PedsCrit

About our Guest: 

Dr. Philip C. Spinella is a professor in the Departments of Surgery and Critical Care Medicine and the Director of the Trauma and Transfusion Medicine Research Center at the University of Pittsburgh. He also co-founded the THOR network for trauma and hemostasis research, and has as been involved with multiple nationally-funded research programs.

References:

Use of whole blood in pediatric trauma: a narrative review - PubMed (nih.gov)

Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during Operation Iraqi Freedom at a U.S. combat support hospital - PubMed (nih.gov)

Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative - PubMed (nih.gov)

Whole Blood Transfusion - PubMed (nih.gov)

Pediatric traumatic hemorrhagic shock consensus conference recommendations - PubMed (nih.gov)

Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial - PubMed (nih.gov)

Precision Platelet Transfusion Medicine is Needed to Improve Outcomes - PubMed (nih.gov)

Just chill—it's worth it! (wiley.com)

Citation: Spinella P, Hodges Z, Shanklin A. From the Battlefield to the Bedside: The Past, Present, and Future of Blood Product Resuscitation. PedsCrit. Online Podcast. 02/2025. https://www.pedscrit.com/from-the-battlefield-to-the-bedside-the-past-present-and-future-of-blood-product-resuscitation-wi/ 

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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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Article: 

Olson EM, Sanborn DM, Dyster TG, Kelm DJ, Murray SG, Santhosh L, DesJardin JT. Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents. ATS Sch. 2023 Feb 13;4(2):164-176. doi: 10.34197/ats-scholar.2022-0025OC. PMID: 37538076; PMCID: PMC10394715.

About our Guests: 

Dr. Emily Olson is a pulmonary and critical care medicine fellow at Northwestern Feinberg School of Medicine. She attended medical school at the University of Wisconsin School of Medicine and completed her internal medicine residency at Mayo Clinic in Rochester, Minnesota. In addition to her work on gender disparities in procedural training, Dr. Olson is interested in clinical feedback and transitions in medical education. 

Dr. Lekshmi Santhosh is an Associate Professor of Medicine in the Division of Pulmonary/Critical Care Medicine and the Division of Hospital Medicine at UCSF. She practices in the MICU, neuro ICU, on the Internal Medicine teaching wards, and at the Pulmonary Outpatient Faculty Practice at UCSF. Dr. Santhosh serves as the Curriculum APD for the Internal Medicine Residency and is an Associate Program Director of the Pulmonary and Critical Care Medicine Fellowship. 

Learning Objectives:

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

1. Define ‘mixed methods’ in a research context.
2. Explain why a researcher might choose focus groups instead of individual interviews for qualitative assessment.  
3. Discuss factors contributing to implicit bias in procedural opportunities for trainees.
4. Explain how implicit bias in educational opportunities might lead to a ‘leaky pipeline’ for competitive subspecialties.
5.  Identify ways to truncate their implicit bias when offering procedures to trainees.

References:

1. Olson EM, Sanborn DM, Dyster TG, Kelm DJ, Murray SG, Santhosh L, DesJardin JT. Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents. ATS Sch. 2023 Feb 13;4(2):164-176. doi: 10.34197/ats-scholar.2022-0025OC. PMID: 37538076; PMCID: PMC10394715.
2. Olson EM, Kennedy CC, Kelm DJ. Assessment of Gender Parity: Leadership Representation in Pulmonary and Critical Care Medicine. J Womens Health (Larchmt). 2022 Mar;31(3):439-446. doi: 10.1089/jwh.2020.8982. Epub 2021 May 5. PMID: 33956512; PMCID: PMC9022127.

Citation: Santhosh L, Olson E, Hodges Z, Shanklin A. Gender Disparities in [Internal Medicine] Procedure Allocation. PedsCrit. Online Podcast. 02/2025. https://www.pedscrit.com/gender-disparities-in-internal-medicine-procedure-allocation-with-drs-emily-olson-and-lekshmi-san/

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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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. Dr. Kudchadkar is also the lead PI for the "PICU Up!" study, a 10-site randomized trial of a multifaceted early mobility program for critically ill children.

In this episode, Dr. Kuchadkar shares her path from her general pediatrics residency at Hopkins to running a large multi-center trial as a dual-trained pediatric intensivist and anesthesiologist. 

Citation: Kudchadkar S, Hodges Z, Shanklin A. Building a Research Career. PedsCrit. Online Podcast. 01/2025. https://www.pedscrit.com/building-a-research-career-with-dr-sapna-kudchadkar-part-2/ 

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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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. She completed her training in pediatrics, pediatric intensive care, anesthesiology, and pediatric anesthesiology at Johns Hopkins Children’s Center and the Johns Hopkins Hospital, during which she also received her Ph.D. in clinical investigation at the Johns Hopkins Bloomberg School of Public Health. Dr. Kudchadkar is now the lead PI for the "PICU Up!" study, a 10-site randomized trial of a multifaceted early mobility program for critically ill children.

