We discuss the impact of family presence during resuscitations.

Hosts:
Ellen Duncan, MD, PhD
Brian Gilberti, MD

• Historical Context: The conversation around allowing family members in the room during resuscitation events began gaining attention in 1987. Since then, the practice has been increasingly encouraged.
• Current Practices in Pediatrics:
  • Family presence during pediatric resuscitations remains inconsistent, with healthcare provider acceptance ranging from 15% to 85%.
  • Many subspecialists and consultants still request that families step out, often due to outdated concerns.
• Common Concerns & Myths:
  • Interference in resuscitation → Studies show minimal disruption.
  • Legal risks → No increased litigation risk has been demonstrated.
  • Family trauma → Research suggests that presence may help with grieving and reduce PTSD symptoms.

New England Journal of Medicine study on Family Presence During Cardiopulmonary Resuscitation (Jabre et al., 2013):

• In a randomized controlled trial of 570 relatives, PTSD-related symptoms were significantly higher in family members who were not offered the oppo...

We discuss the recognition and treatment of necrotizing fasciitis.

Hosts:
Aurnee Rahman, MD
Brian Gilberti, MD

0:00 – Introduction

0:41 – Overview

1:10 – Types of Necrotizing Fasciitis

2:21 – Pathophysiology & Risk Factors

3:16 – Clinical Presentation

4:06 – Diagnosis

5:37 – Treatment

7:09 – Prognosis and Recovery

7:37 – Take Home points

• Necrotizing soft tissue infections can be easily missed in routine cases of soft tissue infection.
• High mortality and morbidity underscore the need for vigilance.

• A rapidly progressive, life-threatening infection of the deep soft tissues.
• Involves fascia and subcutaneous fat, causing fulminant tissue destruction.
• High mortality often due to delayed recognition and treatment.

• Type I (Polymicrobial)
  • Involves aerobic and anaerobic organisms (e.g., Bacteroides, Clostridium, Peptostreptococcus).
  • Common in immunocompromised patients or thos...

We sit down with one of our toxicologists to discuss acetaminophen toxicity.

Hosts:
Marlis Gnirke, MD
Brian Gilberti, MD

0:35 – Hidden acetaminophen toxicity in OTC products

3:24 – Pharmacokinetics and toxicokinetics

6:06 – Clinical Course

9:22 – The antidote – NAC

11:02 – The Rumack-Matthew Nomogram

17:36 – Treatment protocols

22:34 – Monitoring and Lab Work

23:23 – Considerations when treating pediatric patients

23:57 – IV APAP overdose, fomepizole

25:42 – Take Home Points

Acetaminophen vs. Tylenol:

• The importance of recognizing that acetaminophen is found in many products beyond Tylenol.
• Common medications containing acetaminophen, such as Excedrin, Fioricet, Percocet, Dayquil/Nyquil, and others.
• The risk of unintentional overdose due to combination products.

Prevalence of Acetaminophen Toxicity: