Podcasts about Picu

Though I am a Pediatric Emergency Provider, most of the time I don't treat true emergencies. Intensive care is a fairly small portion of what I do. That is why I invited Dr. Matt Goldstein, a PICU doctor from NY to come on the show and discuss the 5 things PICU docs want PEM docs to know…  Low threshold to call and communicate concerns regarding a decompensating patient. Identify high risk intubations Try and get as much history as possible (understanding how busy ED is) Reassess ICU level patients once they are admitted (every hospital is different) The power of airway clearance (especially in children with complex care needs, tracheostomy etc)

Kebakaran hutan melanda wilayah utara Reno, Nevada, Amerika Serikat, menghanguskan sekitar 6 ribu hektare lahan. Dua titik api di kawasan Bug dan Fred Mountain dilaporkan bergabung menjadi satu, sementara ribuan warga terpaksa dievakuasi akibat ancaman penyebaran api yang semakin cepat.

Krisis listrik kembali memicu protes di Irak di tengah gelombang panas yang terus melanda. Suhu di sejumlah wilayah bahkan menembus 50 derajat Celsius. Kondisi ini semakin menekan warga, sekaligus menambah beban pada jaringan listrik nasional.

Gelombang migrasi besar memicu krisis kemanusiaan di wilayah kantong Spanyol, Ceuta. Ribuan migran, termasuk pencari suaka asal Gaza, terdampak keterbatasan fasilitas dan masih menunggu proses suaka di tengah kondisi yang memprihatinkan.

Aksi kelompok sayap kanan di Kota Ceuta, Spanyol, berujung pada ketegangan dengan warga setempat. Peristiwa ini terjadi di tengah memanasnya perdebatan mengenai krisis migran yang terus menjadi perhatian di wilayah tersebut. Insiden ini mencerminkan meningkatnya polarisasi sosial dan politik terkait isu migrasi di kawasan perbatasan Spanyol.

MetroTV, Hujan deras memicu banjir di sejumlah wilayah negara bagian New York, Amerika Serikat. Peringatan banjir dikeluarkan setelah curah hujan ekstrem menyebabkan sejumlah jalan tertutup dan mengganggu aktivitas masyarakat.

Charles Berde, MD, PhD, is the Sara Page Mayo Chair in Pediatric Pain Medicine and a Professor of Anaesthesia at Harvard Medical School. As a co-founder of the Pain Treatment Center at Boston Children's Hospital, he has spent decades at the forefront of pediatric analgesic pharmacology and the development of novel local anesthetics. His extensive translational research focuses on local anesthetic mechanisms and prolonged-duration formulations, making him a preeminent authority on the physiological impacts and safety profiles of these agents in neonates and children. A recipient of the Myron Yaster Lifetime Achievement Award from the Society for Pediatric Anesthesia, Dr. Berde brings unparalleled expertise to the discussion of managing and preventing local anesthetic systemic toxicity (LAST) within the high-stakes environments of the PICU and pediatric operating rooms.Guest Conflicts of Interest (COI)Algavita Bio: Collaborator/Developer of novel, prolonged-duration local anesthetics.Quiver Bioscience: Unpaid Scientific Advisor and co-PI on an NINDS-HEAL grant focused on rare disease pain treatments.Latigo Biotherapeutics: Scientific Advisor and recipient of past research support for novel analgesics development.Algos: Scientific Advisor for non-opioid analgesics development.Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to the management of local anesthetic systemic toxicity (LAST) in children.References:Patient and Doctor Reconcile for Greater GoodBerde CB. Toxicity of local anesthetics in infants and children. J Pediatr. 1993 May;122(5 Pt 2):S14-20. doi: 10.1016/s0022-3476(11)80004-1.McMahon K, Paster J, Baker KA. Local anesthetic systemic toxicity in the pediatric patient. Am J Emerg Med. 2022 Apr;54:325.e3-325.e6. doi: 10.1016/j.ajem.2021.10.021. Epub 2021 Oct 25. Lavonas et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com.  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Topan Noul menerjang wilayah selatan China setelah mendarat di Provinsi Guangdong. Badai terkuat tahun 2026 ini membawa angin kencang dan hujan lebat yang memicu banjir, merusak fasilitas umum, serta membuat ratusan ribu warga harus dievakuasi. Sejumlah penerbangan di Hong Kong juga dibatalkan akibat cuaca ekstrem.

