Podcasts about Picu

In this episode of "PICU Doc on Call," pediatric intensivists Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray discuss a critical case involving a 16-year-old male who experienced severe carbon monoxide poisoning after being found unresponsive in a garage. They chat about the pathophysiology, clinical manifestations, diagnostic workup, and management of carbon monoxide toxicity. Furthermore, they cover the importance of early oxygen administration, recognizing potential delayed neurological sequelae, and keeping an eye out for cardiac complications. Tune in and hear more about a comprehensive approach to treatment and the significance of multidisciplinary support for achieving the best patient outcomes.Show Highlights:Case presentation of a 16-year-old male with severe carbon monoxide poisoningPathophysiology of carbon monoxide toxicity and its effects on hemoglobinClinical manifestations and symptoms associated with carbon monoxide poisoningDiagnostic workup for suspected carbon monoxide exposureManagement principles for treating carbon monoxide poisoning in pediatric patientsSources and scenarios leading to carbon monoxide poisoningComplications arising from carbon monoxide exposure including neurological injuriesImportance of early oxygen administration and monitoring in treatmentDiscussion of hyperbaric oxygen therapy and its indicationsKey takeaways for clinicians regarding the management and follow-up of carbon monoxide poisoning casesWe welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.References:Tapking, C., et al. (2021). Burn and inhalation injury. In J. J. Zimmerman & A. T. Rotta (Eds.), Fuhrman and Zimmerman's Pediatric Critical Care (6th ed., pp. 1347–1362). Elsevier.Nañagas KA, Penfound SJ, Kao LW. Carbon Monoxide Toxicity. Emerg Med Clin North Am. 2022 May;40(2):283-312. doi: 10.1016/j.emc.2022.01.005. Epub 2022 Apr 5. PMID: 35461624.Smollin C, Olson K. Carbon monoxide poisoning (acute). BMJ Clin Evid. 2010 Oct 12;2010:2103. PMID: 21418677; PMCID: PMC3217756.Palmeri R, Gupta V. Carboxyhemoglobin Toxicity. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

Wet or dry. Air in or out. Reactive or obstructive. The possibilities may seem endless when treating the pediatric patient with undifferentiated respiratory distress. It is confounded by the fact that pediatrics are outside the comfort zone of many novice critical care transport providers. In this podcast episode, neonatal/pediatric specialist Nate Brown eases your worries with concise and effective means of diagnostics and intervention. Primarily, we cover croup, bronchiolitis, and asthma disease processes. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Dr. Sharon Sandell joins us to share her path to becoming a pediatric critical care doctor — from discovering the field to joining a small, close-knit practice. We talk about what drew her in, how she navigates the challenges of the PICU, and what her day-to-day looks like caring for critically ill kids.

About our Guest: Dr. Omar Alibrahim is a professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. He completed his Pediatric Residency and Chief Residency at St. Joseph's Children's Hospital, followed by Pediatric Critical Care Fellowship at the University of Buffalo. He served as the Pediatric Critical Care Division chief, the PICU Medical Director, and the PCCM fellowship Director in Buffalo, NY, for more than 8 years, during which he worked with the pulmonology and respiratory therapy divisions to develop a negative pressure ventilation program for acute respiratory failure. In 2021 Dr. Alibrahim was recruited to Duke Children's Hospital and now serves as the PICU Medical Director and the program director for the Pediatric Critical Care Fellowship. Learning Objectives: By the end of this podcast series, listeners should be able to: Critique the physiologic rationale for negative pressure ventilation (NPV) in acute respiratory failure.Understand the experience of introducing a novel form of respiratory support in a PICU.Describe the stepwise escalation of NPV settings often used in acute respiratory failure.References:Derusso, M., Miller, A. G., Caccamise, M., & Alibrahim, O. (2024). Negative-Pressure Ventilation in the Pediatric ICU. Respiratory Care, 69(3), 354–365. https://doi.org/10.4187/RESPCARE.11193Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS. Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2017 Dec;62(12):1540-1549. doi: 10.4187/respcare.05531. Epub 2017 Aug 31. PMID: 28860332.Deshpande SR, Maher KO. Long term negative pressure ventilation: Rescue for the failing fontan? World J Cardiol. 2014 Aug 26;6(8):861-4. doi: 10.4330/wjc.v6.i8.861. PMID: 25228965; PMCID: PMC4163715.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Welcome to another exciting episode of PICU Doc on Call! Today, we're diving deep into the world of pediatric critical care with our expert hosts, Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray. Get ready to unravel the mysteries of the oxygen extraction ratio (O2ER) and its pivotal role in managing pediatric acute respiratory distress syndrome (ARDS) and multi-organ dysfunction.Picture this: a seven-year-old girl battling severe pneumonia that spirals into ARDS and septic shock. Our hosts walk you through this gripping case, shedding light on calculating O2ER and why central venous oxygen saturation (ScvO2) is a game-changer. They'll share their top strategies for optimizing oxygen delivery and cutting down on oxygen demand.But that's not all! This episode is all about the holistic approach to managing critically ill pediatric patients. Tune in to discover how these insights can lead to better outcomes for our youngest and most vulnerable patients. Don't miss out on this vital conversation!Show Highlights:Clinical significance of the oxygen extraction ratio (O2ER) in pediatric critical careImportance of understanding oxygen delivery and consumption in critically ill patientsCalculation and interpretation of O2ER and its relationship to central venous oxygen saturation (ScvO2)Physiological concepts related to oxygenation, including intrapulmonary shunting and ventilation-perfusion mismatchManagement strategies for increasing oxygen delivery and reducing oxygen demand in ARDS and septic shockInterventions such as blood transfusions, sedation, and optimization of cardiac outputImplications of lactic acidosis and anaerobic metabolism in the context of inadequate oxygen deliveryHolistic approach to patient management, focusing on both numerical values and overall metabolic needsWe welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.References:Fuhrman B.P. & Zimmerman J.J. (Eds.). Pediatric Critical Care, 6th ed. Elsevier; 2021. (Key concepts of oxygen delivery, consumption, and extraction in shock states are discussed in Chapter 13) .Nichols D.G. (Ed.). Roger's Textbook of Pediatric Intensive Care, 5th ed. Wolters Kluwer; 2016. (Comprehensive review of oxygen transport and utilization in critically ill children, including ARDS and shock).Lucking S.E., Williams T.M., Chaten F.C., et al. Dependence of oxygen consumption on oxygen delivery in children with hyperdynamic septic shock and low oxygen extraction. Crit Care Med. 1990;18(12):1316–1319. doi:10.1097/00003246-199012000-00002.Ronco J.J., Fenwick J.C., Tweeddale M.G., et al. Pathologic dependence of oxygen consumption on oxygen delivery in acute respiratory failure. Chest. 1990;98(6):1463–1466. doi:10.1378/chest.98.6.1463 .Carcillo J.A., Davis A.L., Zaritsky A. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock. Crit Care Med. 2002;30(6):1365–1378. (ACCM guidelines emphasizing ScvO₂ targets in shock) .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 (PALICC-2). Pediatr Crit Care Med. 2023;24(2):143–168. doi:10.1097/PCC.0000000000003147.

Robyn Lao knows first hand how challenging it can be to eat at restaurants when living with food allergies. Since her nine-year-old daughter Addie was diagnosed with several life-threatening food allergies as an infant, the family has generally avoided eating out. So when the family recently ventured out to a local restaurant for a meal, they were blown away by the clarity and transparency the menu provided regarding food allergens.That experience inspired the Lao family to introduce ADDE's bill, which would require restaurants in California to label menu items that contain any of the 9 major food allergens. Tune in now to learn more about Robyn and Addie's incredible mission to make dining out safer for the food allergy community!To learn more about the ADDE Act and how to get involved visit: www.addietellsall.comFollow along on social media @addie.tells.allRobyn is originally from San Francisco and has been an NP for over 15 years. She received her Masters in Nursing from University of California, San Francisco (UCSF) in the Pediatric Acute Care NP program and her Doctorate in Nursing Practice (DNP) degree in Healthcare Leadership from the University of San Francisco.  She was a Pediatric ICU (PICU) nurse at UCSF and started a PICU/transport NP program at UCSF as part of her doctoral project.  She has experience as a pediatric critical care nurse practitioner and has been practicing in pediatric surgery for over 10 years. She helped launch the pediatric general surgery program at Shriners Northern California, and she helped University of California Davis Children's Hospital (UCD ) become one of the first Level 1 Children's Surgery Centers verified by the American College of Surgery.  She was a past president of the National Association of Pediatric Nurse Practitioners (NAPNAP)- San Francisco chapter, and she was the founding president of the NAPNAP Sacramento Chapter. She now has been the Legislative Chair of NAPNAP Sacramento for the past 3 years, and she just completed a 2 year term as Director of Practice and Quality on the national board of the American Pediatric Surgical Nurses Association (APSNA). 

