PedsCrit

Two expert pulmonologists discuss the intricate decision-making process surrounding tracheostomies in children. They delve into the essential support systems for families transitioning from hospital to home care. Topics include oxygen management, the pivotal role of respiratory therapists, and the necessity of emergency preparedness. They also highlight valuable resources designed to assist families, emphasizing personalized care and effective communication in navigating these challenging circumstances.

Dr. Parisa Kaviany and Dr. Maria Arroyo discuss the tracheostomy decision, including introducing the concept to families, home nursing challenges during the pandemic, options for post-tracheostomy transfer, and reflections on alarm sensitivity and discharging children with artificial airways.

Dr. Laura Ortmann, an associate professor and the Medical Director of the Cardiovascular Intensive Care Unit at Children's Hospital and Medical Center, discusses topics related to Tetralogy of Fallot with Pulmonary Stenosis. The podcast covers surgical procedures, bedside approaches for managing arrhythmias, postoperative care considerations, feeding intolerance, long-term complications, and the historical significance of repairing Tetralogy of Fallot.

Dr. Lakshmi Raman, pediatric cardiopulmonary resuscitation (ECPR) expert, discusses the rationale for ECPR in pediatric cardiac arrest, patient selection for ECPR, and challenges in determining the cause of arrest. They also delve into choosing the best cannulation location for ECPR and the preferred access for children over 30 kilos. The importance of being an experienced program in handling high-stress situations like ECMO and deploying ECPR is emphasized.

Dr. Ali McMichael and Dr. Lisa Settle discuss the challenges of interpreting lab test results in neonates on ECMO, the use of thromboelastography tags to assess anticoagulation, and managing anticoagulation in patients with elevated bilirubin and triglyceride levels. The podcast also explores patient selection for ECMO and alternative interventions for hemorrhaging.

Listener Feedback SurveyPedsCrit stickers are now available! To get one, email your shipping information to PedsCritPodcast@gmail.com, DM Zac or Alice on Twitter, or DM the PedsCrit Instagram. Email: PedsCritPodcast@gmail.comTwitter: @ZHodges1, @AliceShanklin, @CritPedsInstagram: @PedsCrit If you'd like to support the show, you can send donations to @PedsCrit on Venmo or become a monthly subscriber to the PedsCrit Patreon. Thank you for listening to PedsCrit. Please remember that all content 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.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Dr. Ali McMichael and Dr. Lisa Settle discuss challenges in anticoagulation on ECMO, differences between adults and children, heparin resistance in neonates, and the use of bivalirudin as an alternative anticoagulant. They highlight the need for further research in ECMO anticoagulation.

This podcast explores communication strategies and palliative care in the PICU. Topics include the R-E-M-A-P framework for discussing difficult medical situations, using nurse statements to build rapport, developing communication skills in the ICU, and navigating difficult scenarios in palliative care.

Pediatric palliative care specialists discuss the definition of palliative care, the importance of early involvement, and debunk misconceptions about hospice care. They share their approach to communicating with families in challenging cases, emphasizing listening, humility, and being forthright. The chapter also covers general principles and guidelines for involving palliative care in seriously ill patients, and provides tips for communicating with families in different clinical scenarios.

Dr. Greg Yurasek, a CICU attending and the director of critical care simulation at Children’s National Hospital, discusses d-TGA physiology & repair, including preoperative considerations, intubation in newborns, levels of mixing, prostaglandin, early repair, and the arterial switch operation. The average length of hospital stay and potential long-term complications are also explored.