POPULARITY
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Antrean panjang dilaporkan terjadi di Bandara Ben Gurion, Tel Aviv, Israel, setelah sejumlah maskapai membatalkan penerbangan di tengah meningkatnya ketegangan antara Israel dan Iran. Situasi ini memicu kepanikan di kalangan penumpang serta mengganggu aktivitas penerbangan internasional.
Jakarta – Anggota Komisi IV DPR RI, Firman Subagyo, menyoroti turunnya harga tandan buah segar (TBS) kelapa sawit di berbagai daerah setelah pemerintah menerapkan kebijakan ekspor satu pintu melalui PT Danantara Sumber Daya Indonesia (DSI). Menurutnya, kebijakan tersebut menimbulkan hambatan rantai pasok ekspor yang berdampak langsung pada harga TBS di tingkat petani.Hal tersebut disampaikan Firman Subagyo dalam wawancara bersama Radio Elshinta pada Sabtu (30/5/2026). Dalam kesempatan itu, ia menjelaskan bahwa salah satu penyebab utama merosotnya harga TBS adalah terjadinya bottleneck atau antrean ekspor akibat seluruh ekspor crude palm oil (CPO) dan palm kernel oil (PKO) harus melalui PT DSI.“Terjadi bottleneck atau antrean ekspor. Dengan sistem satu pintu, seluruh ekspor CPO dan PKO harus melalui DSI terlebih dahulu. Sementara kapasitas gudang, kapal, perizinan, dan sumber daya manusia yang dimiliki masih sangat terbatas,” kata Firman kepada Radio Elshinta.Akibat keterbatasan tersebut, lanjutnya, stok CPO di sejumlah pabrik kelapa sawit menumpuk karena tidak dapat segera diekspor seperti sebelumnya. Kondisi itu membuat perusahaan mengurangi pembelian TBS dari petani maupun mitra plasma.“Ketika stok CPO menumpuk dan tangki penyimpanan penuh, pabrik terpaksa mengurangi serapan TBS dari petani. Jika pabrik tidak lagi menyerap hasil panen secara optimal, maka harga TBS langsung jatuh mengikuti mekanisme pasar,” ujarnya.Firman mengungkapkan, sebelum kebijakan ekspor satu pintu diterapkan, harga TBS di sejumlah daerah masih berada pada kisaran Rp3.500 hingga Rp3.700 per kilogram. Namun kini harga tersebut turun menjadi sekitar Rp2.500 hingga Rp2.700 per kilogram.Menurutnya, penurunan harga yang cukup tajam ini berpotensi mengurangi pendapatan jutaan petani sawit yang selama ini bergantung pada stabilitas harga TBS.Data pemerintah juga menunjukkan dampak kebijakan tersebut mulai dirasakan luas di lapangan. Tercatat sebanyak 139 pabrik kelapa sawit telah menurunkan harga pembelian TBS dari petani.Firman meminta pemerintah segera melakukan evaluasi menyeluruh terhadap implementasi kebijakan ekspor satu pintu agar tidak menimbulkan dampak negatif yang berkepanjangan terhadap sektor perkebunan sawit nasional.“Kita harus memastikan kebijakan yang dibuat tidak merugikan petani. Sawit merupakan salah satu tulang punggung ekonomi nasional dan sumber penghidupan jutaan masyarakat di daerah,” tegasnya.Ia berharap pemerintah dapat segera mencari solusi untuk memperlancar proses ekspor, meningkatkan kapasitas operasional DSI, serta menjaga stabilitas harga TBS agar kesejahteraan petani sawit tetap terjaga.
In this episode of PICU Doc on Call, hosts Dr. Monica Gray and Dr. Pradip Kamat discuss a 15-year-old girl who attempted suicide by ingesting rat poison, acetaminophen, ibuprofen, and amlodipine. The episode focuses on long-acting anticoagulant rodenticides (LAARs), such as brodifacoum, which inhibit vitamin K epoxide reductase, causing delayed coagulopathy. Key topics include clinical presentation, diagnostic evaluation, and management, emphasizing vitamin K1 as the primary antidote and prothrombin complex concentrate or fresh-frozen plasma for major bleeding. The patient stabilized with aggressive supportive care, including vasoactive agents and NAC therapy, alongside psychiatric intervention. Listen to learn more!Show HighlightsClinical case of a 15-year-old girl who attempted suicide through polypharmacy ingestionIngestion of multiple substances, including chewable rat poison, acetaminophen, ibuprofen, and amlodipineDiscussion of toxicology related to long-acting anticoagulant rodenticides (LAARs) like brodifacoumSymptoms and clinical presentation following acute ingestion, including metabolic acidosis and elevated lactateDiagnostic evaluation and laboratory findings, including coagulation studies and liver function testsManagement strategies for LAAR poisoning, including the use of vitamin K and supportive careImportance of monitoring for delayed coagulopathy and serial INR testingConsideration of calcium channel blocker toxicity in the context of the patient's clinical instabilityOverview of the mechanisms of action of LAARs and their impact on vitamin K-dependent clotting factorsKey take-home points regarding the recognition and management of rodenticide ingestion in pediatric patientsReferencesReference: King N, Tran MH. Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management. Transfus Med Rev. 2015 Oct;29(4):250-8.Reference 2: Feinstein DL, Akpa BS, Ayee MA, et al. The emerging threat of superwarfarins: history, detection, mechanisms, and countermeasures. Ann N Y Acad Sci. 2016 Jun;1374(1):111-22.
Presiden Prabowo Subianto menyebut rakyat Indonesia tidak bermimpi menjadi kaya raya, melainkan hanya ingin hidup layak dengan kebutuhan dasar terpenuhi. Namun, pernyataan itu justru memicu kritik dan sentimen negatif di media sosial. Apakah pilihan diksi tersebut gagal membangun empati publik? Simak analisis komunikasi politik bersama Gunawan Wicaksono.
Hujan deras dengan intensitas ekstrem melanda sejumlah wilayah di China Tengah dan Timur, memicu banjir bandang, evakuasi massal, hingga melumpuhkan aktivitas publik. Otoritas China melaporkan satu orang tewas dan dua lainnya hilang di Kabupaten Shimen, Provinsi Hunan. Akibat bencana ini, lebih dari 18 ribu warga terpaksa dievakuasi ke tempat yang lebih aman sementara tim penyelamat terus melakukan operasi pencarian korban. Dampak parah juga dirasakan di Provinsi Hubei, khususnya Kota Jingzhou dan Zhijiang, di mana genangan banjir memaksa pemerintah setempat menghentikan sementara kegiatan perkantoran, sekolah, bisnis, hingga operasional transportasi umum.
Aparat kepolisian bersama militer Bolivia mulai membongkar aksi blokade jalan utama yang menuju ke ibu kota La Paz. Tindakan tegas tersebut diambil setelah para demonstran menutup jalur distribusi makanan dan bahan bakar selama dua pekan sebagai bentuk protes atas krisis ekonomi yang melanda negara tersebut. Dalam aksinya, para pengunjuk rasa menuntut pengunduran diri Presiden Rodrigo Paz yang dinilai gagal mengatasi keterpurukan ekonomi nasional. Kendati sejumlah truk logistik dan kapal tanker kini mulai dapat melintas setelah puing-puing jalan dibersihkan, bentrokan kecil masih terjadi karena sebagian massa melemparkan batu serta bahan peledak rakitan ke arah petugas. Pemerintah Bolivia melaporkan bahwa akibat blokade yang melumpuhkan pasokan pangan dan cadangan oksigen rumah sakit ini, tiga orang warga dinyatakan meninggal dunia karena terhambatnya akses bantuan medis.
Send us Fan MailThis episode of Sirens, Slammers and Service goes straight into the intensity of critical care with Brittany Foy—a STARS Air Ambulance flight nurse and Pediatric ICU pro from the Stollery Children's Hospital.