In this episode of *Pediatric Critical Care Insights*, Dr. Monica Gray and Dr. Pradip Kamat chat about how capnography, specifically end-tidal CO2 monitoring, is used in the pediatric ICU. They walk through a real-life case of a 9-year-old with respiratory failure from influenza A, showing how ETCO2 monitoring helps confirm endotracheal tube placement, guides ventilation, spots cardiac arrest, and even helps assess the quality of CPR. Along the way, they break down how to interpret capnography waveforms, discuss different types of devices, and explain the key physiological concepts. The episode is packed with practical, bedside tips for intensivists caring for critically ill kids.Show Highlights:Importance of capnography (end-tidal CO2 monitoring) in the pediatric intensive care unit (PICU)Clinical case study of a 9-year-old boy with respiratory failure due to influenza AUse of capnography for confirming endotracheal tube placement and assessing ventilation statusDetection of cardiac arrest and guidance for CPR quality through ETCO2 monitoringOverview of capnography physics and physiology, including terminology distinctionsTypes of capnography: mainstream vs. sidestream, and their applications in pediatric patientsAssumptions for accurate ETCO2 approximation of arterial CO2 and conditions affecting this relationshipAnalysis of capnography waveform phases and their clinical significancePrognostic value of ETCO2 during cardiac arrest and its correlation with patient outcomesPractical applications of ETCO2 monitoring in critical care, focusing on airway, breathing, and circulation managementReferences:Noninvasive respiratory monitoring and assessment of gas exchange. David F. Butler; Kenneth A. Schenkman. Fuhrman and Zimmerman's Pediatric Critical Care, 43, 483-491.e3Humphreys S, Schibler A, von Ungern-Sternberg BS. Carbon dioxide monitoring in children—A narrative review of physiology, value, and pitfalls in clinical practice. Pediatr Anaesth. 2021;31:839–845. https://doi.org/10.1111/pan.14208Lasa JJ, Dhillon GS, Duff JP, et al. Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2026;157(1):e2025074351O'Flaherty. Capnography: principles and practice. London: BMJ Publishing Group; 1994.Aminiahidashti H, Shafiee S, Zamani Kiasari A, Sazgar M. Applications of End-Tidal Carbon Dioxide (ETCO2) Monitoring in Emergency Department; a Narrative Review. Emerg (Tehran). 2018;6(1):e5. Epub 2018 Jan 15. PMID: 29503830; PMCID: PMC5827051.

Avery is putting her nurse hat back on. In this solo episode, she pulls from her years as a PICU and NICU nurse and her own postpartum experience to give new and expecting moms the real talk nobody else will. She opens up about the night feeds that broke her, the guilt she carried as a working mom who couldn't afford the fancy stuff, and why social media is setting mothers up to feel like failures. Then she runs through her full list of baby and postpartum must-haves, the same one ICU doctors used to ask her for. Fed is best, sleep when the baby sleeps, and trust your gut. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Hujan lebat dan angin kencang terus melanda kawasan Pegunungan Ural di Rusia. Cuaca ekstrem tersebut memicu banjir bandang, proses evakuasi warga secara massal, hingga gangguan operasional pada jalur kereta api utama di wilayah setempat.

