Listen to the Podcast
Paediatric Critical Care Pearls are key points that should be remembered when treating the critical ill child, each summarised into a sentence. These are not all my own pearls and I have been collecting these throughout my career. This will be a multi-part series and I plan to release them in batches of 10. The pearls themselves below may not make much sense on their own and you will need to listen to the above podcast to fully understand them, but once you have listened to the podcast the below list will serve as a useful summary.
The Pearls
- Consider going straight for intraosseous access in crashing patients
- Use cefotaxime rather than ceftriaxone initially in septic shock
- Don’t exceed the adult maximum dose when using salbutamol infusions
- Don’t delay calling the ambulance in a patient needing time critical transfer
- When you see a collar think use a bougie
- Use a cuffed endotracheal tube in all critically ill children unless contraindicated
- Don’t insert upper circulation central lines in patients with hypokalaemia
- Use ultrasound to help insert arterial lines in children with weak or impalpable pulses
- Start prostaglandin infusions at a dose appropriate to the clinical situation
- Don’t try to lead and do at the same time
I’m always on the search for new pearls so if you have any please get in touch in the comments section to share yours and I’ll feature the best ones in a future podcast.
Useful Links
Video demonstrating the effectiveness of intraosseous access
Podcast – Should cuffed endotracheal tubes be used routinely in critically ill children?
Video demonstrating task fixation and why trying to lead and do at the same time doesn’t work
Video demonstrating effective leadership
Great pearls Chris. I totally agree with these and am hungry for more….
This so useful and the website is a brilliant resource, Thanks!
Hi Becki, glad you are finding it useful. Thanks for taking the time to leave feedback. Chris
Very interesting listen and informative, from a nurses point of view it’s great to have background understanding about why certain decisions may be made in order to preempt potential plans of action and increase team effectiveness in the critical care environment
Hi Deborah, its great to hear that it not just the doctors who are finding this useful, multidisciplinary learning has always been the aim with this. Thanks for taking the time to share your feedback. Chris
Dear Chris,
Fantastic pearls, they are so good and you are doing an amazing stuff. Pearl 10 about human factors, do not try to lead and do, is really great. I do love human factors and I am normally use another pearl in the emergency department. ” Share your mental model, the Emergency Department is not the place to guess what others are thinking”.
Carry on with a good work and thank you so much for sharing your knowledge and passion with us. BW. Fernando
Thanks Fernando, for your feedback and for taking the time to share your own Pearl. I agree with you about the human factors, once you know the medicine I think optimising the human factors are the best way to improve care delivered. Chris
I am really enjoying your Podcasts.
I have taken alot of valuable information from them.
Janet from Australia