En este episodio, nos vamos a fondo con todos los juegos de los pasados dos días, le decimos adiós a uno de los grandes del deporte, le hacemos la autopsia a los Celtics, adivinamos quién se lleva el primer turno el domingo y cerramos con Trivia. Únete a la comunidad de Whatsapp de Los NBA Freaks:https;//chat.whatsapp.com/FmSCEFkbeLyGzwnzfpSEFJRedes sociales:Facebook, X, Instagram: @losnbafreaksEmail:losnbafreaks@gmail.com
This episode of the World PICU Awareness Week 2026 podcast series explores the realities of working in pediatric intensive care across the Middle East, with a focus on the wellbeing of healthcare professionals. Through expert insights and real-life experiences, the discussion highlights the emotional impact of high-intensity PICU environments – moving beyond burnout to address deeper challenges such as moral distress and moral injury. Practical strategies are shared, from simple daily practices that strengthen team connection to structured organizational initiatives that support resilience and retention. The episode also examines the role of leadership in fostering psychologically safe environments, as well as the influence of culture, family dynamics, and faith in shaping care across the region. HOST Raghad Al Abdwani Head of Division of Pediatric Critical Care Sultan Qaboos. University Hospital, University Medical City, Muscat, Oman GUEST Marianne Majdalani Head of Division of Pediatric Critical Care American University of Beirut Medical Center Ashley Cowan Clinical Nurse Facilitator Sidra Hospital Caroline McIntire Manager of Child Life Services Sidra Medicine DATE Initial publication date: May 8, 2026 TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript Spanish - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript?position=7 French - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript?position=3 Portuguese - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript?position=6 Italian - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript?position=5 German - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript?position=4 Arabic - https://cdn.bfldr.com/D6LGWP8S/as/qjxhnqx8jt9zvn848svp2955/Middle_East_26_transcript?position=2 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
In this North America episode of the World PICU Awareness Week 2026 podcast, leading experts explore how leadership directly influences caregiver wellbeing and burnout in pediatric intensive care. Through practical examples and evidence-based insights, the discussion highlights the importance of listening to teams, addressing system-level challenges, and fostering a culture where wellbeing is embedded into everyday practice. From leadership behaviors to institutional support, this episode emphasizes a clear message: sustainable PICU care starts with how we lead. HOST Leah Harris Professor and Chair, Department of Pediatrics Dell Medical School at the University of Texas at Austin - Dell Children's Hospital GUEST Asha N Shenoi Professor, Associate Dean University of Kentucky Will Border Chief Physician Wellness Officer, Director of Noninvasive Cardiac Imaging Children's Healthcare of Atlanta and Emory University School of Medicine Wendy Quiroz Nasser Pediatric Nurse Practitioner Baylor College of Medicine (BCM) | Texas Children's Hospital DATE Initial publication date: May 7, 2026 TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript Spanish - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=7 French - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=3 Portuguese - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=6 Italian - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=5 German - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=4 Arabic - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=2 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
In this episode of the World PICU Awareness Week 2026 podcast series, we explore caregiver wellbeing through the perspective of PICU teams across Africa. Moderated by Dr. Charlyne Kilba, this discussion brings together multidisciplinary voices from across the continent, highlighting both the shared challenges and the strength of teams working in resource-limited, high-demand environments. The conversation provides an honest reflection on the realities of pediatric critical care in Africa – including staff shortages, high patient volumes, ethical dilemmas, and limited access to essential resources – and how these factors impact the wellbeing of healthcare professionals. At the same time, the episode showcases powerful and practical approaches to support caregivers, including team-based support systems, debriefing practices, spirituality, and community-driven initiatives. A strong emphasis is placed on resilience – not only at the individual level, but as a collective and system-supported effort. HOST Marie-Charlyne Kilba Paediatric Intensivist, Head of Department Child Health, Greater Accra Regional Hospital, Ghana GUEST Ireen Primrose Machira Nursing Officer PICU in the Mercy James Centre, Malawi Rohini Kalagouda Patil Lead Paediatric Intesivist Nairobi Hospital, Kenya Susan Zakariah Paediatric emergency and critical care specialist, Head of the PICU Korle Bu Teaching Hospital, Ghana Brenda Morrow Physiotherapist University of Cape Town, South Africa DATE Initial publication date: May 6, 2026 TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript Spanish - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript?position=6 French - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript?position=7 Portuguese - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript?position=5 Italian - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript?position=4 German - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript?position=3 Arabic - https://cdn.bfldr.com/D6LGWP8S/as/4rpjqpv6nxzcxf7w78z9h4z/Africa_26_transcript?position=2 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
In this episode of the World PICU Awareness Week 2026 podcast series, we explore caregiver wellbeing through a Nordic perspective, with contributions from clinicians and researchers across Europe. Moderated by Prof. Janet Mattsson, this discussion brings together experienced PICU professionals from Sweden and Denmark to reflect on how wellbeing is supported in daily clinical practice. The conversation highlights the importance of structured approaches – from team check-ins and mentorship to ethical discussions and simulation-based learning – while also acknowledging the real challenges of implementing these practices in busy, high-demand PICU environments. HOST Janet Mattsonn Professor of Critical Care nursing Linnaeus University GUEST Johanne Meijers IC nurse Karolinska Universitetssjukhuset Solna Rikke Louise Stenkjaer Researcher Copenhagen University Hospital DATE Initial publication date: May 4, 2026 TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript Spanish - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript?position=6 French - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript?position=3 Portuguese - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript?position=7 Italian - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript?position=5 German - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript?position=4 Arabic - https://cdn.bfldr.com/D6LGWP8S/as/pbp7m6rprj24tc8b4hnthjcp/Europe_26_transcript?position=2 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
Munculnya kabar yang menyebut Menteri Agama Nasaruddin Umar melarang penyembelihan hewan kurban memicu kegaduhan di ruang publik. Informasi ini cepat menyebar di media sosial, terutama melalui potongan video yang tidak utuh dan terlepas dari konteks pernyataan aslinya. Lalu, bagaimana sebenarnya kronologi munculnya disinformasi ini? Mengapa pesan yang disampaikan bisa disalahartikan? Dan bagaimana strategi Kementerian Agama dalam merespons serta mencegah hoaks serupa di isu-isu keagamaan yang sensitif? Talk bersama Thobib Al Ahsyar, Kepala Biro Humas dan Komunikasi Publik Kemenag.
Upaya pembersihan besar-besaran terus dilakukan di Tuapse, Rusia, setelah fenomena hujan hitam akibat polusi minyak pasca serangan drone Ukraina yang menargetkan kilang minyak setempat.Lebih dari 600 personel gabungan dikerahkan untuk membersihkan hampir 10.000 meter kubik tanah dan air yang terkontaminasi minyak di sepanjang Sungai Tuapse. Serangan tersebut juga memicu kebakaran, kerusakan fasilitas umum, hingga tumpahan minyak di Laut Hitam yang menimbulkan ancaman lingkungan serius.
In this opening episode of the World PICU Awareness Week 2026 podcast series, we explore caregiver wellbeing through the lens of the Oceania region. Moderated by Jacinta Winderlich (Australia), this episode features Dr. Liz Crowe, a leading expert in clinician wellbeing with over two decades of experience in pediatric intensive care and extensive research on workforce sustainability. The conversation challenges conventional narratives around burnout and distress in PICU, shifting the focus toward what sustains healthcare professionals in this demanding environment. Drawing on both clinical experience and research, Dr. Crowe highlights the importance of meaning, team dynamics, and system-level responsibility in supporting those who deliver care. This episode offers a thought-provoking perspective on how PICU teams can move beyond individual-focused solutions and instead foster environments where clinicians can continue to thrive. HOST Jacinta Winderlich Paediatric Clinical Specialist Dietitian Monash Children's Hospital GUEST Liz Crowe Director of Wellbeing Royal Brisbane and Women's Hospital DATE Initial publication date: May 2, 2026 TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript Spanish - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript?position=7 French - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript?position=3 Portuguese - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript?position=6 Italian - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript?position=5 German - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript?position=4 Arabic - https://cdn.bfldr.com/D6LGWP8S/as/jf785nrnf4pqtx6jr4z6mw/Oceania_26_transcript?position=2 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
Kebakaran terjadi di Apartemen Mediterania Tanjung Duren Jakarta Barat pada Kamis pagi sekitar pukul 07.31 WIB. Api diduga berasal dari area basement dan langsung ditangani petugas pemadam yang mengerahkan belasan unit ke lokasi.Lebih dari 70 penghuni dievakuasi akibat asap tebal yang menyebar hingga ke lantai atas gedung. Sejumlah warga juga dilarikan ke rumah sakit karena menghirup asap. Saat ini api telah berhasil dipadamkan dan memasuki tahap pendinginan, sementara petugas masih melakukan penyisiran. Hingga kini belum ada laporan korban jiwa.