The World Federation of Pediatric Intensive & Critical Care Societies (WFPICCS), in collaboration with OPENPediatrics, recognizes World PICU Awareness Week 2025. This initiative aims to raise global awareness about the importance of PICUs and critical care wards worldwide, emphasizing how healthcare professionals in these units, regardless of resource setting, are driving change. From frugal innovations to digital transformation, this episode highlights how pediatric intensive care is evolving across Asia. Hear from experts in Bangladesh, India, and Indonesia as they share how low-cost technologies, telemedicine, and integrated referral systems are improving outcomes for critically ill children even in the most remote settings. Discover how resilience and resourcefulness are driving change across the region. HOST Arun Bansal, MD, FCCM, FRCPCH Professor in Pediatric Critical Care at PGIMER Chandigarh, India and Chairperson of Pediatric Intensive Care Chapter of India GUESTS Mohammod Joyaber Chisti, MBBS, MMed (Paediatrics), PhD Professor of Pediatrics at icddr,b, Bangladesh Renowned for pioneering low-cost respiratory support technologies like bubble CPAP. Jayashree Muralidharan, MBBS MD Pediatrics FIAP FICCM Head of Pediatric Critical Care at PGIMER, Chandigarh, India A leader in intensive care in India. She had helped in developing and integrating digital health systems into PICU workflows using TelePICU. She also helped in developing a PICU Referral App Kurniawan Taufiq Kadafi, Sp.A(K) Chief of Pediatric Emergency Services, Indonesia, An expert on remote and interfacility pediatric transport across Indonesia's archipelago. DATE Initial publication date: May 7, 2025. TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/at/k7x72vx63hnbvwx6wpwc4xnt/WPAW-25_Asia_Final_English.pdf Spanish - https://cdn.bfldr.com/D6LGWP8S/at/qxkcv5b23xs49tj6z6w6np/WPAW-25_Asia_Final_Spanish.pdf French - https://cdn.bfldr.com/D6LGWP8S/at/v463w7zbhbbpfbbmj8qf8b/WPAW-25_Asia_Final_French.pdf Portuguese - https://cdn.bfldr.com/D6LGWP8S/at/p377fk7m84xmppk9hx6bbq6/WPAW-25_Asia_Final_Portuguese.pdf Italian - https://cdn.bfldr.com/D6LGWP8S/at/gxbshfgg7xcm7rfpx3p5n4vm/WPAW-25_Asia_Final_Italian.pdf German - https://cdn.bfldr.com/D6LGWP8S/at/4px7mgpbf65rbb8n8vv2sjr/WPAW-25_Asia_Final_German.pdf Arabic - https://cdn.bfldr.com/D6LGWP8S/at/64vtqntqj7v99j4ztc2pk5n3/WPAW-25_Asia_Final_Arabic.pdf 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

Meet Taylor: Super Mom! Taylor joins us in the bunker today to talk about preemies! After a journey with infertility and IVF, Taylor and her husband were expecting triplets when the unexpected happened. This mom found herself in the hospital delivering triplets early, spending weeks fighting for her boys' lives, and learning firsthand what a momsday moment is all about. Listen to the end to hear her incredible story of how she named her one surviving twin!  This episode talks about premature birth, preemie, PICU, fertility, IVF, infant mortality, triplets, multiples, blindness, sight, pregnancy, miscarriage, death, burial, momsday moment, survival, hope, encouragement, motherhood, supermom, mom and beauty in the ashes!  Connect with Keri at www.momsdayprepper.com Facebook: https://www.facebook.com/hensonk/ Instagram: https://www.instagram.com/keri_henson_aka_momsdayprepper/ Until next time, y'all! 

About our Guest: Dr. Omar Alibrahim is a professor of pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital. He completed his Pediatric Residency and Chief Residency at St. Joseph's Children's Hospital, followed by Pediatric Critical Care Fellowship at the University of Buffalo. He served as the Pediatric Critical Care Division chief, the PICU Medical Director, and the PCCM fellowship Director in Buffalo, NY, for more than 8 years, during which he worked with the pulmonology and respiratory therapy divisions to develop a negative pressure ventilation program for acute respiratory failure. In 2021 Dr. Alibrahim was recruited to Duke Children's Hospital and now serves as the PICU Medical Director and the program director for the Pediatric Critical Care Fellowship. Learning Objectives: By the end of this podcast series, listeners should be able to: Critique the physiologic rationale for negative pressure ventilation (NPV) in acute respiratory failure.Understand the experience of introducing a novel form of respiratory support in a PICU.Describe the stepwise escalation of NPV settings often used in acute respiratory failure.References:Derusso, M., Miller, A. G., Caccamise, M., & Alibrahim, O. (2024). Negative-Pressure Ventilation in the Pediatric ICU. Respiratory Care, 69(3), 354–365. https://doi.org/10.4187/RESPCARE.11193Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS. Negative-Pressure Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2017 Dec;62(12):1540-1549. doi: 10.4187/respcare.05531. Epub 2017 Aug 31. PMID: 28860332.Deshpande SR, Maher KO. Long term negative pressure ventilation: Rescue for the failing fontan? World J Cardiol. 2014 Aug 26;6(8):861-4. doi: 10.4330/wjc.v6.i8.861. PMID: 25228965; PMCID: PMC4163715.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Di momen peringatan May Day atau Hari Buruh Internasional, Indonesia diingatkan untuk bersiap secara nasional dalam menghadapi tantangan global di masa depan.

Behind the Scenes of Pediatric Critical Care with Dr. Rana ShamiIn this episode of The Pediatric Lounge, hosts Herb and George bring on Dr. Rana Shami, the medical director of the pediatric intensive care unit at Inova Children's Hospital. Dr. Shami discusses her journey from the American University of Beirut to leading a premier PICU in Fairfax, Virginia. She shares insights into the challenges and innovations in pediatric critical care, such as the use of high-flow oxygen and bedside ultrasound, as well as the critical importance of multidisciplinary teamwork. Dr. Shami also talks about the growth of their PICU fellowship program and her advocacy for early diabetes screening to prevent DKA. The episode illuminates how pediatric ICU care has evolved and the ongoing efforts to improve patient outcomes through simulation education and data-driven approaches.00:00 Introduction to The Pediatric Lounge00:28 Sponsor Message: Hippo Education01:08 Meet Dr. Rana Shami: From Beirut to Fairfax01:30 Dr. Rana Shami's Journey in Pediatric Critical Care05:46 Legacy of Dr. Steve Keller in Pediatric Critical Care11:26 Advancements in Pediatric Intensive Care15:36 Challenges and Innovations in Pediatric Care21:42 The Role of Technology in Modern Pediatric Care30:06 Personal Stories and Reflections in Pediatric Care31:48 Using Data to Improve Healthcare33:25 The Power of Tableau in Data Visualization35:48 Leadership Style in the PICU39:25 The Role of Simulation in Medical Training42:35 Launching a PICU Fellowship Program47:18 Telehealth and Remote ICU Work51:16 Advocating for Pediatric Health56:27 The Parent Wise NGO59:19 Concluding Thoughts and FarewellSupport the show

In this episode, Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray dive into a critical case involving a five-week-old baby facing acute respiratory failure due to pertussis. They chat about how this condition shows up, how it's diagnosed, and the best ways to manage it, especially considering the serious complications it can cause in infants, like pulmonary hypertension and the potential need for ECMO. The conversation underscores the importance of catching it early and providing supportive care, while also highlighting how crucial vaccination is in preventing pertussis. Tune in to learn how severe this disease can be and why staying alert in pediatric care is so important.Show Highlights:Clinical case of a five-week-old infant with acute respiratory failure and pertussis diagnosisEpidemiology and public health impact of pertussis, including vaccination rates and outbreak patternsPathophysiology of pertussis and its effects on respiratory health, particularly in infantsClinical presentation of pertussis, including stages of the disease and atypical symptoms in infantsDiagnostic approaches for pertussis, including laboratory findings and PCR testingManagement strategies for severe pertussis, including supportive care and antibiotic therapyPotential complications associated with pertussis, especially in young infantsDifferential diagnosis considerations for pertussis and distinguishing features from other infectionsImportance of vaccination in preventing pertussis and reducing morbidity and mortalityECMO as a treatment option for severe cases and its associated challenges, and outcomesWe welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.References:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter and Rogers texbook of Pediatric intensive care -both do not have any Pertussis mentioned in their index.Rowlands HE, Goldman AP, Harrington K, Karimova A, Brierley J, Cross N, Skellett S, Peters MJ. Impact of rapid leukodepletion on the outcome of severe clinical pertussis in young infants. Pediatrics. 2010 Oct;126(4):e816-27. doi: 10.1542/peds.2009-2860. Epub 2010 Sep 6. PMID: 20819895.Lauria AM, Zabbo CP. Pertussis. [Updated 2022 Oct 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519008/Berger JT, Carcillo JA, Shanley TP, Wessel DL, Clark A, Holubkov R, Meert KL, Newth CJ, Berg RA, Heidemann S, Harrison R, Pollack M, Dalton H, Harvill E, Karanikas A, Liu T, Burr JS, Doctor A, Dean JM, Jenkins TL, Nicholson CE; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Collaborative Pediatric Critical Care Research Network (CPCCRN). Critical pertussis illness in children: a multicenter prospective cohort study. Pediatr Crit Care Med. 2013 May;14(4):356-65. doi: 10.1097/PCC.0b013e31828a70fe. PMID: 23548960; PMCID: PMC3885763.Cousin, V.L., Caula, C., Vignot, J. et al. Pertussis infection in critically ill infants: meta-analysis and validation of a mortality score. Crit Care 29, 71 (2025). https://doi.org/10.1186/s13054-025-05300-2Domico M, Ridout D, MacLaren G, Barbaro R, Annich G, Schlapbach LJ, Brown KL. Extracorporeal Membrane Oxygenation for Pertussis: Predictors of Outcome Including Pulmonary Hypertension and Leukodepletion. Pediatr Crit Care Med. 2018 Mar;19(3):254-261. doi:...

About our Guest: Kyle Rehder, MD, is a Professor of Pediatrics at Duke University and a pediatric intensivist at Duke Children's Hospital, where he serves as the Vice-Chair of Pediatric Education. He completed his medical school, residency, and chief residency at UNC-Chapel Hill, followed by his fellowship at Duke University. His research is focused on team development and evaluation of advanced respiratory support in the PICU.Learning Objective:Develop an expert-based approach to diagnosing and managing common presentations of patient-ventilator asynchrony in the PICU.References: Flynn, B. C., Miranda, H. G., Mittel, A. M., & Moitra, V. K. (2022). Stepwise Ventilator Waveform Assessment to Diagnose Pulmonary Pathophysiology. Anesthesiology, 137(1), 85–92. https://doi.org/10.1097/ALN.0000000000004220Patient-Ventilator Dyssynchrony • LITFL • CCC VentilationCitation:Rehder K, Hodges Z, Shanklin A. Patient-Ventilator Asynchrony. PedsCrit. Online Podcast. 04/2025. [insert link]Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Kemacetan parah masih terjadi di wilayah Jakarta Utara akibat imbas tingginya volume bongkar muat angkutan di Pelabuhan Tanjung Priok.Untuk mengetahui informasi terkini, sudah bergabung rekan Insan Suardi di lokasi kemacetan.

