Discover and read the best of Twitter Threads about #PedsICU

Most recents (24)

Palliative & end of life care is a small but critically important part of #pedsICU

Our community has the knowledge & skills that our patients need but we lack simple & robust frameworks

My talk on #pedsPC at @worldcongressic #WCIC19
@worldcongressic Few kids die but they die after long battles, with chronic illnesses & in hospital or #pedsICU

¾ kids who die in PICU do after WLST

= palliative care in the PICU is inextricably linked with care in the PICU, & we are the best ppl to manage it

#pedsPC #WCIC19 @worldcongressic
@worldcongressic A simple & robust framework for palliative care in the #pedsICU

1. See clearly (use benefits vs burdens)
2. Build professional consensus
3. Create shared understanding w family
4. Offer active palliative care

#pedsPC #WCIC19 @worldcongressic
Read 7 tweets
Why is so important (even vital) to improve research networks in LMICs ?
Here an awesome example of why NO ONE IS BETTER THAN ALL TOGETHER

Nadie es mejor que todos juntos. Sobre la importancia del trabajo en RED.

#PedsICU @WFPICCS
(Thread/Hilo)
1/x
2/x
First, CONTEXT. Look at this video from Queen Elizabeth Central Hospital in #Malawi 🇲🇼
Primero para conocer el CONTEXTO, miren este video

3/x
In 2014, this trial on bCPAP for #RDS in #preterms was published in @PLOSMedicine

Artículo salido en 2014 sobre CPAP en SDR neonatal

👉87 👶/ 1🏥

journals.plos.org/plosone/articl…
Read 6 tweets
With the help of @PICJournalWatch @harrykchris we though we could put together a collaborative thread with useful #PedsICU resources like apps, websites, blogs and accounts. This thread is open so please don’t hesitate to add yours. Here are mine 👇🏻
Apps:
- I-Perfuse: great tool for anything cardiovascular including #ECMO cannula sizes, equations, a calculator... very useful for #PedsCICU
- Heartpedia: awesome 3D models of heart anatomy. Also great for teaching at the #PedsCICU. And it was created by the great @pccm_doc
Apps continued:
- The Sanford Guide: it costs 25€/year. I’d pay 250€ since I use it everyday in the #PedsICU. Basically everything you need to now about antibiotics and bugs #PedsID.
Read 14 tweets
Cuidados de Segundo Nivel en #TBI

Abro hilo, iniciamos y abierto los comentarios👩‍💻👨‍💻

#PedsICU #EduMed #MedEd
Cuarto hilo de #TBI enfocado a los casos Severos por Escala de Coma de Glasgow. Te sugerimos leer los hilos previos para continuar la temática (Abordaje prehospitalario y Urgencias, Cuidados Basales y Terapias de Primer Nivel)
Iniciamos comentándote que todas las terapias de segundo nivel "cuentan con mayor cantidad de efectos adversos", por lo que debes estar preparado para tratar estos efectos y saber como solucionarlos (te cobrarán factura). Una vez mencionando esto, iniciamos.
Read 25 tweets
1/11
Short #Tweetorial

How did we started with heated humified high flow nasal cannula in 🇺🇾 ?

Easy explanation of 3 #HHHFNC homemade models #HFNC devices?

(No COI to declare)

#PedsICU #SoMe4MV #historyofmedicine @WFPICCS
2/
It is really easy.
You can get information of its uses and applications in this nice review in @respcare ▶️ncbi.nlm.nih.gov/pubmed/27016353

This is basically the diagram 👇
3/
So back in 2012 in our country we wanted to try some kind of respiratory support for the youngest infants in which interfases for #NIV was difficult.

SO we came up with an idea: What if we dismantle the old ventilators we do not use any more?

Like this ones 👇
Read 13 tweets
#PedsICU #FridayQuiz
2/12term👶♀
PrevF+W
24h⬆️WOB
🚑🔜🏥
O/E
HR200-220
RR↕️-gasps
Sats85%(L=R)FiO2 15L/min
CRT6
A♈️PU
BP34/14-L=R
AF↔️
⬇️AE Lbase
❌murmurs
pulses feeble-palpable
❌rash
A)ETT plan-drugs/preox?
B)Post ETT plan
C)Ddx
D)InterpretECG&identify intervention @Τ=5
/1
Acronyms
F+W Fit&Well
↕️Variable
♈️Responds to voice
↔️Soft
L=R Equal bilaterally
⬇️AE Decreased air entry
Ddx Differentials
Cases from published peer reviewed reports
Answers next week
Focus on management
Tomorrow is the 1 year anniversary of the #PedsICU #FridayQuiz/2
🎈 🎉 🍰
It has grown into this collaborative #FOAMed clinical storytelling platform that is fun, evidenced based & credible.
It wouldn’t have been a success without all the people that supported it from the very beginning and all of you playing along /3
Read 13 tweets
Citation counts come from OTHER RESEARCHERS. They are important, yes.