In this episode of "PICU Doc on Call," Drs. Monica Gray and Pradip Kamat from Children's Healthcare of Atlanta dive into the use of inhaled anesthetics, especially isoflurane, in the pediatric ICU. We're focusing on those tough cases: refractory status asthmaticus and status epilepticus. We'll chat about why isoflurane is our go-to over other agents like sevoflurane, desflurane, or nitrous oxide, and break down its bronchodilatory and anticonvulsant properties. We'll also touch on important pharmacology concepts, such as MAC and the blood-gas partition coefficient, and discuss how we approach dosing and ventilator management when using isoflurane.Of course, we'll also discuss the potential adverse effects that can come with prolonged use, and why it's important to stop other sedatives and beta-agonists once you start isoflurane. Join us as we walk through the practical aspects and pearls for using inhaled anesthetics in the PICU!Show Highlights:Use of inhaled anesthetics in pediatric intensive care units (PICU)Focus on isoflurane for managing refractory status asthmaticus and status epilepticusComparison of inhaled anesthetic agents: isoflurane, sevoflurane, nitrous oxide, and desfluraneImportance of minimum alveolar concentration (MAC) and blood-gas partition coefficient in anesthetic pharmacodynamicsMechanism of action of isoflurane in airway management and bronchodilationClinical administration techniques for isoflurane in critically ill childrenVentilator management principles for intubated children with status asthmaticusRole of isoflurane in refractory and super-refractory status epilepticusPotential adverse effects and considerations for prolonged isoflurane useSummary of pharmacologic concepts essential for safe isoflurane therapy in pediatric patientsReferences:Rogers Text Book of Pediatric Intensive Care: Chapter 47: Acute Severe Asthma. Stewart C, Brilli RJ. pages 763-775Reference 1: Stetefeld HR, Schaal A, Scheibe F, Nichtweiß J, Lehmann F, Müller M, Gerner ST, Huttner HB, Luger S, Fuhrer H, Bösel J, Schönenberger S, Dimitriadis K, Neumann B, Fuchs K, Fink GR, Malter MP; IGNITE Study Group, with support from the German Neurocritical Care Society (DGNI). Isoflurane in (Super-) Refractory Status Epilepticus: A Multicenter Evaluation. Neurocrit Care. 2021 Dec;35(3):631-639. doi: 10.1007/s12028-021-01250-z. Epub 2021 Jul 20. PMID: 34286464; PMCID: PMC8692280.Reference 2: Zeiler FA, Zeiler KJ, Teitelbaum J, Gillman LM, West M. Modern inhalational anesthetics for refractory status epilepticus. Can J Neurol Sci. 2015 Mar;42(2):106-15. doi: 10.1017/cjn. 2014.121. Epub 2015 Jan 9. PMID: 25572922.Reference 3: Werner HA. Status asthmaticus in children: a review. Chest. 2001 Jun;119(6):1913-29. doi: 10.1378/chest. 119.6.1913. PMID: 11399724.Reference 4: Gill B, Bartock JL, Damuth E, Puri N, Green A. Case report: Isoflurane therapy in a case of status asthmaticus requiring extracorporeal membrane oxygenation. Front Med (Lausanne). 2022 Nov 8;9:1051468. doi: 10.3389fmed. .2022.1051468. PMID: 36425104; PMCID: PMC9679515.
Militer Amerika Serikat kembali menyita kapal tanker minyak Majestic X berbendera Guyana di Samudra Hindia karena diduga terkait jaringan penyelundupan minyak Iran. Kapal yang sedang menuju China ini merupakan target sanksi Pentagon untuk memutus pendanaan Teheran. Aksi penyitaan ini langsung memicu guncangan ekonomi global, menyebabkan harga minyak mentah Brent melonjak di atas 100 dolar per barel dan melambungkan harga pangan dunia hingga 35 persen.
Konflik Timur Tengah Picu Kenaikan Biaya EnergiSumber: UN TV
Aksi blokade depot dan kilang minyak (Whitegate) oleh pengunjuk rasa di Irlandia memicu krisis bahan bakar, menyebabkan sekitar 600 SPBU kehabisan stok.
In this episode of *PICU Doc on Call*, Drs. Monica Gray, Pradip Kamat, and Rahul Damania chat about a 17-year-old girl who ended up with acute liver failure after she intentionally took 22.5 grams of acetaminophen. She came in 48 hours later with really high transaminases and an INR of 5.5, so she was admitted to the PICU. The hosts break down how acetaminophen affects the body, walk through its four clinical stages, and discuss how to manage it—focusing on N-acetylcysteine as the primary antidote. They also touch on other treatments, like fomepizole. Thankfully, this patient recovered without needing a liver transplant, which really shows how important it is to have a team approach with intensivists, hepatologists, toxicologists, and psychiatry all working together.Show Highlights:Clinical case presentation of a 17-year-old girl with acetaminophen ingestion leading to acute liver failureMechanism of acetaminophen toxicity and its metabolic pathwaysEpidemiology of acetaminophen toxicity in pediatric populationsPathophysiology of acetaminophen overdose and its effects on liver functionClinical manifestations and progression of acetaminophen toxicity through various stagesEvaluation and diagnostic criteria for assessing acetaminophen toxicityManagement strategies for acetaminophen overdose, including the use of N-acetylcysteine (NAC).Discussion of adjunctive therapies such as fomepizole in severe cases.Importance of supportive care in managing complications of acute liver failureAn interdisciplinary approach to treatment involving various medical specialtiesReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter ***.Reference 1: 2019 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 37th Annual Report. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, Rivers LJ, Pham NPT, Ryan ML. Clin Toxicol (Phila). 2020;58(12):1360.Reference 2: Pepin L, Matsler N, Fontes A, Heard K, Flaherty BF, Monte AA. Fomepizole Therapy for Acetaminophen-Induced Liver Failure in an Infant. Pediatrics. 2023 Oct 1;152(4):e2022061033. doi:10.1542/peds. 2022-061033. PMID: 37681263.Reference 3. Chiew AL, Buckley NA. Acetaminophen Poisoning. Crit Care Clin. 2021 Jul;37(3):543-561.Reference 4. Squires JE, Alonso EM, Ibrahim SH, Kasper V, Kehar M, Martinez M, Squires RH. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure. J Pediatr Gastroenterol Nutr. 2022 Jan 1;74(1):138-158. doi: 10.1097/MPG.0000000000003268. PMID: 34347674.
Harga bahan pangan di Pasar Jombang, Tangerang Selatan, Banten, alami kenaikan. Kenaikan terjadi terutama pada komoditas cabai dan tomat. Akibat banyaknya komoditas yang mengalami kenaikan, masyarakat mengurangi pembelian.
In this compelling lecture by Dr. David Winlaw of Northwestern University, we hear his thoughts on the state of the CICU/Surgeon relationship and he offers his thoughts on how to improve care for children with congenital heart disease undergoing surgery. Why does he believe that the more old fashioned approach of having cardiac programs run by academic departments is no longer optimal? What do critical care doctors not understand about surgery and vice versa? Are we asking too much of our CICU practitioners? How can the 'shift work' mentality be abolished and how can we avoid burnout for our critical care front line staff while also improving outcomes for patients? How can we bring joy back into the care of children with critical heart disease? Dr. Winlaw shares his insights from a long career in multiple centers worldwide in the Thomas J. Spray Lecture at the Cardiology 2026 CHOP conference from late February, 2026 in Arizona.
In this World Shared Practice Forum Podcast, Drs. Luregn Schlapbach and Janet Kelly-Geyer discuss the implementation and impact of the Airway, Breathing, Circulation - Plan, Risk, Options (ABC-PRO) handover tool in the Pediatric Intensive Care Unit. They discuss how a structured, proactive risk assessment during clinical handovers can reduce cardiac arrest rates and improve patient outcomes. They share perspectives on enhancing team situational awareness by anticipating high-risk events, identifying management strategies, and encouraging multidisciplinary participation in anticipatory care. Lastly, they highlight how the ABC-PRO framework advances overall patient safety in critical care settings. LEARNING OBJECTIVES - Understand the ABC-PRO tool's function in reducing cardiac arrests and enhancing safety - Examine bedside team-based discussions around key patient risks during handovers using the ABC-PRO tool - Recognize the significance of interdisciplinary collaboration in patient management - Assess the potential for implementing similar handover improvements in diverse healthcare settings AUTHORS Luregn Schlapbach, MD, PhD Professor in Pediatric Intensive Care, Head of Department of Intensive Care and Neonatology, University Children`s Hospital Zurich Janet Kelly-Geyer, MBChB Senior PICU Consultant University Children's Hospital Zurich Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: March 24, 2026. ARTICLES REFERENCED - Catchpole KR, de Leval MR, McEwan A, et al. Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. Paediatr Anaesth. 2007;17(5):470-478. doi:10.1111/j.1460-9592.2006.02239.x - Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803-1812. doi:10.1056/NEJMsa1405556 - Riley CM, Diddle JW, Harlow A, et al. Shifting the Paradigm: A Quality Improvement Approach to Proactive Cardiac Arrest Reduction in the Pediatric Cardiac Intensive Care Unit. Pediatr Qual Saf. 2022;7(1):e525. Published 2022 Jan 21. doi:10.1097/pq9.0000000000000525 - Spaeder MC, Lee L, Miller C, Keim-Malpass J, Harmon WG, Kausch SL. Incidence of cardiac arrest following implementation of a predictive analytics display in a pediatric intensive care unit. Resusc Plus. 2025;21:100862. Published 2025 Jan 2. doi:10.1016/j.resplu.2024.100862 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/f7xr7vcxc6f4mhc9736tzpb/202603_WSP_Schlapbach___Kelly-Geyer_Transcript.pdf 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 thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Schlapbach LJ, Kelly-Geyer JF, Burns JP. Reducing Cardiac Arrests in the PICU with ABC-PRO. 03/2026. OPENPediatrics. Online Podcast.
This week on Fishing Without Bait, we continue our powerful conversation with returning guest Emily as she shares the next chapter in her daughter McKenna's incredible journey. From the uncertainty of the PICU to the first small signs of awareness, Emily walks us through the emotional highs and devastating lows of recovery. She recounts moments of hope—like McKenna responding for the first time—and moments where that hope seemed to disappear just as quickly. As the journey unfolds, Emily shares what it was like to advocate fiercely for her daughter in life-or-death situations, including a critical moment where speaking up quite literally saved McKenna's life. Through it all, time lost meaning, routines became survival, and resilience became essential. This episode also explores the long road of recovery—rehabilitation, regaining movement, and the emotional milestone of bringing McKenna home. But the journey didn't end there. Emily shares the next challenge: kidney failure, the transplant process, and her unwavering certainty that she would be the one to donate. This is a story of courage, advocacy, and the deep connection between parent and child—where love becomes the driving force through unimaginable circumstances. This is Part 2 of Emily's story.