In this special episode of *PICU Doc on Call*, hosts Dr. Monica Gray and Dr. Rahul Damania welcome new pediatric critical care fellows across the U.S. with practical advice for day one of fellowship. Joined by third-year PICU fellow Dr. Alexandra Bryant, the episode covers three key areas: navigating PICU logistics, protecting mental health, and managing the overwhelming volume of critical care knowledge. Dr. Bryant shares candid insights from her own training journey, offering actionable strategies for success. The hosts remind listeners that fellowship is a learning process and that new fellows can make a meaningful impact.Show HighlightsIntroduction to pediatric critical care fellowship for new fellows and learnersKey insights and advice for first-year fellows in pediatric intensive careImportance of understanding logistics in the PICU environmentStrategies for effective communication and collaboration within the PICU teamManaging mental health and self-care during fellowshipTechniques for absorbing and retaining vast knowledge in pediatric critical careRecommendations for organizing study materials and resourcesEmphasis on lifelong learning and accessing information effectivelyPractical tips for time management and responsibility organizationSuggested resources for mindfulness and emotional support in medical trainingResource:PICU Doc on Call Episode 31

Mabes Polri telah menetapkan eks Jaksa Agung Muda Pidana Khusus (Jampidsus), Febrie Adriansyah (FA) sebagai tersangka dalam kasus dugaan korupsi tata kelola batu bara.Untuk mencegah perselisihan antara Polri dan Kejaksaan Agung (Kejagung) pasca-penetapan tersangka ini, kedua lembaga perlu mengedepankan koordinasi kasus secara terbuka, gelar perkara bersama (sinergi), menjunjung tinggi asas praduga tak bersalah, serta menjaga fokus penegakan hukum dari muatan politis.Saat ini, Korps Pemberantasan Tindak Pidana Korupsi (Kortastipidkor) Polri secara resmi telah menyerahkan berkas perkara dugaan korupsi dan TPPU ini kepada pihak Kejaksaan Agung untuk memperkuat sinergi institusi.Mabes Polri tetapkan mantan Jampidsus Febri Ardiansyah sbg tersangka kasus korupsi dan TPPU tata kelola batu bara, apa yang harus dilakukan agar tdk picu perselisihan antara polri dan kejagung? Narasumber1. Koordinator Koalisi Sipil Masyarakat Anti Korupsi (KOSMAK), Ronald Loblobly2. Pengacara Publik dari Pusat Bantuan Hukum Masyarakat, Ralian Jawalsen

Kebakaran hutan hebat melanda kawasan Pegunungan Sierra de los Filabres, Provinsi Almeria, Spanyol. Sedikitnya 12 orang dilaporkan tewas, termasuk beberapa warga negara Inggris, sementara ratusan warga dan wisatawan dievakuasi dari area terdampak.Api yang dipicu gelombang panas ekstrem terus meluas. Pemerintah Spanyol mengerahkan ratusan petugas pemadam kebakaran dan personel militer untuk mengendalikan kobaran api serta mencegah jatuhnya korban lebih banyak.