But, sharing #science on #SoMe=broad & instantaneous dissemination to those who focus their time AT THE BEDSIDE. Which may surprise some- but is MOST OF MEDICINE especially....#anesthesiology.(Thread) #AUA2019
A metric like the “Kardashian Index” *MAY* be relevant in genome biology where the proportion of basic/translational science is significantly higher and no immediate bedside application for a general practitioner is there. (and I’m making an assumption here) #medtwitter #aua2019
When your #research is relevant primarily to other #scientists who are also writing research papers then citation counts do more wholly reflect the paper’s impact. But in clinical research, it’s different. Bedside clinicians are looking to the literature for guidance & new ideas.
Read 13 tweets
Pediatric Sepsis Research on LMIC countries: Overcoming challenges. Another oustanding conferences by Daniela @danicds72 #PedsICU #Sepsis@ILASepse⁩ ⁦@WFPICCS⁩ ⁦@LA_Rednetwork⁩ ⁦@slepe8
The Agenda #PedsICU
The 80/20 Rule. We know 80% from those places where the 20% happens #PedsICU @WFPICCS @SLACIP17 @slepe8 @LA_Rednetwork @atip_latam
Read 28 tweets
1/
Some time ago y discovered this amazing project: archive.worldmapper.org/textindex/text…

Altough it needs updating, I am sure many things shouldn´t have changed a bit.

Like this map of phisicians working

@WHO

(Thread)
2/
My collegue @mardi_steere is currently working with @PECCAfrica and gathering info about health-care human resources in the african continent. Today she detected a frightening number👉6 #PEM / #PEdsICU trained docs for more than 800 millons inhab👇

3/
Yes, believe the numbers

TO make things worse:
It is predicted that by 2050, 35–40% of children and adolescents globally are projected to be living in Africa.

This is what Vearey J et al recently published: bmcpublichealth.biomedcentral.com/articles/10.11…
Read 6 tweets
#PedsICU #FridayQuiz
8mo ♂F+W36hHx D+V 🤮
status epilepticus @🏡➡️☎️🚨2xBenzo by🚑
➡️🏥
Ο/Ε TC fit 30 min ⏰
sats💯(15L/min O2 NRBM)
RR10
HR140-160
CRT5
NIVBP84/63
Temp37.3C
PEARL👀4
a)Initial mgmt plan
b)post ictal fluid mgmt plan
c)Interpret ECG
d)Investigation panel
e)Ddx
#PedsICU #FridayQuiz
Acronyms
F+W Fit&Well
D+V Diarrhoea&Vomiting
TC TonicClonic
NRBM Non-Rebreathe Mask
NIV Non invasive
🚑Paramedics
Mgmt Management
Ddx Differentials
Cases from peer reviewed reports,answers Sunday
Quiz curated4 #paediatricemergencies course,give team a follow
Read 5 tweets
Solución Salina Hipertónica
¿Cómo preparar diferentes concentraciones?

Abro🧵iniciamos👩‍💻y abierto los comentarios

#PedsICU #FOAMed
Los métodos mostrados usarán Cloruro de Sodio al 17.7% (también conocida como Concentrado de Sodio al 17.7%), al ser la presentación común en países de #LatinAmerica donde usualmente no se cuenta con presentaciones al 3%, 5%, etc (con el método avanzado, podemos crear estas)
En otros países del mundo, cuentan con presentación también al 20% (España, p. ej.)
Read 23 tweets
Mnemotecnias Médicas👩‍⚕️👨‍⚕️🌏🌍🌎