This week on Fishing Without Bait, we continue our powerful conversation with returning guest Emily as she shares the next chapter in her daughter McKenna's incredible journey. From the uncertainty of the PICU to the first small signs of awareness, Emily walks us through the emotional highs and devastating lows of recovery. She recounts moments of hope—like McKenna responding for the first time—and moments where that hope seemed to disappear just as quickly. As the journey unfolds, Emily shares what it was like to advocate fiercely for her daughter in life-or-death situations, including a critical moment where speaking up quite literally saved McKenna's life. Through it all, time lost meaning, routines became survival, and resilience became essential. This episode also explores the long road of recovery—rehabilitation, regaining movement, and the emotional milestone of bringing McKenna home. But the journey didn't end there. Emily shares the next challenge: kidney failure, the transplant process, and her unwavering certainty that she would be the one to donate. This is a story of courage, advocacy, and the deep connection between parent and child—where love becomes the driving force through unimaginable circumstances. This is Part 2 of Emily's story.
Episode 44 - Sarah Vermilyea - Nutrition in Children with Complex Health HistoryIn this episode of Nutrition Pearls: the Podcast, co-hosts Jen Smith and Megan Murphy speak with Sarah Vermilyea MS, RD, CSP, LD, CNSC on the topic of nutrition in children with complex health history. Sarah is a pediatric dietitian with 20 years of experience. Over her career she has practiced across numerous pediatric specialty areas, most often in the PICU and its counterpart, outpatient complex care. She currently works at a pediatric intermediate care facility, providing nutrition care to both children and adults with complex medical needs.Of particular interest to this podcast, Sarah was an inaugural NASPGHAN CPNP board member and the original organizer of the Nutrition Pearls YouTube series; serving CPNP members for more than 7 years. Sarah has authored two book chapters on pediatric nutrition assessment—including NFPE for children with medical complexity—and has 12 publications in peer-reviewed journals. For the past two years, she has traveled to pediatric hospitals across the United States to train dietitians in performing NFPE on infants.She serves as a preceptor for clinical and community nutrition interns from the University of Cincinnati, recently receiving their Outstanding Preceptor Award. Sarah is currently engaged in an exciting international collaboration with clinicians caring for children with neurological impairment. Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.Resources:Catastrophic Rupture – Orange Hat Publishing‘How to SGNA' by Donna Secker:Secker DJ, Jeejeebhoy KN. How to perform Subjective Global Nutritional assessment in children. J Acad Nutr Diet. 2012 Mar;112(3):424-431.e6. doi: 10.1016/j.jada.2011.08.039. Epub 2012 Mar 1. PMID: 22717202.‘Updated SGNA' template by Laura Carter:Carter L, Hulst JM, Afzal N, Jeejeebhoy K, Brunet-Wood K. Update to the pediatric Subjective Global Nutritional Assessment (SGNA). Nutr Clin Pract. 2022 Dec;37(6):1448-1457. doi: 10.1002/ncp.10859. Epub 2022 May 20. PMID: 35594373.Produced by: Corey IrwinNASPGHAN - Council for Pediatric Nutrition Professionalscpnp@naspghan.org
In this special “PICU Doc On Call Shorts” episode, pediatric ICU physicians Dr. Monica Gray, Dr. Pradip Kamat, and Dr. Rahul Damania break down the concept of Mean Arterial Pressure (MAP). Using a case of a six-year-old in septic shock, they discuss how to calculate MAP, normal pediatric values, and the physiological determinants and clinical significance of MAP. The hosts highlight MAP's role in guiding management of critically ill children, review autonomic and endothelial regulation, and reinforce learning with a board-style question. This episode emphasizes practical bedside application for pediatric interns and ICU providers.Show Highlights:Overview of Mean Arterial Pressure (MAP) and its clinical significance in pediatric critical care.Introduction of a clinical case involving a 6-year-old child in septic shock.Explanation of the formula for calculating MAP and its application to the clinical case.Discussion of normal reference values for MAP in children and their clinical implications.Physiological determinants of MAP, including cardiac output and systemic vascular resistance.Role of the autonomic nervous system in regulating MAP through baroreceptor reflexes.Importance of maintaining adequate MAP for organ perfusion, particularly in critically ill patients.Clinical applications of MAP monitoring and management strategies in the PICU.Summary of key takeaways regarding MAP calculation, physiological determinants, and clinical relevance.Mention of related topics, such as invasive versus non-invasive blood pressure monitoring.References:DeMers D, Wachs D. Physiology, Mean Arterial Pressure. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Pediatric Blood Pressure Metrics and Hypotension Thresholds (details the task force data used to derive the 5th and 50th percentile MAP estimation formulas for children)Berlin DA, Bakker J. Starling curves and central venous pressure. Crit Care. 2015 Feb 16;19(1):55.Magder S. Volume and its relationship to cardiac output and venous return. Crit Care. 2016 Sep 10;20(1):271
In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with Javier Varela, MD, MSc, about his study, “Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study revealed new insights into airway pathophysiology in infants with severe bronchiolitis who require mechanical ventilation, a population that comprises a substantial portion of winter pediatric intensive care unit (PICU) admissions worldwide. Dr. Varela is an intensivist in the PICU in the Department of Pediatrics at Clínica Alemana de Santiago, in Santiago, Chile. Differing ventilatory strategies and the heterogeneous phenotypes of bronchiolitis motivated Dr. Varela's team to investigate airway closure, which was detected in seven of the 12 patients included in the study. Airway opening pressure frequently exceeded the set positive end-expiratory pressure (PEEP) levels—highlighting a potential gap in traditional ventilator management. Dr. Varela explains that respiratory mechanics, particularly driving pressure and respiratory system compliance, can be misinterpreted when airway opening pressure is not considered. Study limitations included bacterial coinfection in nearly half the patients and the constraints of a single-center design, but Dr. Varela said that these factors did not appear to alter the physiologic observations. Although more research is needed before making clinical recommendations, the study established a foundational understanding of airway closure in patients with bronchiolitis and underscores the need for future work on personalized ventilation strategies, PEEP titration, and the potential heterogeneity of airway behavior in this population. Resources referenced in this episode: Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure (Varela J, et al. Pediatr Crit Care Med. 2025;26:e1096-e1104) Airway Closure in Acute Respiratory Distress Syndrome: An Underestimated and Misinterpreted Phenomenon (Chen L, et al. Am J Respir Crit Care Med. 2018;197:132-136)
In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Nadir Yehya, MD, MSCE, an attending physician in the Pediatric Sepsis Program and the Division of Critical Care Medicine at the Children's Hospital of Philadelphia in Philadelphia, Pennsylvania, USA. They discuss Dr. Yehya's study, “Parent and Provider Perspectives on Short-Term Outcomes of Critically Ill Ventilated Children,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study explores whether widely used composite clinical outcomes such as ventilator-free days truly reflect what families value most when their child is in the pediatric intensive care unit (PICU). Dr. Yehya discusses how the project emerged from a long-standing question in pediatric critical care research: Are the outcomes we measure in clinical trials aligned with the priorities and lived experiences of families? Because mortality is low in pediatrics, composite short-term outcomes such as ventilator-free days, ICU-free days, and hospital-free days are commonly used. However, little is known about whether these metrics are truly patient- and family-centered. Using survey data from parents and PICU clinicians, the study found strong agreement between parents and clinicians on the importance of minimizing duration of invasive mechanical ventilation. But parents and clinicians diverged on other short-term outcomes. Families ranked oxygen duration as more important than ICU or hospital length of stay, reflecting concerns about ongoing medical needs, missed work, and the possibility of going home on oxygen. Clinicians prioritized ICU and hospital days over oxygen use. Substantial variation was also found within both groups. Dr. Yehya highlights the value of feedback from patient and family advisory councils in designing this type of research, explaining that such feedback informed the study's instrument design and family approach. He calls for deeper investigation into post-discharge recovery, functional outcomes, and long-term developmental trajectories—areas families consistently identify as their greatest concerns. Resources referenced in this episode: Parent and Provider Perspectives on Short-Term Outcomes of Critically Ill Ventilated Children (Shannon MM, et al. Pediatr Crit Care Med. 2025;26:e1149-e1153)
In this episode of "PICU Doc on Call," Drs. Pradip Kamat and Rahul Damania dive into a pediatric ICU case involving a 4-year-old girl who presents with severe anemia and bleeding, ultimately diagnosed with von Willebrand disease (VWD). They chat about the causes and different types of VWD, walk through the key clinical features, and break down how to diagnose and manage this condition. Drs. Kamat and Damania highlight the important roles of desmopressin and factor concentrates in treatment. Throughout the episode, they stress the need to recognize VWD in kids who have mucosal bleeding and offer practical tips for intensivists on lab evaluation and treatment strategies for this common inherited bleeding disorder.Show Nighlights: Clinical case discussion of a 4-year-old girl with severe anemia and bleeding symptomsDiagnosis of von Willebrand disease (VWD) and its significance in pediatric critical careEtiology and pathogenesis of von Willebrand diseaseClassification of von Willebrand disease into types (Type 1, Type 2 with subtypes, Type 3)Clinical manifestations and symptoms associated with VWDDiagnostic approach for identifying von Willebrand disease, including laboratory testsManagement strategies for VWD, including desmopressin and von Willebrand factor concentratesRole of adjunctive therapies such as antifibrinolytics and hormonal treatmentsImportance of multidisciplinary collaboration in managing complex bleeding disordersOverview of the pathophysiology of von Willebrand factor and its role in hemostasisReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter ***.Reference 1: Leebeek FW, Eikenboom JC. Von Willebrand's Disease. N Engl J Med. 2016 Nov 24;375(21):2067-2080.Reference 2: Ng C, Motto DG, Di Paola J. Diagnostic approach to von Willebrand disease. Blood. 2015 Mar 26;125(13):2029-37.Platton S, Baker P, Bowyer A, et al. Guideline for laboratory diagnosis and monitoring of von Willebrand disease: A joint guideline from the United Kingdom Haemophilia Centre Doctors' Organisation and the British Society for Hematology. Br J Haematol 2024 May;204(5):1714-1731.Mohinani A, Patel S, Tan V, Kartika T, Olson S, DeLoughery TG, Shatzel J. Desmopressin as a hemostatic and blood-sparing agent in bleeding disorders. Eur J Haematol. 2023 May;110(5):470-479. doi: 10.1111/ejh.13930. Epub 2023 Feb 12. PMID: 36656570; PMCID: PMC10073345.
