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critical care medicine pediatric

Utpal Bhalala, Praveen Khilnani
Pediatric critical care services in India have grown with leaps and bounds. There has been a growing need of physicians specially trained in pediatric critical care medicine (PCCM) in India. Physicians returning to India after their formal training in PCCM abroad have partly supported this growing need. Development of formal PCCM training programs in India has been a huge step toward supporting the growing clinical needs. This article focuses on advances in pediatric critical care training in India and its future directions...
2018: Frontiers in Pediatrics
Meredith Merz Lind, Marco Corridore, Cameron Sheehan, Melissa Moore-Clingenpeel, Tensing Maa
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Samantha W Gee, Philip L Holt, Michael J Stoner
INTRODUCTION: Critically ill children who require transfer to tertiary care centers often require transport by specialized transport teams (TT). These interfacility transports require a medical control physician (MCP). Traditionally this role is assigned to fellows who are taught "on-the-job", but achieving competency in communication for those trained this way may not be optimal. We sought to close this curriculum gap by developing a MCP training program immersing emergency medicine (EM) and critical care (CC) fellows together with TT members to manage a simulated patient...
March 2018: Air Medical Journal
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia Rodgers, James A Russell, Greet Van den Berghe
To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients.
February 23, 2018: Intensive Care Medicine
Lena M Napolitano, Venkatakrishna Rajajee, Kyle J Gunnerson, Michael D Maile, Michael Quasney, Robert C Hyzy
Critical care fellowship training in the United States differs based on specific specialty, and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine and neurocritical care training pathways. We provide an update regarding the number and growth of U.S. critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education (ACGME) and specialty boards [American Board of Internal Medicine (ABIM), American Board of Surgery (ABS), American Board of Anesthesiology (ABA), American Board of Pediatrics (ABP), American Board of Emergency Medicine (ABEM)] and the United Council for Neurologic Subspecialties (UCNS) for the last 16 years (2001-2017)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Priya Bhaskar, Mallikarjuna Rettiganti, Jeffrey M Gossett, Punkaj Gupta
Background: The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim: To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design: Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015)...
January 2018: Annals of Pediatric Cardiology
Aayush Gabrani, Taiki Kojima, Ronald C Sanders, Asha Shenoi, Vicki Montgomery, Simon J Parsons, Sandeep Gangadharan, Sholeen Nett, Natalie Napolitano, Keiko Tarquinio, Dennis W Simon, Anthony Lee, Guillaume Emeriaud, Michelle Adu-Darko, John S Giuliano, Keith Meyer, Ana Lia Graciano, David A Turner, Conrad Krawiec, Adnan M Bakar, Lee A Polikoff, Margaret Parker, Ilana Harwayne-Gidansky, Benjamin Crulli, Paula Vanderford, Ryan K Breuer, Eleanor Gradidge, Aline Branca, Lily B Grater-Welt, David Tellez, Lisa V Wright, Matthew Pinto, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. DESIGN: Prospective cohort study. SETTING: Twenty-five PICUs at various children's hospitals across the United States. PATIENTS: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children)...
February 5, 2018: Pediatric Critical Care Medicine
Oksana Babenko
This study investigated the roles of basic psychological needs-autonomy, competence, and relatedness-in physicians' professional well-being, specifically satisfaction with professional life, work-related engagement, and exhaustion. Using an online survey, quantitative data were collected from 57 practicing physicians. Overall, 65% of the participants were female; 49% were family medicine (FM) physicians, with the rest of the participants practicing in various non-FM specialties (e.g., internal medicine, pediatrics, surgery); and 47% were in the early-career stage (≤10 years in practice)...
February 2, 2018: Healthcare (Basel, Switzerland)
Zaccaria Ricci, Stefano Romagnoli
BACKGROUND: The acute reduction of kidney function in critically and noncritically ill patients (regardless of their age) is one of the deadliest clinical conditions ever reported in modern medicine. Acute kidney injury (AKI) symptoms are sneaky and potentially difficult to be identified at the right time at the bedside. One of the greatest efforts of the recent history of critical care nephrology has been to find a common classification for AKI definition and staging with the purpose of allowing a timely diagnosis and push forward epidemiologic research...
2018: Contributions to Nephrology
Erik Su, Nicholas Dalesio, Aliaksei Pustavoitau
Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population...
January 19, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Anne E Pidano, Prerna Arora, Polly Y Gipson, Bradley O Hudson, Kriston B Schellinger
Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families...