In today's episode, Dr. Rahul Damania and Dr. Pradip Kamat welcome their new co-host, Dr. Monica Gray. They'll dive into the topic of upper airway obstruction in children and explore a case involving a 12-month-old girl who presents with stridor and fever. Throughout the discussion, they delve into the underlying causes, possible diagnoses, and management strategies. Key takeaways include the significance of keeping the child calm, ensuring proper positioning, and utilizing treatments such as dexamethasone and Racemic epinephrine. They'll also touch on advanced therapies and serious infections like epiglottitis. The episode highlights the importance of recognizing stridor, knowing when to consider PICU admission, and the effectiveness of low-dose dexamethasone. Tune in to learn more!Show Highlights:Overview of upper airway obstruction in pediatric patientsCase presentation of a 12-month-old girl with stridor and feverDiscussion on the pathophysiology of stridor and its clinical significanceDifferential diagnoses for stridor, including croup, epiglottitis, and foreign body aspirationManagement strategies for upper airway obstruction, including stabilization and medicationImportance of calming the child and optimal positioning during treatmentUse of dexamethasone and racemic epinephrine in managing croupAdvanced therapies, such as Helios, for specific casesIndicators for pediatric intensive care unit (PICU) admissionKey clinical points and takeaways for healthcare professionals managing airway emergenciesReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 47 Otteson T, Richardson C, Shah J: Diseases of the upper Airway. Pages 524-535Rogers Textbook of Pediatric Intensive Care: Chapter 25; Ong May Soo Jacqueline, Tijssen J, Bruins BB and Nishisaki A: Airway management. Pages 341-365Reference: Asmundsson AS, Arms J, Kaila R, Roback MG, Theiler C, Davey CS, Louie JP. Hospital Course of Croup After Emergency Department Management. Hosp Pediatr. 2019 May;9(5):326-332. doi: 10.1542/hpeds.2018-0066. PMID: 30988017; PMCID: PMC6478427.Reference: Aregbesola A, Tam CM, Kothari A, Le ML, Ragheb M, Klassen TP. Glucocorticoids for croup in children. Cochrane Database Syst Rev. 2023 Jan 10;1(1):CD001955. doi: 10.1002/14651858.CD001955.pub5. PMID: 36626194; PMCID: PMC9831289.Previous Episode Mentioned:PICU Doc On Call Episode 80

“Saving lives” is what we do. But at what cost? Are we threatening the survival of the world by our PIC practices? What's the point of healthcare, if we are destroying the world's future for those same children? We talked to Heather Baid, an ICU nurse and lead for sustainability […]

Diduga gara-gara sopir mengantuk, sebuah mobil keluar jalur, dan menabrak sepeda motor serta mobil lainnya, sebelum menerobos pagar beton. Akibat laka beruntun ini pemotor alami luka ringan dan langsung dibawa ke klinik terdekat

In this episode, Dr. Lewis discusses the difference between acute urinary retention and chronic urinary retention.Guest bio: Dr. Jennifer Lewis graduated from the DNP program at the University of Oklahoma in 2015. She received her MSN and FNP from Graceland University in 2011. Since that time, she has been practicing as a Nurse Practitioner in the Department of Urology at OU Health. Dr. Lewis transitioned as faculty from OU College of Medicine to OU College of Nursing in 2023 where she is currently an Assistant Professor in the undergraduate and graduate nursing programs. Before that, she worked as an RN in the PICU and the resident surgery specialty outpatient clinics. In 2022 she became a certified urologic nurse practitioner. In 2023, Dr. Lewis became a certified interprofessional educator. She presently serves as the research chairperson for SUNA (Society of Urologic Nurses & Associates) and with the AUA (American Urologic Association) on the APP education and membership committee. In 2024, she was selected as a Fellow of the Academy of Urologic Nurses Association. Most recently Dr. Lewis has returned to the student role, to obtain my Psychiatric Mental Health Nurse Practitioner Certificate with plans to carve a niche in the work of uropsychiatry for APPs.Visit https://www.coloplastprofessional.us/ for more offerings! 

Este programa está patrocinado por KEEPGOING. Puedes conocer todos los productos aquí: https://findyoureverest.es/categoria-producto/marcas/keepgoing/ Pregunta de carrera: ¿Cómo se llama el punto más alto del maratón de la Xtreme Lagos? Entre los acertantes se sortea una camiseta + dorsal para el Trail Xtreme. En este episodio del Find Your Everest Podcast by Javi Ordieres: - Hablamos con Ivan Pinino y Cris, sobre la nueva edición del Trail Picu Llosorio. Podéis conocer más detalles de la carrera aquí: https://trailpicullosorio.com/ - Realizamos una intensa previa, sobre el Tenerife Blue Trail by UTMB En la sección del experto, hablamos de fisioterapia con Cesar Castaño. Podéis contactar con Cesar aquí: https://clinicajlmartinez.com/ En la sección material, hablamos sobre los bastones LEKI: https://findyoureverest.es/categoria-producto/marcas/leki/ Y para cerrar el programa, Richar nos comenta los resultados de la encuesta “Zapatillas para el maratón del Tenerife Blue Trail”: - Nnormal Tomir 2.0: https://findyoureverest.es/producto/zapatillas-nnormal-tomir-2-0/ - Sportiva Prodigio Pro: https://findyoureverest.es/producto/zapatillas-la-sportiva-prodigio-pro/ - Salomon Genesis: https://findyoureverest.es/producto/zapatillas-salomon-genesis/ - Hoka Speedgoat 6: https://findyoureverest.es/producto/zapatillas-hoka-speedgoat-6/ ESPERO QUE OS GUSTE EL PROGRAMA QUE HEMOS PREPARADO! Ya sabéis que podéis apoyarnos, visitando nuestra tienda online de Trail Running en: https://www.findyoureverest.es/ Suscríbete a nuestra newsletter: https://findyoureverest.es/newsletter/

Direktur Eksekutif CELIOS menilai kondisi pasar modal di Indonesia sudah masuk kategori lampu kuning.

I want to remind you that this might be my last pastor'schat for a couple of weeks. I would also like to ask you for special prayers forseveral things. For the next couple of days, I will be extremely busy takingcare of some family matters that involve my older sister, Lynda Smith, who wasput into palliative care this past week. Then on Tuesday, the 18th,my son Jonathan and I will be flying to India to take care of a specialsituation there involving both of our ministries. We especially need for you toask the Lord to give us wisdom and for safety as we travel.  On Saturday, the 22nd, we will fly from India toCairo Egypt, to meet some ministry partners there and prepare for our scheduledtour to Jordan and Egypt that will take place this fall from October 14thto the 25th. We are hoping many of you will join us on thisunforgettable journey to places where some of the most powerful revelations andmiracles of God in the Bible took place. For more information on this tour,click on this link: https://www.gpartners.org/tour Also, would you please continue to pray for my grandsonLuke, who is in PICU in the Roanoke hospital, and will be there for the nextcouple of weeks dealing with a terrible infection. When they are assured thatit is gone, Luke will be going through major surgery to replace everything inhis brain and body to keep the pressure off his brain. I believe that this willbe his 31st surgery on his little brain. Your prayers and supportfor all the above are always very important and appreciated!  In Luke 12:13-21, when Jesus was warning us to “bewareof covetousness”, He told the story of a rich farmer that He called a fool,because he forgot to prepare for eternity. Then, it is if Jesus turns to us andbasically says, we are fools if, like this farmer, we only live for money andthings now and forget to live for heaven.This is what Jesus said in verse 21; “So is hewho lays up treasure for himself, and is not rich toward God." A number of years ago, as a pastor I led our churchmembership though a series of lessons called the “The Treasure Principle” thatwas written by Randy Alcorn. I highly recommend this little book and theprinciples that Randy shares concerning how we should handle the resources thatthe Lord puts at our disposal. The Treasure Principle that Jesus gives here,and Randy highlights is very simple but profoundly true, “You can't take itwith you, but you can send it on ahead.”  Money is not evil, but the love of money and temporalthings is the root of all evil. Randy reminds us: “Anything we try to hang onto here will be lost. But anything we put into God's hands will be ours for eternity,(insured for infinitely more than $100,000 by the real FDIC, the Father'sDeposit Insurance Corporation. If we give instead of keep, if we invest in theeternal instead of in the temporal, we store up treasures in heaven that willnever stop paying dividends.” “Whatever treasures we store up on earth will be leftbehind when we leave. Whatever treasures we store up in heaven will be waitingfor us when we arrive.” Several of the keys to being a good steward of God'swonderful resources are: “God owns everything. I'm His money manager”.Remember: “My heart always goes where I put God's money”. “Heaven, not earth,is my home”. (Hebrews 11:16). “Giving is the only antidote to materialism”. And,“God prospers me not to raise my standard of living, but to raise my standardof giving.” My friend, remember what Paul wrote in 2 Corinthians 9:6-8:“But this I say: He who sows sparingly will also reap sparingly, and he whosows bountifully will also reap bountifully. So let each one give as hepurposes in his heart, not grudgingly or of necessity; for God loves a cheerfulgiver. And God is able to make all grace abound toward you, that you, alwayshaving all sufficiency in all things, may have an abundance for every goodwork.” God bless!