When your child survives one medical emergency only to face another, parenting becomes a constant act of advocacy and courage. Today's guest joins us to share her daughter's journey with rare and complex medical conditions, from early respiratory failure and unexplained hospitalizations to epilepsy, lung disease, and life with medical uncertainty. As a military spouse navigating deployments, Brittany shares what it means to walk this path largely alone, trust her instincts as a mother, and fight to be believed by medical professionals. This episode explores navigating rare disease without clear answers, the life-changing impact of compassionate child life support, supporting siblings through medical trauma, and how rituals, play, and community help families find hope and meaning in the midst of chaos. Download our free Children's Hospital Passport to help empower your child and family during hospital stays. Sponsored in part by HealthWell Foundation—learn how you can help families afford life-saving medications at healthwellfoundation.org. Resources from today's episode: Medical Support: Stanford Children's Health Undiagnosed Diseases Network Nonprofit & Community Support: Live Like JoJo Foundation The Meg Foundation (Pediatric Pain & Poke Plans) Brave Bears Club (Epilepsy Support) Child Life Mommy CHYP Connect with Brittany Follow Brittany's journey as she shares life as a medical mom, military spouse, and advocate. Connect & Support from Child Life On Call Subscribe: Never miss an episode on Apple Podcasts or Spotify. Visit insidethechildrenshospital.com to easily search stories and episodes Follow us on Instagram for updates and opportunities to connect with other parents Download SupportSpot: receive Child Life tools at your fingertips. Leave a Review: It helps other families find us and access our resources! Keywords: Rare disease parenting, Medical motherhood, Medically complex child, Pediatric lung disease, Pediatric epilepsy, Intractable epilepsy, PICU parent experience, Military family healthcare, Parent advocacy in healthcare, Child life specialist support, Sibling support during hospitalization, Parenting after medical trauma, Coping with chronic illness, Undiagnosed disease journey, Hospital parent support Medical information provided is not a substitute for professional advice—please consult your care team
In this episode of "PICU Doc On Call," Drs. Pradip Kamat and Rahul Damania discuss the acute management of a 14-year-old boy with severe rectal bleeding and hypertension, ultimately diagnosed with inflammatory bowel disease (IBD). They review the approach to pediatric lower GI bleeding, diagnostic workup, and imaging, emphasizing early recognition and resuscitation. They outline IBD management, including steroids, biologics such as infliximab, and nutritional support, while highlighting the importance of screening for infections before immunosuppression. The episode provides practical insights for PICU physicians on handling acute GI emergencies in children.Show Nighlights: Clinical case of a 14-year-old male with hypertension and rectal bleeding.Diagnosis of inflammatory bowel disease (IBD) following significant blood loss.Approach to pediatric rectal bleeding and its implications.Diagnostic workup including laboratory tests and imaging modalities.Management strategies for IBD in acute pediatric care.Importance of early recognition and resuscitation in cases of shock.Physiological principles related to blood loss and shock in children.Differential diagnoses for lower gastrointestinal bleeding in pediatrics.Initial evaluation and stabilization protocols for pediatric patients.Nutritional support and multidisciplinary care in managing IBD. References:Romano C, Oliva S, Martellossi S, et al. Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol. 2017;23(8):1326-1337.Pai AK, Fox VL. Gastrointestinal bleeding and management. Pediatr Clin North Am. 2017;64(3):543-561.Padilla BE, Moses W. Lower gastrointestinal bleeding and intussusception. Surg Clin North Am. 2017;97(1):63-80.Kaur M, Dalal RL, Shaffer S, Schwartz DA, Rubin DT. Inpatient management of inflammatory bowel disease-related complications. Clin Gastroenterol Hepatol. 2020;18(11):2417-2428.Ashton JJ, Ennis S, Beattie RM. Early-onset paediatric inflammatory bowel disease. Lancet Child Adolesc Health. 2017;1(2):147-158.Bouhuys M, Lexmond WS, van Rheenen PF. Pediatric inflammatory bowel disease. Pediatrics. 2022;150(6):e2022059341.Rosen MJ, Dhawan A, Saeed SA. Inflammatory bowel disease in children and adolescents. JAMA Pediatr. 2015;169(11):1053-1060.Conrad MA, Rosh JR. Pediatric Inflammatory Bowel Disease. Pediatr Clin North Am. 2017 Jun;64(3):577-591.
When your newborn is healthy one moment and rushed to the PICU the next, life can change in an instant. Today's guest joins us to share her son's journey with severe hemophilia—from unexpected bleeding after a routine circumcision to a spontaneous brain bleed, emergency surgery, and a months-long PICU stay. This episode explores being thrust into medical motherhood, learning to advocate under unimaginable stress, and how community, child life, and modern medicine help families navigate life with a complex diagnosis. Download our free Children's Hospital Passport to help empower your child and family during hospital stays. Sponsored in part by HealthWell Foundation—learn how you can help families afford life-saving medications at healthwellfoundation.org. Resources Medical Support: Mayo Clinic Children's Center & Hemophilia Treatment Center, Rochester, MN Nonprofit & Community Support: Hemophilia Foundation of Minnesota & the Dakotas Connect with Sami Follow Sami and Cooper's journey on Instagram Connect & Support from Child Life On Call Subscribe: Never miss an episode on Apple Podcasts or Spotify. Visit insidethechildrenshospital.com to easily search stories and episodes Follow us on Instagram for updates and opportunities to connect with other parents Download SupportSpot: receive Child Life tools at your fingertips. Leave a Review: It helps other families find us and access our resources! Keywords: Severe hemophilia, Hemophilia in infants, Newborn hemophilia diagnosis, Infant brain bleed, Pediatric hemophilia, Medical motherhood, PICU parent experience, Emergency brain surgery infant, Rare disease parenting, Bleeding disorders in babies, Hemophilia treatment center, Parent advocate in healthcare, Life after a NICU or PICU stay, Medically complex child, Child life specialist support, Coping with a chronic diagnosis, Parenting after medical trauma, Hemophilia A awareness, Infant seizures medical emergency, Hospital parent support Medical information provided is not a substitute for professional advice—please consult your care team.
In this episode of "PICU Doc on Call," Dr. Pradip Kamat and Dr. Rahul Damania dive into a fascinating case of a 9-month-old infant who comes in with hypoglycemia and seizures. Together, they break down the basics of glucose metabolism, walk through the causes of hypoglycemia, and discuss the best diagnostic strategies and acute management steps. They put a special spotlight on using diazoxide for hyperinsulinemic hypoglycemia, discussing not only how it works but also its potential side effects. The conversation also discusses dietary interventions for metabolic disorders and highlights the importance of rapid diagnosis and personalized treatment.Show Highlights:Pediatric hypoglycemia and its implications in infantsCase study of a 9-month-old infant with hypoglycemia and seizuresPhysiology of glucose metabolism and its regulationCauses of hypoglycemia, categorized into primary and secondary etiologiesDiagnostic approaches for identifying the cause of hypoglycemiaInitial management strategies for acute hypoglycemiaLong-term treatment options based on underlying causesImportance of timely diagnosis and intervention in the PICU settingPharmacologic management of hyperinsulinemic hypoglycemia, including the use of diazoxideMultidisciplinary care and follow-up for pediatric patients with hypoglycemiaReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 84 Alder M et al. Pediatric Sepsis. Pages 1293-1309Honarmand K, Sirimaturos M, Hirshberg EL, Bircher NG, Agus MSD, Carpenter DL, Downs CR, Farrington EA, Freire AX, Grow A, Irving SY, Krinsley JS, Lanspa MJ, Long MT, Nagpal D, Preiser JC, Srinivasan V, Umpierrez GE, Jacobi J. Society of Critical Care Medicine Guidelines on Glycemic Control for Critically Ill Children and Adults 2024. Crit Care Med. 2024 Apr 1;52(4):e161-e181. doi: 10.1097/CCM.0000000000006174. Epub 2024 Jan 19. PMID: 38240484.Rosenfeld E, Thornton PS. Hypoglycemia in Neonates, Infants, and Children. 2023 Aug 22. In: Feingold KR, Ahmed SF, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Muzumdar R, Purnell J, Rey R, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 37665756.Rayas MS, Salehi M. Non-Diabetic Hypoglycemia. 2024 Jan 27. In: Feingold KR, Ahmed SF, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N,...