In this episode of *PICU Doc on Call Shorts*, pediatric ICU physicians Dr. Pradip Kamat and Dr. Rahul Damania discuss respiratory time constants and their clinical relevance in pediatric critical care. Using a case of a six-year-old with near-fatal status asthmaticus on mechanical ventilation, they explain how prolonged time constants from high airway resistance cause air trapping, dynamic hyperinflation, and intrinsic PEEP. They emphasize recognizing these issues through ventilator waveforms and highlight that increasing respiratory rate can worsen hypercapnia in obstructive disease. Key management strategies include reducing respiratory rate, extending expiratory time, and accepting permissive hypercapnia to ensure hemodynamic stability.Show HighlightsRespiratory time constants and their clinical significance in pediatric patientsCase study of a six-year-old boy with near-fatal status asthmaticusManagement of severe obstructive respiratory failure in pediatric patientsUnderstanding airway resistance and lung compliance in relation to time constantsImpact of ventilator settings on patient outcomes, including air trapping and intrinsic PEEPImportance of adequate expiratory time to prevent dynamic hyperinflationRecognizing signs of inadequate expiratory time in mechanically ventilated patientsStrategies for managing hypercapnia and optimizing ventilator settingsDifferences in time constants related to various pediatric respiratory conditionsKey takeaways for pediatric critical care practice and ventilator managementReferencesDepta F, Kallet RH, Gentile MA, Kassis EN. Expiratory time constants in mechanically ventilated patients: rethinking the old concept — a narrative review. Intensive Care Medicine Experimental. 2025;13:40. The review summarizes the definition of expiratory time constant, the relationship to resistance and compliance, the 63/86/95/98/99% rule, and clinical applications in obstructive and acute lung injury states.Depta F, et al. Six methods to determine expiratory time constants in mechanically ventilated patients: a prospective observational physiology study. Intensive Care Medicine Experimental. 2024. This study describes expiratory time constant as a parameter that can guide respiratory rate and I:E adjustment to support complete exhalation.Alibrahim O, Rehder KJ, Miller AG, Rotta AT. Mechanical Ventilation and Respiratory Support in the Pediatric Intensive Care Unit. Pediatric Clinics of North America. 2022;69(3):587–605. This pediatric review specifically discusses passive exhalation, the expiratory time constant, and why asthma and bronchiolitis require longer expiratory times to avoid gas trapping.Arnal JM. Monitoring respiratory mechanics in mechanically ventilated patients. Hamilton Medical Knowledge Base. This source provides a practical bedside description of time constants, waveform-based respiratory mechanics, and typical RCexp ranges, while emphasizing dependence on resistance and compliance.Emeriaud G, López-Fernández YM, Iyer NP, et al.; PALICC-2 Group; PALISI Network. Executive summary of the second international guidelines for the diagnosis and management of pediatric ARDS. Pediatric Critical Care Medicine. 2023;24(2):143–168. The PALICC-2 guideline framework supports lung-protective ventilation in PARDS, including attention to tidal volume, PEEP, plateau pressure, and driving pressure.

Dampak paparan asap dari kebakaran Tempat Pembuangan Akhir (TPA) Jatiwaringin, Kabupaten Tangerang, Banten, mulai mengancam kesehatan masyarakat. Ratusan warga di sekitar lokasi dilaporkan mulai terjangkit Infeksi Saluran Pernapasan Akut (ISPA).

In this podcast, recorded at the Top Articles of 2025 Session at PEDICRITICON 2025, Dr. Traci Wolbrink interviews Drs. Ashish Agarwal and Ramesh Kumar Ramachandran about two randomized controlled trials. These studies comparing 0.9% normal saline with Ringer's lactate in diabetic ketoacidosis and the efficacy of high flow nasal cannula versus nasal prong bubble CPAP in bronchiolitis. The conversation reveals challenges in resource-limited settings, emphasizing the importance of protocol adherence, mentorship, and resource management. Valuable insights into fluid management, respiratory support, and research execution are offered for healthcare professionals keen on advancing clinical practice and research knowledge. Learning Objectives - Recognize the limitations of using normal saline in diabetic ketoacidosis - Understand the physiological benefits of balanced fluids like Ringer's Lactate - Identify the logistical challenges in conducting trials in resource-limited settings - Appreciate the role of teamwork and protocol adherence in research success AUTHORS Ashish Agarwal, MD Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India Ramachandran Rameshkumar, MD, DM, FRCPCH Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India Pediatric Intensive Care Unit, Department of Pediatrics, Mediclinic City Hospital, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates Traci Wolbrink, MD, MPH‌ Co-Director, OPENPediatrics Senior Associate in Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Associate Professor of Anesthesia Harvard Medical School DATE Initial publication date: July 1, 2026. ARTICLES REFERENCED Agarwal A, Jayashree M, Nallasamy K, Dayal D, Attri SV. 0.9% Saline versus Ringer's lactate as initial fluid in children with diabetic ketoacidosis: a double-blind randomized controlled trial. BMJ Open Diabetes Res Care. 2025;13(2):e004623. https://pubmed.ncbi.nlm.nih.gov/40194836/ Maya M, Rameshkumar R, Selvan T, Delhikumar CG. High-Flow Nasal Cannula Versus Nasal Prong Bubble Continuous Positive Airway Pressure in Children With Moderate to Severe Acute Bronchiolitis: A Randomized Controlled Trial. Pediatr Crit Care Med. 2024;25(8):748-757. https://pubmed.ncbi.nlm.nih.gov/38639564/ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/szcrpthcfg3w4398gkvf9ch/202606_Pedicriticon_Podcast_2025_Transcript 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 Agarwal A, Rameshkumar R, Wolbrink TA. PEDICRITICON 2025: Top Articles in PICU Research. 07/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pedicriticon-2025-top-articles-in-picu-research.

