Review for exams and maintain your knowledge of pediatric critical care with the new self-study program from a source you can trust. Brought to you by the American Academy of Pediatrics' Pediatrics Review and Education Program®, PREP® ICU is an online subspecialty self-assessment program designed to help pediatric intensivists succeed in the PICU. Click here for a FREE trial.

Pediatric Critical Care Education: PICU Course

This is now only available for for a registration fee here...

The PedsCCM File Cabinet

• A growing resource of original, peer reviewed articles, reviews, and lectures
• A dynamic series of contextual links to pertinent documents around the Internet
• Read the new Introduction and Call for Submissions
• Go directly to the File Cabinet Index

Case Reports in Pediatric Critical Care

A collection of rare, unusual, or simply instructive patient case reports

• With the proliferation of case reports of both common and uncommon scenarios on the web that offer educational rewards, this section has now been more appropriately entitled "Case Reports in Pediatric Critical Care."
• Consider sharing your experiences with colleagues

Pediatric Critical Care Nursing

Resources and information about Advanced Practice Nursing for pediatric critical care

• Pediatric Critical Care Advanced Practice Nursing has their own email discussion list: PICUAPN. Information about this resource and how to join are here...
• Minutes from the most recent meeting of the APN Committee of the SCCM Pediatric Section are now available here. Read more about this group and participate!
• A comprehensive survey of APN's in Pediatric Critical Care is now available on PedsCCM... please participate and read more here...
• Pediatric Critical Care Nursing Job Opportunities: now with a full-service PICU Nursing Jobs Database. Use the new web-based form here to submit a position to us.
• Pediatric Critical Care Nursing Literature Reviews: concise summaries and critiques of pertinent articles. Three new reviews include:
  • Review by Mary McCulley of: Runton N, Toth J. Introducing the Basic Knowledge Assessment Tool for Pediatric Critical Care Nursing (PEDS-BKAT). Critical Care Nurse 1998; 18:67-72.
  • Review by Mary McCulley of: Briening E. Pediatric Management of children in status asthmaticus. Critical Care Nurse 1998;18:74-82.
• PICU-Nurse-International is

  A nursing group interested in discussing any matters related to pediatric intensive care. This egroup serves as a principal meeting place for the International Pediatric Intensive Care Nurses Network. Therefore, in addition to addressing specific clinical topics, this nursing group is also interested in discussing issues from an international perspective,

The New PICU List

• The new PICU List is operational. Details are here... Or to join the new forum and email list, click on http://www.vpicu.org/piculist_signup.php
• UCIP-NET: a spanish language mail list for pediatric critical care
• Pediatric Critical Care Advanced Practice Nursing has their own email discussion list: PICUAPN. Information about this resource and how to join are here...

Software for pediatric critical care

• Mack EH, Wheeler DS, Embi PJ. Clinical decision support systems in the pediatric intensive care unit. Pediatr Crit Care Med. 2009 Jan;10(1):23-8. [abstract]
• The Virtual PICU, in association with the National Association of Children's Hospitals and Related Institutions, and The National Outcomes Center announce the creation of VPS, LLC, the distributor and coordinating center for VPS (Virtual PICU Performance System), PICU database software. Go to myvps.org to learn more and sign up to participate.
  
• PICNET; Paediatric Intensive Care Networked Database A pilot project to develop a collective information system for Paediatric Intensive Care in the UK. Part of Paediatric Intensive Care Framework of the UK's Department of Health
• Medical Calculators with Javascript, including Emergency Medications, Drip Rate-Dose, Body Surface Area, A-a gradient, and Creatinine clearance, from Steve Pon at Cornell University Medical Center's PICU.
• A wide variety of online calculators, from eMedicine Pediatrics, a free online textbook of pediatrics. From eMedicine.com
• The Nutrition Calculator from From Michael Apkon, MD, PhD and Yale's Section of Critical Care and Applied Physiology now is database enabled: "it knows about the caloric, Na, and K content of each formula as well as the distribution of calories among carbohydrate, fat and protein." Also see Also check out Drugcalc: An Infusion Calculator. And now both Nutricalc and Drugcalc are available for PalmOS here... care. Read more...
• Medical applications and software sites for Palm OS PDA's
• Clinformatix, LLC at http://www.clinformatix.com/ provides an electronic medical record, clinical and administrative database, decision support and more for Pediatric ICU's (and neonatal ICUs). From Mike Apkon, MD, PhD at Yale University.
• PICU Tools - a Palm OS application for pediatric intensive care practitioners. Calculate infusion rates, osmolarity, drug dosages, and complete hemodynamic profiles from pulmonary artery catheter data. Provides arterial blood gas interpretation, lab values and more. Version 5.0 now supports some EBM calculations, several new tools, and a more comprehensive drug and resuscitation database, and has been updated for PALS 2005. Freeware, by M. Verive. Details here...
• Isabel; a online pediatric differential diagnosis tool, with APLS protocols and other guidelines
• NICU Tools: Paediatric Calculators; includes calculators for glucose delivery, gestational age and more. From Michael and Paul Hewson, Wellington, New Zealand
• PedBase+ is a new version of Dr. Alan Gandy's downloadable database of pediatric disorders for PalmOS PDA's. Now with updatable records and other new features. Thanks to Dr. Michael Verive for this version. Available here... (700K).

Clinical Pathways and Guidelines - the collection begins

• We propose collecting clinical pathways pertinent to the care of critically ill or injured infants and children - why should each institution "reinvent the wheel?"
• Review this area before creating one, and consider submitting pathways from your PICU that others might benefit from.
• Also with such practical items as:
  • Two files (Microsoft Word and Rich Text Format) that can be used for PICU Attending Progress Note templates. Provided by Gene Fisher, M.D., Medical College of Georgia. Read more and download them from here.
  • Another PICU Attending Progress Note template, courtesy of John Straumanis, M.D., University of Maryland.
  • And a set of templates for complete PICU documentation, from John Mickell, M.D., Medical College of Virginia
  • "Evidence-Based Care of the Child with Traumatic Head Injury"; a Powerpoint presentation by T. Trimarchi. The evidence behind current management recommendations for the head injured patient in the PICU. [original file: head_trauma_research.ppt (668K)] Accompanying file: "ICP management bibliography" - a Word document bibliography for this presentation. [ICP_management_biblio.doc (44K)]
• Includes links to other guideline databases, such as the new National Guideline Clearinghouse; evidence-based guideline collection - a joint effort of the Agency for Health Care Policy and Research (AHCPR), American Medical Association (AMA), and American Association of Health Plans (AAHP).
• See a wide range of evidence-based guidelines from Cincinnati Children's Hospital here... (many cardiac conditions most relevant to PICU care...)
• Also, ACCM/SCCM Guidelines and Practice Parameters are now on the SCCM's Website
  • See, for example: Guidelines for developing admission and discharge policies for the pediatric intensive care unit. Pediatric Section Task Force on Admission and Discharge Criteria, Society of Critical Care Medicine in conjunction with the American College of Critical Care Medicine and the Committee on Hospital Care of the American Academy of Pediatrics. Crit Care Med. 1999;27:843-5. (pdf)

CA-BSI Collaborative - Phase II Announcement

The National Association of Children’s Hospitals and Related Institutions (NACHRI) and a team of PICU clinicians and Improvement Science faculty launched a three-year quality improvement project (Phase I) in October of 2006 that focused on prevention of catheter-associated blood stream infections (CA-BSI) in the 29 pediatric intensive care units (PICU) of 27 children’s institutions. The results of this Phase I collaborative have been remarkable. This Phase I collaborative is now being expanded to additional PICUs that seek to improve the healthcare of children by preventing CA-BSI events. Our initial collaborative progress to date shows:

The number of infections has decreased from a pre-collaborative CA-BSI rate of 5.39 per 1,000 catheter days to a sustained rate of 3.19 per 1,000 catheter days. This reduction represents a statistically significant 41 percent decrease in CA-BSI events. The reduced CA-BSI rate can be extrapolated to:

• Prevention of 177 infections in the 27 institutions
• Cost savings of approximately $6 million
• Estimated 20 deaths prevented

As the Co-Chairs for this project we want to make you aware that we are now enrolling participating sites into the second phase of the project. We hope to enroll an additional 40 - 50 PICUs. In addition, we are happy to answer questions you may have. We are attaching additional information and an enrollment sheet for you.

Richard J. Brilli (rich.brilli@cchmc.org ) and Marlene M. Miller (mmiller@nachri.org)