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

1. Discuss the best ways to prevent delirium in young children, including sedative medication selection and non-pharmacologic techniques.
2. Describe the optimal level of sedation for a child who requires invasive mechanical ventilation for acute respiratory failure and the staffing needed to achieve this safely.
3. Discuss how to obtain hospital resources to support early mobilization and motivate a team to accomplish these goals.

Selected References:

1. Traube, C., Silver, G., Gerber, L. M., Kaur, S., Mauer, E. A., Kerson, A., Joyce, C., & Greenwald, B. M. (2017). Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium*. Critical Care Medicine, 45(5), 891–898. https://doi.org/10.1097/CCM.0000000000002324

2. Traube, C., Silver, G., Kearney, J., Patel, A., Atkinson, T. M., Yoon, M. J., Halpert, S., Augenstein, J., Sickles, L. E., Li, C., & Greenwald, B. (2014). Cornell Assessment of Pediatric Delirium. Critical Care Medicine, 42(3), 656–663. https://doi.org/10.1097/CCM.0b013e3182a66b76

3. Wieczorek B, Ascenzi J, Kim Y, Lenker H, Potter C, Shata NJ, Mitchell L, Haut C, Berkowitz I, Pidcock F, Hoch J, Malamed C, Kravitz T, Kudchadkar SR. PICU Up!: Impact of a Quality Improvement Intervention to Promote Early Mobilization in Critically Ill Children. Pediatr Crit Care Med. 2016 Dec;17(12):e559-e566. doi: 10.1097/PCC.0000000000000983. PMID: 27759596; PMCID: PMC5138131.

Citation: Kudchadkar S, Hodges Z, Shanklin A. An Expert Approach to Sedation and Early Mobility. PedsCrit. Online Podcast. 01/2025. https://www.pedscrit.com/an-expert-approach-to-sedation-and-early-mobility-with-dr-sapna-kudchadkar-part-1/ 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Kristina Betters, MD is an Associate Professor of Pediatrics in the division of Critical Care Medicine at Vanderbilt University and a pediatric intensivist at Monroe Carell Jr. Children’s Hospital. Dr. Betters' research interests are focused on early mobility, rehabilitation of the ICU patient, sedation, and delirium in critically ill children. She was an author of the 2022 SCCM PANDEM guidelines.

Brooke Light, MD is a pediatric resident physician at Prisma Health in Greenville, SC. Prior to residency, she completed her MD at the Medical University of South Carolina. She is (obviously) an aspiring pediatric intensivist, and we are so happy she reached out to coordinate this episode.

Learning Objectives:

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

1. The rationale supporting the use of an ICU liberation bundle.
2. Key components of the A to F ICU liberation bundle.
3. An expert’s approach to implementing the A to F ICU liberation bundle

References:

1. Smith et al. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatr Crit Care Med. 2022 Feb 1;23(2):e74-e110. 
2. Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017 Apr;33(2):225-243. 
3. Curley et al; RESTORE Study Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators Network. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. JAMA. 2015 Jan 27;313(4):379-89. 
4. Madden K, Wolf M, Tasker RC, Figueroa J, McCracken C, Hall M, Kamat P. Antipsychotic Drug Prescription in Pediatric Intensive Care Units: A 10-Year U.S. Retrospective Database Study. J Pediatr Intensive Care. 2021 Oct 22;13(1):46-54. 

Citation: Betters K, Light B, Shanklin A, Hodges Z. ICU Liberation. PedsCrit. Online Podcast. 12/2024. https://www.pedscrit.com/icu-liberation-with-dr-kristina-betters-dr-brooke-light-part-1/ 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Kristina Betters, MD is an Associate Professor of Pediatrics in the division of Critical Care Medicine at Vanderbilt University and a pediatric intensivist at Monroe Carell Jr. Children’s Hospital. Dr. Betters' research interests are focused on early mobility, rehabilitation of the ICU patient, sedation, and delirium in critically ill children. She was an author of the 2022 SCCM PANDEM guidelines.

Brooke Light, MD is a pediatric resident physician at Prisma Health in Greenville, SC. Prior to residency, she completed her MD at the Medical University of South Carolina. She is (obviously) an aspiring pediatric intensivist, and we are so happy she reached out to coordinate this episode.

Learning Objectives:

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

1. The rationale supporting the use of an ICU liberation bundle.
2. Key components of the A to F ICU liberation bundle.
3. An expert’s approach to implementing the A to F ICU liberation bundle

References:

1. Smith et al. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatr Crit Care Med. 2022 Feb 1;23(2):e74-e110. 
2. Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017 Apr;33(2):225-243. 
3. Curley et al; RESTORE Study Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators Network. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. JAMA. 2015 Jan 27;313(4):379-89. 
4. Madden K, Wolf M, Tasker RC, Figueroa J, McCracken C, Hall M, Kamat P. Antipsychotic Drug Prescription in Pediatric Intensive Care Units: A 10-Year U.S. Retrospective Database Study. J Pediatr Intensive Care. 2021 Oct 22;13(1):46-54. 