In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Rebecca Mitting, MD, MRCPCH, consultant pediatric intensivist and clinical lead for the PICU at Imperial College Healthcare NHS Trust in London. They discuss Dr. Mitting's article, “Sedation and Ventilator Weaning Bundle and Time to Extubation in Infants With Bronchiolitis: Secondary Analysis of the Sedation AND Weaning in Children (SANDWICH) Trial,” published in the April 2025 issue of Pediatric Critical Care Medicine. The SANDWICH trial, conducted in the United Kingdom, evaluated a nurse-led intervention of sedation scoring, goal-based sedation weaning, and protocolized extubation readiness testing. While the original trial demonstrated only a modest reduction in ventilation duration, Dr. Mitting's subgroup analysis of infants with bronchiolitis found a reduction of median time to successful extubation by approximately 16 to 17 hours. Dr. Mitting highlights the importance of these findings during the winter season when bronchiolitis drives up PICU occupancy and strain. The critical trade-off between minimizing ventilator days and avoiding extubation failure is discussed, as well as implementation challenges after the COVID-19 pandemic, the importance of protocolized care under resource strain, and future directions for predictive models and personalized strategies to optimize extubation timing. Listeners will gain practical insights into evidence-based approaches for improving outcomes in infants with bronchiolitis and the broader implications for PICU workflow and patient safety. Resources referenced in this episode: Sedation and Ventilator Weaning Bundle and Time to Extubation in Infants With Bronchiolitis: Secondary Analysis of the Sedation AND Weaning in Children (SANDWICH) Trial (Mitting RB, et al. Pediatr Crit Care Med. 2025;26:e423-e431). Effect of a Sedation and Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units: A Randomized Clinical Trial (Blackwood B, et al. JAMA. 2021;326:401-410).
There's room for everyone to grow on social media! In this solo episode, Avery breaks down exactly how she did it, and how you can, too. From filming on her days off as a PICU nurse to buying her family home at 29, she shares the real blueprint behind turning “silly little videos” into a full-time career: mindset, consistency, brand deals, and more.Avery also opens up about the mental health toll of going viral, why she stopped reading comments, and how she protects her peace while still showing up online. If you've ever thought that could be me, this episode is your permission slip and your game plan. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Today, Dr. Monica Gray, Dr. Pradip Kamat, and Rahul Damania discuss a critical case involving a 10-year-old boy who developed post-intubation desaturation. Using the DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure), they systematically troubleshoot the emergency, highlighting the importance of teamwork, capnography, and manual ventilation. The team emphasizes structured approaches, simulation training, and essential bedside tools to ensure rapid, effective management of acute deterioration in intubated children, turning a life-threatening crisis into a controlled, solvable situation.Show Highlights:Clinical case discussion of a ten-year-old boy with post-intubation desaturation in the pediatric ICUUse of the "DOPE" mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) for troubleshootingSystematic approaches in emergency situations in pediatric critical careAssessment and management of sudden desaturation in intubated patientsEvaluation of potential causes of desaturation, including tube displacement and obstructionRole of equipment failure in acute deterioration and strategies to address itSignificance of continuous capnography and manual ventilation techniquesPrevention strategies for unplanned extubation in pediatric ICU settingsEmphasis on teamwork, communication, and simulation training in crisis managementReview of literature insights related to hypoxemia and equipment issues in pediatric intubationReferences:Topjian AA, et al. Part 4: Pediatric Basic and Advanced Life Support—2020 AHA PALS Guidelines. Circulation. 2020.Foundational pediatric resuscitation guidance endorsing early switch to manual ventilation and structured troubleshooting for the deteriorating intubated child.Cook TM, et al. Major complications of airway management in the UK: NAP4. British Journal of Anaesthesia. 2011.Seminal audit highlighting ICU/ED airway failures and the critical role of waveform capnography in preventing unrecognized esophageal intubation.Volpicelli G, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Medicine. 2012. High-impact consensus placing lung ultrasound at the bedside to rapidly diagnose pneumothorax during post-intubation deterioration.Prekker ME, et al. Video vs direct laryngoscopy for ED intubation—randomized trial. New England Journal of Medicine. 2023.NEJM RCT showing higher first-pass success with video laryngoscopy—relevant to preventing displacement/misplacement drivers of desaturation.Chrimes N, et al. Preventing unrecognised oesophageal intubation: consensus guideline. Anaesthesia. 2022.Modern, practice-changing guidance: sustained waveform capnography is the mainstay to exclude esophageal placement and avert catastrophic hypoxemia.
This episode brings together three leaders working at the intersection of pediatric innovation, health security, and early-stage commercialization. Kolaleh Eskandanian, Program Director of SPARK, is joined by founders Dori Jones of AcQumen Medical and Jugal Suthar of Vesynta for a conversation about advancing breakthrough solutions for children. They discuss the mission behind the BARDA-funded SPARK for Innovations in Pediatrics Hub at Children's National Hospital, the challenges of developing technologies for pediatric populations, and the impact of public-private partnerships in moving lifesaving tools to market. Dori and Jugal share what their companies are building, the inflection points that shaped their journeys, and how BioHealth Innovation's Entrepreneur-in-Residence program supported their progress. The group reflects on lessons learned, the value of mentorship, and how collaborative accelerator ecosystems help drive breakthroughs in pediatric care, preparedness, and health equity. Editing and post-production work for this episode was provided by The Podcast Consultant (https://thepodcastconsultant.com). Dr. Kolaleh Eskandanian is a nationally recognized leader in pediatric health innovation with more than twenty years of experience across academia, government, and industry. She previously served as Vice President and Chief Innovation Officer at Children's National Hospital, where she founded Innovation Ventures and secured significant federal funding, patents, and licensed technologies. She now leads the BARDA-funded SPARK Accelerator Hub for Pediatrics and serves as Chief Strategy and Innovation Officer at Compremium AG, while also supporting early-stage innovators as an angel investor with Citrine Angels. Dori Jones is the Co-Founder and CEO of AcQumen Medical, a medtech company developing UltraTrac, the first ultrasound-guided impedance technology designed for rapid assessment of hemodynamics in critically ill infants and children. She brings nearly two decades of experience across R&D, clinical education, and commercialization roles supporting cardiac and critical care devices at organizations ranging from early startups to Abbott and Medtronic. Her commitment to pediatric innovation is shaped in part by her experience as the mother of a NICU and PICU patient. Dr. Jugal Suthar is the Co-Founder and CEO of Vesynta, a precision medicine company developing the DosoLogic platform, the first marketplace-enabled precision prescribing software aimed at improving accuracy and safety for every patient. His background includes clinical work as a hospital pharmacist and roles in drug development in the pharmaceutical industry. His PhD in precision medicine fuels his focus on bringing personalized dosing insights to populations often underrepresented in clinical research.
