This step-by-step guide to the procedure of central venous line insertion in children is primarily aimed at those new to the procedure, however clinicians familiar with the procedure in adults will still find some key pearls on how to modify their standard technique to achieve a high success rate in small infants.
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This episode covers ‘Paediatric Critical Care Pearls’ 31 – 40. This is the fourth episode of the multipart series.
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What you need to know about how to modify the standard intubation technique as well as key learning points to remember when intubating children in special circumstances.
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A step by step approach of how to succeed with direct laryngoscopy in children.
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What you need to know about the medications used for intubation of the critically ill child (induction agents, muscle relaxants, rescue medications and post intubation drugs).
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This episode provides an introduction to mechanical ventilation of the critically ill child and covers the basics of setting up the ventilator.
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This episode covers ‘Paediatric Critical Care Pearls’ 21 – 30. This is the third episode of the multipart series.
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This episode covers the steps required when preparing to intubate a critically ill child and introduces the Paediatric Emergencies Pre-intubation Checklist.
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This episode covers ‘Paediatric Critical Care Pearls’ 11 – 20. This is the second episode of the multipart series.
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Paediatric Critical Care Pearls are key points that should be remembered when treating the critical ill child, each summarised into a sentence.
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This article provides advice on how to use ‘Push Dose Adrenaline’ and ‘Peripheral Adrenaline Infusions’ in critically ill children.
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In this episode the quantitative approach to acid-base interpretation is explained with examples of how to perform the calculations at the bedside.
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Like any sick child the initial management of the ‘Collapsed Neonate’ involves an ABCDE approach. While there are many possible causes, four major diagnoses must be considered…
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Over the last few years cuffed endotracheal tubes are being used more frequently in critically ill children. This episode looks at the possible reasons for this and reviews the evidence of whether this practise is safe…
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Bronchiolitis is a viral infection of the lower airways, most often in infants but can affect children up to two years of age. It is commonly caused by respiratory syncytial virus (RSV), although it can be caused by numerous other viruses and it has a peak incidence in the autumn/winter…
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Airway opening manoeuvres (avoid head-tilt and chin-lift in trauma, use jaw thrust) as required with high flow oxygen (10-15 litre/minute via face-mask with reservoir bag) and suction airway as needed. Immobilise cervical spine in trauma patient…
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Urgent semi-elective intubation and ventilation should be undertaken if there is ongoing signs of shock unresponsive to 40 ml/kg of fluid resuscitation or if there is airway obstruction/loss of protective airway reflexes at any stage (cardiovascular resuscitation should occur before induction of anaesthesia)…
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Airway opening manoeuvres with high flow oxygen (10-15 litre/minute via face-mask with reservoir bag) and suction secretions as needed. Consider nasopharyngeal airway if difficultly maintaining airway (insertion of oropharyngeal airway normally not possible due to clenched teeth)…
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Intubate if there are life threatening features that are refractory to standard treatment i.e. silent chest, oxygen saturations <92%, cyanosis, poor respiratory effort, hypotension, altered consciousness or exhaustion...
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Informative, enjoyable and pertinent ★★★★★
Very enjoyable and educational podcasts, presented by an obviously highly skilled and capable Intensivist. It is delivered in straight forward detail with a case study to support and demonstrate the information discussed. Dr Flannigan is easy to listen to and his presentation style is delivered at a pace that allows absorption of the information easily.
Working within a mixed ED myself I think that it is of great educational use to those who work in such environments. It can get hectic with all the “adult problems” clogging up such an ED that the paediatric patients can get “lost in the mix” a little and the exposure to serious paediatric illness is no where near as frequent as it would be in a dedicated paediatric facility. Having information dealing with such serious issues presented along with a case study really helps reinforce concepts and practice for such occassions.
Furthermore reinforcement on the basics of escalation and planning ahead to a potential tubing is always a timely reminder on how quick a childs condition can turn and how time is not on your side with the sick paediatric patient.
The content discussed within these podcasts is highly pertinent to all those who deal within paediatrics, particularly useful to those who don’t have rapid access to a PICU or tertiary paediatric facility.
Overall, Highly enjoyable, hope to hear more.
As an ED registrar with no neonatal experience (and about to start a paediatric rotation!) I found this fantastically helpful. I feel much more equipped in terms of main differentials to consider as well as in formulating a safe, structured approach. The case-based ABCDE approach makes it seem very do-able (there’s a lot to be said for a familiar formula in a terrifying situation) and I like that it’s broken down simply and pragmatically (don’t mess around too long with the drip – get an IO in). Nice (not too lengthy) asides about logic for choosing certain drugs/doses etc, which I found particularly helpful as someone from a non-paeds background. I also like the way ‘key learning points’ are highlighted – it does help the info stand out and stick. Thank you!
Doctor (Paediatric Registrar) ★★★★★
Fantastic podcasts to help you mentally prepare for the time when NETS (retrieval team) is en route and you’re the registrar on the floor. The 3 episodes on Critical Care Pearls were particularly good, and the episode on acid-base has changed my practice. Thanks Dr Flannigan!
Great podcast ★★★★★
I would recommend this podcast for anyone who looks after children in their emergency department. Balanced , informative with very useful information. Thank you – keep them coming 🙂
Absolute GOLD!! ★★★★★
I re-re-relisten to these on my way into work & totally prepares my thoughts & processes for the stressful (uncommon) situations– very appreciative! Website detail & links fantastically useful too. I am an Australian trainee.
Little pieces of pediatric emergency pearls ★★★★★
by X-stitcher 🙁
For an adult emergency physician like me, this podcast helps with the little things that matter for the little sick patients. Great job!
Listened to these during my paediatrics rotation and found them really helpful! They give a great systematic and thorough approach!
by k k 1
great podcast, lots of good advice. i enjoyed the ‘pearls’. one technical issue: i listen to the podcast on the way to my work, and in busy traffic the volume is sometimes a bit low.
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