Growth, development, and failure to thrive: Factors that underlie the availability of pediatric critical care facilities in the United States

2006 ◽  
Vol 7 (1) ◽  
pp. 70-73
Author(s):  
Folafoluwa O. Odetola ◽  
Sarah J. Clark ◽  
Matthew M. Davis
Keyword(s):  
United States ◽  
Critical Care ◽  
Failure To Thrive ◽  
The United States ◽  
Pediatric Critical Care ◽  
Care Facilities ◽  
Growth Development

A National Survey of Pediatric Critical Care Resources in the United States

PEDIATRICS ◽  
2005 ◽  
Vol 115 (4) ◽  
pp. e382-e386 ◽  
Author(s):  
F. O. Odetola ◽  
S. J. Clark ◽  
G. L. Freed ◽  
S. L. Bratton ◽  
M. M. Davis
Keyword(s):  
United States ◽  
Critical Care ◽  
National Survey ◽  
The United States ◽  
Pediatric Critical Care

scholarly journals Posttraumatic Stress Namong Pediatric Critical Care Physicians in the United States in Association with Coronavirus Disease 2019 Patient Care Experiences

2021 ◽  
pp. 088506662110593
Author(s):  
Meena Kalyanaraman ◽  
Ashwini Sankar ◽  
Edem Timpo ◽  
Derrick McQueen ◽  
Kavita Morparia ◽  
...  
Keyword(s):  
United States ◽  
Posttraumatic Stress Disorder ◽  
Critical Care ◽  
Regression Analysis ◽  
Patient Care ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
The United States ◽  
Comfort Level ◽  
Pediatric Critical Care

Posttraumatic stress among pediatric critical care physicians in the United States in association with coronavirus disease 2019 patient care experiences. Our objective was to assess the prevalence of posttraumatic stress (PTS) and its association with COVID-19 patient care experiences among pediatric critical care physicians. Our study was a cross-sectional study of pediatric critical care physicians in the United States. We measured PTS which included posttraumatic stress disorder (PTSD) and subthreshold posttraumatic stress disorder (SubPTSD) using validated PTSD Checklist- 5 survey tool. Association of PTS with COVID-19 patient care experiences was analyzed using regression analysis. Prevalence of PTS was noted in 120 among 294 pediatric critical care physicians (41%; 95% CI, 35-47%). The predominant symptoms were that of hyperarousal and feelings of negative cognition and mood. Among our physicians with PTS, 19% had PTSD and 81% had SubPTSD. Demographic and practice characteristics were not significant for increased PTS on regression analysis. Posttraumatic stress was significantly associated with physicians testing positive or taking time off for COVID-19 illness, self-isolation, fear of infecting their loved ones, families scared of being infected, feeling helpless, patients expressing fears of dying, having pre-existing depression, anxiety, or insomnia, working beyond comfort level of training and having thoughts of quitting (p < 0.05). Thoughts of quitting was associated with the highest significant increase in PTS scores (coefficient:11.643; 95% CI:8.551,14.735; P < 0.01) followed by feeling of helplessness (coefficient:11.055; 95% CI: 8.484,13.624; P < 0.01) and need for additional medications for depression, anxiety and insomnia (coefficient: 10.980; 95% CI: 4.970, 16.990; P < 0.01). Posttraumatic stress is high in pediatric critical care physicians and is associated with various COVID-19 patient care experiences. Thoughts of quitting was associated with highest increase in posttraumatic stress score which could have major implications for the workforce in the future. Subthreshold posttraumatic stress disorder should be recognized, and mental health issues of pediatric critical care physicians addressed.

Employment Opportunities for Pediatric Critical Care Fellowship Trained Physicians in the United States

2020 ◽  
Author(s):  
Abdallah R. Dalabih ◽  
Parthak Prodhan ◽  
Zena L. Harris ◽  
Meredith F. Bone
Keyword(s):  
United States ◽  
Critical Care ◽  
Training Programs ◽  
The United States ◽  
Full Time ◽  
Market Demand ◽  
Employment Opportunities ◽  
Pediatric Critical Care ◽  
Time Period ◽  
Full Time Employment

AbstractPediatric Critical Care Medicine (PCCM) training programs and trained fellows in the United State increased steadily without a corresponding increase in population growth. PCCM trainees worry about limited employment prospects. This study aimed to quantify the demand for PCCM trained physicians in the United States by prospectively tracking full-time employment opportunities over 12 months. The number of advertised opportunities identified was low compared with number of fellows likely to be seeking jobs during same time period. If market demand remains stable, there is risk of excess supply if number of newly fellowship-trained PCCM physicians continues to rise.