Linda Schatz, Director of AKASA, explains the role of Clinical Documentation Integrity (CDI) specialists in ensuring accurate coding and bridging the gap between clinical documentation and specific, accurate codes to ensure proper reimbursement. The complexity of medical coding often leads to errors, which can be nearly eliminated by using AI to review 100% of patient encounters to identify inconsistencies and help CDI and coding professionals process more accurate claims quickly. Accurate documentation is important for hospital revenue, patient care quality, and perception of the hospital's performance. Linda explains, "Well, the old adage, if it isn't documented, it wasn't done. If the doctor uses incorrect or perfectly acceptable medical terminology, it doesn't translate into an appropriate code. You've heard the term UIs, this is years ago, right? Grandma had UTIs and died. In the coding world, that used to code for a simple UTI. So the hospitals are getting paid for a patient that took care of a UTI, when in reality that patient was septic. To the outside world, it looks like Grandma came to the hospital, something that could have been treated outpatient, and she died. So the public perception of quality is less. So not only is it revenue, it's quality, but ultimately it's delivering patient care." "I'm an old nurse. I've been in this field for over 40 years. I've worked across the NICU, PICU, and adult ICU. I've worked in access hospitals to large academics and all the way through hospice. That's pretty unique as a nurse to have that big of a background. Then I became a CDS, or clinical documentation specialist, or integrity specialist, and learned the documentation and coding aspect." "Then I moved into the consulting role and worked with organizations and physicians all across this nation, helping them learn how to do this. And so you've got the clinical background, the coding background, and now I understand how generative AI works. And so while you're a new nurse, you're a horse, right? When we hear a heartbeat, we think of a horse, and after years, you earn your stripes and you become a zebra, and then you add all of these multiple areas of expertise, you become uniquely valuable as a pink zebra." #AKASA #GenAI #CDI #RevenueCycleManagement akasa.com Download the transcript here
Linda Schatz, Director of AKASA, explains the role of Clinical Documentation Integrity (CDI) specialists in ensuring accurate coding and bridging the gap between clinical documentation and specific, accurate codes to ensure proper reimbursement. The complexity of medical coding often leads to errors, which can be nearly eliminated by using AI to review 100% of patient encounters to identify inconsistencies and help CDI and coding professionals process more accurate claims quickly. Accurate documentation is important for hospital revenue, patient care quality, and perception of the hospital's performance. Linda explains, "Well, the old adage, if it isn't documented, it wasn't done. If the doctor uses incorrect or perfectly acceptable medical terminology, it doesn't translate into an appropriate code. You've heard the term UIs, this is years ago, right? Grandma had UTIs and died. In the coding world, that used to code for a simple UTI. So the hospitals are getting paid for a patient that took care of a UTI, when in reality that patient was septic. To the outside world, it looks like Grandma came to the hospital, something that could have been treated outpatient, and she died. So the public perception of quality is less. So not only is it revenue, it's quality, but ultimately it's delivering patient care." "I'm an old nurse. I've been in this field for over 40 years. I've worked across the NICU, PICU, and adult ICU. I've worked in access hospitals to large academics and all the way through hospice. That's pretty unique as a nurse to have that big of a background. Then I became a CDS, or clinical documentation specialist, or integrity specialist, and learned the documentation and coding aspect." "Then I moved into the consulting role and worked with organizations and physicians all across this nation, helping them learn how to do this. And so you've got the clinical background, the coding background, and now I understand how generative AI works. And so while you're a new nurse, you're a horse, right? When we hear a heartbeat, we think of a horse, and after years, you earn your stripes and you become a zebra, and then you add all of these multiple areas of expertise, you become uniquely valuable as a pink zebra." #AKASA #GenAI #CDI #RevenueCycleManagement akasa.com Listen to the podcast here
A collection of exploring the concept of time from various dimensions from a medical humanities program. Includes seven pieces by authors Idan Yoel, MD, Lydia I. Healy, MD, MSc, RCPI, Dyla Ginter, MD, FRCPC, Faizeen Zafar, MBBS, MS, Mariam Naguib, MD, Roxanne Kirsch, MD, MBE, Briseida Mema, MD, MHPE. Read the original article here: https://www.academicpedsjnl.net/article/S1876-2859(25)00373-0/abstract
"My baby went from fussy to lifeless in hours—by the time we reached the PICU, they said he might have had six hours to live." In this episode, TikTok Influencer and Medical Mom Marlee Brandon, a pediatric speech-language pathologist turned full-time mom, shares the whirlwind diagnosis of her 12-month-old son Bain with Type 1 diabetes and severe DKA, the traumatic hospital stay, and the everyday advocacy that followed. Raw, practical, and deeply hopeful. Why this episode matters Emotional clarity: what a Type 1 diagnosis really feels like in infancy Practical advocacy: scripts, choices, and language that help toddlers cope System gaps: when even major hospitals say "we've never seen this in a baby" Hope forward: raising a confident kid who knows why care matters What You'll Learn Early signs & ER visit: how "ear infection" symptoms masked T1D in a baby DKA in plain language: what "acidic blood" means and how PICU treats it The learning cliff: carb ratios, breastfeeding while dosing insulin, and why it's OK not to "get it" on day one Toddler coping: give choices, narrate care, build independence Rebuilding trust after mistakes: when training/tools aren't perfect Finding your people: groups, podcasts, and creators who answer "what now?" Timestamps 00:00 Meet Marlee (pediatric SLP → motherhood) 01:40 Why speech therapy & pediatrics 03:55 Bain turns one → sudden "ear infection" → nonstop vomiting 06:30 Small-town ER: "He has diabetes" (dismantling stereotypes) 08:35 Life-flight & PICU: severe DKA, hourly sticks, no food for 48 hrs 10:20 Turning the corner: energy returns; the six-hour window 11:22 "I don't understand this"—carb ratios, nursing, overwhelm 13:05 "We've never seen this in a baby" at a major children's hospital 15:23 Tears → handing tasks to partner → first solo shot 17:20 The Chick-fil-A moment: necessity builds confidence 18:44 Finding community: Facebook groups, YouTube, TikTok 19:55 Narrating care for toddlers—SLP tools that build trust & language 21:19 Offering choices: stickers, shot sites, pushing the button 22:53 Caregiver reality: self-care with very young T1D 24:32 Why daycare felt unsafe: syringe mix-ups & trust 25:54 Joy check: rocks, crafts, and a kid excited by everything 27:56 Best resources for newly diagnosed families 29:52 "Diabetes doesn't define your life." Marlee Shares that... "Type 1 isn't about weight or diet—my baby was still nursing." "They told my husband he probably had six hours to live." "I thought I needed nursing school to understand our endo." "I won't chase him with a shot. I explain why—insulin keeps you safe." "You can be anything and do anything…and have diabetes." Resources & Links Support communities Diapers & Diabetes (Facebook group for infants/toddlers with T1D) Juicebox Podcast Related Child Life On Call resources Explaining shots, blood draws and vaccines to kids SupportSpot App (by Child Life On Call) Procedure guides, coping plans, journals, and parent resources to feel prepared and advocate with confidence
Send us a textWhat does it take to build safer clinicians, not just better test takers? We sit down with pediatric critical care pioneer and simulation leader Tonya Schneidereith to trace a career defined by curiosity, courage, and a relentless focus on patient safety. From early days as one of the first PICU nurse practitioners in the country to associate director of simulation at Johns Hopkins, Tonya reveals how mentorship, research, and design thinking shaped her approach to teaching and assessment.We dig into her medication safety work using Google Glass to capture the learner's point of view, exposing why accurate math still leads to dangerous IV pump programming when context is missing. That insight led to national recommendations on verifying dosage calculation competence and a sharper focus on debriefing. Tanya shares a memorable morphine case where most learners turned up oxygen as ventilation failed, and how a single probing question in debrief uncovered the real driver behind a “correct” action. The lesson is clear: simulation must illuminate decision-making, not just outcomes.Tonya also opens the doors to SIMPL Simulation, the consultancy she co-founded to elevate faculty development, program design, and simulation operations. She walks us through a bold project with BSA LifeStructures and Wake Tech Community College: a true simulation hospital spanning EMS arrival, diagnostics, acute care rooms, an operating room, and a live MRI. It's a blueprint for interprofessional education that makes teamwork the default. We then explore responsible AI in healthcare simulation, drawing on a new white paper Tonya helped shape. Ethical integration, transparent limits, and scenario design that builds judgment are essential as AI becomes part of daily clinical work.If you care about better debriefing, safer medication practices, AI in nursing education, and simulation spaces that teach as powerfully as people do, this conversation will sharpen your approach. Listen, share with your team, and tell us the one change you'll make in your next sim. Subscribe for more expert stories and leave a review to help others find the show.Innovative SimSolutions.Your turnkey solution provider for medical simulation programs, sim centers & faculty design.
Welcome to "PICU Doc on Call," the podcast where the world of pediatric critical care comes alive! Today, Dr. Monica Gray, Dr. Pradip Kamat, and Rahul Damania delve into a fascinating case involving a 16-year-old male presenting with headache, photophobia, anemia, and cerebral venous thrombosis. After some detective work, the diagnosis? Paroxysmal nocturnal hemoglobinuria, or PNH.Join us as we break down the pathogenesis and clinical features of PNH, walk through the diagnostic workup, and discuss management strategies, especially the game-changing role of complement inhibitors like Eculizumab. We'll also review this patient's clinical journey, highlighting the key pearls for recognizing and treating PNH in the pediatric intensive care unit.So, tune in to hear more!Show Highlights:Clinical case presentation of a 16-year-old male with symptoms including headache, photophobia, and anemiaDiagnosis of paroxysmal nocturnal hemoglobinuria (PNH) and its clinical significancePathogenesis of PNH, including the role of the PIGA gene mutation and GPI-anchored proteinsClinical features and complications associated with PNH, such as thrombosis and hemolysisDiagnostic workup for PNH, including laboratory tests and flow cytometryManagement strategies for PNH, focusing on complement inhibitors like EculizumabImportance of supportive care in the PICU for patients with PNHDiscussion of emerging therapies and advancements in PNH treatmentPatient outcome and clinical course following treatment for PNHKey takeaways regarding the diagnosis and management of PNH in pediatric intensive careReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care.Reference 1: Brodsky RA. Paroxysmal nocturnal hemoglobinuria. Blood. 2014 Oct 30;124(18):2804-11.Reference 2 Waheed A, Shammo J, Dingli D. Paroxysmal nocturnal hemoglobinuria: Review of the patient experience and treatment landscape. Blood Rev. 2024 Mar;64:101158.Reference 3: Kokoris S, Polyviou A, Evangelidis P, Grouzi E, Valsami S, Tragiannidis K, Gialeraki A, Tsakiris DA, Gavriilaki E. Thrombosis in Paroxysmal Nocturnal Hemoglobinuria (PNH): From Pathogenesis to Treatment. Int. J. Mol. Sci. 2024 Nov 11;25(22):12104.
