Pediatrica intensiva: Art & Science of Pediatric Critical Care

Culture and Practice Change are a vital element to implement ICU based rehabilitation in the pediatric ICU - because even when we know what to do it can be really hard to get our large and diverse teams on board and manage resource limitations, change fatigue and differing views.

Here, experts from around the world discuss how they implemented change in their units - using everything from quality science to gossip and merchandise!

Invited guests are Dr Brianna McKelvie from @CHEO, an intensivist with a masters degree in quality science, Dr Matteo DiNardo from Bambino Gesu, who has implemented QI projects in Italy and in low resource settings and Dr Mirjana Cvetkovic @mirjanaxxx @GreatOrmondStreet a cardiac intensivist and anesthetist who has driven change at GOS. Featuring regular hosts @drpetaalexander @BostonChildrens @karen_choong @MCH-childrens @drgregkelly @SCHNkids

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter @pedsintensiva and our website here

https://pedsintensiva.com/culture-practice-change-in-picu-based-rehabilitation/

Long term & technology dependent aka "chronic critically ill" #pedsICU patients with Dr Rob Graham @BostonChildrens @karen_choong @drgregkelly @drpetaalexander

Our #ICUrehab season focussed on preventing PICU morbidities & improving recovery. Our successes in #pedsICU mean that most kids survive & we increasingly see survivors with chronic complex conditions, either in ICU or frequently readmitted. They are still a relatively small population but use a huge proportion of our bed days and are a population with unique risks & needs. Dr Rob Graham established the home ventilation program at Boston Children's and has deep expertise on these patients.

#ICUrehab #ICUSurvivorship

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter @pedsintensiva and our website here

https://pedsintensiva.com/long-term-technology-dependent-aka-chronic-critically-ill-pedsicu-patients-feat-dr-rob-graham/

There is a growing awareness of the broad range of problems that patients and their families can face after a stay in the #pedsICU which is now known as Post Intensive Care Syndrome - pediatrics

Nurse researcher and clinician Joseph Manning developed the PICS-p framework and has deep experience in following up these patients and families after they leave the ICU

Pediatrica Intensiva season 3 is guest edited by Professor Karen Choong from McMaster University in Hamilton, Canada and co hosted by Drs Greg Kelly (Sydney Children's Hospital Network), Peta Alexander (Boston Children's Hospital) and Mike Clifford (Royal Children's Hospital Melbourne)

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here

https://pedsintensiva.com/post-intensive-care-syndrome-in-pedsicu-pics-p-with-nurse-researcher-joseph-manning-mbe-rn/

Analgesia and/or Sedation is provided to almost all the patients in the #pedsICU but it is something that often lacks precision.

In this episode we speak to intensivist Prof Jayashree Muralidharan, #pedsICU nurse Sharon Prior and pharmacist Jonathon Wong

Pediatrica Intensiva season 3 is guest edited by Professor Karen Choong from McMaster University in Hamilton, Canada and co hosted by Drs Greg Kelly (Sydney Children's Hospital Network), Peta Alexander (Boston Children's Hospital) and Mike Clifford (Royal Children's Hospital Melbourne)

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/analgesia-sedation-in-pedsicu-feat-jayashree-muralidharan/

Delirium is a hugely important topic in the #pedsICU with up to 90% of some patient populations being affected and impacts on disease severity, length of stay and quality of life, even months after discharge. It is related to underlying disease, but also to the drugs and abnormal environment that we expose our patients to.

Chani Traube and Deb Long are two of the foremost experts on pediatric delirium and offer countless pearls in this practice-changing conversation.

Pediatrica Intensiva season 3 is guest edited by Professor Karen Choong from McMaster University in Hamilton, Canada and co hosted by Drs Greg Kelly (Sydney Children's Hospital Network), Peta Alexander (Boston Children's Hospital) and Mike Clifford (Royal Children's Hospital Melbourne)

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/delirium-in-pedsicu-feat-chani-traube-deb-long/

Early Mobilization in the #pedsICU with groundbreaker Sapna Kudchadkar from Johns Hopkins

Early Mobilization is enormously important because while survival continues to increase, so do the numbers of children who leave PICU with a new functional limitation. Survival is not enough anymore - it's all about the quality of survival

Pediatrica Intensiva season 3 is guest edited by Professor Karen Choong from McMaster University in Hamilton, Canada and co hosted by Drs Greg Kelly (Sydney Children's Hospital Network), Peta Alexander (Boston Children's Hospital) and Mike Clifford (Royal Children's Hospital Melbourne)

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/early-mobilization-in-the-pedsicu-feat-sapna-kudchadkar/

Survival in PICU continues to increase around the world. The hidden cost of this is ever increasing numbers of children with severe, sometimes lifelong, problems from their critical illness and intensive care stay.

Joining us as a guest editor for this season is one of the world experts on this topic - Professor Karen Choong from McMaster University in Hamilton, Canada.

The episodes for this season cover the breadth of rehabilitation in the peds ICU.

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/picu-based-rehabilitation-season-trailer/

6th regular episode of Pediatrica Intensiva with Aparna Hoskote, consultant in cardiac ICU at Great Ormond St Hospital London.

The time around the stage 1 procedure is the time of the highest mortality for single ventricle patients, up to 15%. What we do in the #pedsICU really matters for these patients but there is very little high quality evidence to inform our practice. Consequently, practice varies greatly around the world with things to learn from many great centers.

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/110-2/

5th regular episode of Pediatrica Intensiva with Peta Alexander from Boston Children's, Mike Clifford from Royal Children's Melbourne & Greg Kelly from Westmead Children's Sydney.

The interstage is a time of incredibly high mortality despite the fact it only lasts a few months. These patients can get sick for a variety of reasons between the mundane and the catastrophic - management is tricky and varies between centers.

Hosts: Dr Greg Kelly (Westmead Children's Hospital, Sydney, Australia), Peta Alexander (Boston Children's Hospital), Mike Clifford (Royal Children's Hospital, Melbourne). Produced & edited by Caitlin Gibson, special thanks to Maya Newell.

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/the-sick-interstage-single-ventricle-patient/

4th regular episode of Pediatrica Intensiva with Liz Crowe - Senior PICU Social Worker

Having a child with single ventricle disease is an extraordinarily stressful time for the child, the family, and the staff who are involved. Liz Crowe is a world expert on these matters with over 20 years experience clinical work and a recently completed PhD on grief, resilience and wellbeing.

Hosts: Dr Greg Kelly (Westmead Children's Hospital, Sydney, Australia), Peta Alexander (Boston Children's Hospital), Mike Clifford (Royal Children's Hospital, Melbourne). Produced & edited by Caitlin Gibson, special thanks to Maya Newell.

No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter https://twitter.com/PedsIntensiva and our website here https://pedsintensiva.com/supporting-the-child-family-in-single-ventricle-disease-feat-liz-crowe/