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

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.

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:

1. Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.
2. Recognize common risk factors of post-intensive care syndrome in children.
3. Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.
4. Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.
5. 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

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.

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:

1. Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.
2. Recognize common risk factors of post-intensive care syndrome in children.
3. Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.
4. Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.
5. 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

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.

Alexis Topjian, MD, MSCE is a Professor of Anesthesiology and Critical Care at the University of Pennsylvania. She is an intensivist at the Children’s Hospital of Philadelphia where she also serves as the Fellowship Director of Neurocritical Care, Director of the Pediatric Neurocritical Care Program, and the Director of Faculty Development. She also was the first author on the 2019 Pediatric Post–Cardiac Arrest Care Scientific Statement from the American Heart Association.

Learning Objectives:

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

1. The clinical characteristics of post-cardiac arrest syndrome.
2. The general goals and guiding principles of high quality post-cardiac arrest care.
3. An evidence-based approach to diagnostic testing and monitoring of the post-cardiac arrest patient.
4. An evidence-based approach to supportive treatment of the post-cardiac arrest patient with an emphasis on targeted temperature management.
5. Relevant prognostic factors and best practices communicating prognosis to families of children who have suffered a cardiac arrest.
6. 
   

References:

Topjian AA, de Caen A, Wainwright MS, Abella BS, Abend NS, Atkins DL, Bembea MM, Fink EL, Guerguerian AM, Haskell SE, Kilgannon JH, Lasa JJ, Hazinski MF. Pediatric Post-Cardiac Arrest Care: A Scientific Statement From the American Heart Association. Circulation. 2019 Aug 6;140(6):e194-e233. doi: 10.1161/CIR.0000000000000697. Epub 2019 Jun 27. PMID: 31242751.

Moler et al. Therapeutic hypothermia after out-of-hospital cardiac arrest in children. N Engl J Med. 2015 May 14;372(20):1898-908. doi: 10.1056/NEJMoa1411480. Epub 2015 Apr 25. PMID: 25913022; PMCID: PMC4470472.

Moler et al; THAPCA Trial Investigators. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children. N Engl J Med. 2017 Jan 26;376(4):318-329. doi: 10.1056/NEJMoa1610493. Epub 2017 Jan 24. PMID: 28118559; PMCID: PMC5310766.

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.

Alexis Topjian, MD, MSCE is a Professor of Anesthesiology and Critical Care at the University of Pennsylvania. She is an intensivist at the Children’s Hospital of Philadelphia where she also serves as the Fellowship Director of Neurocritical Care, Director of the Pediatric Neurocritical Care Program, and the Director of Faculty Development. She also was the first author on the 2019 Pediatric Post–Cardiac Arrest Care Scientific Statement from the American Heart Association.

Learning Objectives:

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

1. The clinical characteristics of post-cardiac arrest syndrome.
2. The general goals and guiding principles of high quality post-cardiac arrest care.
3. An evidence-based approach to diagnostic testing and monitoring of the post-cardiac arrest patient.
4. An evidence-based approach to supportive treatment of the post-cardiac arrest patient with an emphasis on targeted temperature management.
5. Relevant prognostic factors and best practices communicating prognosis to families of children who have suffered a cardiac arrest.

References:

Topjian AA, de Caen A, Wainwright MS, Abella BS, Abend NS, Atkins DL, Bembea MM, Fink EL, Guerguerian AM, Haskell SE, Kilgannon JH, Lasa JJ, Hazinski MF. Pediatric Post-Cardiac Arrest Care: A Scientific Statement From the American Heart Association. Circulation. 2019 Aug 6;140(6):e194-e233. doi: 10.1161/CIR.0000000000000697. Epub 2019 Jun 27. PMID: 31242751.

Moler et al. Therapeutic hypothermia after out-of-hospital cardiac arrest in children. N Engl J Med. 2015 May 14;372(20):1898-908. doi: 10.1056/NEJMoa1411480. Epub 2015 Apr 25. PMID: 25913022; PMCID: PMC4470472.

Moler et al; THAPCA Trial Investigators. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children. N Engl J Med. 2017 Jan 26;376(4):318-329. doi: 10.1056/NEJMoa1610493. Epub 2017 Jan 24. PMID: 28118559; PMCID: PMC5310766.

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.

 About our guest:

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

1. Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition. 
2. Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.  
3. Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
4. Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation. 
5. Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation. 
6. Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation, 
7. Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
8. Palen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.
9. LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics. 

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.

Dr. Tarif Choudhury is a pediatric cardiac intensivist at Columbia University College of Physicians and Surgeons. After finishing his residency in pediatrics at Cohen Children’s Medical Center, he completed his cardiology fellowship at Lurie Children’s Hospital in Chicago followed by a pediatric critical care fellowship at Morgan Stanley Children’s Hospital at Columbia University School of Medicine. His areas of interest are the impact of clinical simulation to improve team performance, clinical outcomes of PCICU patients and clinical outcomes of patients on mechanical circulatory support in the PCICU.

