Pediatric Critical Care: A Primer for All Clinicians

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Series: Emergency and Intensive Care Medicine
BISAC: MED094000

Pediatric critical care is an emotionally and intellectually demanding field of medicine; however, it is at its core the discipline focused on saving and improving the lives of children affected by acute and chronic illnesses, injuries, and toxicities. The heart of any successful pediatric critical care program is the multidisciplinary and interdisciplinary care provided by pediatric intensivists and their team of specialized co-workers including pediatric critical care nurses, respiratory therapists, pharmacists, social workers, and nutritionists working in concert with the pediatric ICU (PICU). It is this interplay between clinical specialists that ensures children are afforded cutting-edge, technologically complex, holistic, and age-appropriate care, while at the same time ensuring that the needs of both the child and the family are addressed. Additionally, critical care medicine encompasses the extremes of all pediatric medicine and as such, those charged with caring for children in the PICU must be well-versed in all areas of pediatric medicine, as well as prepared for any contingency or emergency.

Caring for sick children both within and outside of the pediatric intensive care unit (PICU) requires an understanding of how pediatric physiology differs from that of adults. Recognizing a deteriorating child and stabilizing that patient rapidly is a requisite skill that every clinician charged with caring for a child must master. This practical handbook is written for all clinicians who care for children with acute illness, and who may need to assess and stabilize a deteriorating child before transfer to the PICU. Specifically, chapters provide helpful insights for all levels of pediatric providers including pediatric critical care and general care nurses, advanced practice nurses, medical students, pediatric residents, and residents from other disciplines who rotate through the PICU, pediatric hospitalists, and emergency physicians who care for children. In addition to covering PICU-specific topics such as mechanical ventilation and procedural sedation, this handbook also includes guidance in the initial resuscitation, management and stabilization of children with impending critical illnesses or those at risk for acute deterioration. Management of life-threatening situations that are specifically included in this book include respiratory failure, cardiovascular failure, electrolyte derangements, diabetic ketoacidosis, burn injuries, status epilepticus, status asthmaticus, toxic ingestions, and sepsis, among many others. (Imprint: Nova Medicine and Health)

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Table of Contents

Table of Contents

Chapter 1. Preface

General Procedures and Administration

Chapter 2. Rapid Assessment of the Critically Ill Pediatric Patient
(Edward E. Conway, Jr.)

Chapter. 3 Basic Concepts of Pediatric Transport
(Paul Severin)

Chapter 4. Cardiopulmonary Resuscitation
(Priti Jani)

Chapter 5. Procedural Sedation
(Julie Williamson)

Chapter 6. Invasive Vascular Access
(Whitney Kopp, Chelsey A. Willie and Tara L. Petersen)

Cardiovascular Conditions

Chapter 7. Shock
(Nathan Thompson, Martin Wakeham and Timothy E. Corden)

Chapter 8. Neonatal Cyanotic Heart Disease
(Jeremy T. Affolter)

Chapter 9. Common Pediatric Arrhythmias
(Fei Fei Z. Williams)

Chapter 10. Hyper-Cyanotic Spells in Tetralogy of Fallot
(Ahmeneh Ghavan)

Chapter 11. Single Ventricle Physiology
(Jeremy T. Affolter)

Chapter 12. Pediatric Cardiomyopathy and Myocarditis
(Jeremy T. Affolter)

Respiratory Conditions

Chapter 13. Acute Status Asthmaticus
(Toni Petrillo)

Chapter 14. Foreign Body Aspiration
(Madeline Charlson and Andrea M. Kline-Tilford)

Chapter 15. Mechanical Ventilation
(Jason M. Kane)

Chapter 16. Acute Respiratory Distress Syndrome (ARDS)
(Jaime Braverman)

Chapter 17. Pneumonia
(B. Louise Giles and Maria L. Dowell)

Chapter 18. Pediatric Tracheostomy
(Andrea M. Kline-Tilford and Madeline Charlson )

Chapter 19. Transfusion Related Acute Lung Injury
(Ahmeneh Ghavan)

Hematologic Conditions

Chapter 20. Anemia
(Walter Palmer, Aamne Shalabi and Joseph R. Hageman)

Chapter 21. Disseminated Intravascular Coagulation
(Miki Nishitani and Joseph R. Hageman)