In today's episode, Dr. Monica Gray and Dr. Pradip Kamat sit down with neurosurgeon Dr. Neal Laxpati, MD, PhD, to chat about intracranial pressure (ICP) monitoring in pediatric critical care. Using real case studies, they dive into how and when to use external ventricular drains (EVDs) and ICP bolts, walking listeners through setup, potential risks, and everyday challenges. The group discusses device complications, ways to prevent infections, how to interpret waveforms, and shares practical bedside tips. It's a must-listen for intensivists looking for hands-on advice and key insights to help optimize care for kids with brain injuries or hydrocephalus.Show Highlights:Pediatric critical care unit (PCU) case discussionsIntracranial pressure (ICP) monitoring in pediatric patientsCase studies involving a 10-year-old girl with diffuse midline glioma and a 16-year-old male with a ruptured arteriovenous malformation (AVM)Cerebrospinal fluid (CSF) physiology and its role in ICP managementTypes of ICP monitoring devices: external ventricular drains (EVDs) and intraparenchymal monitorsIndications and complications associated with ICP monitoringInterpretation of ICP waveforms and their clinical significanceManagement strategies for elevated ICP and CSF drainageRisks and challenges of ICP monitoring, including infection and device malfunctionImportance of interdisciplinary communication and meticulous bedside care in pediatric critical care settingsReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 118. Traumatic brain injury. Kochaneck et al. Page 1375 -1400Rogers textbook:Reference 1: Forsyth RJ, Parslow RC, Tasker RC, Hawley CA, Morris KP; UK Paediatric Traumatic Brain Injury Study Group; Paediatric Intensive Care Society Study Group (PICSSG). Prediction of raised intracranial pressure complicating severe traumatic brain injury in children: implications for trial design. Pediatr Crit Care Med. 2008 Jan;9(1):8-14. doi: 10.1097/01.PCC.0000298759.78616.3A. PMID: 18477907.Reference 2: Appavu B, Burrows BT, Foldes S, Adelson PD. Approaches to Multimodality Monitoring in Pediatric Traumatic Brain Injury. Front Neurol. 2019 Nov 26;10:1261. doi: 10.3389/fneur.2019.01261. PMID: 32038449; PMCID: PMC6988791.
Ever wondered how PICU teams make those critical calls about blood pressure and vasoactive meds? On this episode, Dr. Monica Gray and Dr. Pradip Kamat dive into the real-world questions that come up during pediatric intensive care rounds. They break down the pros and cons of arterial line versus non-invasive cuff measurements, talk through blood pressure targets for tough cases like sepsis and brain injury, and share practical tips for weaning kids off vasoactive drugs. With a focus on the latest guidelines and research, Monica and Pradip offer actionable advice to help you fine-tune hemodynamic management for your sickest patients. Tune in!Show Highlights:Relationship between blood pressure and cardiac output in pediatric patientsComparison of arterial line (invasive) versus non-invasive cuff measurements for blood pressure monitoring in the PICUBlood pressure targets for critical illnesses such as sepsis, traumatic brain injury, and respiratory failure in childrenStrategies for weaning vasoactive medications in critically ill pediatric patientsImportance of accurate blood pressure measurement and monitoring in the PICUDiscussion of organ autoregulation and its impact on blood pressure managementClinical assessment and individualized care in setting blood pressure goalsRecommendations for initial vasoactive agents in pediatric septic shockChallenges and considerations in vasoactive medication selection and weaningNeed for further research on pediatric vasoactive medication management strategiesReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 110. Alder M et al. Pediatric Sepsis. Pages 1293-1309.Rogers Textbook of Pediatric Critical Care Medicine. Chapter 88. Fitzgerald J et al. Bacterial Sepsis.Pages 1469-1485.Reference 1 Weiss S. Vasoactive Selection for Pediatric Septic Shock-Where to begin. JAMA Network Open, 2025;8(4):e254726.Reference 2 Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):665-674.
Guest: Emma Justice, MS, CCC-SLP, CLC, NTMTCEarn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/courses/pfd-problem-solvingTune in as we welcome one of our favorite humans, Emily Justice, a dedicated speech language pathologist with a wealth of experience working in the NICU and public schools in Boston. Join us for an engaging discussion about her path into speech therapy, her passion for supporting minority recruitment in the field, and her advocacy for accessible feeding therapy. We delve into important topics such as the necessity of instrumental swallow studies, the power of family and caregiver involvement in therapy, and the importance of interprofessional collaboration. This episode is packed with practical insights for therapists, caregivers, and anyone invested in improving pediatric feeding practices.About the Guest: Emma Justice, MS, CCC-SLP, CLC, NTMTC, works full-time for Boston Public Schools and is the owner of Justice for Infant Feeding Therapy and Lactation. She specializes in pediatric feeding and swallowing, with a focus on medical complexities and culturally diverse populations. Emma is certified in lactation counseling as well as neonatal touch and massage. She received her master's degree in Speech-Language Pathology from Northeastern University and completed her clinical fellowship at Johns Hopkins All Children's Hospital. Emma has experience across several settings, including pediatric acute care, encompassing a Level III NICU, PICU, Oncology, Cleft and Craniofacial team, Aerodigestive team, and the well-baby Mother-Infant Unit. Additionally, Emma has experience in pediatric outpatient rehab, home health, and public school settings. She is a guest lecturer and the primary pediatric consultant for the Swallowing Wellness Center, where she teaches a course on pediatric swallow studies. Emma co-created BABY S.T.E.P. with Dr. Ianessa Humbert, an infant and pediatric adaptation of Humbert's S.T.E.P. (Swallowing Training Educational Portal), designed to provide accessible, affordable, and evidence-based swallowing education. She currently serves on ASHA's topic committee for Pediatric Feeding Disorders and has presented nationally on topics related to pediatric dysphagia and cultural disparities.
We're back on The Mail-In this week with Brett Merriman and Sally deFries taking on your questions. Here's what we've got: 1. How do I let my friends know we're not interested in swinging? 2. AITA for getting annoyed with my gf for spending too much time shopping for gifts during our international trip? 3. Any recs for a day trip to Lake Tahoe? 4. Need tips for a night shift PICU nurse 5. Feeling stuck in a relationship, unsure whether to move on? Our Partners: Green Chef: Get 50% OFF your first month then 20% OFF your next two with code 50MAIL at GreenChef.com/50MAIL MasterClass: Get 15% OFF at MasterClass.com/MAILIN WRITE IN TO THE MAIL-IN FOLLOW US ON INSTAGRAM FOLLOW US ON TWITTER Learn more about your ad choices. Visit megaphone.fm/adchoices
Mishelle recounts how she and her sister, Angellyn, stumbled upon their past medical and court records while helping Lisa and Carey move. This discovery prompted the sisters to reach out to people who could offer a perspective unfiltered by their mother's influence: Judy, the PICU nurse who once treated Angellyn, and Bea Yorker, the Munchausen by proxy expert who testified against Lisa more than twenty years ago. *** Justice for Collin: Contact Birmingham PD https://docs.google.com/document/d/1tEg2mpbrwNJnuVMNdbHANCofEFYvH9_bO5MULHUxqLs/edit Order Andrea's new book The Mother Next Door: Medicine, Deception, and Munchausen by Proxy. Click here to view our sponsors. Remember that using our codes helps advertisers know you're listening and helps us keep making the show! Subscribe on YouTube where we have full episodes and lots of bonus content. Follow Andrea on Instagram: @andreadunlop Buy Andrea's books here. For more information and resources on Munchausen by Proxy, please visit MunchausenSupport.com The American Professional Society on the Abuse of Children's MBP Practice Guidelines can be downloaded here. *** This season covers sensitive subject matter involving allegations of child abuse, medical child abuse (also known as Munchausen by proxy), and the death of a minor. All information presented is based on court records, first-person interviews, contemporaneous documentation, and publicly available sources. The podcast includes personal statements and perspectives from individuals directly involved in or affected by these events. These accounts represent their experiences and interpretations, and some statements reflect opinions that may be emotionally charged. Where appropriate, the reporting team has verified claims through official records or corroborating sources. Nothing in this podcast should be interpreted as a legal conclusion or diagnosis. All subjects are presumed innocent unless convicted in a court of law. This podcast is intended for informational and public interest purposes. This podcast contains audio excerpts from two phone conversations recorded in the states of Georgia and Alabama, respectively. Both recordings were obtained by a third-party source, who acted in accordance with the relevant one-party consent laws of those states, which allow for the lawful recording of a conversation with the consent of one participant. These recordings were subsequently shared with the producers of this podcast after the fact, and were not made by or at the direction of the podcast team or its parent organization. The podcast producers have made good-faith efforts to confirm the legal compliance of the original recordings, and are presenting these materials in the context of public interest reporting. The inclusion of this audio is intended for journalistic, educational, and documentary purposes in alignment with the principles of fair use and First Amendment protections. Listeners are advised that the views expressed in the recordings are those of the individuals speaking and do not necessarily reflect the views of the producers or affiliated entities. Learn more about your ad choices. Visit podcastchoices.com/adchoices
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