Thread by @DrKanaris

#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

I’ve had it described to me as “my quiz”. It certainly is not, I have no strong ownership feelings about it. Everyone contributes to it(I’ve certainly learned things that have changed my practice from others contributions to the quiz)& it is based on real patients peer reviewed/4

stories; this belongs to our patients-who are hopefully the beneficiaries of the different nuggets of knowledge we get from it each week- as well all of us, the healthcare providers.
Nor is it, strictly speaking a standalone #pedsicu quiz, it takes an army to save these kids/5

so Paramedics/Nurses/EM/General Peds/Anaesthesia/Neo/Surgery and numerous tertiary specialties contribute in real life for a favorable outcome, and the quiz certainly reflects that all important collaboration and inclusivity.
There are lots of exciting developments brewing for/6

r year 2, stay tuned for those.
I thank you all for making it a success and more importantly fun. I am especially grateful to this lovely bunch who have engaged/retweeted/enriched the quiz&kept me in check with their knowledge, wit and expertise week upon week, thank you:👇👇/7

🔹@SapnaKmd
🔹@harrykchris
🔹@jez_tong
🔹@pccm_doc
🔹@DeannaMarie208
🔹@mr_astvad
🔹@sgdambrauskas
🔹@miguelrdgzrubio
🔹@ketaminh
🔹@DrSeanBarnes
🔹@LavergneNatalie
🔹@Playfor
🔹@EMManchester
🔹@Damian_Roland
🔹@PushpaShivaram
🔹@henrygoldstein
🔹@LaCampo4
🔹@JorgeJany
You ROCK🎸

#PedsICU #FridayQuiz
Answers are in
Delayed Presentation of strangulated congenital diaphragmatic hernia presenting with shock & complete heart block (hypocalcaemia)
Based on attached cases👇👇 👀
🌍 Global Engagement from 26 countries
Numerous brilliant answers
/1

Best #PedsICU #fridayquiz answers
@edd_broad
@Pediatric_ICU
@miguelrdgzrubio
@jez_tong
@CoffeeAddictNZ
@DrPaulomi
@sgdambrauskas
@hussaminany
@stephen_streat
@JorgeJany
@anniezk1
@pccm_doc
@Playfor
@LaCampo4
@davidannesley
@NikkiAbela
@drbidz
@mr_astvad
@as_bakshi
@swatiwaves
/2

Best answers continued...
@adrianhumphry
@MireiaYllia
@babyPICUrn
Take home message
1)In CDH avoid BMV prior to intubaton if possible, if you need to, have an NGT in situ first with someone aspirating all the extra air continuously.
2)Regardless if the patient is in shock
/3

not, if they have a heart block, don't forget to check Ca/Mg and treat accordingly, you may not need anything more fancy.

Special thanks to our 2 specialists for their expertise
@PushpaShivaram for expert cardiology input and @ffoliet for expert paediatric surgical input
/4

See you tomorrow when @henrygoldstein will kick off the global #FOAMEd #pedsicu #fridayquiz initiative representing the @DFTBubbles team ( 2 months 6 continents, 11 nationalities) running a quiz each (this will be awesome)
/fin