Discover and read the best of Twitter Threads about #pedsanes

Most recents (6)

Board things: Fontan Circulation goals 🧵

Fontan physiology is usually the end-result of palliative procedures (of which there are several variations) for patients born with single-ventricle physiology.

#MedTwitter #MedEd #FOAMEd #Anesthesia #PedsAnes #CardsAnes Image Credit: https://kidsh...
Examples of single ventricular physiology:
- Hypoplastic left heart syndrome
- Pulmonary atresia
- Tricuspid atresia
- Ebstein anomaly
- Double outlet RV
Etc.
This is usually completed step wise, starting with a Norwood procedure/Sano shunt hybrid (reconstructs a neoaorta and provides shunt connection from RV to PA), followed by a Glenn (shunt takedown with connection of SVC to PA), then a Fontan (IVC also connected to PA). Image Credit: https://www.s...
Read 10 tweets
Steven E. Wolf now talks about #PedsICU #airway #burns

Airway burns is something I always worry about. Looking forward to his insights in this topic

#WFPICCS20 #PedsAnes
Airway probs can occur from:
- direct burns
- inhalation injury (10-20% of all burns pts)
- trauma from other injuries
- 3rd spacing oedema during fluid resuscitation
- long term intubation (eg subglottic stenosis)

#PedsICU #PedsAnes #WFPICCS20
Don’t forget carbon monoxide poisoning in airway burns!

#PedsICU #PedsAnes #WFPICCS20
Read 5 tweets
Allan Doctor discusses the functional assessment of haemostasis and anticoagulation therapy during critical illness

#PedsICU #WFPICCS20
let’s look at normal #coagulation system #physiology...

New ways of thinking at a cellular level moves from the classic intrinsic and extrinsic a pathway to a cell based process consisting of:
- Initiation
- amplification phase
- propagation phase

#PedsICU #WFPICCS20
And fibrinolysis is an important part of #coagulation #physiology to prevent excess clot growth and clot break down after healing...

It is this process we accelerate with thrombolysis

#PedsICU #WFPICCS20
Read 5 tweets
Opening talk @WFPICCS is ‘protective lung ventilation’ by Robinder Khemani

Much data is from the adult ARDSNet work demonstrating 6ml/kg is optimal data for adults

#PedsICU #WFPICCS20
However - limited #PedsICU data for #pARDS and some data suggests higher tidal volumes in children may have better survival.

But this is not an RCT data...and some data shows higher driving pressure is associated with increased mortality...

#WFPICCS20
Should we be using transpulmonary pressure as a measurement rather than driving pressures in #pARDS?

In our unit we don’t measure transpulmonary pressures... but might be worth thinking about

#PedsICU #WFPICCS20 #PedsAnes
Read 8 tweets
💥Four very important resources to keep for new 2020 PALS guidelines
#PedsICU #PedsCICU #PedsAnes #CPR

1. Pediatrics
2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care pediatrics.aappublications.org/content/early/… @PIPSQC
Why new AHA respiratory rate recommendations is 20-30 question?
Supporting paper 👇
2. Ventilation Rates and Pediatric In-Hospital Cardiac Arrest Survival Outcomes pubmed.ncbi.nlm.nih.gov/31369424/
3. Pediatric and neonatal recommendations from @CircAHA Pages 11-14

Executive Summary: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations ahajournals.org/doi/10.1161/CI…
Read 4 tweets
A short thread on using #online #education following my own experience in moving to this for #PedsICU teams @UHSFT @SotonChildHosp & our #medical #students @UoS_Medicine @unisouthampton

Hope this helps.... #MedEd
TIP 1:
Be kind to yourself

This is knew. It feels different. Recognise this will take time for you to adapt. Learners realise this and have been delighted people have taken the effort to teach and be innovative
TIP 2:
Learn your platform

Practice with the resource you are using before the session. Discover:
- chat room
- interactive whiteboard
- screen share
- raise hand/question function
- break out small group function
- mute & camera functions
Read 12 tweets

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