January 10, 2018: Journal of Clinical Psychology in Medical Settings
Maria Alcocer Alkureishi, Wei Wei Lee, Sandra Webb, Vineet Arora
BACKGROUND: Electronic health record (EHR) use can enhance or undermine the ability of providers to deliver effective, humanistic patient-centered care. Given patient-centered care has been found to positively impact patient health outcomes, it is critical to provide formal education on patient-centered EHR communication skills. Unfortunately, despite increasing worldwide EHR adoption, few institutions educate trainees on EHR communication best practices. OBJECTIVE: The goal of this research was to develop and deliver mandatory patient-centered EHR training to all incoming housestaff at the University of Chicago...
January 4, 2018: JMIR Medical Education
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 US Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year olds between 2000 (2...
December 24, 2017: American Journal of Obstetrics and Gynecology
M Taveira, N Yousef, J Miatello, C Roy, C Claude, B Boutillier, C Dubois, A-F Pierre, P Tissières, P Durand
BACKGROUND: Lung ultrasound (LU) is a bedside point-of-care technique in critical care and emergency medicine. LU is quick and non-irradiating, and provides accurate diagnostic information when compared with chest radiographs. Specific LU signs have been described for bronchiolitis. This study aimed to evaluate the correlation between severity of LU-diagnosed lung lesions, using a quantitative LU score, and the length of non-invasive ventilation (LOV) for infants diagnosed with severe viral bronchiolitis...
December 13, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Robert S Ream, Eric S Armbrecht
INTRODUCTION: Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. RESEARCH QUESTION: To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics...
January 1, 2017: Progress in Transplantation
Meredith G van der Velden, Megan K Barrett, Gretchen A Sampadian, Richard J Brilli, Jeffrey P Burns
OBJECTIVES: To describe growth trends in the number of programs, positions, and applicants in pediatric critical care medicine fellowship training as part of the Pediatric Critical Care Medicine Training Study. DESIGN: Descriptive study. SETTINGS: Available archived Match data through the National Resident Matching Program and training data from the Accreditation Council for Graduate Medical Education. PATIENTS: None...
January 2018: Pediatric Critical Care Medicine
Jasmine Patterson, Alison Gardner
OBJECTIVE: Burnout is a syndrome in which a reduced sense of personal accomplishment, depersonalization, and emotional exhaustion develop in response to prolonged stress. It is well known that physicians suffer high rates of burnout; emergency medicine physicians experience significantly increased rates of burnout, whereas physicians in other specialties, like pediatrics, may be spared. Pediatric emergency medicine physicians are on the frontline of care for the critically ill child, which could put them at high risk for burnout...
December 1, 2017: Pediatric Emergency Care
Mohamed A A Yousef, Darius Dranginis, Scott Rosenfeld
BACKGROUND: Children with neuromuscular disorders have a significant chance of developing scoliosis and/or hip dislocation during childhood and adolescence and often undergo surgical reconstruction. Because of their high rate of medical comorbidities, these patients are at higher risk of postoperative complications and are therefore often comanaged, along with orthopaedics, by pediatric medicine and critical care teams. Fever during the postoperative stay is a frequent occurrence and often prompts extensive diagnostic workup which increases the cost and burden on the health system but have unclear effects on the care of the patient...
February 2018: Journal of Pediatric Orthopedics
Maya Ragavan, Wendy Li, A Rani Elwy, John Cowden, Megan Bair-Merritt
OBJECTIVES: Well-child visits are a critical component of pediatric healthcare; however, disparities in attendance and quality of care exist for Asian children. Limited research has explored Asian immigrant parents' perspectives about their well-child visit experience. METHODS: Qualitative interviews were conducted with Chinese, Vietnamese, and Asian Indian immigrant parents. Participants were recruited from community-based organizations in the Boston area. Interviews focused on parents' perceptions about well-child visits, including individual attitudes, social and cultural factors impacting their opinions, perceived behavioral control, and improving visits for Asian immigrant families...
November 17, 2017: Academic Pediatrics
Diane DerMarderosian, Heather A Chapman, Christina Tortolani, Matthew D Willis
Eating disorders are a group of psychiatric disorders with potentially fatal medical complications. Early integrated care including the family as well as pediatric medicine, nutrition, psychology and psychiatry is critical for improving prognosis and limiting negative outcomes. Mental health services are a critical component of treatment; timely weight restoration maximizes efficacy. Despite being relatively common, there are many misperceptions about eating disorders, their severity, and the associated morbidity and mortality...
January 2018: Child and Adolescent Psychiatric Clinics of North America
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