Week in review Feb 20-24, 2023
Myron Yaster MD
Fentanyl Drives Startling Increases in Adolescent Overdose Deaths
Myron Yaster MD and Bonnie MIlas MD
Original article
Tanz LJ, Dinwiddie AT, Mattson CL, O'Donnell J, Davis NL. Drug Overdose Deaths Among Persons Aged 10-19 Years - United States, July 2019-December 2021. MMWR Morbidity and mortality weekly
Bystanders are present at 2/3 of overdose deaths and do not attempt life saving care. Intranasal naloxone will be an over the counter drug shortly…Please pick it up and carry with you!
Adults are not giant neonates: Cardiac arrest in ADULT patients admitted to CHILDREN'S hospitals
Myron Yaster, MD, Vanessa Mazandi, MD, and Justin L. Lockman, MD, MSEd
Original article
O'Halloran AJ, Callif CG, Romano JC, Ross CE, Kleinman ME. In-Hospital Cardiac Arrest in Adult Patients Admitted to a Quaternary Children's Center. Pediatr Emerg Care. 2023 Jan 1;39(1):e15-e19. PMID: 35470292
Original article
O'Halloran AJ, Grossestreuer AV, Balaji L, Ross CE, Holmberg MJ, Donnino MW, Kleinman ME; American Heart Association’s Get With The Guidelines-Resuscitation Investigators. Characteristics and Outcomes of Cardiac Arrest in Adult Patients Admitted to Pediatric Services: A Descriptive Analysis of the American Heart Association's Get With The Guidelines-Resuscitation Data. Pediatr Crit Care Med. 2023 Jan 1;24(1):17-24. PMID: 36516345
Original article
Sperotto F, Daverio M, Amigoni A, Gregori D, Dorste A, Allan C, Thiagarajan RR. Trends in In-Hospital Cardiac Arrest and Mortality Among Children With Cardiac Disease in the Intensive Care Unit: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023 Feb 1;6(2):e2256178. PMID: 36763356
Original article
Kienzle MF, Morgan RW, Dewan M, Hebbar KB, Nadkarni VM, Srinivasan V, Tegtmeyer K, Sutton RM, Wolfe HA. Weight-Based Versus Flat Dosing of Epinephrine During Cardiac Arrest in the PICU: A Multicenter Survey. Pediatr Crit Care Med. 2022 Oct 1;23(10):e451-455. PMID: 35678459
Increasingly adult survivors of major childhood diseases continue to receive care in chldren’s hospitals. If one of them arrests is your institution ready to handle them? And about 30% of these arrests occur perioperatively.
ERAS
Myron Yaster MD, Lynn Martin MD, and Megan Brockel MD
Original article
Lynn D Martin, Jennifer L Chiem, Elizabeth E Hansen, Daniel K Low, Kayla Reece, Corrie Casey, Christina S Wingate, Leah K Bezzo, Paul A Merguerian, Sanjay R Parikh, Srinivas M Susarla, Vikas N O'Reilly-Shah. Completion of an Enhanced Recovery Program in a Pediatric Ambulatory Surgery Center: A Quality Improvement Initiative. Anesth Analg. 2022 Dec 1;135(6):1271-1281. PMID: 36384014
The ERAS elements discussed in this article applied to ALL patients undergoing ambulatory surgery and were no directed at specific surgical procedures
Achieving equity for women in anesthesiology
Rebecca Margolis DO, FAOCA, Jennifer Lau, MD and Myron Yaster, MD
Original article
Spitzer Y, Garcia-Marcinkiewicz AG, Malinzak EB. Programmatic approaches to achieving equity for women in anesthesiology. Int Anesthesiol Clin. 2023 Jan 1;61(1):42-48. PMID: 36374567
Almost 40% of women physicians go part-time or leave medicine altogether within six years of completing their residencies. Pregnancy has a large part to do with it.
Reader response
Kim Battle responded that we will NOT be distributing intranasal naloxone kits at the SPA meeting. Dr Paul Halweg commented on ultrasound guided penile nerve block vs ultrasound guided pudendal nerve block. Dr. Lynn Maxwell corrected a PAAD statement…she was not the first to study dorsal penile nerve blocks for circumcision but was the first to use pulse oximetry to detect heart rate and desaturation as a surrogate marker of pain. Finally Dr. Paul Halweg also commented on bradycardia, atropine and the induction of anesthesia in Down syndrome patients.