Abro 🧵iniciamos👨‍💻y abierto los comentarios

#FOAMed #FOAMped #medtwitter #Urgenciologa #Urgencias #MedStudentTwitter #Pediatrics #Pediatria #FOAMex #UCIP #UTIP #PedsICU #ENARM2019 #MIR2019 #FACMED
Son tres los objetivos, donde el principal, es compartir y fomentar el conocimiento útil en la práctica médica
Saber que puede usarse tanto nemotecnia como mnemotecnia según @RAEInforma
Read 38 tweets
Monitoreo de CO2 Exhalado

Abro hilo, iniciamos 👨‍💻y abierto los comentarios

#FOAMed #PedsICU #Urgencias #Pediatrics #SoMe #FOAMped #Pediatria

@sgdambrauskas @CantillMauricio @AMEEMCTI2018 @OlgaPena @diegovinci @ESACMex @SaidDLCR @Javier_Prego @erikablasco ¡Ayuda a compartir!
Un caso clínico no ayudará a entrar al tema, veremos conceptos básicos de #EtCO2, y algunas de sus aplicaciones clínicas en Urgencias y #UCI
Caso clínico
Read 42 tweets
Cetoacidosis Diabética #DKA #CAD #AMTIP

Bases de la Enfermedad y análisis del Diagráma de Flujo @NICEcomms Diciembre 2018

Abro hilo, iniciamos👨‍💻y abierto comentadios

@MarianaPediatra @FOAMexico @CantillMauricio @Javier_Prego @erikablasco @pediatraweb10 @RobustosMD @carsolbal
Para ti #urgenciologos, #pediatras e #intensivistas

Daremos un repaso discreto de CAD y analizaremos el texto de la NICE Pathway

Comentaremos con relación a las guías @ispad_org, una de las más utilizadas a nivel mundial

En pocas palabras, el diagrama con relevante información
#CAD puede presentarse en #T1D y #T2Diabetes. Debido a obesidad, han aumentado los casos en esta última, presentándose también como debút.

#T1D es resultado de destrucción autoinmune progresiva de células beta. Ocurre a una tasa de 6-8%/año en aquellos con Dx establecido.
Read 39 tweets
Traumatismo Craneoencefálico Severo 🧠 #TCE

Abro hilo, iniciamos 👨‍💻 y abierto los comentarios

A propósito de la publicación del @PedCritCareMed

@MarianaPediatra @FOAMexico @CantillMauricio @FOAMedMX @FranLoachamin @PatologCritica @ecameselle @RobustosMD @naidxielli 🔁
90 artículos contribuyeron a la evidencia, 68 describían protocolos aplicados para el manejo

Documento intencionado a uniformar la práctica clínica y mejorar desenlace, intentando motivarla innovación y búsqueda en áeras donde la evidencia es escasa
Objetivo del algoritmo es su utilidad en el manejo general en #PedsICU en el TBI severo así como aspectos específicos

La #CT valora la extensión de la lesión cerebral y la necesidad potencial de intervención quirúrgica

El monitoreo de #ICP para guiar la terapia de la ICP y #CPP
Read 39 tweets
La definición es simple y fácil de recordar.

A pesar de existir muchas más, la definición de la #OMS es práctica y usada a nivel mundial.
La mayoría son extensiones <20%

En #Latam las lesiones por escaldadura son el tipo principal de quemaduras reportadas

Si hay afectación a vía aérea, los costos y morbi-mortalidad se incrementan.

>% afectada = >% mortalidad
Read 33 tweets
Choque Séptico en #Pediatria

Porque #PedsICU facilita la información

Abro hilo, veamos definición, bloques, monitoreó y reanimación hídrica y medidas de soporte. Enfoque a "low income countries"

¡@Sepsis_Mx @FOAMexico @CantillMauricio @DrBlood5 @XiumaraCher ayudame a difundir!
El diagnóstico es muy práctico. Y solo necesitas dos puntos a considerar:
Ahora, vamos a facilitar recordar los criterios con las tres ventanas de perfusión:

(Irritable, somnoliento, estuporoso, puedes ocupar AVDI o Glasgow; cianótico, pálido, reticulado, rubicundo; uresis disminuida)
Read 22 tweets
There is a fundamental misunderstanding in the public about end-of-life care, which I think is relate to, but not the root cause of, a significant amount of vitriol directed at abortion by forced birth advocates. 1/
If there is one thing I have learned in the #pedsICU, where death and dying are part of everyday life and medicine, it is that the goal of medicine is not to “save” the life of every baby, child, adolescent, or adult that comes through the doors. 2/
The medical team acts on the wishes of the parents and family to provide goal-directed care based on the patient’s quality of life, potential for meaningful recovery, and more. We can almost always keep a heart beating,but that doesn’t always mean we should. 3/
Read 9 tweets
🗣️And it is finally out!