Episode Summary: Mothers of children with special needs experience a wide range of emotions: fear, disappointment, guilt, grief, despair. They have a yearning for relief but often feel isolated and inadequate as they look at the parenting experience of others. As you pour your energy and resources into raising a special needs child, it’s easy to struggle with feelings of isolation, competition, and overwhelm. For the special needs mom who yearns for community and support on what can be a lonely road, my guest, Carrie Holt, wants to remind you that you are not alone, your best IS good enough, and even on the hard days, there are blessings to be had. In honor of Developmental Disabilities Awareness Month, we’re sharing how to find hope and flourish when parenting a special needs child. Quotables from the episode: I have seen how families lose hope, feel strung out, and all alone living this life of being in and out of the hospital. From the time my son was around 20 months of age, I began volunteering at our local children’s hospital and have been passionate about encouraging others ever since. I was joyfully expecting our third child when at a 20 week ultrasound, our doctor told us something was wrong with the baby. We learned he had Myelomeningocele (Spina Bifida) and Hydrocephalus and would require two life-saving surgeries the first day of his life, with one following a few days later. I read a lot about his condition, grieved, and then planned – trying to control everything. It wasn’t until the last few years, that I have truly grieved that, and have been learning to live in the tension of lament. My son ended up being admitted for 64 days, 30 of those in the PICU. He came home with a trach, ventilator, and g-tube with 16 hours a day/7 days a week of home nursing care. He’s been in and out of the hospital repeatedly and to date has had 64 surgeries. The life of parenting a special needs child is continual, so we are all learning to live in the tension of our kids not being healed and how God is with us in all of this. I’m learning that it’s okay to feel disappointed, to lament that to God, and grieve the hard moments of realizing that my son isn’t going to be like other kids. I’m also trying to help him navigate life’s hard questions: “Why did God allow this? Why didn’t he heal me?” His complex emotions, doubts, and anger over being in a wheelchair has been really hard for us. Do not be afraid of grief. Sometimes we feel like it’s going to drown us, but it’s so important to take our messy emotions to God. It’s okay to take our messy emotions to God – even anger, doubt, and fear, but it’s actually essential to our relationship with God and how He meets us there. Emotions aren’t something we get over, they continually come up again and again, but we’ve learned some strategies to deal with them. Gratefulness, getting quiet, and lament are just a few. I think for me personally, it is learning to take this one day at a time, crying out in the pain when it’s there, and then also remembering that God is in control. It’s also just looking for the little gifts of hope and joy that he gives us on a daily basis. Probably the biggest thing has just been his presence and knowing him in a way that I had not known him if I wasn’t in this. As difficult as pain and suffering is, God has showed me his character and his presence and sometimes it's just that perspective shift of Lord show me you, instead of my eyes being on my pain and my suffering, show me how you've prepared me for this, show me your character, show me your glory, show me your comfort. Jesus wants to be present in your pain. Scripture References: Psalm 40:1-3 ESV I waited patiently for the LORD; he inclined to me and heard my cry. He drew me up from the pit of destruction, out of the miry bog, and set my feet upon a rock, making my steps secure. He put a new song in my mouth, a song of praise to our God. Many will see and fear, and put their trust in the LORD. Lamentations 3:21-26, ESV But this I call to mind, and therefore I have hope: The steadfast love of the LORD never ceases; his mercies never come to an end; they are new every morning; great is your faithfulness. “The LORD is my portion,” says my soul, “therefore I will hope in him.” The LORD is good to those who wait for him, to the soul who seeks him. It is good that one should wait quietly for the salvation of the LORD. Recommended Resources: The Other Side of Special, Navigating the Messy, Emotional, Joy-Filled Life of a Special Needs Mom by Amy J. Brown, Sara Clime, and Carrie M. Holt Sacred Scars: Resting in God’s Promise That Your Past Is Not Wasted by Dr. Michelle Bengtson The Hem of His Garment: Reaching Out To God When Pain Overwhelms by Dr. Michelle Bengtson, winner AWSA 2024 Golden Scroll Christian Living Book of the Year and the 2024 Christian Literary Awards Reader’s Choice Award in the Christian Living and Non-Fiction categories YouVersion 5-Day Devotional Reaching Out To God When Pain Overwhelms Today is Going to be a Good Day: 90 Promises from God to Start Your Day Off Right by Dr. Michelle Bengtson, AWSA Member of the Year, winner of the AWSA 2023 Inspirational Gift Book of the Year Award, the 2024 Christian Literary Awards Reader’s Choice Award in the Devotional category, the 2023 Christian Literary Awards Reader’s Choice Award in four categories, and the Christian Literary Awards Henri Award for Devotionals YouVersion Devotional, Today is Going to be a Good Day version 1 YouVersion Devotional, Today is Going to be a Good Day version 2 Revive & Thrive Women’s Online Conference Revive & Thrive Summit 2 Trusting God through Cancer Summit 1 Trusting God through Cancer Summit 2 Breaking Anxiety’s Grip: How to Reclaim the Peace God Promises by Dr. Michelle Bengtson, winner of the AWSA 2020 Best Christian Living Book First Place, the first place winner for the Best Christian Living Book, the 2020 Carolina Christian Writer’s Conference Contest winner for nonfiction, and winner of the 2021 Christian Literary Award’s Reader’s Choice Award in all four categories for which it was nominated (Non-Fiction Victorious Living, Christian Living Day By Day, Inspirational Breaking Free and Testimonial Justified by Grace categories.) YouVersion Bible Reading Plan for Breaking Anxiety’s Grip Breaking Anxiety’s Grip Free Study Guide Free PDF Resource: How to Fight Fearful/Anxious Thoughts and Win Hope Prevails: Insights from a Doctor’s Personal Journey Through Depression by Dr. Michelle Bengtson, winner of the Christian Literary Award Henri and Reader’s Choice Award Hope Prevails Bible Study by Dr. Michelle Bengtson, winner of the Christian Literary Award Reader’s Choice Award Free Webinar: Help for When You’re Feeling Blue Social Media Links for Host and Guest: Connect with Carrie Holt: Website / Carrie Instagram / Special Moms Instagram / Carrie Facebook / Podcast & Book For more hope, stay connected with Dr. Bengtson at: Order Book Sacred Scars / Order Book The Hem of His Garment / Order Book Today is Going to be a Good Day / Order Book Breaking Anxiety’s Grip / Order Book Hope Prevails / Website / Blog / Facebook / Twitter (@DrMBengtson) / LinkedIn / Instagram / Pinterest / YouTube / Podcast on Apple Guest: Carrie M. Holt is the co-host of the Take Heart Special Moms Podcast, an author and speaker whose passion is to encourage women to flourish in the unexpected. Through her testimony of raising and homeschooling four children, including her son, with medical, mental, and physical disabilities, her desire is for women and mothers to experience the hope we have in trials through the steadfast love of Christ. Her recent book, "The Other Side of Special: Navigating the Messy, Emotional, Joy-Filled Life of a Special Needs Mom," was released May 9th through Revell Publishing. She spent twelve years speaking and advocating through volunteer groups such as Family as Faculty and the Family Advisory Council at Nationwide Children's Hospital, a press conference in Washington D.C., several hospital fundraisers, and an event featuring former Ohio Governor John Kasich. She has also been a guest on various radio shows, including KNEO Author's Corner, Family Life Radio, and Moody Radio, and has spoken for women's events in churches, conferences, and smaller homeschool groups. Hosted By: Dr. Michelle Bengtson Audio Technical Support: Bryce Bengtson Discover more Christian podcasts at lifeaudio.com and inquire about advertising opportunities at lifeaudio.com/contact-us.

In this episode of PICU DOC on Call, Dr. Rahul Damania and Dr. Pradip Kamat chat about a challenging case involving a 15-year-old girl dealing with acute myocarditis and worsening respiratory failure. They explore the intricate dance between the heart and lungs, especially how positive pressure ventilation can affect heart function. They cover important topics like cardiac output, preload, and afterload, and discuss the delicate balance needed to manage myocarditis effectively. The episode offers practical tips for optimizing care for critically ill children, underscoring the importance of personalized treatment plans and teamwork in pediatric critical care. Tune in!Show Highlights:Clinical case of a 15-year-old girl with acute myocarditis and respiratory failureImportance of understanding cardiopulmonary interactions in pediatric critical careEffects of positive pressure ventilation on cardiac functionKey concepts of cardiac output, preload, and afterload in the context of myocarditisChallenges of managing hemodynamic instability in critically ill pediatric patientsDifferences between spontaneous breathing and positive pressure ventilationStrategies for optimizing preload and fluid management in myocarditis patientsTailoring ventilatory support and transitioning to invasive mechanical ventilationMonitoring for arrhythmias and managing myocardial function with inotropic supportImportance of frequent assessments and collaboration with cardiac ICU teams for patient careManagement StrategiesOptimizing Preload:Volume depletion is common in patients with hypotension and tachycardia. A careful fluid challenge is important to restore circulatory volume, but fluid overload should be avoided, especially with impaired left ventricular function.Tailoring Ventilatory Support:Adjust BiPAP settings to improve oxygenation without overloading the heart with excessive positive pressures.Use the optimal level of PEEP to recruit alveoli while maintaining adequate venous return to the heart.Supporting Myocardial Function:Inotropic support (e.g., milrinone) may be necessary to improve myocardial contractility. Milrinone also provides vasodilation, which can reduce afterload but must be used cautiously due to its potential to lower blood pressure.Frequent Reassessments:Bedside echocardiography and regular monitoring of biomarkers (lactate, BNP) and clinical status are essential for ongoing evaluation.In severe cases, advanced therapies like ECMO may be required if the patient's hemodynamic status continues to deteriorate.

