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PedsCrit

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May 16, 2022 • 33min

Pediatric Burn Injury with Dr. Samuel Mandell -- Part 1: Initial Resuscitation & Managing the Airway

Samuel Mandell, M.D., M.P.H., is an Associate Professor in the Department of Surgery at UT Southwestern Medical Center. He specializes in trauma surgery, surgical critical care, and comprehensive care of burn-injured patients. Dr. Mandell also serves as Burn Section Chief and Director of the Parkland Regional Burn Center in Dallas, Texas.Objectives for this series:By the end of listening to this two-part series, learners should be able to:1. Describe the key elements of the initial evaluation and resuscitation of the burn injured pediatric patient.2. Recognize risk factors and clinical features of inhalation injury.3. Recognize risk factors and clinical features of carbon monoxide and cyanide poisoning.4. Estimate the total body surface area (TBSA) burned.5. Recall general indications for transfer to a specialty burn center.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.
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Apr 16, 2022 • 32min

Ventilation of the Neuromuscular Patient with Dr. Bill Bortcosh--Part 2: Ventilation and Airway Clearance

Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care and a practicing pediatric intensivist at the University of Florida. Learning Objectives for this series:Discuss unique physiology of the neuromuscular patient and how it relates to work of breathingDefine obstacles to effective ventilation in patients with neuromuscular diseaseDescribe ventilation strategies to utilize in patients with neuromuscular diseaseReferences1.Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177-89.2.Mercuri E, Finkel RS, Muntoni F, Wirth B, Montes J, Main M, et al. Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscul Disord. 2018;28(2):103-15.3.Finkel RS, Mercuri E, Meyer OH, Simonds AK, Schroth MK, Graham RJ, et al. Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscul Disord. 2018;28(3):197-207.4.Marino PL SK. The ICU Book. Wilkins LW, editor. Philadelphia: Lippincott Williams & Wilkins; 2007.5.Machado DL, Silva EC, Resende MB, Carvalho CR, Zanoteli E, Reed UC. Lung function monitoring in patients with duchenne muscular dystrophy on steroid therapy. BMC Res Notes. 2012;5:435.6.Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: "Children are not small adults!". Open Inflamm J. 2011;4:4-15.7.Lo Mauro A, Aliverti A. Physiology of respiratory disturbances in muscular dystrophies. Breathe (Sheff). 2016;12(4):318-27.8.Diaz CE, Deoras KS, Allen JL. Chest wall motion before and during mechanical ventilation in children with neuromuscular disease. Pediatr Pulmonol. 1993.9.Perez A, Mulot R, Vardon G, Barois A, Gallego J. Thoracoabdominal pattern of breathing in neuromuscular disorders. Chest. 1996;110(2):454-61.10.Testa MB, Pavone M, Bertini E, Petrone A, Pagani M, Cutrera R. Sleep-disordered breathing in spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2005;84(9):666-70.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.
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Apr 4, 2022 • 26min

Ventilation of the Neuromuscular Patient with Bill Bortcosh, Part 1

Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care and a practicing pediatric intensivist at the University of Florida. Learning Objectives for this series:Discuss unique physiology of the neuromuscular patient and how it relates to work of breathingDefine obstacles to effective ventilation in patients with neuromuscular diseaseDescribe ventilation strategies to utilize in patients with neuromuscular diseaseReferences1.Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177-89.2.Mercuri E, Finkel RS, Muntoni F, Wirth B, Montes J, Main M, et al. Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscul Disord. 2018;28(2):103-15.3.Finkel RS, Mercuri E, Meyer OH, Simonds AK, Schroth MK, Graham RJ, et al. Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscul Disord. 2018;28(3):197-207.4.Marino PL SK. The ICU Book. Wilkins LW, editor. Philadelphia: Lippincott Williams & Wilkins; 2007.5.Machado DL, Silva EC, Resende MB, Carvalho CR, Zanoteli E, Reed UC. Lung function monitoring in patients with duchenne muscular dystrophy on steroid therapy. BMC Res Notes. 2012;5:435.6.Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: "Children are not small adults!". Open Inflamm J. 2011;4:4-15.7.Lo Mauro A, Aliverti A. Physiology of respiratory disturbances in muscular dystrophies. Breathe (Sheff). 2016;12(4):318-27.8.Diaz CE, Deoras KS, Allen JL. Chest wall motion before and during mechanical ventilation in children with neuromuscular disease. Pediatr Pulmonol. 1993.9.Perez A, Mulot R, Vardon G, Barois A, Gallego J. Thoracoabdominal pattern of breathing in neuromuscular disorders. Chest. 1996;110(2):454-61.10.Testa MB, Pavone M, Bertini E, Petrone A, Pagani M, Cutrera R. Sleep-disordered breathing in spinal muscular atrophy types 1 and 2. Am J Phys Med Rehabil. 2005;84(9):666-70.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.
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Mar 7, 2022 • 28min

