Discover and read the best of Twitter Threads about #whatrdsdo
Most recents (4)
Let's talk about Bundled Care of Pediatric Critical Care Patients: Guidelines and Implementation Part 2! We start with Dr. John Berkenbosch talking about choosing the right analgesic/sedation/NMB agent
#SCCM2022 #PedsICU
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#SCCM2022 #PedsICU
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One of the neat things about food & being a dietitian is that it's not as easy as good vs bad. For example:
A 240 cal milkshake🧋? Not great for person who needs to monitor carb/sugar intake but may be perfect for person who's lost wt due to cancer treatment & has taste changes..
A 240 cal milkshake🧋? Not great for person who needs to monitor carb/sugar intake but may be perfect for person who's lost wt due to cancer treatment & has taste changes..
...or how about a high protein🥩 meal? may be good for an athlete trying to to build/maintain muscle mass but not good for someone with PKU. Whole wheat/high fiber cereal?🥣 good for someone trying to increase fiber for gut health---bad for someone w/ celiac disease.
#whatRDsDo
#whatRDsDo
...or how about a big bowl of fresh fruit🍐🍑🥝🍇🍓? Great for many of us who enjoy fruit or the taste and fiber - but not good for a child with a seizure disorder who needs to follow a ketogenic (low carb) diet for seizures. Nutrition & food can be complicated! #whatRDsDo
Top 10 key expert opinion recommendations for nutrition support for the critically ill patient with #COVID19 via @ASPENWEB.
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These recs are based on indirect evidence (2016 SCCM/ASPEN and 2019 EPSEN Guidelines), direct evidence from limited COVID19 trials, and expert opinion. 2/
Key Rec #1:
-Use wt based equations to determine energy & protein needs
-15-20 kcals/kg/d; 1.2-2 g protein/kg
-Do not use indirect calorimeter as this increases contamination risk
-Monitor for refeeding syndrome (monitor phos, mag, potassium)
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-Use wt based equations to determine energy & protein needs
-15-20 kcals/kg/d; 1.2-2 g protein/kg
-Do not use indirect calorimeter as this increases contamination risk
-Monitor for refeeding syndrome (monitor phos, mag, potassium)
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Lots of talk happening on different enteral feeding methods. Here is a thread to describe each and their ideal usages. #RDChat #WhatRDsDl 1/
Continuous (pump assisted): requires feeding bag (feed&flush bag or RTH allows both to be given via pump) & pump. Typically used for ICU, j-tubes or G who🙅🏻♀️ tolerate bolus. Rate ordered is infused over the full hour (eg 60mL/hr infused 60mL over 1 hour) 2/ #WhatRDsDo #RDChat
Keep in mind that any volume of formula via pump is given over the entire hour, whereas a flush via pump is usually given in one quick bolus. This can sometimes lead to cramping, dumping esp in j tube patients. Smaller, more frequent flushes are helpful. 3/#WhatRDsDo #RDChat