No parent ever wants to end up in the Pediatric ICU; but we know it happens and we want you to be informed and know what to expect.  I invited my social media friend and Pediatric Critical Care Doctor, Dr. Anita Patel on the show to chat about the Pediatric ICU and what to expect.  We discuss:  The common reasons children end up in the Pediatric ICU and what to expect  The questions to ask your care team in the ICU How we manage health anxiety as a pediatric ICU doctor and general pediatrician  To connect with Dr. Anita Patel follow her on Instagram @anitakpatelmd and check out all her resources on https://linktr.ee/anitakpatelmd. 00:00 Introduction & Why This Conversation Matters 02:00 Meet Dr. Anita Patel 04:10 Common Reasons for Pediatric ICU Admissions 10:46 What Happens Inside the PICU? 14:23 Navigating the ICU Experience as a Parent 20:27 Key Questions Parents Should Ask the Care Team 24:46 The Emotional Toll on Parents & Doctors 31:14 Balancing Medical Knowledge with Parenting Anxiety 35:16 Final Thoughts & Words of Encouragement 37:59 Where to Follow Dr. Anita Patel & Closing Remarks We'd like to know who is listening! Please fill out our Listener Survey to help us improve the show and learn about you! Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website.  Learn more about your ad choices. Visit megaphone.fm/adchoices

No parent ever wants to end up in the Pediatric ICU; but we know it happens and we want you to be informed and know what to expect.  I invited my social media friend and Pediatric Critical Care Doctor, Dr. Anita Patel on the show to chat about the Pediatric ICU and what to expect.  We discuss:  The common reasons children end up in the Pediatric ICU and what to expect  The questions to ask your care team in the ICU How we manage health anxiety as a pediatric ICU doctor and general pediatrician  To connect with Dr. Anita Patel follow her on Instagram @anitakpatelmd and check out all her resources on https://linktr.ee/anitakpatelmd. 00:00 Introduction & Why This Conversation Matters 02:00 Meet Dr. Anita Patel 04:10 Common Reasons for Pediatric ICU Admissions 10:46 What Happens Inside the PICU? 14:23 Navigating the ICU Experience as a Parent 20:27 Key Questions Parents Should Ask the Care Team 24:46 The Emotional Toll on Parents & Doctors 31:14 Balancing Medical Knowledge with Parenting Anxiety 35:16 Final Thoughts & Words of Encouragement 37:59 Where to Follow Dr. Anita Patel & Closing Remarks We'd like to know who is listening! Please fill out our Listener Survey to help us improve the show and learn about you! Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Kyle Lemley, M.D., Amy Morrill, RN, and Amanda Horsley, RN, return to discuss the challenges and rewards of working in the Pediatric Critical Care Unit at Monument Health Rapid City Hospital. They discuss the differences between NICU and PICU and the complexities of treating chronically ill children. The trio share the path's that led them to the joining the PICU team. They emphasize the importance of clear communication with families, setting small goals to maintain hope and providing emotional support. Hosted on Acast. See acast.com/privacy for more information.

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"I had to teach myself to advocate – no one should leave a hospital with more trauma than they came with."- Julie Walters We extend our sincere gratitude to our sponsor for this episode, Gebauer PainEase®. We are pleased to provide more information about this product, and we invite you to learn more by visiting their website. In this episode, Katie speaks with Julie Walters, a mom of two neurodivergent children, entrepreneur, and fierce advocate for inclusion and health equity.Julie shares her deeply personal journey navigating her daughter's epilepsy diagnosis, the challenges of parenting through complex medical experiences and how these experiences led her to create The Connected Parent – a resource hub empowering families to find critical services for children with medical complexities or neurodivergence. Julie's story is one of strength, determination and advocacy.  Key Takeaways we learn from Julie and Katie's Conversation: ✨ Becoming an Advocate Early: Julie's passion for advocacy began in childhood, growing up with a mother who had schizoaffective disorder. She learned how to find resources through persistence and necessity.

Today, pediatric intensivists Dr. Pradip Kamat and Dr. Rahul Damania discuss a complex case of a 12-year-old girl who suffered a seizure and unresponsiveness due to a subarachnoid hemorrhage from a ruptured aneurysm. They explore the multi-system effects of traumatic brain injury (TBI) and intracranial hemorrhage, focusing on non-neurologic organ dysfunction. They'll also highlight the impact on cardiovascular, respiratory, renal, and hepatic systems, emphasizing the importance of understanding these interactions for better patient management. Tune in to hear relevant studies and management strategies to improve outcomes in pediatric TBI cases.In This Episode:Clinical case of a 12-year-old girl with seizure and unresponsiveness due to subarachnoid hemorrhage from a ruptured aneurysmManagement of non-neurologic organ dysfunction in traumatic brain injury (TBI) and intracranial hemorrhageMulti-system effects of brain injuries, including cardiovascular, respiratory, renal, and hepatic complicationsImportance of recognizing non-neurologic organ dysfunction in pediatric patientsEpidemiology and prevalence of non-neurologic organ dysfunction in patients with aneurysms or subarachnoid hemorrhageMechanisms of organ dysfunction following brain injury, including inflammatory responses and cytokine releaseManagement strategies for cardiovascular complications in TBI patients.Discussion of respiratory complications, such as acute lung injury and ARDS, in the context of TBIRenal and hepatic dysfunction associated with traumatic brain injury and their managementEmphasis on the need for a comprehensive understanding of organ interactions to improve patient outcomes in pediatric critical careConclusionIn summary, the episode underscores the complex interplay between brain injury and multi-system organ dysfunction. The hosts emphasize the need for a comprehensive understanding of these interactions to improve patient outcomes in pediatric TBI cases. They advocate for a team-based approach to management, focusing on individual patient physiology and the delicate balance required to address the challenges posed by non-neurologic organ dysfunction.Connect With Us!We hope you found value in this case-based discussion. Please share your feedback, subscribe, and leave a review on our podcast. For more resources, visit our website at PICUoncall.org.Thank you for joining us, and stay tuned for our next episode!

Welcome to another insightful episode of PICU on Call, a podcast dedicated to current and aspiring intensivists. In this episode, our hosts, Dr. Pradip Kamat, Dr. Rahul Damania, and their colleague, Dr. Jordan Dent, delve into the complexities of managing pneumonia in pediatric patients. The discussion is anchored around a clinical case involving a 10-year-old girl presenting with difficulty breathing and a fever, suggestive of pneumonia. We will break down the key themes and insights from the case, providing a comprehensive guide to understanding and managing pediatric pneumonia.Case PresentationThe episode begins with a detailed case presentation:Patient: 10-year-old girl, 28-week preemie with chronic lung disease.Symptoms: Progressive respiratory distress over eight days, worsening cough, increased work of breathing, hypoxemia (oxygen saturation in the low 80s despite supplemental oxygen).Findings: Chest X-ray reveals bilateral lower lobe infiltrates and a left-sided pleural effusion. Lab results show elevated CRP and a positive respiratory PCR for a bacterial pathogen.This case sets the stage for an in-depth discussion on the various aspects of pediatric pneumoRisk Factors for PneumoniaUnderstanding the risk factors for pneumonia is crucial for early identification and prevention. These risk factors can be categorized into three main groups:Host FactorsIncomplete Immunization Status: Children who are not fully vaccinated are at higher risk.Young Age: Infants and young children have immature immune systems, making them more susceptible.Lower Socioeconomic Status: Limited access to healthcare and poor living conditions can increase risk.Environmental FactorsExposure to Tobacco Smoke: Secondhand smoke can damage the respiratory tract and impair immune function.Seasonal Variations: Pneumonia cases peak during fall and winter due to increased circulation of respiratory viruses.Contact with Other Children: Daycare settings and schools can facilitate the spread of infections.Healthcare-Associated FactorsProlonged Mechanical Ventilation: Increases the risk of ventilator-associated pneumonia (VAP).Nasogastric Tube Placement: Can introduce pathogens into the respiratory tract.Neuromuscular Blockade: Impairs the ability to clear secretions.Inadequate Humidification: Dry air can damage the respiratory mucosa.Pathogenesis of PneumoniaPneumonia occurs when pathogens invade the lower respiratory tract, triggering an inflammatory response. This leads to fluid...

In today's episode, we explore a tragic but educational case involving a 15-year-old girl who suffered severe inhalation injury following a house fire. While heroically rescuing her brother and his friend, she endured prolonged cardiac arrest and severe multi-organ dysfunction. We'll focus on the pathophysiology, investigation, and management of inhalation injuries, including the critical role of recognizing carbon monoxide and cyanide poisoning in these complex cases.Key Learning Points:Exposure to house fire and prolonged cardiac arrestSigns of inhalation injury and airway compromisePathophysiology of inhalation injuries and their impact on multiple organ systemsManagement strategies for inhalation injury, including airway protection and ventilationDifferentiating carbon monoxide and cyanide poisoning in pediatric fire victimsCase PresentationA 15-year-old previously healthy girl is brought to the Pediatric Intensive Care Unit (PICU) after experiencing cardiac arrest during a house fire. She was found unconscious by firefighters after a heroic rescue attempt where she saved her brother and his friend. Upon arrival at the hospital, she was unresponsive, intubated, and in severe cardiovascular distress with signs of multi-organ dysfunction.Key findings include:Soot deposits and superficial burns on extremitiesProlonged resuscitation (45 minutes of field CPR and 47 minutes of in-hospital CPR)Cardiovascular compromise with PVCs, cool extremities, and delayed capillary refillMetabolic acidosis, AKI, coagulopathy, transaminitisSevere hypoxic-ischemic encephalopathy on EEGThese findings raise immediate concern for inhalation injury, which is the primary focus of today's discussion.Pathophysiology of Inhalation InjuryWhen a patient is exposed to smoke and hot gases during a fire, inhalation injury results in significant damage to the respiratory system. Inhalation injury has three main components:Upper airway involvement – Thermal injury can cause swelling and obstruction.Chemical pneumonitis – Noxious chemicals like carbon monoxide and cyanide trigger inflammation in the lungs.

Host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, sits down with Christina L. Cifra, MD, MS, to discuss communication strategies for interfacility transfers to the pediatric intensive care unit (PICU). Dr. Cifra shares insights from her recent study on verbal handoffs during transfers, examining the challenges and vital elements of communication during these high-stakes situations (Thirnbeck CK, et al. Pediatr Crit Care Med. 2024;52:162-171). Dr. Cifra is an attending physician in the Division of Medical Critical Care at Boston Children's Hospital and assistant professor of pediatrics at Harvard Medical School in Boston, Massachusetts.

