PedsCrit

Welcome to PedsCrit! We are a collaborative educational PICU podcast working with pediatric critical care educators around the world to create high-yield podcast episodes on core PICU topics. Find us at PedsCrit.com, or reach us via email at [email protected]. We hope you enjoy!No conflicts of interest.Each clinical episode is made in coordination with a pediatric intensivist or guest that is otherwise a clinical or scholarly leader on the topic being discussed. Podcasts do not receive formal peer review prior to publication but quality and accuracy is closely monitored throughout the creation process. If you have any comments, suggestions, or feedback-you can email us at [email protected]. You can also find us on twitter visit @critpeds and @pedscrit on instagram.Please 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.Thank you for listening to PedsCrit!-Alice Shanklin & Zac Hodges

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Top 10 PedsCrit Episodes

Goodpods has curated a list of the 10 best PedsCrit episodes, ranked by the number of listens and likes each episode have garnered from our listeners. If you are listening to PedsCrit for the first time, there's no better place to start than with one of these standout episodes. If you are a fan of the show, vote for your favorite PedsCrit episode by adding your comments to the episode page.

Natural Airway Sedation with Pradip Kamat, Part 1

PedsCrit

08/12/21 • 25 min

Dr. Pradip Kamat is an Associate Professor of Pediatrics at Emory School of Medicine and practicing pediatric intensivist at Children's Healthcare of Atlanta. His clinical and research interests are in procedural sedation and education. We are very excited to have him on our podcast.
Dr. Kamat is also active in PICU open access education. Please check out the PICU Doc On Call podcast co-hosted by Rahul Damania and him at https://picudoconcall.org
During our conversation we discuss:
1. Why this topic is so important for PICU physicians
2. Procedural sedation vs. general anesthesia
3. Conscious sedation???
4. Safety considerations, risk factors and adverse events
5. Patient selection
6. Drug selection
7. Appropriate monitoring
8. Rescue medications.

References and further reading:
Coté CJ, Wilson S; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatrics. 2016 Jul;138(1):e20161212. doi: 10.1542/peds.2016-1212. PMID: 27354454.
Emrath ET, Stockwell JA, McCracken CE, Simon HK, Kamat PP. Provision of deep procedural sedation by a pediatric sedation team at a freestanding imaging center. Pediatr Radiol. 2014 Aug;44(8):1020-5. doi: 10.1007/s00247-014-2942-z. Epub 2014 May 24. PMID: 24859263.
Grunwell JR, McCracken C, Fortenberry J, Stockwell J, Kamat P. Risk factors leading to failed procedural sedation in children outside the operating room. Pediatr Emerg Care. 2014 Jun;30(6):381-7. doi: 10.1097/PEC.0000000000000143. PMID: 24849275.
Hooper MC, Kamat PP, Couloures KG. Evaluating the Need for Pediatric Procedural Sedation Training in Pediatric Critical Care Medicine Fellowship. Pediatr Crit Care Med. 2019 Mar;20(3):259-261. doi: 10.1097/PCC.0000000000001809. PMID: 30431555.
Kamat PP, McCracken CE, Simon HK, Stormorken A, Mallory M, Chumpitazi CE, Cravero JP. Trends in Outpatient Procedural Sedation: 2007-2018. Pediatrics. 2020 May;145(5):e20193559. doi: 10.1542/peds.2019-3559. PMID: 32332053.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:
Please complete our Listener Feedback Survey
Please 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 [email protected]. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Mechanical Ventilation in Status Asthmaticus Part 1 with Dr. Mekela Whyte-Nesfield

PedsCrit

02/06/23 • 31 min

Dr. Whyte-Nesfield is a Critical Care attending at Children’s National Hospital in Washington, DC. She completed her medical degree in her home country of Grenada at St. George’s University, and her fellowship in Pediatric Critical Care at Penn State Health Children’s Hospital, PA. Mekela’s research interest is the role of parent and child traumatic stress management in improving long term outcomes of children in the PICU; she ran a multi-center prevalence study during her fellowship. She is also interested in advanced ventilator modes and educating the next generation of intensivists about pulmonary physiology.
Objectives:
After listening to this episode, listeners should be able to:

Define indications for intubation in a patient with asthma.
Review adjunct therapies, including high-dose steroids, mag, epi, terbutaline, isoproterenol, aminophylline, isoflurane, and manual decompression of the chest.
Identify the physiologic and logistic rationale supporting each mode of mechanical ventilation in asthma (PRVC vs PCPS).
Identify the benefits and risks of paralyzing an intubated asthmatic.
Discuss the relationshiop between static compliance, dynamic compliance, and reversible bronchoconstriction.
Describe the complications of mechanical ventilation in asthma, including indications for ECMO.

