When I was a fellow training in pediatric critical care, one of my attendings would wander by just when I needed him and say "I thought you might need a friend"

Anyway, be like Don Vernon, MD

lol

Change approved

PICU nurse said I look like Professor Snape and tbh I see it

This

😬

I never learn

*PICU phone ringing off the hook*

Me: Hello, PICU

Caller: Hi, this is patient placement, can you transfer me to the nurse in 22

Me: Um . . . so I'm not allowed to answer the phone because I can't do anything but I wanted you to feel heard

Caller:

Me: Please hold while I find someone competent

First of all, I object to the term "ancient" in my presence"

Second of all, truth!

Which calcium preparation should we use in paediatric resuscitation? A comprehensive review of basic physiology, pharmacokinetics, and clinical evidence - Journal of Anesthesia, Analgesia and Critical Care Background The optimal choice between calcium gluconate (CaGN) and calcium chloride (CaCl₂) for hypocalcaemia correction during paediatric critical illness and resuscitation remains debated. This literature review aimed to compare the efficacy and safety profiles of both preparations to determine an evidence-based clinical preference. Methods A comprehensive review of in vitro, in vivo, and clinical trials involving critically ill patients was conducted, focusing on the pharmacokinetics, therapeutic efficacy (measured by the rise in ionised calcium, iCa2⁺), and comparative adverse event profiles, particularly the risk of extravasation injury. Results Both CaGN and CaCl₂ effectively correct hypocalcaemia when equivalent elemental calcium doses are administered. CaCl₂ holds a significant dosing advantage in volume-restricted or extreme emergent scenarios due to its higher concentration of elemental calcium (27.2 mg/mL vs. 9.0 mg/mL for 10% solutions). Whilst the hepatic metabolism requirement for CaGN has been widely refuted, limited paediatric data suggest CaCl₂ may yield a greater response in mean arterial pressure (MAP) in critically ill children. Crucially, the safety profile favours CaGN; a substantial body of evidence indicates that the risk and severity of tissue necrosis following extravasation are markedly higher with CaCl₂. Conclusion The selection of a calcium preparation must be conditional and context-dependent. We recommend reserving CaCl₂ for central venous administration in volume-restricted or extreme emergent settings, whilst CaGN is the preferred choice for peripheral line administration or routine maintenance due to its superior safety profile.

Ever wondered whether calcium gluconate is superior to calcium chloride in paediatric resuscitation ? Fret no more as our new paper in the Journal of Anesthesia, Analgesia and Critical Care is now out and open access .
Have a read 👇 #pedsicu #foamED

link.springer.com/article/10.1...

Approved

We are kindred spirits

Yup

Southern California

and I take a TUMS

Every year, after I pay my property taxes, I go somewhere beautiful to remind me why I live here

Landmark Studies in Critical Care Medicine Landmark Studies in Critical Care Medicine 🫁 Pulmonary & Respiratory Medicine Acute Respiratory Distress Syndrome (ARDS) ARMA (Ventilation with Lower Tidal Volumes - 2000): Showed a significant mortal...

💡 My Takeaway: 18mg of Alteplase is a viable strategy for treating intermediate high risk PE with anticoagulation unrelated to catheter directed approach.

​📚 I’ve added the full protocol & Josh Farkas's review to my open-access ICU Cheat Sheet. Get it here 👇

It's 3:00 AM. The nurses are decorating. I got me some doctor vibes. Happy Doctors Day! It's mostly a good gig. ❤️

PICU life

they boss me around Morty

you complete me

Going through patient discharge instructions today and I made the Spanish interpreter laugh so I guess I still got it?

Trump, Who Calls Mail-in Voting ‘Cheating,’ Just Voted by Mail

Trump, Who Calls Mail-in Voting ‘Cheating,’ Just Voted by Mail www.nytimes.com/2026/03/24/u...

I'm so glad you're posting about this!

"Everywhere in the world they hurt little girls"

PICU decor

One year later the child died. Vaccination is the way to prevent this.

Baby gets measles at 7 months of age. Survives but measles isn't done with him. When he is 7 years old, he gets Subacute Sclerosing Panencephalitis, which is fatal
Stage I – Behavioral/cognitive change
Stage II – Motor dysfunction
Stage III – Severe deterioration
Stage IV – Vegetative state ➡️ death