Dr. Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program next year. He is interested in pursuing a career in cardiac intensive care.

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

1. Strategize how to approach an arrest as the code leader
2. Recognize the key elements of high-quality CPR and how to optimize perfusion during an arrest 
3. Recall airway management, oxygenation, and ventilation during CPR
4. Recall different approaches to physiological monitoring during an arrest to guide therapy      
5. Recognize appropriate resuscitation drug administration and timing during CPR
6. Recall management with manual defibrillation for arrests with a shockable rhythm
7. Develop approach to determining code duration and when to discontinue CPR

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.

Dr. Tarif Choudhury is a pediatric cardiac intensivist at Columbia University College of Physicians and Surgeons. After finishing his residency in pediatrics at Cohen Children’s Medical Center, he completed his cardiology fellowship at Lurie Children’s Hospital in Chicago followed by a pediatric critical care fellowship at Morgan Stanley Children’s Hospital at Columbia University School of Medicine. His areas of interest are the impact of clinical simulation to improve team performance, clinical outcomes of PCICU patients and clinical outcomes of patients on mechanical circulatory support in the PCICU.

Dr. Gav Apfel is a CICU hospitalist at Columbia University College of Physicians and Surgeons. He completed his residency training at Columbia University College of Physicians and Surgeons and will be joining the Columbia University’s critical care fellowship program next year. He is interested in pursuing a career in cardiac intensive care.

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

1. Strategize how to approach an arrest as the code leader
2. Recognize the key elements of high-quality CPR and how to optimize perfusion during an arrest 
3. Recall airway management, oxygenation, and ventilation during CPR
4. Recall different approaches to physiological monitoring during an arrest to guide therapy      
5. Recognize appropriate resuscitation drug administration and timing during CPR
6. Recall management with manual defibrillation for arrests with a shockable rhythm
7. Develop approach to determining code duration and when to discontinue CPR

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.

James D. Fortenberry MD, MCCM, FAAP is a Professor Pediatrics in the Division of Pediatric Critical Care at Emory University School of Medicine. He is the Chief Medical Officer of Children's Healthcare of Atlanta & the interim Chief of Critical Care Medicine. He is a past Chair of Critical Care sub-board of the American Board of Pediatrics and on SCCM and AAP critical care committees  He is also a past president of Extracorporeal Life Support Organization (ELSO). 

Objective:
By the end of this podcast, listeners should be able to identify key leadership skills across the spectrum of an academic career and apply these to their own professional development.

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.

Dr. Nada Mallick is a pediatric intensivist at Children's National Hospital in Washington, DC. She has a master’s in Biochemistry and Molecular Biology from the Johns Hopkins University School of Public Health, after which she did her medical residency and chief resident year at Virginia Commonwealth University and her critical care fellowship at Children's National Hospital. Nada now serves as the physician chair for both the Pediatric Early Recognition and Resuscitation Committee and the Late Rescue Collaborative at Children’s National.

The Cribsiders:

The Cribsiders is a pediatric medicine podcast composed of a national network of students, residents and clinician educators from across the country and multiple institutions. On the show we “curbside” the experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge and a weight-based dosing of fun.

Learning Objectives:
By the end of this series, listeners should be able to:
1) Describe techniques for diagnosis of historically oppressed groups
2) Describe acute stabilization of impending hypoxemic respiratory failure from a complicated pneumonia.
3) Discuss workup for a patient with undifferentiated shock.
4) Describe options for ICU support for a patient who does not meet ICU criteria.

References

1. Jones DA, DeVita MA, Bellomo R. Rapid-response teams. N Engl J Med. 2011;365(2):139-146. doi:10.1056/NEJMra0910926
2. Levin AB, Brady P, Duncan HP, Davis AB. Pediatric Rapid Response Systems: Identification and Treatment of Deteriorating Children. Curr Treat Options Pediatr. 2015;1(1):76-89. doi:10.1007/S40746-014-0005-1/TABLES/1
3. Gold DL, Mihalov LK, Cohen DM. Evaluating the Pediatric Early Warning Score (PEWS) system for admitted patients in the pediatric emergency department. Acad Emerg Med. 2014;21(11):1249-1256. doi:10.1111/acem.12514
4. Tews MC, Liu JM, Treat R. Situation-Background-Assessment-Recommendation (SBAR) and Emergency Medicine Residents’ Learning of Case Presentation Skills. J Grad Med Educ. 2012;4(3):370-373. doi:10.4300/JGME-D-11-00194.1
5. Gross CJ, Porter JJ, Lipsett SC, Monuteaux MC, Hirsch AW, Neuman MI. Variation in Management and Outcomes of Children With Complicated Pneumonia. Hosp Pediatr. 2021;11(3):207-214. doi:10.1542/hpeds.2020-001800
6. Bjorklund A, Resch J, Slusher T. P

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.