Citation: Betters K, Light B, Shanklin A, Hodges Z. ICU Liberation. PedsCrit. Online Podcast. 12/2024. https://www.pedscrit.com/icu-liberation-with-dr-kristina-betters-dr-brooke-light-part-1/ 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Matthew A. Borgman, M.D. is a Professor of Pediatrics in the Division of Pediatric Critical Care at the University of Texas Southwestern.  Dr. Borgman graduated from Uniformed Services University (USU), he completed Pediatric Residency at Brooke Army Medical Center in 2007, followed by a fellowship in Critical Care at Boston Children’s Hospital.  He is a prolific author in pediatric trauma management which has helped redefine the care of injured children. He is also the former national chair of the Pediatric Trauma Society Research Committee and has co-authored the 2022 Pediatric Traumatic Hemorrhagic Shock Consensus Conference Recommendations. 

Learning Objectives:

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

1. Define pediatric hemorrhagic shock and massive transfusion.
2. Develop a guideline-based clinical approach to managing a child with hemorrhagic shock.
3. Explore an expert’s approach to managing a child with hemorrhagic shock where the evidence might not be clear. 

References:

1. Russell et al. Pediatric traumatic hemorrhagic shock consensus conference recommendations. J Trauma Acute Care Surg. 2023 Jan 1;94(1S Suppl 1):S2-S10. 
2. Spinella et al. Transfusion Ratios and Deficits in Injured Children With Life-Threatening Bleeding. Pediatr Crit Care Med. 2022 Apr 1;23(4):235-244. 
3. Gaines et al. Low Titer Group O Whole Blood In Injured Children Requiring Massive Transfusion. Ann Surg. 2023 Apr 1;277(4):e919-e924. 
4. Roberts et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013 Mar;17(10):1-79. 
5. Dewan et al. CRASH-3 - tranexamic acid for the treatment of significant traumatic brain injury: study protocol for an international randomized, double-blind, placebo-controlled trial. Trials. 2012 Jun 21;13:87.
6. Spinella et al. Survey of transfusion policies at US and Canadian children's hospitals in 2008 and 2009. Transfusion. 2010 Nov;50(11):2328-35.
7. MATIC-2: https://classic.clinicaltrials.gov/ct2/show/NCT06070350 

Citation: Borgman M, Shanklin A, Hodges Z. Hemorrhagic Shock. PedsCrit. Online Podcast. 11/2024. https://www.pedscrit.com/hemorrhagic-shock-with-dr-matthew-borgman/ 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Dr. Bill Bortcosh received his Doctorate of Medicine from Albany Medical School, NY. He completed his pediatric residency at the University of Massachusetts Medical School followed by pediatric critical care fellowship at Massachusetts General Hospital.
Learning Objectives:

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

1. Why critical evaluation of a patient’s acid-base status can be useful and practical in the acute care setting
2. The basic pathophysiology of each acid-base disturbance
3. The definition of an anion gap and how to use it as a screening tool
4. The use of Winter’s formula to identify a respiratory acidosis or alkalosis
5. The utility of the delta-delta to identify additional metabolic acidosis or alkalosis

Link to Acid/Base Handout

References

1. Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.

2. Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.

3. Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.

4. Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.

5. https://emcrit.org/ibcc/salicylates/

Citation: Bortcosh W, Shanklin A, Hodges Z. Acid-Base Diagnosis & Clinical Approach. PedsCrit Online Podcast. 10/2024. https://www.pedscrit.com/acid-base-diagnosis-clinical-approach-with-dr-bill-bortcosh-part-1/ 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

Dr. Bill Bortcosh received his Doctorate of Medicine from Albany Medical School, NY. He completed his pediatric residency at the University of Massachusetts Medical School followed by pediatric critical care fellowship at Massachusetts General Hospital.
Learning Objectives:

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

1. Why critical evaluation of a patient’s acid-base status can be useful and practical in the acute care setting
2. The basic pathophysiology of each acid-base disturbance
3. The definition of an anion gap and how to use it as a screening tool
4. The use of Winter’s formula to identify a respiratory acidosis or alkalosis
5. The utility of the delta-delta to identify additional metabolic acidosis or alkalosis

Link to Acid/Base Handout

References

1. Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.

2. Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.

3. Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.

4. Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.

5. https://emcrit.org/ibcc/salicylates/

Citation: Bortcosh W, Shanklin A, Hodges Z. Acid-Base Diagnosis & Clinical Approach. PedsCrit Online Podcast. 10/2024. https://www.pedscrit.com/acid-base-diagnosis-clinical-approach-with-dr-bill-bortcosh-part-1/ 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

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. 

Send us Fan Mail

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.

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].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!