James Perucho, MD, MLS

Team
For anyone involved in paediatric airway management
KEY PHRASE

"PILLOW PLEASE"

www.maskinduction.com/positioning-...
Aman Kalra, Professor of Anesthesiology, (Author, Illustrator and Web Designer)
#Ansky #Medsky #Anaesthesia #Anaesthetist #ICM #ICU #Intensivist #Anaesthesiologist #PHEM #HEMS

I love my job #PedsICU #PICUSky

A large (maybe 3 feet wide by 5 feet tall) sign on the end of a row of bookshelves that tells the “address” of books that have sensitive content.

Sometimes I think it’s going to be the librarians who will save us all.

Whooping cough sucks, even mild cases. The kids who die from it have a combination of the worst respiratory distress, and cardiac effects that are a struggle to support even with ECMO. The decrease in cases after the rec for pregnant moms to get boosted was wonderful.

I have a f*ing doctorate in epidemiology and I’m still so confused about how to pick a health insurance plan. Open enrollment should not be this hard!

Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀

Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)

If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC

Key point from my invasive CO talk the other day #CHEST2025

Got roomed in the kids’ room for my PCP appointment, do I really give off pediatrician vibes that much?? Anyway #GetVaccinated

#VaccinesSaveLives #VaccinesCauseAdults #pediatrician

Ha! Shout out to my former PICU fellow when I was resident for finding me out in the wild! Thanks to the @ameracadpeds.bsky.social Section on Critical Care for the award, excited to share my project soon! #PedsICU #PICU #Pediatrician #CriticalCare #PICUSky

It's okay to primordial scream if you need to

Ty for my CICU crew, especially Kayla for organizing this cute birthday surprise and Peter for accidentally ruining it 😂🥳 #PedsICU #CICU #PICUSky @ucsfchildrens.bsky.social

Efficacy and safety of analgosedation with dexmedetomidine in critically ill mechanically ventilated children: a systematic review and meta-analysis of randomized controlled trials - Intensive Care Medicine – Paediatric and Neonatal Intensive Care Medicine – Paediatric and Neonatal - Dexmedetomidine is an increasingly popular analgosedative in critically ill children receiving invasive mechanical ventilation (IMV). We...

Our systematic review and meta-analysis of RCTs evaluating dexmedetomidine in critically ill mechanically ventilated children is live in Intensive Care Medicine-Paediatric and Neonatal @espnic.bsky.social

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

Today’s ACIP meeting promoted false claims and misguided information about vaccines. AAP will continue stepping up and working with our local, state and federal partners to make sure every child in every community continues to have access to immunizations.
bit.ly/4puP4uf

Effectiveness of Pfizer-BioNTech mRNA Vaccination Against COVID-19 Hospitalization Among Persons Aged 12-18 Years - United States, June-September 2021 - PubMed Pfizer-BioNTech COVID-19 vaccine is authorized for use in children and adolescents aged 12-15 years and is licensed by the Food and Drug Administration (FDA) for persons aged ≥16 (1). A randomized pla...

Hello Senate Committee on Vaccine Effectiveness: YES, COVID vax decreases hospitalizations for <18 yo. In fact many studies like this in peer reviewed medical journals. #PedsICU pubmed.ncbi.nlm.nih.gov/34673751/

@nsanchezpinto.bsky.social presenting with Dr. Anoop Bhalla of CHLA in the @palisinet.bsky.social main meeting on the new proposed #PIERCE study as a collaboration between multiple subgroups #PALISI25 #PEDAL #PREVENT and the PICU Data Collaborative 🤩🤩

Champagne and oysters at @palisinet.bsky.social #PedsICU

Presenting (and smiling through the nerves) a Works in Progress for one of my fellowship projects at PALISI (the Long-Term Ventilation subgroup which is the best one but I’m biased!) @palisinet.bsky.social #PALISI #PALISI25 #PedsICU #MedSky #PICUSky

That looks great! Just had some tonging as well, it was a Japanese style one with roasted eggplant

If you are comparing childhood vaccination requirements with slavery

a) you neither understand vaccines nor slavery

b) you have no business being a “surgeon general” of any state

"I’m deeply alarmed, and we should all be, that critical vaccine policy decisions are being made without scientific rigor, eroding public trust and endangering our nation’s health. The unjustified removal of the CDC director & sidelining of experts in favor of non-specialists is unprecedented. (1/3)

Hi #PedsICU friends, just wondering if anyone has a “long stay rounds” type working group at their institution for complex discharges. Would love to know how others have theirs set up!

Inside the CDC director's ouster: Kennedy demanded acceptance of new vaccine policies; Susan Monarez refused Susan Monarez’s resistance to Robert F. Kennedy Jr.’s moves to assert control over vaccine guidance is at the center of her dismissal as CDC director

However bad you think things are at the CDC they are worse.

That's the takeaway from this well-reported story from Daniel Payne w/back-up from an all-star STAT team.

Must-read.

www.statnews.com/2025/08/28/c...

Influenza and COVID-19 Vaccination in Children Receiving Long-Term Ventilation This cohort study examines rates of vaccination for COVID-19 and for influenza among children receiving long-term home ventilation.

Not getting better with further politicization of #healthcare and #publichealth. Those #at-risk will incur the most #morbidity and #mortality, but everyone will be impacted.

jamanetwork.com/journals/jam...

'Like She Was Not Even There': Children With Disabilities Face Discrimination in Health Care Children with disabilities, and their families, may face discrimination in in the hospitals and clinics they visit for their health care, according to a new study led by researchers at University of U...

“The study did not measure how common it is for clinicians to show bias against children with disability, but it exposes a serious problem, said lead author Dr. Stefanie Ames, a critical care physician at U of U Health.”

https://consumer.healthday.com/disability-child-2661926069.html

#PedsICU 👇watch out for this vape related “new” opioid like drug as kids/young adults go back to school/college!

US pediatric group breaks with federal policy, recommends COVID vaccines for young children The American Academy of Pediatrics on Tuesday recommended that all young children get vaccinated against COVID-19, differing from federal policy that no longer recommends routine vaccination for healthy children.

Resistance

www.reuters.com/business/hea...

Sadly, this warning by @peterhotezmdphd.bsky.social was prescient

It won’t end with COVID: Countering the next phase of American antivaccine activism 2025–29

journals.plos.org/globalpublic...

Bodega ramps are all over New York City. The humble, concrete blobs ease entry into delis and other stores — and affirm the civic compact. nyti.ms/3UnFivI

Specific q’s:
    •    scope of the fellow in CICU (FLP vs supervisory, or hybrid)
    •    Procedure division btw fellow/ APP
    •    Expectations for unit-wide awareness vs assigned pt’s, duties for transports, RRTs, or bed flow
    •    Wknd/PM coverage
    •    Anything else?

#PedsICU (2/2)

Love the warm welcome from the #PedsICU folks! Quick q: I’m one of the 4th yr chiefs and my fellowship program is transitioning the fellow role in the CICU from supervisory to frontline provider to be more in line with other programs. I was wondering if I could pick your collective brains (1/2)