Chapter 22. Hemophilia
(Rhukmi Bhat)

Chapter 23. Pediatric Febrile Neutropenia
(Muayad Alali, Amir Bari Siddiqui and Jennifer L. McNeer)

Chapter 24. Complications of Sickle Cell Disease
(Josephine Misun Jung, Gabriela Villanueva and Radhika Peddinti)

Chapter 25. Oncologic Emergencies
(Elizabeth Sokol)

Infection and Immunology

Chapter 26. Anaphylaxis
(Leena V. Padhye and Christina E. Ciaccio)

Chapter 27. Fever in the Immunocompromised Patient
(Priscila Badia and Christopher E. Dandoy)

Chapter 28. Fungal Infections
(Allison H. Bartlett)

Chapter 29. Sepsis
(Philip A. Verhoef)

Gastrointestinal Disorders

Chapter 30. Acute Abdominal Pain in Children
(Anna F. Tyson and Nikunj K. Chokshi)

Chapter 31. Gastrointestinal (GI) Bleeding
(Manish Tushar Raiji and Lindsey Zhang

Chapter 32. Bowel Obstruction
(Grace Mak, MD, and Jared Emolo, MD)

Chapter 33. Refeeding Syndrome
(Joseph Runde and Timothy Sentongo)

Chapter 34. Acute Liver Failure
(Joseph Runde and Ruba Azzam)

Endocrine Emergencies and Metabolic Disorders

Chapter 35. Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
(Rachel Stork Poeppelman, Michelle Lemelman Elizabeth Littlejoh and Stephen Duck)

Chapter 36. Adrenal Crisis
(Harini Kolluri and Dianne Deplewski)

Chapter 37. Salt Syndromes
(Casey W. Stulce)

Chapter 38. Hypoglycemia
(Juan J. Lado)

Chapter 39. Thyroid Emergencies
(Dianne Deplewski)

Chapter 40. Hyperammonemia
(Vincent Dimaggio and Stephanie Sacchrow)

Neurologic Conditions
Chapter 41. Status Epilepticus
(Jason L. Adler)

Chapter 42. Pediatric Traumatic Brain Injury
(Jason L. Adler)

Chapter 43. Coma in Children
(Jason L. Adler)

Chapter 44. Guillian Barre Syndrome and Other Neuropathologies
(Janet L. Rossi)

Chapter 45. Acute Spinal Cord Injury
(Casey W. Stulce)

Chapter 46. Evaluation & Management of New-Onset Seizures
(Bridget M. Wild and Leah Finkel)

Chapter 47. Acute Paresis
(Afsaneh Talai)

Chapter 48. Encephaliitis
(Casey W. Stulce)

Chapter 49. Delirium and Psychosis
(Afsaneh Talai)

Chapter 50. Analgesia and Sedation in Pediatric Critical Care
(Julie Williamson)

Renal and Electrolyte Disorders

Chapter 51. Acute Kidney Injury
(Reem Itani and Shireen Hashmat)

Chapter 52. Hemolytic Uremic Syndrome (HUS)
(Anna Rodenbough, Eltsa Nicolaou and Christopher Clardy)

Chapter 53. Hypertensive Emergencies
(Juan R. Barron-Alemany and L. Nelson Sanchez-Pinto)

Chapter 54. Evaluation and Management of Dehydration
(Sadie LaPonsie)

Chapter 55. Electrolyte Derangements and Emergencies
(Reem Nubani)

Chapter 56. Acute Acid Base Disorders
(Cesar Menchaca, B. Louis Giles and Shireen Hashmat

Trauma

Chapter 57. Hanging Injuries in Children
(Tracy Koogler)

Chapter 58. The Acute Pediatric Trauma Patient
(Leslie Hueschen)

Chapter 59. Drowning and Submersion Injury
(Jana A. Stockwell)

Chapter 60. Toxidromes and Poisonings
(Meral M. Patel)

Chapter 61. Bites and Stings
(Leslie Hueschen)

Chapter 62. Burns, Smoke Inhalation, Chemical and Electrical Injuries
(Tracy Koogler)

Chapter 63. Child Maltreatment
(Norell Rosado)

Frequently Used Medications

Chapter 64. Pharmacology for Pediatric Patients
(Allison Nelson)

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