Serangan udara Pakistan di Provinsi Paktia, Afghanistan timur, memicu kecaman keras dari pemerintah Afghanistan. Serangan yang diklaim menargetkan kelompok militan tersebut disebut menyebabkan puluhan warga sipil tewas dan ratusan lainnya terluka.

Kebakaran hutan besar melanda Provinsi Huesca, Spanyol, dan telah menghanguskan sekitar 4.000 hektare lahan. Kondisi suhu ekstrem, kelembapan rendah, dan angin kencang diduga menjadi pemicu utama cepatnya penyebaran api di wilayah tersebut.Api mulai muncul pada Kamis pagi di antara wilayah Tamarite de Litera dan Alcampell, kemudian meluas dengan cepat ke area sekitar yang didominasi lahan kering. Hingga saat ini, tim darurat masih terus berupaya mengendalikan kobaran api di beberapa titik sekaligus.Sekitar 240 warga telah dievakuasi, sementara warga di beberapa kota terdekat diminta tetap waspada akibat kepulan asap tebal.

What do you do when life breaks you, your family is under pressure, and the man you thought you were falls apart? In this powerful Christian men's podcast episode, Josh Price shares the story of his daughter Brighton's life-limiting diagnosis, the hospital moment that shattered his identity, and how God began rebuilding him as a husband, father, and leader. This conversation is for Christian men, fathers, husbands, and leaders who feel overwhelmed by pressure, trauma, fear, marriage struggles, parenting challenges, or hard decisions. Josh talks about faith under pressure, post-traumatic growth, choosing life, spiritual formation, masculine identity, leadership, marriage, fatherhood, and learning to stop giving away your authority to fear, circumstances, anger, control, or pain. If you have ever wondered how to lead your family when life feels impossible, how to hear God in suffering, how to make better decisions under pressure, or how to become the man God is forming you to be, this episode will challenge and encourage you. Josh shares the heartbreaking story of his daughter Brighton's diagnosis with Leigh syndrome and the hospital crisis that forced him to face fear, grief, and helplessness in a new way. You'll hear how God used one moment of brokenness to begin reshaping Josh's identity, helping him move from ego, control, and brash confidence toward empathy, love, humility, and spiritual formation. Tim and Josh unpack what it means for Christian men to choose life, walk the narrow road, and experience post-traumatic growth instead of being destroyed by pain. Josh also explains how men give away their authority under pressure, why better decision-making creates better leadership, and how fathers can stop parenting from their own wounds and start parenting the child in front of them. 00:00 Intro01:31 Josh shares his daughter Brighton's early health struggles03:19 The hospital search for answers04:56 Receiving the Leigh syndrome diagnosis06:45 The morning Brighton stopped breathing08:53 The moment Josh froze under pressure10:07 Life in the PICU and learning to care for Brighton12:28 Grief, terror, and the dreams parents lose16:18 How that hospital moment broke Josh's old identity18:19 Army leadership, confidence, and decisiveness21:02 How Josh pursued his wife Kelly27:14 Hearing God say, “If you walk with Me, I'll walk with you”29:24 How suffering changed Josh's marriage31:28 Breakthroughs in fatherhood and parenting his son34:04 Don't reparent yourself—parent your child38:26 Marriage, opposition, and learning to listen to your wife40:35 Why men need to pause under pressure43:09 Brighton's progress and choosing hope45:44 Choosing life instead of being destroyed48:21 Post-traumatic growth52:35 Holding your identity under pressure57:51 Where men give away their authority59:35 Finding the hidden lesson in your hardest season01:01:50 Josh's six-week coaching process01:05:17 How to connect with Josh #ChristianMen#FaithUnderPressure#ChristianFatherhood#MensLeadership#ChooseLife Learn more about your ad choices. Visit megaphone.fm/adchoices

Gelombang panas ekstrem yang disertai angin kencang memicu kebakaran hutan besar di wilayah barat Amerika Serikat.

Otoritas Crimea yang ditunjuk Rusia secara resmi menghentikan sementara penjualan bahan bakar bagi masyarakat umum dan pelaku usaha. Kebijakan ini diambil menyusul meningkatnya serangan drone Ukraina yang menargetkan jalur logistik serta infrastruktur energi di wilayah semenanjung tersebut. Saat ini, pasokan bahan bakar dibatasi dan diprioritaskan hanya untuk instansi pemerintah serta lembaga yang menjaga keamanan dan operasional wilayah.

In this episode of PICU Doc on Call, hosts Dr. Monica Gray and Dr. Pradip Kamat explore procedural sedation in the pediatric ICU. They cover sedation levels, pre-screening, risk stratification using ASA classifications, and medication selection tailored to each patient's hemodynamic and respiratory status. Through real-world case discussions involving respiratory failure, septic shock, and acute neurological decline, they highlight the importance of end-tidal CO2 monitoring and early adverse event recognition. Key takeaways include avoiding the term "conscious sedation," preparing rescue plans, and prioritizing patient safety through careful assessment and monitoring.Show Highlights:Definitions and levels of sedation (minimal, moderate, deep sedation, and general anesthesia)Importance of terminology in procedural sedationMonitoring sedation levels using scales like the Richmond Agitation-Sedation Scale (RASS)Pre-screening and risk stratification considerations for pediatric patientsASA physical status classification system for assessing patient riskUnique challenges of procedural sedation in critically ill childrenAdverse events associated with pediatric procedural sedation, particularly respiratory complicationsManagement strategies for specific cases requiring sedation (e.g., respiratory failure, septic shock)Importance of end-tidal CO2 monitoring during sedationKey takeaways for safe sedation practices in the pediatric ICU settingReferences: Nir Atlas; Rahul C. Damania; Pradip P. Kamat In Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 135, 1624-1628Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia by Committee on Quality Management and Departmental Administration. Last Amended: October 23, 2024.Coté CJ, Wilson S; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures. Pediatrics. 2019 Jun;143(6):e20191000. doi: 10.1542/peds.2019-1000. PMID: 31138666.xKrauss B, Green SM. Procedural sedation and analgesia in children. Lancet. 2006 Mar 4;367(9512):766-80. doi: 10.1016/S0140-6736(06)68230-5. PMID: 16517277.Sharif S, Kang J, Sadeghirad B, Rizvi F, Forestell B, Greer A, Hewitt M, Fernando SM, Mehta S, Eltorki M, Siemieniuk R, Duffett M, Bhatt M, Burry L, Perry JJ, Petrosoniak A, Pandharipande P, Welsford M, Rochwerg B. Pharmacological agents for procedural sedation and analgesia in the emergency department and intensive care unit: a systematic review and network meta-analysis of randomised trials. Br J Anaesth. 2024 Mar;132(3):491-506. doi: 10.1016/j.bja.2023.11.050. Epub 2024 Jan 6. PMID: 38185564.Smith, Heidi A. B. MD, MSCI (Chair)1,2; Besunder, James B. DO, FCCM3,4; Betters, Kristina A. MD1; Johnson, Peter N. PharmD, BCPS, BCPPS, FCCM, FPPA, FASHP5,6; Srinivasan, Vijay MBBS, MD, FCCM7,8; Stormorken, Anne MD9,10; Farrington, Elizabeth PharmD, FCCM11; Golianu, Brenda MD12,13; Godshall, Aaron J. MD14; Acinelli, Larkin CPNP-AC, ACHPN15; Almgren, Christina CPNP16; Bailey, Christine H. MD17; Boyd, Jenny M. MD18,19; Cisco, Michael J. MD20; Damian, Mihaela MD, MPH21,22; deAlmeida, Mary L. MD23,24; Fehr, James MD13,25; Fenton, Kimberly E. MD, FCCM14; Gilliland, Frances DNP, CPNP-AC/PC26,27; Grant, Mary Jo C. CPNP-AC, PhD, FAAN28; Howell, Joy MD29; Ruggles, Cassandra A. PharmD, BCCCP, BCPPS30; Simone, Shari DNP31,32; Su, Felice MD21,22; Sullivan, Janice E. MD33,34; Tegtmeyer, Ken MD, FAAP, FCCM35,36; Traube, Chani MD, FCCM29; Williams, Stacey CPNP-AC37; Berkenbosch, John W. MD, FAAP, FCCM (Chair)33,34. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatric Critical Care Medicine 23(2):p e74-e110, February 2022. | DOI: 10.1097/PCC.0000000000002873Benzoni T, Agarwal A, Cascella M. Procedural Sedation. [Updated 2025 Mar 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551685/Kerson AG, DeMaria R, Mauer E, Joyce C, Gerber LM, Greenwald BM, Silver G, Traube C. Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children. J Intensive Care. 2016 Oct 26;4:65. doi: 10.1186/s40560-016-0189-5. PMID: 27800163; PMCID: PMC5080705.Tel-Dan SF, Shavit D, Nates R, Samuel N, Shavit I. Emergency Physician-Administered Sedation for Thoracostomy in Children With Pleuropneumonia. Pediatr Emerg Care. 2021 Dec 1;37(12):e1209-e1212. doi: 10.1097/PEC.0000000000001975. PMID: 31929389.Cosgrove P, Krauss BS, Cravero JP, Fleegler EW. Predictors of Laryngospasm During 276,832 Episodes of Pediatric Procedural Sedation. Ann Emerg Med. 2022 Dec;80(6):485-496. doi: 10.1016/j.annemergmed.2022.05.002. Epub 2022 Jun 23. PMID: 35752522.Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, Gelman B; Pediatric Sedation Research Consortium. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics. 2006 Sep;118(3):1087-96. doi: 10.1542/peds.2006-0313. PMID: 16951002.