References:

Manual external chest compression reverses respiratory failure in children with severe air trapping. Pediatric Pulmonology, 56(12), 3887–3890. https://doi.org/10.1002/ppul.25689
Mechanical ventilation of the intubated asthmatic: How much do we really know? *. Pediatric Critical Care Medicine, 5(2), 191–192. https://doi.org/10.1097/01.CCM.0000113929.14813.51
Volatile Anesthetic Rescue Therapy in Children With Acute Asthma. Pediatric Critical Care Medicine, 14(4), 343–350. https://doi.org/10.1097/PCC.0b013e3182772e29
Pressure-controlled ventilation in children with severe status asthmaticus*. Pediatric Critical Care Medicine, 5(2), 133–138. https://doi.org/10.1097/01.PCC.0000112374.68746.E8
Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*. Pediatric

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Atrioventricular Septal Defects with Dr. Melinda Cory

PedsCrit

12/19/22 • 32 min

Melinda Cory, M.D., is an Assistant Professor in the Department of Pediatrics at UT Southwestern Medical Center. She earned her medical degree at UT Southwestern, where she also completed her residency in pediatrics. She gained advanced training through fellowships in pediatric cardiology and pediatric critical care medicine at Emory University School of Medicine.

Board certified in pediatrics, pediatric cardiology, and pediatric critical care, she attends in the cardiovascular intensive care unit at Children's Medical Center in Dallas, TX. She is also very active in medical education including serving as the associate program director for the pediatric cardiology fellowship program and helps lead the pediatric critical care simulation team.

Learning objectives:
After listening to this episode on atrioventricular septal defects, learners should be able to:

Recognize the relevant preoperative anatomy that influences operative plan and postoperative care in the cardiac intensive care unit (CICU).
Recall the goals and general options for operative repair.
Recognize the key information provided in surgical and anesthesia handover that will affect postoperative management.
Recognize the common and important postoperative complications and develop an approach to their management.
Develop a mental framework of the expected postoperative CICU course with a focus on common or important barriers to ICU discharge.

References:
Atrioventricular Septal Defects. Peter Sassalos MD, Ming-Sing Si MD, Richard G. Ohye MD, Edward L. Bove MD and Jennifer C. Romano MD, MS. Critical Heart Disease in Infants and Children, 50, 606-614.e2
Peterson JK, Setty SP, Knight JH, Thomas AS, Moller JH, Kochilas LK. Postoperative and long-term outcomes in children with Trisomy 21 and single ventricle palliation. Congenit Heart Dis. 2019 Sep;14(5):854-863. doi: 10.1111/chd.12823. Epub 2019 Jul 22. PMID: 31332952; PMCID: PMC7329297.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Point of Care Ultrasound with Dr. Thomas Conlon and Dr. Sarah Ginsburg--Part 1

PedsCrit

04/08/24 • 43 min

Thomas Conlon, MD is a pediatric intensivist at the Children's Hospital of Philadelphia, where he also serves as the Director of Pediatric Critical Care Ultrasound. His professional/research interests include clinical and educational outcomes in diagnostic and procedural ultrasound as well as programmatic ultrasound implementation.

Sarah Ginsburg, MD is an Assistant Professor of Pediatrics at the University of Texas Southwestern and pediatric intensivist at Children’s Medical Center Dallas. Her professional & research interests include clinical applications of POCUS in the PICU. She is very active both locally and nationally in improving POCUS skills for pediatric intensivists, including participating in Pediatric Research Collaborative on Critical Ultrasound, a subgroup of PALISI.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Identify the limitations of the physical exam and lab-based data in evaluating shock at the bedside of critically ill children.
Describe how point-of-care ultrasound might provide greater accuracy in our evaluation of complex shock physiology.
Discuss limitations to our ability as critical care physicians to use point-of-care ultrasound in our clinical practice and suggest solutions to overcome commonly encountered barriers.

