PedsCrit

Dr. Philip C. Spinella, a leading professor and trauma expert at the University of Pittsburgh, discusses groundbreaking advancements in blood product resuscitation. He highlights the shift to whole blood use over crystalloids for better survival rates in hemorrhagic shock. The episode delves into the complexities of citrate management in transfusions and the evolution of platelet storage practices. Spinella also explores the importance of localized approaches in pediatric care, concluding with an unexpected culinary diversion featuring a delicious meatball recipe.

Dr. Philip Spinella, a professor and director at the University of Pittsburgh's Trauma and Transfusion Medicine Research Center, shares insights from his unique journey from pediatrician to battalion surgeon. He discusses transformative blood transfusion practices, including the importance of whole blood in pediatric care and the establishment of 'walking blood banks.' Spinella highlights the necessity of bending rules in high-pressure medical environments to foster innovation and save lives, while also exploring advancements in managing severe hemorrhage.

Dr. Emily Olson, a fellow in pulmonary and critical care medicine, and Dr. Lekshmi Santhosh, an Associate Professor at UCSF, tackle the pressing issue of gender disparities in medical training. They share their personal journeys in medicine and discuss how gender impacts procedural opportunities for residents. Insights into implicit bias, the importance of mentorship, and strategies to foster equity in training are explored. They emphasize the need for a safe space to facilitate open discussions and enhance career progression for underrepresented groups.

Dr. Sapna Kudchadkar, Anesthesiologist-in-Chief of Johns Hopkins Children's Center, shares her remarkable journey from general pediatrics to leading groundbreaking research in pediatric critical care. She emphasizes the importance of mentorship and collaboration in building a successful research career. Dr. Kudchadkar discusses her innovative 'PICU Up!' intervention, highlighting how unexpected opportunities can reshape one's path. Her anecdotes reveal a passion for improving outcomes for critically ill children through early mobility strategies and rehabilitation.

Dr. Sapna Kudchadkar, Anesthesiologist-in-Chief at Johns Hopkins Children's Center, discusses innovative sedation strategies for critically ill children. She shares techniques to reduce delirium risks and the importance of effective pain management. Listeners learn about optimizing sedation practices, prioritizing 'therapeutic cuddles' for early mobility, and the human element of care. Dr. Kudchadkar emphasizes teamwork, tailored approaches, and family involvement in recovery, all aimed at enhancing outcomes in pediatric critical care.

Dr. Kristina Betters, a pediatric intensivist and delirium researcher at Vanderbilt University, joins aspiring intensivist Dr. Brooke Light to discuss vital topics in pediatric critical care. They delve into the challenges of diagnosing delirium in young patients, highlighting the importance of screening tools. The duo advocates for early mobility interventions tailored to developmental needs and emphasizes family involvement in the ICU to enhance recovery. Their insights on implementing ICU bundles reveal how even partial strategies can lead to improved outcomes.

In this engaging discussion, Dr. Kristina Betters, a pediatric intensivist at Vanderbilt University, and aspiring intensivist Dr. Brooke Light explore crucial aspects of ICU liberation for children. They delve into the A to F ICU liberation bundle, sharing insights on personalized sedation strategies and pain management. A powerful case study showcases the recovery of a young boy, emphasizing family involvement and evidence-based practices. They also address the critical role of nursing staff and multidisciplinary teams in enhancing patient care and safety.

Dr. Matthew Borgman, a Professor of Pediatrics specializing in Critical Care, shares his vast expertise in managing pediatric hemorrhagic shock. He delves into the complexities of recognizing and treating this condition, emphasizing careful fluid resuscitation and the strategic use of blood products. The discussion highlights the advantages of low titer group O whole blood and advanced coagulation testing methods like TEG and ROTEM. Borgman also addresses the challenges of implementing these practices in various healthcare settings, paving the way for improved trauma care.

Dr. Bill Bortcosh, a pediatric critical care expert, dives deep into the acid-base status evaluation essential for patient care. He discusses the practical application of the anion gap and how it serves as a vital screening tool. The conversation explores the nuances of fluid management, focusing on the effects of normal saline versus Plasmalite on chloride levels. Bortcosh also addresses the complexities of diagnosing metabolic acidosis, including renal tubular acidosis, emphasizing the importance of continuous learning in navigating these challenges.

Dr. Bill Bortcosh, a pediatric critical care expert and associate medical director of safety, shares insights into acid-base diagnosis in this engaging discussion. He emphasizes the importance of understanding acid-base status for acute care, illustrates this with a compelling case study, and explains the role of anion gap in diagnosis. Bortcosh also explores the emotional challenges in critical care and discusses his transition to pharmaceutical safety, shedding light on drug safety assessments and the complexities faced by healthcare providers.