAP
In this episode of The Household Health Podcast, we have a conversation with our guest, Pediatric Emergency Room Fellow, Dr. Schneider about Pediatric Trauma. According to the CDC, unintentional injury, or Trauma, is the leading cause of death for the pediatric population. To help raise awareness about this topic we break down through age groups, where the child is at developmentally and how in that stage of development, they might be at an increased risk for a traumatic event to occur. Followed by, offering tips on how to then prevent the traumatic event from occurring once the risk has been identified. From birth to 18 years, and even some tips for parents who now have young adults. Accidents do happen, but through an increased awareness, prevention of preventable traumatic events can occur.
An interview with Dr. Richard Falcone and Dr. Denis Bensard about an exciting new program they have developed to enhance pediatric trauma care in the U.S. They discuss how their Level 1 Pediatric Trauma Center has partnered with multiple adult Level 2 centers to enhance their ability to provide high quality pediatric trauma care, and to successfully obtain ACS verification as pediatric trauma centers. Supplementary materials: download a presentation with additional information and resources related to the PTTC. Link to Dr. Falcone’s CME talk on Trauma Simulation Training
Happy Halloween!!!! In this episode we discuss a flying AED prototype that has been designed in the Netherlands. See the article here. We also highlight the Pediatric Appendix to the Tactical Emergency Casualy Care Guidelines. You can view the draft document here. Finally, by popular demand we bring you another pediatric case study from Dr. Ann Dietrich. Watch for future pediatric CE oportunities.
DISASTER TRIAGE METHODS
DISASTER TRIAGE METHODS
I got to speak with Michael McGonigal, MD of the Trauma Professional's Blog about severe pediatric trauma in the ED.
EMT - P Dominic Silvestro, EMS Medical Director Dr. Coleman, and EMT - P moderator John Chamberlin discuss Pediatric Trauma
Dr. Karen Lidsky of UH Rainbow Babies and Children's Hospital descussed pediatric trauma care.
Anthony Slonim, MD, DrPH, FCCM, and Angela Hsu, MD, both from the Children's National Medical Center at the George Washington University School of Medicine in Washington, D.C., discuss their article in the February issue of Critical Connections, titled "Preventing Pediatric Trauma: The Role of the Critical Care Professional." They focus on the different levels of prevention in this patient population and how critical care professionals can play a more active role in making sure fewer young patients are treated for trauma. (Crit Conn 2006 Vol.5 No.1)
Anthony Slonim, MD, DrPH, FCCM, and Angela Hsu, MD, both from the Children's National Medical Center at the George Washington University School of Medicine in Washington, D.C., discuss their article in the February issue of Critical Connections, titled "Preventing Pediatric Trauma: The Role of the Critical Care Professional." They focus on the different levels of prevention in this patient population and how critical care professionals can play a more active role in making sure fewer young patients are treated for trauma. (Crit Conn 2006 Vol.5 No.1)