References:

Lu et al. Recommendations for Cardiac Point-of-Care Ultrasound in Children: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2023 Mar;36(3):265-277. doi: 10.1016/j.echo.2022.11.010. Epub 2023 Jan 23. PMID: 36697294.
Walker et al. Clinical Signs to Categorize Shock and Target Vasoactive Medications in Warm Versus Cold Pediatric Septic Shock. Pediatr Crit Care Med. 2020 Dec;21(12):1051-1058.
Conlon et al. Diagnostic Bedside Ultrasound Program Development in Pediatric Critical Care Medicine: Results of a National Survey. Pediatr Crit Care Med. 2018 Nov;19(11):e561-e568.
Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine. Ann Emerg Med. 2023 Sep;82(3):e115-e155.
Conlon et al. Establishing a risk assessment framework for point-of-care ultrasound. Eur J Pediatr. 2022 Apr;181(4):1449-1457.
https://coreultrasound.com/
https://coreultrasound.com/5ms/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Post-Intensive Care Syndrome in Children (PICS-P) with Dr. Elizabeth Killien--Part 1

PedsCrit

01/22/24 • 35 min

Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children’s. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.
Learning Objectives:

By the end of this podcast, listeners should be able to:

Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.
Recognize common risk factors of post-intensive care syndrome in children.
Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.
Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.
Recall key next steps in post-intensive care syndrome research.

References:
Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476

https://www.palisi.org/

Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.

Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. d

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Intubation Essentials with Dr. Alyssa Stoner and Dr. Gina Patel, Part 6 Neuromuscular Blockade

PedsCrit

08/05/21 • 16 min

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.
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.
Objectives

The participant will compare and contrast various medications for an induction plan for intubation, highlighting the pros and cons for each medication.
The participant will appropriate describe a medication plan for induction based upon the clinical scenario provided
The participant will accurately describe the procedure for rapid sequence intubation including the administration of the medication.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Disorders of Metabolism with Dr. Deb Regier (Part 2)

PedsCrit

10/21/24 • 27 min

About our Guest:

Debra Regier, M.D., Ph.D., is the chief of Genetics and Metabolism at Children's National Hospital in Washington, DC. Before transitioning to clinical medicine, Dr. Regier was a biochemist. She came to CNH as a combined pediatric genetics resident and later completed a metabolic fellowship at NIH and served as Children's National's medical genetics program director.

Dr. Regier’s current work in educational outcomes research has led to federal, industry, and philanthropic funding of almost two million dollars. She has received multiple awards for her impact on rare disease education across the country and is the president-elect of the Society of Inherited Metabolic Disorders.

Learning Objectives:

By the end of this podcast, listeners should be able to:

1. List the three main metabolic pathways and describe how they work together to make ATP

2. Describe the science behind the main diagnostic tests for inborn errors of metabolism

3. Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Navigating the End of Life and Taking Next Steps with Dr. Ethan Sanford

PedsCrit

02/12/24 • 47 min

Ethan Sanford, MD is an Assistant Professor of Anesthesia and Pediatrics at the University of Texas Southwestern in Dallas. He completed his MD at Harvard University followed by Anesthesiology residency at Brigham and Women’s Hospital and pediatric anesthesia fellowship at Boston Children’s Hospital. He then completed a pediatric critical care fellowship at UTSW. He is board certified in both pediatric anesthesia and pediatric critical care medicine. He works both as a pediatric anesthesiologist and intensivist at UTSW/CMC Dallas.

Learning Objective:
By the end of this podcast, listeners should have an improved understanding of the grief experienced by parents at the end of their child's life and be better equipped to care for them in the pediatric intensive care unit.

