A prospective observational study of video laryngoscopy-guided coaching in the pediatric intensive care unit.

Background: There are limited data on the use of video laryngoscopy for pediatric patients outside of the operating room.

Aim: Our primary aim was to evaluate whether implementation of video laryngoscopy-guided coaching for tracheal intubation is feasible with a high level of compliance and associated with a reduction in adverse tracheal intubation-associated events.

Methods: This is a pre-post observational study of video laryngoscopy implementation with standardized coaching language for tracheal intubation in a single-center, pediatric intensive care unit.

Leveraging EHR Data to Evaluate the Association of Late Recognition of Deterioration With Outcomes.

Objectives: Emergency transfers (ETs), deterioration events with late recognition requiring ICU interventions within 1 hour of transfer, are associated with adverse outcomes. We leveraged electronic health record (EHR) data to assess the association between ETs and outcomes. We also evaluated the association between intervention timing (urgency) and outcomes.

Implementation of a Multidisciplinary Debriefing Process for Pediatric Ward Deterioration Events.

Objectives: Event debriefing has established benefit, but its adoption is poorly characterized among pediatric ward providers. To improve patient safety, our hospital restructured its debriefing process for ward deterioration events culminating in ICU transfer. The aim of this study was to describe this process' implementation.

Brain Death Evaluation in Children With Suspected or Confirmed Coronavirus Disease 2019.

Objectives: To discuss the challenges of conducting a death by neurologic criteria or brain death evaluation in the coronavirus disease 2019 era and provide guidance to mitigate viral transmission risk and maintain patient safety during testing.

Design: Not applicable.

Setting: Not applicable.

Ventilator-Weaning Pathway Associated With Decreased Ventilator Days in Pediatric Acute Respiratory Distress Syndrome.

Objectives: There is limited evidence on the impact of protocolized ventilator weaning in pediatric acute respiratory distress syndrome, despite utilization in clinical trials and clinical care. We aimed to determine whether protocolized ventilator weaning shortens mechanical ventilation duration and PICU length of stay in pediatric acute respiratory distress syndrome survivors.

Design: Secondary analysis of a prospective pediatric acute respiratory distress syndrome (Berlin definition) cohort from July 2011 to June 2019 analyzed using interrupted time series analysis pre- and postimplementations of a ventilator-weaning pathway.

Just-in-Time Simulation to Guide Workflow Design for Coronavirus Disease 2019 Difficult Airway Management.

Objectives: The coronavirus disease 2019 pandemic has required that hospitals rapidly adapt workflows and processes to limit disease spread and optimize the care of critically ill children.

Design And Setting: As part of our institution's coronavirus disease 2019 critical care workflow design process, we developed and conducted a number of simulation exercises, increasing in complexity, progressing to intubation wearing personal protective equipment, and culminating in activation of our difficult airway team for an airway emergency.

Patients And Interventions: In situ simulations were used to identify and rework potential failure points to generate guidance for optimal airway management in coronavirus disease 2019 suspected or positive children.

The recognition and treatment of amyloidosis in the critical care patient.

Primary amyloidosis is a little understood, often misdiagnosed disease. Characterized by extracellular protein deposits in tissue and vital organs, this disease gives patients a survival period of 13.2 months after diagnosis.