PedsCrit

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

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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. 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

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!

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.

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. 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. Pediatric Shock Review. Pediatr Rev. 2023;44(10):551-562. doi:10.1542/PIR.2022-005630

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. 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. Pediatric Shock Review. Pediatr Rev. 2023;44(10):551-562. doi:10.1542/PIR.2022-005630

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!

Priya Bhaskar, M.D. is an Associate Professor of Pediatrics at UT Southwestern and an attending in the Cardiac ICU at Children’s Medical Center Dallas. She completed her pediatric residency at Inova Children’s Hospital in Virginia and critical care fellowship at UTSW prior to completing a 1 year CICU fellowship at Laurie Children’s in Chicago. Prior to her current position here at UTSW she was a cardiac intensivist at Arkansas Children’s Hospital. Her professional interests include extracorporeal support and education. She serves on the ECMO team as a core staff physician, and she has co-authored a review on this topic that we will use to guide our conversation. 

Learning Objectives:

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

1. The general indications for VA-ECMO in pediatrics.
2. The anatomic and physiologic rationale supporting various VA-ECMO cannulation strategies.
3. Physiologic targets to ensure adequate oxygen delivery for patients on VA-ECMO.
4. Hemodynamic complications of VA-ECMO such as left atrial hypertension and harlequin syndrome and general strategies in their management. 
5. Liberation strategies for VA-ECMO either to decannulation or conversion to ventricular assist device.

References:

Bhaskar, P., Davila, S., Hoskote, A., & Thiagarajan, R. (2021). Use of ECMO for Cardiogenic Shock in Pediatric Population. Journal of clinical medicine, 10(8), 1573. https://doi.org/10.3390/jcm10081573

Brown G, Moynihan KM, Deatrick KB, Hoskote A, Sandhu HS, Aganga D, Deshpande SR, Menon AP, Rozen T, Raman L, Alexander PMA. Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failure. ASAIO J. 2021 May 1;67(5):463-475. doi: 10.1097/MAT.0000000000001431. Erratum in: ASAIO J. 2022 Jul 1;68(7):e129. PMID: 33788796.

Xie A, Forrest P, Loforte A. Left ventricular decompression in veno-arterial extracorporeal membrane oxygenation. Ann Cardiothorac Surg. 2019 Jan;8(1):9-18. doi: 10.21037/acs.2018.11.07. PMID: 30854308; PMCID: PMC6379183. 

https://www.elso.org/ecmo-resources/elso-ecmo-guidelines.aspx 

https://www.congenitalheartacademy.com/home 

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. Michelle Kittleson is the Director of Postgraduate Education in Heart Failure and Transplantation, Director of Heart Failure Research, and Professor of Medicine at the Smidt Heart Institute at Cedars-Sinai. She received her MD at Yale University School of Medicine followed by a residency in Internal Medicine at Brigham and Women's Hospital, and a fellowship in Cardiology at John Hopkins, where she also received a PhD in clinical investigation from the Johns Hopkins Bloomberg School of Public Health. 

Dr. Kittleson is also a guideline author: she was the chair of the writing group for the 2020 American Heart Association Scientific Statement on Cardiac Amyloidosis; she also co-authored the American College of Cardiology’s 2020 Hypertrophic Cardiomyopathy Guidelines and the American Heart Association’s 2022 Heart Failure Guidelines.

Learning Objectives:

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

1. Describe goals for rounds on a busy inpatient service. 
2. Critique the common methods for priming trainees for optimal rounds.
3. Develop a technique for working with trainees at different levels of patient ownership, including the toddler, the waiter, and the captain. 
4. Discuss the best times to add teaching points on rounds
5. Discuss the different ways to structure feedback on a busy inpatient team.

Dr. Kittleson's Textbook on patient care:

Mastering the Art of Patient Care 1st Edition. 2022. (Amazon Link)

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!

Proshad Efune, MD is an Assistant Professor at UT Southwestern. She completed both her pediatric critical care and pediatric anesthesia fellowships here at UT, and she now practices in both the operating room and the pediatric ICU here at Children’s Medical Center in Dallas. She is interested in pre-operative management of critically ill children.

Learning Objectives
After listening to this episode, learners should be able to:

1. Identify clinical scenarios at high risk for cardiovascular collapse surrounding endotracheal intubation.
2. Discuss a clinical approach to minimize the risk of peri-intubation cardiovascular collapse in the following high-risk scenarios:
   1. Severe hypoxemia
   2. Severe metabolic acidosis
   3. Hypotension/septic shock
   4. Obstructive lung disease
   5. Hemorrhagic shock
   6. Cardiac tamponade

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. Eric Silver is an Associate Professor of pediatrics at Columbia University Medical Center. He completed his cardiology fellowship at Columbia University College of Physicians and Surgeons and his electrophysiology fellowship at Stanford’s Lucile Packard Children’s Hospital. He is a certified specialist in pediatric electrophysiology and his research has focused on invasive management of AV nodal reentrant tachycardia in children, the response of the transplanted heart to adenosine therapy, and placement of pacemakers and ICDs with minimal fluoroscopy utilizing 3-dimensional mapping systems.

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.

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

1. Recognize common indications for temporary pacing in the CICU
2. Understand the nomenclature used to describe temporary epicardial pacemakers and different pacing modalities
3. Recall the function of each pacing mode and which clinical settings in which it is used
4. Recognize the surgical and pre surgical factors that lead to higher risk of arrhythmias
5. Recognize and troubleshoot temporary pacemaker dysfunction
6. Develop a mental framework for managing those who require prolonged pacing

References:

Pediatric & Congenital Electrophysiological Society: https://pacesep.org/
Heart University: https://www.heartuniversity.org

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!

Bradley Fuhrman, MD completed his training in pediatrics followed by fellowships in cardiology and neonatology at the University of Minnesota where he went on to found the first PICU and serve as the Chief of critical care at that institution. He has also served as the associate director of the PICU at Children’s Hospital of Pittsburgh, Division Chief of Critical Care at Children’s Hospital Buffalo and Physician-in-Chief at El Paso Children’s Hospital. His career in pediatric critical care exceeds 40 years. He has many peer-reviewed publications with a research career that is focused in cardiac and respiratory physiology. He is also the co-author of Fuhrman and Zimmerman’s Pediatric Critical Care.

Learning Objectives:

By the end of listening to this 2-part series, learners should be able to discuss clinically relevant cardiopulmonary interactions and a fundamental clinical approach to optimizing cardiopulmonary mechanics in patients with:

1. Spontaneous (negative pressure) respirations with severe work of breathing 
2. Septic shock
3. Mechanical (positive pressure) ventilation
4. Pulmonary hypertension with right ventricular systolic dysfunction
5. Left ventricular systolic dysfunction
6. Right ventricular diastolic dysfunction
7. Single ventricle Fontan circulation

References:

Bronicki RA, Penny DJ, Anas NG, Fuhrman B. Cardiopulmonary Interactions. Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S182-93. doi: 10.1097/PCC.0000000000000829. PMID: 27490598.

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!