Welcome and Episode IntroductionHosts: Dr. Pradip Kamat (Children's Healthcare of Atlanta/Emory University) and Dr. Rahul Damania (Cleveland Clinic Children's Hospital)Mission: A podcast dedicated to current and aspiring pediatric intensivists, exploring intriguing PICU cases and acute care pediatric managementFocus of the Episode: Managing toxic alcohol ingestion in the PICU with emphasis on ethanol, methanol, ethylene glycol, propylene glycol, and isopropyl alcoholCase PresentationPatient Details: A 7-month-old male presented with accidental ethanol ingestion after his formula was mixed with vodkaKey Symptoms: Lethargy, uncoordinated movements, decreased activity, and ethanol odorInitial Labs & Findings:EtOH level: 420 mg/dL.Glucose: 50 mg/dL.Normal CXR and EKG.PICU Presentation: Tachycardic, normotensive, lethargic, with signs of CNS depressionInitial Management: Dextrose infusion, glucose monitoring, neurological observation, and ruling out complicationsKey Learning Points from the CaseToxic alcohol ingestion in pediatrics requires rapid stabilization and targeted interventionsHypoglycemia and CNS depression are common features of ethanol toxicity in infantsManagement prioritizes glucose correction, airway support, and close neurological monitoringDeep Dive: Toxic Alcohols in the PICU1. EthanolTypical Presentation in Infants/Toddlers: Hypotonia, ataxia, coma, hypoglycemia, hypotension, and hypothermiaDiagnostic Workup:Focus on CNS and metabolic effectsLabs: Glucose, electrolytes, bicarbonate, anion gap, ketones, toxicology screenImaging (head CT) if indicatedManagement: Stabilization, IV dextrose for hypoglycemia, NPO status until alert, and consultation with poison control and social work2. MethanolSources: Windshield fluids, cleaning agents, moonshineClinical Stages:Early: Dizziness, nausea, vomiting (0–6 hours)Latent: Asymptomatic (6–30 hours)Late: Vision disturbances, seizures, respiratory failure (6–72 hours)Key Symptoms: “Snowstorm blindness” from retinal toxicityManagement: Fomepizole, correction of metabolic acidosis, and hemodialysis in severe cases3. Ethylene GlycolSources: Antifreeze, brake fluids, household cleanersPathophysiology: Metabolism to glycolic acid (acidosis) and oxalic acid (renal failure due to calcium oxalate crystals)Red Flags: Hypocalcemia, renal failure, QT prolongationManagement: Fomepizole, supportive care, and hemodialysis for severe toxicity4. Propylene GlycolSources: Medications like lorazepam and pentobarbitalPresentation: High anion gap metabolic acidosis at high doses, with renal and liver dysfunctionManagement: Discontinue offending agent, supportive care, and hemodialysis if severe5. Isopropyl AlcoholSources: Disinfectants, hand sanitizersPresentation: CNS depression, GI irritation, fruity acetone breath, but no metabolic acidosisManagement: Supportive care; fomepizole and ethanol are ineffectiveKey Laboratory InsightsOsmolar Gap Formula:Measured Osmolality - Calculated OsmolalityA high osmolar gap indicates unmeasured osmoles like toxic alcohols.Lactate Gap in Ethylene Glycol: Discrepancy between bedside and lab lactate levels due to glycolate interferenceManagement PearlsEthanol and...

Our guest this week is Tieal Bishop, of Walkerton, IN, mother to six including a medical fragile son and founder of A Rosie Place For Children.Tieal and her husband,Travis, have been married for eight years and between them they are the proud parents of six children: Max (25), Sam (22) and Gigi (20) and triplet 21 year old girls, Madeline, Abby and Kate.   Her oldest son, Max, had a precarious entry into the world.  Diagnosed with RSV, he required a G-Tube for feeding, a Trach for breathing and seven month in the PICU, which resulted in the family staying at the local Ronald McDonald House for seven months. Despite the early challenges, Max is thriving as a young adult.  Tieal is founder of A Rosie Place for Children, a state of the art, nurse-staffed specialty hospital for medically fragile children and respite for their parents, based in South Bend, IN. Tieal has a zest for life and a passion for service.  You'll hear her uplifting story on this episode of the SFN Dad to Dad Podcast.Show Notes - Phone – (574) 315-6283Email - tieal@arosieplace.orgLinkedIn - https://www.linkedin.com/in/tieal-bishop-b821237/A Rosie Place For Children- https://arosieplace.org/Children's Respite Homes of America - https://childrensrespitehomes.org/National Center for Pediatric Palliative Care Homes (NCPPCH) - https://www.ncppch.org/She's All Set (a short film by The Grotto Network at the University of Notre Dame) - https://www.youtube.com/watch?v=gNgD2wdUv-s&t=2sSpecial Fathers Network - SFN is a dad to dad mentoring program for fathers raising children with special needs. Many of the 800+ SFN Mentor Fathers, who are raising kids with special needs, have said: "I wish there was something like this when we first received our child's diagnosis. I felt so isolated.  There was no one within my family, at work, at church or within my friend group who understood or could relate to what I was going through."SFN Mentor Fathers share their experiences with younger dads closer to the beginning of their journey raising a child with the same or similar special needs. The SFN Mentor Fathers do NOT offer legal or medical advice, that is what lawyers and doctors do. They simply share their experiences and how they have made the most of challenging situations.Check out the 21CD YouTube Channel with dozens of videos on topics relevant to dads raising children with special needs - https://www.youtube.com/channel/UCzDFCvQimWNEb158ll6Q4cA/videosPlease support the SFN. Click here to donate: https://21stcenturydads.org/donate/Special Fathers Network: https://21stcenturydads.org/  

Send us a textIn this conversation, Dr. Kyle Willse, a pediatric intensivist, shares insights on the Pediatric Intensive Care Unit (PICU).  The discussion is meant to provide a basic understanding as to how the  PICU operates and to help parents be an advocate for their children.   A must listen for anybody who has a child or a loved one in the PICU.Kyle Willse, DO, is board certified in Pediatrics and in Pediatric Critical Care.  For the past 5 years, he has worked at Cedars-Sinai hospital as an attending in the pediatric and congenital cardiac intensive care unit.  His comments in the podcast are his individual thoughts and opinions and do not represent Cedars Sinai.    Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. For more content from Dr Jessica Hochman:Instagram: @AskDrJessicaYouTube channel: Ask Dr JessicaWebsite: www.askdrjessicamd.com-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20-To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Welcome to The Peds NP Acute Care Faculty series! This series was created and peer-reviewed by national leaders in acute care PNP education collaborating with one another to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.    This episode reviews the features of a patient presentation in the pediatric intensive care unit (PICU) and goes in depth on how learners can incorporate trends, new findings, and summaries into a succinct discussion in family-centered rounds. After an introduction with some general best practices, the guide begins with effective pre-rounding and progresses to the step-by-step components of a PICU patient presentation. The template describes each component's contents in detail, followed immediately by an example to demonstrate the practical application of each concept… “It might sound something like this:”... This episode is a valuable tool for any pediatric provider seeking to increase their skills in succinct synthesis and patient presentations, regardless of clinical setting.   This episode was peer reviewed by The Peds NP faculty series peer review team. You can read about our novel and scholarly approach to peer review, review our faculty lineup, and learn more about the series, competency mapping, references, and show notes at www.thepedsnp.com. There was no financial support or conflicts of interest to report. Follow me on Instagram @thepedsnppodcast.  Email me at thepedsnp@gmail.com.  Remember that this isn't just a podcast, you're listening for the kids.   Authors (alphabetical): Jackie Calhoun, DNP, CRNP, CPNP-AC, CCRN, Becky Carson, DNP, APRN, CPNP-PC/AC, Lena Oliveros, MSN, CPNP-AC, Priscila Reid, DNP, APRN, FNP-C, CPNP-AC   References:  Bolick, B.N., Reuter-Rice, K., Madden, M.A., Severin, P.N. (2020). Pediatric Acute Care: A guide for Interprofessional Practice (2nd ed.). Jones & Barlett Learning. Burlington, MA.    Oubre, R. (2024). Systems versus problem-based notes. Dr. Oubre's Digest. https://droubredigest.beehiiv.com/p/systems-versus-problems-based-notes   Stanford Medicine. (nd). Coaching best practices– Presenting a patient. https://med.stanford.edu/content/dam/sm/peds/documents/Program%20Information/coaching/Coaching%20Feedback%20Summary_Presenting%20a%20Patient.pdf   UC San Diego School of Medicine. (2018). Overview and general information about oral presentation. Practical Guide to Clinical Medicine. https://meded.ucsd.edu/clinicalmed/oral.html

Negara-negara di berbagai penjuru dunia bersiap menghadapi gejolak ekonomi seiring ancaman Presiden-Terpilih AS Donald Trump untuk mengenakan tarif besar-besaran, terutama terhadap China. Sementara itu, rencana pemerintah Indonesia menaikkan PPN menjadi 12 persen dinilai tidak tepat.

