Welcome to the Yale Pediatric Overnight Emergency Podcast. This podcast’s purpose is to educate residents about urgent and emergent management of various diagnoses while on the wards. Our first episode is hosted by Joshua Pulinat PGY-2 with special guest and Program Director Rachel Osborn.
Written by Nan Du and Joshua Pulinat.
Important Timestamps:
0:00 Intro and Bridgeport Bronchiolitis
3:20 Patient History
6:15 Reactive Airway vs Bronchiolitis (Chicken or the Egg?)
8:36 Vitals and Physical Exam findings
10:06 Bacterial pneumonia vs Bronchiolitis (Asthmonialitis)
- Toxic appearing, higher procalcitonin then maybe CXR
13:05 Pathophysiology of Bronchiolitis
15:01 Viral induced exacerbation of Asthma
17:15 Supportive Measures
17:45 Fluids
19:02 Respiratory Support - Supp Oxygen vs High Flow or Positive Pressure
19:42 High Flow in PICU vs High Flow on the Floor
20:45 Is supplementary oxygen offering positive pressure?
21:12 Oxygen Dissociation Curve and Alveolar Gas Equation - Ventilation vs Oxygenation
23:35 Albuterol. Yay or Nay?
28:56 Atopy vs Recurrent Viral Wheezing
29:40 Hypertonic Saline
32:20 Complex medical patient and pulmonary toilet
32:49 Racemic Epinephrine
35:10 Steroids for Bronchiolitis
37:26 Chest PT
39:01 Suctioning
40:55 Initial Vignette - How to stabilize while PICU arrives
43:40 Sometimes PICU happens
45:40 Parting Advice