Burnout and Psychological Distress Among Pediatric Critical Care Physicians in the United States*

2018 ◽  
Vol 46 (1) ◽  
pp. 116-122 ◽  
Author(s):  
Asha N. Shenoi ◽  
Meena Kalyanaraman ◽  
Aravind Pillai ◽  
Preethi S. Raghava ◽  
Scottie Day
Keyword(s):  
United States ◽  
Critical Care ◽  
Psychological Distress ◽  
The United States ◽  
Pediatric Critical Care

scholarly journals Current Use of Invasive and Noninvasive Monitors in Academic Pediatric Intensive Care Units

2018 ◽  
Vol 07 (03) ◽  
pp. 135-146
Author(s):  
Kyle Rehder ◽  
George Ofori-Amanfo ◽  
David Turner ◽  
Awni Al-Subu
Keyword(s):  
United States ◽  
Critical Care ◽  
Near Infrared ◽  
Pediatric Intensive Care ◽  
Noninvasive Monitoring ◽  
The United States ◽  
Fellowship Training ◽  
Invasive Monitoring ◽  
Pediatric Critical Care ◽  
Specific Patient

AbstractTo describe the current use of noninvasive monitoring compared with traditional invasive monitoring in Pediatric Critical Care Medicine (PCCM) accredited fellowship programs in the United States. A web-based survey with the primary aim of describing the utilization of noninvasive monitoring compared with invasive monitoring was distributed to PCCM program directors (PDs) at the 64 accredited fellowship training programs. Questions focused on demographics and the utilization of invasive and noninvasive monitoring for specific patient populations and disease states. Forty-two (66%) PDs responded to the survey. Capnography and near-infrared spectroscopy (NIRS) were the most commonly reported noninvasive monitoring technology. Arterial and central venous catheters were widely used. Other invasive monitoring devices were used sparingly. Despite widespread use of both invasive and noninvasive monitoring in academic pediatric critical care units across the United States, there is significant variability in the use of noninvasive monitoring compared with invasive monitoring. Further investigation is needed to define the standard of care for the use of noninvasive monitors as practitioners attempt to optimize care while minimizing risks and complications.

scholarly journals The Effectiveness of Contact Precautions on Methicillin-Resistant Staphylococcus aureus in Long-term Care Across the United States

2019 ◽  
Vol 71 (7) ◽  
pp. 1676-1683 ◽  
Author(s):  
Daniel J Morgan ◽  
Min Zhan ◽  
Michihiko Goto ◽  
Carrie Franciscus ◽  
Bruce Alexander ◽  
...  
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
The United States ◽  
Standard Precautions ◽  
Term Care ◽  
Contact Precautions ◽  
Care Facilities

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of health care–associated infections in long-term care facilities (LTCFs). The Centers for Disease Control and Prevention recommends contact precautions for the prevention of MRSA within acute care facilities, which are being used within the United States Department of Veterans Affairs (VA) for LTCFs in a modified fashion. The impact of contact precautions in long-term care is unknown. Methods To evaluate whether contact precautions decreased MRSA acquisition in LTCFs, compared to standard precautions, we performed a retrospective effectiveness study (pre-post, with concurrent controls) using data from the VA health-care system from 1 January 2011 until 31 December 2015, 2 years before and after a 2013 policy recommending a more aggressive form of contact precautions. Results Across 75 414 patient admissions from 74 long-term care facilities in the United States, the overall unadjusted rate of MRSA acquisition was 2.6/1000 patient days. Patients were no more likely to acquire MRSA if they were cared for using standard precautions versus contact precautions in a multivariable, discrete time survival analysis, controlling for patient demographics, risk factors, and year of admission (odds ratio, 0.97; 95% confidence interval, .85–1.12; P = .71). Conclusions MRSA acquisition and infections were not impacted by the use of active surveillance and contact precautions in LTCFs in the VA.

Regionalization of Critical Care in the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sharon Leung ◽  
Stephen M. Pastores ◽  
John M. Oropello ◽  
Craig M. Lilly ◽  
Samuel M. Galvagno ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
The United States

scholarly journals Advances in the Management of Sepsis and the Understanding of Key Immunologic Defects

2011 ◽  
Vol 115 (6) ◽  
pp. 1349-1362 ◽  
Author(s):  
Lee P. Skrupky ◽  
Paul W. Kerby ◽  
Richard S. Hotchkiss
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Operating Room ◽  
The United States ◽  
Difficult Problem ◽  
Treatment Algorithms ◽  
New Treatment ◽  
Overall Mortality

Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these new therapeutic regimens. The goal of this review is to include practical points on important advances in the treatment of sepsis and provide a vision of future immunotherapeutic approaches.

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