Dr. Ashley Siems shares her systems-based approach to presenting patients in the PICU. Topics include enhancing presentation styles, importance of neurologic assessment and sedation, understanding ventilator settings, non-invasive respiratory support, and evaluating cardiovascular health in pediatric critical care.
Nurses play a crucial role in presenting patient data and concerns during rounds in the PICU.
Assessing neurological status and hemodynamic stability are key components of patient presentation in the PICU.
Monitoring patient responses to respiratory support and adjusting accordingly is vital in the PICU.
Deep dives
Collaborative Podcasting
The hosts discuss their experiences with podcasting and how collaboration plays a vital role in their podcast Pedscrate.
Presenting Patients on Rounds in the PICU
The hosts interview Dr. Ashley Seems about the best way to present patients on rounds in the PICU, focusing on concise, focused presentations and interpreting data rather than reading off notes.
Respiratory Support in the PICU
The hosts discuss various types of respiratory support in the PICU, including nasal cannula, high flow nasal cannula, and non-invasive positive pressure, highlighting the importance of monitoring patient responses and escalating or de-escalating support accordingly.
Importance of Nurse Involvement on Rounds
On rounds, it is crucial to have the nurse speak first and present the patient's data and concerns. The nurse provides valuable real-time information about any changes in the patient's condition. This allows the resident to focus on interpreting the data and incorporating the most up-to-date information into the management plan. Nurses are key advocates and have an intimate knowledge of the patient, making their input essential during rounds.
Neurological and Hemodynamic Assessments on Rounds
During rounds, it is important to assess the neurological status and hemodynamic stability of the patient. Presenting the patient's neurological assessment helps determine if there is any neurologic pathology or the need for supportive measures. It involves evaluating pain management, sedation levels, and various sedation scores to monitor the patient's response. In terms of hemodynamic assessment, vital signs such as heart rate, blood pressure, and capillary refill are crucial indicators. Presenting the patient's medications and their effect on perfusion helps guide decision-making in terms of vasoactive support and when to escalate or adjust treatment.
Dr. Ashley Siems, pediatric intensivist and PCCM Fellowship Program Director at Johns Hopkins All Children's Hospital, guides us through her systems-based framework for how to present a patient in the PICU.
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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.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
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