Reference:
Sanford EL. Losing Ceci. JAMA. 2023 May 2;329(17):1451-1452. doi: 10.1001/jama.2023.4747. PMID: 37022705.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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High Frequency Jet Ventilation with Dr. Alexander Rotta Part 1

PedsCrit

07/08/24 • 55 min

Alexander Rotta, MD is a Professor of Pediatrics and the Division Chief of Pediatric Critical Care at Duke University School of Medicine. He is an accomplished intensivist, educator and physician scientist with well over 100 publications with a focus on respiratory care in critically ill children. He authored a review on high-frequency jet ventilation that served as the foundation for today’s episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting the use of high frequency jet ventilation (HFJV).
Patient populations most likely to benefit from HFJV.
Key published evidence that informs our use of HFJV in pediatric critical care.
An expert approach to managing a patient with HFJV.

References:

Cheifetz IM, Rotta AT. High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure. Respir Care. 2021 Feb;66(2):191-198. doi: 10.4187/respcare.08241. Epub 2020 Oct 2. PMID: 33008841.

Miller AG, Scott BL, Gates RM, Haynes KE, Lopez Domowicz DA, Rotta AT. High-Frequency Jet Ventilation in Infants With Congenital Heart Disease. Respir Care. 2021 Nov;66(11):1684-1690. doi: 10.4187/respcare.09186. Epub 2021 Jun 9. PMID: 34108137.

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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United States PICU Physician Workforce with Dr. Chris Horvat

PedsCrit

07/29/24 • 33 min

Dr. Chris Horvat is a pediatric intensivist and informaticist at UPMC Children's Hospital of Pittsburgh. He started his academic career at UNC-Chapel Hill where he got his undergraduate and medical degrees, after which he completed a pediatric residency at Seattle Children's Hospital and a pediatric critical care fellowship at UPMC. Dr. Horvat also completed Pittsburgh’s T-32 Postdoctoral Research Fellowship in Pediatric Neurointensive Care through the Safar Center for Resuscitation Research, during which he earned a master’s in health administration (MHA) from the University of Pittsburgh. In his current work, he aims to utilize a combination of electronic health record-derived datasets, pharmaco-kinetic models, and pharmacogenomic insights to develop advanced clinical decision-support tools to help refine the use of potent sedatives and analgesic medications in the pediatric intensive care unit. He also serves as a clinical informatics leader, helping to deploy randomized, embedded, multifactorial, adaptive platform (REMAP) trials across the UPMC system.
Learning Objectives

By the end of this podcast, listeners should be able to:

List the concerns surrounding the pediatric subspecialty workforce and the unique position of PCCM.
Describe the modeling performed for each pediatric subspecialty.
Describe the future of the PCCM workforce, including the job opportunities that current PCCM fellows can expect and the utility of dual boarding in cardiology.

References

1. Leslie LK, Orr CJ, Turner AL, et al. Child Health and the US Pediatric Subspecialty Workforce: Planning for the Future. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678B

2. Horvat CM, Hamilton MF, Hall MW, McGuire JK, Mink RB. Child Health Needs and the Pediatric Critical Care Medicine Workforce: 2020–2040. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678G

3. Fraher E, Knapton A, McCartha E, Leslie LK. Forecasting the Future Supply of Pediatric Subspecialists in the United States: 2020–2040. Pediatrics. 2024;153(Supplement 2). doi:10.1542/peds.2023-063678C

4. Horak R V., Marino BS, Werho DK, et al. Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States. Cardiol Young. 2022;32(11):1748-1753. doi:10.1017/S1047951121004893

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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FAQ

How many episodes does PedsCrit have?

PedsCrit currently has 114 episodes available.

What topics does PedsCrit cover?

The podcast is about Life Sciences, Icu, Pediatrics, Critical Care, Podcast, Podcasts, Education, Science and Emergency Medicine.

What is the most popular episode on PedsCrit?

The episode title 'VV ECMO Part 3: Troubleshooting the circuit & preparing for early rehab' is the most popular.

What is the average episode length on PedsCrit?

The average episode length on PedsCrit is 33 minutes.

How often are episodes of PedsCrit released?

Episodes of PedsCrit are typically released every 9 days, 2 hours.

When was the first episode of PedsCrit?

The first episode of PedsCrit was released on Jun 30, 2021.

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PedsCrit

PedsCrit

Top 10 PedsCrit Episodes

FAQ

How many episodes does PedsCrit have?

What topics does PedsCrit cover?

What is the most popular episode on PedsCrit?

What is the average episode length on PedsCrit?

How often are episodes of PedsCrit released?

When was the first episode of PedsCrit?

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