Did you know that Multi-Organ Dysfunction Syndrome (MODS) can result from both infectious and non-infectious causes? In our latest episode, we delve deep into the pathophysiology of MODS, exploring how different organs interact and fail in sequence. We discuss key concepts like organ functional reserve and the kinetics of organ injury, which aren't as straightforward as they seem. Tune in to learn about the non-linear progression of organ damage and how it impacts management strategies in pediatric critical care.We break down the case into key elements:Patient Background: A 15-year-old girl with chronic TPN dependence and a PICC line presented with septic shock and respiratory failure.Initial Presentation: Blood cultures confirmed Gram-negative rod bacteremia. She developed multi-system complications, including acute kidney injury (AKI), thrombocytopenia, and cardiac dysfunction.Management: Broad-spectrum antibiotics, mechanical ventilation, vasoactive agents, and supportive care for MODS.Key Case Highlights:Clinical case of a 15-year-old girl with sepsis from a gram-negative rodDependence on total parenteral nutrition (TPN) and prolonged PICC line useDiscussion of septic shock, acute respiratory failure, and acute kidney injuryOverview of multiple organ dysfunction syndrome (MODS) and its definitionsPathophysiology of MODS, including organ functional reserve and kinetics of organ injuryMolecular mechanisms involved in MODS, such as mitochondrial dysfunction and immune responsesSpecific phenotypes of sepsis-induced MODS, including TAMOF and IPMOFManagement strategies for MODS, emphasizing multidisciplinary approachesRole and complications of therapeutic plasma exchange (TPE) in treating MODSImportance of recognizing signs of MODS and timely intervention in pediatric patientsSegment 1: MODS Definitions and PhenotypesKey Definition: MODS is the progressive failure of two or more organ systems due to systemic insults (infectious or non-infectious).Phenotypes:TAMOF (Thrombocytopenia-Associated Multi-Organ Failure): Characterized by thrombocytopenia, hemolysis, and decreased ADAMTS13 activity.Immunoparalysis: Persistent immunosuppression and risk of secondary infections.Sequential Liver Failure: Often associated with viral triggers.Segment 2: Pathophysiology of MODSMolecular Insights:Mitochondrial dysfunction and damage-associated molecular patterns (DAMPs)Innate and adaptive immune dysregulationMicrocirculatory dysfunction and ischemia-reperfusion injuryOrgan Interactions: MODS evolves through complex multi-organ interdependenciesSegment 3: Diagnosis and Evidence-Based ManagementKey Diagnostic Pearls:MODS is not solely infection-driven; it requires a shared mechanism and predictable outcomes.Use biomarkers like ADAMTS13 and TNF-α response for phenotypic classification.Management Highlights:Supportive Care: Multisystem approach including lung-protective ventilation, renal replacement therapy, and hemodynamic support.Therapeutic Plasma Exchange (TPE): Especially effective in TAMOF by restoring ADAMTS13 and removing inflammatory mediators.Segment 4: Practical Tips for IntensivistsEarly recognition of MODS phenotypes for targeted therapyImportance of multidisciplinary teamwork in critical care settingsMonitoring for complications like TMA and immunoparalysis during prolonged ICU staysFollow Us:Twitter: @PICUDocOnCallEmail:

In this episode, we discuss the case of a 15-year-old girl who presents with progressive headache, nausea, vomiting, and difficulty ambulating. Her condition rapidly evolves into altered mental status and severe hydrocephalus, leading to a compelling discussion about the evaluation, diagnosis, and management of hydrocephalus in pediatric patients.We break down the case into key elements:A comprehensive look at acute hydrocephalus, including its pathophysiology and causesEpidemiological insights, clinical presentation, and diagnostic approachesManagement strategies, including temporary and permanent CSF diversion techniquesA review of complications related to shunts and endoscopic third ventriculostomyKey Case Highlights:Patient Presentation:A 15-year-old girl with a 3-day history of worsening headaches, nausea, vomiting, and difficulty walkingAltered mental status and bradycardia upon PICU admissionCT scan revealed severe hydrocephalus without a clear mass lesionManagement Steps in the PICU:Hypertonic saline bolus improved her mental status and pupillary reactionsNeurosurgery consultation recommended MRI and close neuro checksInitial management included dexamethasone, keeping the patient NPO, and hourly neuro assessmentsDifferential Diagnosis:Obstructive (non-communicating) vs. non-obstructive (communicating) hydrocephalusConsideration of alternative diagnoses like intracranial hemorrhage and idiopathic intracranial hypertensionEpisode Learning Points:Hydrocephalus Overview:Abnormal CSF buildup in the ventricles leading to increased intracranial pressure (ICP)Key distinctions between obstructive and non-obstructive typesEpidemiology and Risk Factors:Congenital causes include genetic syndromes, neural tube defects, and Chiari malformationsAcquired causes: post-hemorrhagic hydrocephalus (e.g., from IVH in preemies), infections like TB meningitis, and brain tumorsClinical Presentation:Infants: Bulging fontanelles, sunsetting eyes, irritabilityOlder children: Headaches, vomiting, papilledema, and gait disturbancesManagement Framework:Temporary CSF diversion via external ventricular drains (EVD) or lumbar cathetersPermanent interventions include VP shunts and endoscopic third ventriculostomy (ETV)Complications of Shunts and ETV:Shunt infections, malfunctions, over-drainage, and migrationETV-specific risks, including delayed failure years post-procedureClinical Pearl:Communicating hydrocephalus involves symmetric ventricular enlargement and is often linked to inflammatory or post-treatment changes affecting CSF reabsorption.Hosts' Takeaway Points:Dr. Pradip Kamat emphasizes the importance of timely recognition and intervention in hydrocephalus to prevent complications like brain herniation.Dr. Rahul Damania highlights the need for meticulous neurological checks in PICU patients and an individualized approach to treatment.Resources Mentioned:Hydrocephalus Clinical Research Network guidelines.Recent studies on ETV outcomes in pediatric populations.Call to Action:If you enjoyed this discussion, please subscribe to PICU Doc On Call and leave a review. Have a topic you'd like us to cover? Reach out to us via email or on social media!Follow Us:Twitter: @PICUDocOnCallEmail:

In this episode of the ICHE podcast, we explore the theme of respiratory culturing appropriateness in pediatric patients, emphasizing diagnostic stewardship's role in optimizing patient outcomes. Host David Calfee, MD, MS and guest experts, Kathleen Chiotos, MD, MSCE and Edward Lyon, DO, MA, share insights on how stewardship practices can refine respiratory testing in pediatric intensive care units (PICUs), where evidence suggests these tests are often overused without clinical benefit. They examine challenges in implementing stewardship, including barriers like resistance to change and logistical issues, and discuss practical strategies to overcome these obstacles. The conversation highlights two recent studies published in ICHE: Dr. Lyon's work on repeat tracheal aspirate cultures in PICUs, which analyzes their frequency, resistance patterns, and impact on antimicrobial use, and Dr. Chiotos's study on a tracheal aspirate culture stewardship intervention, examining its effect in a tertiary PICU. Both authors discuss their studies' methodologies, findings, limitations, and implications for future practice. To wrap up, each expert offers actionable recommendations for healthcare professionals interested in improving respiratory culturing practices at their institutions, providing practical steps to enhance safety and care efficiency. Full versions of the articles discussed in this episode are available in the September issue of ICHE.

Valley Children's PICU earns prestigious national award    Please Subscribe + Rate & Review KMJ's Afternoon Drive with Philip Teresi & E. Curtis Johnson wherever you listen!  ---     KMJ's Afternoon Drive with Philip Teresi & E. Curtis Johnson is available on the KMJNOW app, Apple Podcasts, Spotify, Amazon Music or wherever else you listen.  ---   Philip Teresi & E. Curtis Johnson – KMJ's Afternoon Drive  Weekdays 2-6 PM Pacific on News/Talk 580 & 105.9 KMJ  DriveKMJ.com | Podcast | Facebook | X | Instagram  ---   Everything KMJ: kmjnow.com | Streaming | Podcasts | Facebook | X | Instagram    See omnystudio.com/listener for privacy information.

IntroductionHosts: Dr. Pradip Kamat (Children's Healthcare of Atlanta/Emory University) and Dr. Rahul Damania (Cleveland Clinic Children's Hospital)Mission: A podcast dedicated to current and aspiring pediatric intensivists, exploring intriguing PICU cases and acute care pediatric managementFocus of the Episode: Managing toxic alcohol ingestion in the PICU with emphasis on ethanol, methanol, ethylene glycol, propylene glycol, and isopropyl alcoholCase PresentationPatient Details: A 7-month-old male presented with accidental ethanol ingestion after his formula was mixed with vodkaKey Symptoms: Lethargy, uncoordinated movements, decreased activity, and ethanol odorInitial Labs & Findings:EtOH level: 420 mg/dL.Glucose: 50 mg/dL.Normal CXR and EKG.PICU Presentation: Tachycardic, normotensive, lethargic, with signs of CNS depressionInitial Management: Dextrose infusion, glucose monitoring, neurological observation, and ruling out complicationsKey Learning Points from the CaseToxic alcohol ingestion in pediatrics requires rapid stabilization and targeted interventionsHypoglycemia and CNS depression are common features of ethanol toxicity in infantsManagement prioritizes glucose correction, airway support, and close neurological monitoringDeep Dive: Toxic Alcohols in the PICU1. EthanolTypical Presentation in Infants/Toddlers: Hypotonia, ataxia, coma, hypoglycemia, hypotension, and hypothermiaDiagnostic Workup:Focus on CNS and metabolic effectsLabs: Glucose, electrolytes, bicarbonate, anion gap, ketones, toxicology screenImaging (head CT) if indicatedManagement: Stabilization, IV dextrose for hypoglycemia, NPO status until alert, and consultation with poison control and social work2. MethanolSources: Windshield fluids, cleaning agents, moonshineClinical Stages:Early:...

Introduction:Today, Dr. Rahul Damania, Dr. Pradip Kamat, and their guest, Dr. Jordan Dent, discuss a critical case involving a 15-year-old male who collapsed during football practice due to exertional heat stroke. The discussion emphasizes the clinical presentation, risk factors, pathophysiology, and evidence-based management of heat stroke and other heat-related illnesses in pediatric patients. The episode also delves into the role of rapid cooling interventions and long-term care to minimize mortality and morbidity.Case Summary: A 15-year-old male with ADHD collapsed during football practice on a hot, humid day. He presented with:Normotension (BP: 101/67 mmHg)Tachycardia (HR: 157 bpm)Tachypnea (RR: 40 breaths/min)Febrile (Rectal temp: 41.8°C/107.2°F)Dry, hot skin, GCS of 9Lab abnormalities: hyponatremia, hypokalemia, hypoglycemia, elevated creatinine, liver enzymes, lactate, CK, and troponinAfter suffering cardiac arrest and undergoing resuscitation, the patient developed multiorgan dysfunction, including seizures, encephalopathy, and cerebral edema. Despite severe initial complications, the patient demonstrated neurological improvement with left-side hemiparesis before discharge.Key Discussion Points:Etiology and Pathophysiology of Heat Stroke:Heat stroke occurs when the body's thermoregulatory mechanisms fail, leading to dangerous elevations in core body temperature. Exertional heat stroke is common during strenuous physical activity in hot, humid environments.Key physiological breakdowns include inadequate sweating, vasodilation dysfunction, and subsequent cellular damage due to hyperthermia.Risk Factors for Exertional Heat Stroke:Environmental factors: High temperature, humidity, lack of hydration, and breaks.Athlete-related factors: Hypohidrosis, dehydration, medical conditions, and medications (e.g., Adderall).Heat illness is the third leading cause of death in high school athletics, with American football players particularly at risk.Spectrum of Heat-Related Illness:Heat Cramps: Involuntary muscle contractions due to dehydration and electrolyte imbalance.Heat Syncope: Transient loss of consciousness due to heat exposure.Heat Exhaustion: Milder heat illness with core temperature < 104°F, potentially progressing to heat stroke if untreated.

