Sebastian Proaño

👇🏻 LEV is safe and effective in terminating seizures in pediatrics. The right loading bolus dose is ~ 50 mg/kg. #PCCM #PCCMsky #medsky

Here is my checklist transferring a patient out of ICU

✅ 2 things to check in computer (labs, vitals)

✅ 2 people to talk to (RN, RT)

✅ 2 things to clean up (meds, lines)

The absolute *key* is talking to the RN & RT. They know the minute-to-minute details of patient care needs & trajectory. #2/2

AARC and PALISI Clinical Practice Guideline: Pediatric Critical Asthma | Respiratory Care To address the lack of guidance for clinicians in their care of children with critical asthma, a multidisciplinary team of medical providers used Grading of Recommendations, Assessment, Development, a...

Very excited to share the great work from @benrwhite.bsky.social @chriscarrollmd.com and the great experts @aarc-community.bsky.social @palisinet.bsky.social pediatric critical asthma CPG #PedsICU

www.liebertpub.com/doi/10.1089/...

10 FAQs on MMR and Measles Protection Boosters, waning immunity, checking titers, infection induced immunity, and more

Measles is now in Indiana

If you have questions about the measles vaccine, if you need a booster, etc

I found this post by @kkjetelina.bsky.social super helpful

yourlocalepidemiologist.substack.com/p/10-faqs-on...

To be honest, no, I do not think the 5th liter of fluid will make all the difference.

“Keep giving fluids until the IVC is plump” is the modern “CVP goal of 8-12”, equally aphysiologic and indefensible

YouTube video by EMSwami Etomidate vs Ketamine in RSI #criticalcare #emergencymedicine #resuscitation #airway

Time to abandon etomidate in RSI?
-Mounting evidence of harm vs ketamine:
2022 RCT(PMID 34904190) 8% incr mortality
2023 Meta(PMID 37127020) NNH = 31
2024 study(PMID 38368326) mod prob ⬇️ mortality w/ ketamine
-Ketamine appears to be better default agent

youtube.com/shorts/8bCPT...
#MedSky #EMIMCC

Money 📉
Measles 📈

WV has one of the strongest childhood vaccination policies. During this legislative session we were dangerously close to changing that policy to allow for "religious and philosophical" exemptions. The House (surprisingly) voted it down today and I'm so relieved.

Continuous Renal Replacement Therapy in Children

CCR Journal Watch - tracking the critical care literature daily
https://criticalcarereviews.com/latest-evidence/journal-watch

Image shows website.

This JAMA Insights explores the use of portable point-of-care ultrasound and focused cardiac ultrasound imaging in the diagnosis and treatment of patients with sepsis and septic shock in the emergency department and intensive care unit. https://ja.ma/3DZmvC6

Today's Paper of the Day is:

Practical approach to thrombocytopenia in patients with sepsis: a narrative review

criticalcarereviews.com/latest-evide...

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025

I went further down this rabbit hole

this meta-analysis is the best evidence-based overview of which ABX select resistance I can find👇

as folks are commenting: this supports that it's more important to d/c ABX & limit duration than argue about exactly which agent

pubmed.ncbi.nlm.nih.gov/35339675/