We implemented and studied a novel curriculum that combined role play, didactic education, and the use of a procedure card for asynchronous learning to improve second-year pediatric residents' skills in delivering serious news. Phase 1 established baseline performance with a self-efficacy survey and observed simulation delivering serious news. Phase 2 included directed education of participants with a validated communication skills training framework.
View Article and Find Full Text PDFObjective In this study, we aimed to develop and pilot a mixed-methods curriculum among pediatric subspecialty fellows that combined didactics, role-play, and bedside coaching with a procedure card. We hypothesized that this curriculum would improve fellows' ability to navigate difficult conversations and would be feasible to implement across training programs. Methods This study was conducted from 2019 to 2020.
View Article and Find Full Text PDFIn rare circumstances, children who have suffered traumatic brain injury from child abuse are declared dead by neurologic criteria and are eligible to donate organs. When the parents are the suspected abusers, there can be confusion about who has the legal right to authorize organ donation. Furthermore, organ donation may interfere with the collection of forensic evidence that is necessary to evaluate the abuse.
View Article and Find Full Text PDFOver the past several years, pediatric critical care units increasingly count on the expert advisement of palliative care specialists. Given the limited availability of pediatric palliative care specialists, all palliative care clinicians may be required to care for pediatric patients and their families. Special considerations in caring for these patients include the relative importance of prognosis, involvement of child life, music and pet therapy, incorporation of parents in end-of-life rituals, care for siblings, use of medical technology, and prolonged duration of stay.
View Article and Find Full Text PDFPharmacokinetic parameters can be significantly altered for both extracorporeal life support (ECLS) and continuous renal replacement therapy (CRRT). This case report describes the pharmacokinetics of continuous-infusion meropenem in a patient on ECLS with concurrent CRRT. A 2.
View Article and Find Full Text PDFMeropenem, a broad-spectrum carbapenem, is commonly used for empirical and definitive therapy in the pediatric intensive care unit (ICU). Pharmacokinetic data to guide dosing in children, however, are limited to healthy volunteers or patients who are not in the ICU. Adult data demonstrate that pharmacokinetic parameters such as the volume of distribution and clearance can be significantly altered in individuals receiving extracorporeal membrane oxygenation (ECMO).
View Article and Find Full Text PDFPediatr Crit Care Med
September 2012
Objective: Many hospitals have established medical futility policies allowing a physician to withdraw or withhold treatment considered futile against families' wishes, although little is known on how these policies are used. The goal of our study was to elucidate the perspective of pediatric critical care physicians on futility.
Methods: We sent an anonymous survey to all active members of the American Academy of Pediatrics Section of Critical Care, using Survey Monkey http://www.
Background: Automated adverse-event detection using triggers derived from the electronic health record (EHR) is an effective method of identifying adverse events, including hypoglycemia. However, the true occurrence of adverse events related to hypoglycemia in pediatric inpatients and the harm that results remain largely unknown.
Objective: We describe the use of an automated adverse-event detection system to detect and categorize hypoglycemia-related adverse events in pediatric inpatients.