Banjir bandang dahsyat menerjang wilayah Ourense di barat laut Spanyol setelah badai ekstrem dan hujan lebat menghantam kawasan Galicia Timur. Hanya dalam waktu sekitar sepuluh menit, arus banjir bandang yang disertai hujan es menghancurkan permukiman warga, mengikis jalan raya, serta menimbun puluhan mobil dengan material lumpur dan batu. Menanggapi situasi darurat yang juga meluas hingga ke desa-desa di Viana do Bolo ini, otoritas setempat langsung mengerahkan alat berat dan meminta bantuan dari Unit Darurat Militer Spanyol demi mempercepat evakuasi serta mengantisipasi adanya cuaca buruk susulan.

Resources: Read Repositioning Guidelines to Decrease Pressure Injury in the Pediatric Intensive Care Unit: A Quality Improvement Project in the July/August 2024 issue of JWOCN and watch the accompanying video abstract. About the Speaker: Margaret Birdsong, DNP, CPNP, CWOCN, is a Pediatric Nurse Practitioner at Johns Hopkins Children's Center. Margaret has been a dedicated member of the Division of Pediatric Surgery since 2000. She has been a Certified Wound, Ostomy, and Continence Nurse (CWOCN) since 2002 and serves as the primary wound care consultant for the pediatric hospital. In 2020, she earned her Doctor of Nursing Practice (DNP) from the Johns Hopkins School of Nursing. In addition to her clinical responsibilities, she works closely with Dr. Isam Nasr in the Colorectal Center, where she is also certified in biofeedback therapy. Margaret has presented nationally on a range of topics, including general pediatric surgery, wound and ostomy care, and pediatric continence management. Her clinical and academic work focuses on improving outcomes and quality of life for pediatric patients with complex surgical and continence needs. Editing and post-production work for this episode was provided by The Podcast Consultant.

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.

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.

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.

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.

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.

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,...

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.

"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