Principles of toxin assessment and screening
• Poisoned patients are frequently encountered in the intensive care setting and often pose a diagnostic challenge. Skills in taking a history and performing a thorough physical exam, as well…
Adverse drug reactions and drug-drug interactions
Pearls • Adverse drug events (ADEs) are defined as any injury resulting from both prescribed and unintended administration of drugs, including inappropriate use or inadvertent side effects not associated with…
Pediatric sepsis
• The typical patient with septic shock has simultaneous derangements of cardiovascular function, intravascular volume status, respiratory function, immune/inflammatory regulation, renal function, coagulation, hepatic function, and/or metabolic function. • The…
Accidental hypothermia
• Accidental or unintentional hypothermia is a potentially lethal complication of exposure to cold. It can occur as a result of exposure to cold air, water immersion/submersion, or snow burial….
Multiple-organ dysfunction syndrome
• Pediatric multiple-organ dysfunction syndrome (MODS) represents the leading final pathway to death in children who suffer critical illness triggered by acute insults such as sepsis (leading cause of MODS),…
Hyperthermic injury
• According to the Centers for Disease Control and Prevention, from 1999 to 2010, 7415 deaths were attributable to excessive heat exposure or hyperthermia in the United States. • With…
Healthcare-associated infections
• Hand hygiene is foundational to infection control in the pediatric intensive care unit (PICU), including the prevention of healthcare-associated infections (HAIs); units should be relentless in pursuing compliance with…
Pediatric rheumatologic disease
• Approximately 1 child in 250 has a rheumatologic disease. • A child may present to the intensive care unit (ICU) with a life-threatening manifestation of an undiagnosed rheumatologic disease…
Immune balance in critical illness
Pearls • The inflammatory response to critical illness is highly dynamic over time, involves both innate and adaptive immunity, and includes both pro- and antiinflammatory features. • These features constitute…