👉Amazing shared forum from @OPENPediatrics about #PedsICU rehab and patient (family)-centered care

👉Please share/RT this paradigm shift lecture

#thrive #ICUrehab @McMasterU

@karen_choong from 🇨🇦
openpediatrics.org/assets/video/e…
🗣️Al final llegó!

👉Increíble foro compartido desde @OPENPediatrics sobre rehabilitación en #PedsICU y cuidados centrados en el niño y su familia

👉Comparte/RT esta charla sobre cambio paradigmas

#thrive #ICUrehab @McMasterU

@karen_choong from 🇨🇦
openpediatrics.org/assets/video/e…
Thread/Hilo (🇬🇧🇪🇸)

3/
Epidemiology has changed. New children population: SURVIVORS
La epidemiología cambió en #PedsICU : nuevos niños: SOBREVIVIENTES

MORTALITY Shift
Cambio el patrón de MORTALIDAD
👇
Read 16 tweets
Hi, all. I’m giving noon conference to the UIC residents on use of social media next week

Can we show them the power of #SoMe?

Any tips you recommend?

@SapnaKmd @namd4kids @hshermd @MAhealthforkids @DrCJohns @DrJaimeFriedman @greenhousemd @PergamIC @sbernsteinmd @EMeadeMD
Side note: there were literally dozens of people I wanted to tag. I used the very scientific method of hitting @ and just putting in names

I’d love for anyone to respond, but if you do, please don’t forget to remove tag for everyone else so I don’t bother all those fine people
Also, @DrJas_Saavedra - do you want this to be a how-to or a why-to talk?
Read 8 tweets
Welcome all my new #PICUQI friends to twitter! Don't be overwhelmed by the number of #PedsICU and #PICUQI tweets right now--they will sadly slow down after #CCC48. In this thread, I will recommend some great follows and some quick how to tutorials!
How do I use # AKA hashtags? Click on the #PedsICU, #CCC48, and #PICUQI hashtags above and see who is tweeting about what you are interested in and what they are saying!
Read about why social media is an important way to connect from @SapnaKmd @virenkaul @DrSeanBarnes and also give them a follow! journals.sagepub.com/doi/abs/10.117…
Read 7 tweets
Thank you to all who were able to participate this past hour. If you are following along in different time zones, I’m going to collect all of the question threads here for ease of following

#PedsICU #PARDIE #PARDS
PALICC vs Berlin - the battle is on!

Please answer with #PedsICU A1

Read 8 tweets
🗣️Hilo

Los mejores artículos #PedsICU (UCIP) del 2018 📖
La suma de lo más relevante publicado y un #Tweetorial acompañante

Selección colaborativa con entre @PICJournalWatch & @sgdambrauskas
Publicado en simultáneo Inglés/Español

Favor comparte. ¡Nos vemos en 2019!
1/
Estudio PARIS en @nejm
Gran estudio que gatilló discusión en el ámbito del #CNAF. Incluso diferentes interpretaciones de resultados de sus coautores

¿Cambió mi práctica? NO
¿Mi investigación? SI

ncbi.nlm.nih.gov/pubmed/29562151

Lean correspondencia:
nejm.org/doi/full/10.10…
2/
ECA en @PedCritCareMed
@pus27 y cols encontraron que #CPAP precoz en niños inmunocomprometidos admitidos en #PedsICU no es mejor (incluso peor) que O2 estándar en 🇬🇧
¿Cambió mi práctica? Quizás
¿Mi investigación? NO

ncbi.nlm.nih.gov/pubmed/30095746
Read 21 tweets
1/ 🗣️
Aquí va un hilo en vivo sobre mis frases preferidas de las III Jornadas Internacionales de @LA_Rednetwork

Here a live-thread about 🔝phrases/ideas from today's III @LA_Rednetwork anual meeting

#sepsis #PICSyndrome
#PedsICU #MeetingLARed18 @juancajara78 @rjabornisky

👇
2/
Arriving at @PeluffoGiguens and we look at the board the invitation
Llegamos Fundación y vemos la cartelera

#MeetingLARed18
3/
With @Nmtvd preparing connections

#MeetingLARed18
Read 52 tweets

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