Dr. Kristen Smith is the PICU medical director, critical care fellowship program director, and director of the nurse practitioner program at the University of Michigan C.S. Mott Children's Hospital. She received her medical degree from the University of Toledo and completed her pediatric residency at Akron Children's Hospital, followed by a critical care fellowship at Johns Hopkins. Dr. Smith's research is focused on the long-term outcome of Pediatric Intensive Care Unit (PICU) survivors.Dr. Carly Schmidt is a critical care fellow at the University of Michigan C.S. Mott Children's Hospital. She received her medical degree from Case Western University and completed her pediatric residency at Brown University, where she also served as chief resident. Carly is interested in the intersection of the PICU and the community via transport medicine, advocacy, and outcomes. Learning Objectives:By the end of this podcast, listeners should be able to describe:Neuroprotective measures that should be provided to all pediatric patients with severe traumatic brain injury (TBI).An expert, guideline-directed approach to managing a child with increased intracranial pressure due to severe TBI.Reference:Kochanek PM, Tasker RC, Bell MJ, Adelson PD, Carney N, Vavilala MS, Selden NR, Bratton SL, Grant GA, Kissoon N, Reuter-Rice KE, Wainwright MS. Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies. Pediatr Crit Care Med. 2019 Mar;20(3):269-279.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Dr. Kristen Smith is the PICU medical director, critical care fellowship program director, and director of the nurse practitioner program at the University of Michigan C.S. Mott Children's Hospital. She received her medical degree from the University of Toledo and completed her pediatric residency at Akron Children's Hospital, followed by a critical care fellowship at Johns Hopkins. Dr. Smith's research is focused on the long-term outcome of Pediatric Intensive Care Unit (PICU) survivors.Dr. Carly Schmidt is a critical care fellow at the University of Michigan C.S. Mott Children's Hospital. She received her medical degree from Case Western University and completed her pediatric residency at Brown University, where she also served as chief resident. Carly is interested in the intersection of the PICU and the community via transport medicine, advocacy, and outcomes. Learning Objectives:By the end of this podcast, listeners should be able to describe:Neuroprotective measures that should be provided to all pediatric patients with severe traumatic brain injury (TBI).An expert, guideline-directed approach to managing a child with increased intracranial pressure due to severe TBI.Reference:Kochanek PM, Tasker RC, Bell MJ, Adelson PD, Carney N, Vavilala MS, Selden NR, Bratton SL, Grant GA, Kissoon N, Reuter-Rice KE, Wainwright MS. Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies. Pediatr Crit Care Med. 2019 Mar;20(3):269-279.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

On this week's episode, we welcome Katie Taylor, Child Life Specialist and CEO & Founder of Child Life On Call - a support and resource provider to families & care teams through strategic partnerships with healthcare organizations. Child Life On Call enhances care & support with innovative, trauma-informed, and child life specialist-based solutions tailored ensure every family feels like an empowered part of the care team. We have such an interesting conversation around Child Life Specialists and the ways they can impact care for babies and children during medical challenges.On this episode, you will hear:- What is a child life specialist?- Child life in the NICU- Child life in pediatrics- The power of play and validation- Education and advocacy in child life specialists- Supporting siblings of children with medical challenges- Integrating child life practices into every day life- Support Spot App- The power of child-friendly language and validating emotions- Advocating for pediatric-focused care and comfort measuresYou can learn more about Child Life On Call by following their Instagram: @childlifeoncall and visiting their website.You can also download the Support Spot App here.Guest Bio:Katie Taylor received her Bachelor of Arts at Penn State University and she did her practicum at Children's National Medical Center. She did her internship at Inova Children's Hospital and received a fellowship in Hem/Onc & Adolescent Medicine at Inova Children's Hospital.Katie has over 12 years of Clinical Experience in PICU, ER, Adult, Outpatient, Inpatient Services and is an international and national speaker on Child Life Services.By leveraging technology, and putting education and support into an easy-to-use app, Katie Taylor found a way to empower patients, their families, and the care team, and expand access to child life services to people who needed it the most.The key to better care is here, and it fits in the palm of your hand. Let me show you what the Child Life On Call app can do for you.For more birth trauma content and a community full of love and support, head to my Instagram at @thebirthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.

Send us a textPaediatric intensive care admissions of preterm children born

Send us a textIn this episode, hosts Ben and Daphna cover a range of neonatal topics, starting with a review of recent research on  mpox in pregnancy and neonates. They discuss a case report of neonatal mpox infection and review current understanding of risks, transmission, and treatment options.The hosts then examine a study on vaccine administration in preterm infants, finding that giving multiple vaccines on a single day did not increase adverse events compared to spreading them out. They also explore research on iron deficiency in extremely preterm infants, which revealed surprisingly high rates despite supplementation, especially in formula-fed babies.Other topics covered include PICU admissions of former NICU patients in the first two years of life, and innovative approaches to reducing non-actionable alarms in intensive care units.The episode concludes with insights from Dr. Rivara's 24 years as a medical journal editor-in-chief, touching on key aspects of research publication.Throughout, Ben and Daphna provide expert commentary on the clinical implications of these studies, making complex research accessible to listeners while emphasizing areas needing further investigation in neonatal care. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Stuart Goldstein, MD is a Professor of Pediatrics at the University of Cincinnati, where he serves as the Clark D. West Endowed Chair. He is a practicing pediatric nephrologist at Cincinnati Children's where he also is the Director for the Center for Acute Care Nephrology and the Medical Director for the Pheresis Service. Dr Goldstein is the Founder and Principal Investigator for the Prospective Pediatric Acute Kidney Injury Research Group and has evaluated novel urinary AKI biomarkers in the pediatric critical care setting. Dr. Katherine Melink (at time of recording) is currently finishing her residency at Cincinnati Children's Hospital where she was able to conduct research in biomarkers for the prediction of kidney injury in critically ill children (particularly in the CICU). Her exposure to CRRT under physicians like Dr. Goldstein at Cincinnati Children's has served as a motivating factor to participate in this episode! She is excited to start PICU fellowship at Boston Children's Hospital in July.Learning Objectives:By the end of this podcast, listeners should be able to discuss:CRRT fundamentals, including how it differs from conventional hemodialysis and the rationale for its use in critically ill pediatric patients.Key differences in ultrafiltration, diffusion, and convection and their clinical applications in CRRT.Patient selection and indications for CRRT (AKI, fluid overload, toxic metabolite/ingestion among others)Key evidence guiding use of CRRT in critically ill children.Components of a CRRT prescription and guiding principles of how to titrate therapy.Pitfalls and complications of CRRTCommon anticoagulation strategies in CRRTGeneral principles guiding liberation from CRRT.Selected references:Sutherland et al; ADQI 26 Workgroup. Epidemiology of acute kidney injury in children Pediatr Nephrol. 2024 Mar;39(3):919-928. doi: 10.1007/s00467-023-06164-w. Epub 2023 Oct 24. Basu et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014 Mar;85(3):659-67. doi: 10.1038/ki.2013.349. Epub 2013 Sep 18. PMID: 24048379; Fuhrman et al; ADQI 26 workgroup. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children. Pediatr Nephrol. 2024 Mar;39(3):929-939. doi: 10.1007/s00467-023-06133-3. Epub Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Stuart Goldstein, MD is a Professor of Pediatrics at the University of Cincinnati, where he serves as the Clark D. West Endowed Chair. He is a practicing pediatric nephrologist at Cincinnati Children's where he also is the Director for the Center for Acute Care Nephrology and the Medical Director for the Pheresis Service. Dr Goldstein is the Founder and Principal Investigator for the Prospective Pediatric Acute Kidney Injury Research Group and has evaluated novel urinary AKI biomarkers in the pediatric critical care setting. Dr. Katherine Melink (at time of recording) is currently finishing her residency at Cincinnati Children's Hospital where she was able to conduct research in biomarkers for the prediction of kidney injury in critically ill children (particularly in the CICU). Her exposure to CRRT under physicians like Dr. Goldstein at Cincinnati Children's has served as a motivating factor to participate in this episode! She is excited to start PICU fellowship at Boston Children's Hospital in July.Learning Objectives:By the end of this podcast, listeners should be able to discuss:CRRT fundamentals, including how it differs from conventional hemodialysis and the rationale for its use in critically ill pediatric patients.Key differences in ultrafiltration, diffusion, and convection and their clinical applications in CRRT.Patient selection and indications for CRRT (AKI, fluid overload, toxic metabolite/ingestion among others)Key evidence guiding use of CRRT in critically ill children.Components of a CRRT prescription and guiding principles of how to titrate therapy.Pitfalls and complications of CRRTCommon anticoagulation strategies in CRRTGeneral principles guiding liberation from CRRT.Selected references:Sutherland et al; ADQI 26 Workgroup. Epidemiology of acute kidney injury in children Pediatr Nephrol. 2024 Mar;39(3):919-928. doi: 10.1007/s00467-023-06164-w. Epub 2023 Oct 24. Basu et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014 Mar;85(3):659-67. doi: 10.1038/ki.2013.349. Epub 2013 Sep 18. PMID: 24048379; Fuhrman et al; ADQI 26 workgroup. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children. Pediatr Nephrol. 2024 Mar;39(3):929-939. doi: 10.1007/s00467-023-06133-3. EpubQuestions, 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 Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.