Extubation Readiness with Alyssa Stoner and Gina Patel, Part 3

Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.Objectives for this episode:The participant will be able to describe 3 factors that influence a patient’s readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient’s clinical picture. The participant will be able to develop and execute a patient’s extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Questions, 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.
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Feb 21, 2022 • 31min

Extubation Readiness with Alyssa Stoner and Gina Patel, Part 2

Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.Objectives for this episode:The participant will be able to describe 3 factors that influence a patient’s readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient’s clinical picture. The participant will be able to develop and execute a patient’s extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Questions, 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.
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Feb 7, 2022 • 19min

Extubation Readiness with Alyssa Stoner and Gina Patel, Part 1

Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.Objectives for this episode:The participant will be able to describe 3 factors that influence a patient’s readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient’s clinical picture. The participant will be able to develop and execute a patient’s extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Questions, 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.
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Dec 6, 2021 • 20min

Work of Breathing Physiology with Dr. Bill Bortcosh, Part 2

Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care at the University of Florida. He received his Doctorate of Medicine from Albany Medical School, NY in 2011. He completed his pediatric residency at the University of Massachusetts Medical School in 2015 and continued his education at Massachusetts General Hospital for his fellowship in Pediatric Critical Care graduating June 2018. ObjectivesExplain the physiology of the common signs of increased work of breathing.Discuss whether a patient is trying to oxygenate or ventilate when s/he is having increased work of breathing.Discuss the role of pulse oximetry in directing the management of lower respiratory tract disease.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.
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Nov 22, 2021 • 28min

Work of Breathing Physiology with Dr. Bill Bortcosh, Part 1

Dr. Bortcosh is an Assistant Professor in the Division of Pediatric Critical Care at the University of Florida. He received his Doctorate of Medicine from Albany Medical School, NY in 2011. He completed his pediatric residency at the University of Massachusetts Medical School in 2015 and continued his education at Massachusetts General Hospital for his fellowship in Pediatric Critical Care graduating June 2018. ObjectivesExplain the physiology of the common signs of increased work of breathing.Discuss whether a patient is trying to oxygenate or ventilate when s/he is having increased work of breathing.Discuss the role of pulse oximetry in directing the management of lower respiratory tract disease.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.
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Nov 2, 2021 • 21min

Severe Asthma with Dr. Nisha Agasthya, Part 2: Non-Invasive Respiratory Support

Dr. Nisha Agasthya is a Pediatric Intensivist at Wesley Children's Hospital in Wichita Kansas and Clinical Assistant Professor at Kansas University School of Medicine. She is interested in Medical Education and Quality Improvement.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo --100% of all funds will go to supporting the show to keep this project going.Learning objectives:Describe the incidence of severe / near fatal asthma in PediatricsRecognize and stratify patients with impending respiratory failure Develop a medication plan for initial management of non-intubated patients with severe asthma 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.
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Oct 25, 2021 • 26min

Severe Asthma with Dr. Nisha Agasthya, Part 1: Acute Stabilization

Dr. Nisha Agasthya is a Pediatric Intensivist at Wesley Children's Hospital in Wichita Kansas and Clinical Assistant Professor at Kansas University School of Medicine. She is interested in Medical Education and Quality Improvement.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo --100% of all funds will go to supporting the show to keep this project going.Learning objectives:Describe the incidence of severe / near fatal asthma in PediatricsRecognize and stratify patients with impending respiratory failure Develop a medication plan for initial management of non-intubated patients with severe asthma 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.

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