Stories about: critical care

Strategies for pediatric telehealth: Lessons from TeleConnect

Boston Children's David Casavant, MD, in a mock TeleConnect drill with South Shore Hospital.

Naomi Fried, PhD, is Boston Children’s Hospital’s chief innovation officer. Shawn Farrell, MBA, Telehealth Program Manager at Boston Children’s Hospital, contributed to this post.

Imagine yourself in an emergency department taking care of a very sick child. Should he be transferred to a higher-level care setting? Can he safely go by ambulance, rather than helicopter? As a doctor, you would like to consult virtually with colleagues and experts at remote locations.

Then imagine yourself in a large room in the heart of Silicon Valley, just a stone’s throw from Cupertino and Apple headquarters. In that room are 5,000 of the biggest thinkers in health care and technology, exploring the next major paradigm shift in care delivery: telehealth. You realize that health care is on the brink of a telehealth explosion.

The energy was palpable as I took the stage at the recent American Telemedicine Association (ATA) conference. I was there to share our experiences launching the TeleConnect program at Boston Children’s Hospital,

Read Full Story | Leave a Comment

Breathing an idea to life: Injectable oxygen microparticles

This syringe, containing particles of oxygen gas mixed with liquid, can potentially save the lives of patients unable to breathe -- like the infant Kheir was unable to save early in his career.

John Kheir, MD, is a staff physician and researcher in the Cardiac Intensive Care Unit at Boston Children’s Hospital. As reported this week in Science Translational Medicine, he led a team that created a method for IV oxygen delivery — tiny particles filled with oxygen gas, mixed with liquid and injected directly into the blood. In an emergency, the injections could potentially buy clinicians time to start life-saving therapies. The technology was reported by The Atlantic, Popular Science, Scientific American, Technology Review and other outlets.

It was an ordinary Saturday night in the ICU at Boston Children’s, in the fall of 2006.  One of my patients was a 9-month-old girl who was admitted with pneumonia, and was having trouble breathing. I had gone in to check on her just a few minutes before; although she was not feeling well, she reached out and touched my hand as I examined her. I assured her mother she was in the best possible place for her care.

Five minutes later, the code bell alarmed. Our team rushed into her room to the most horrific sight I have ever seen.

Read Full Story | 7 Comments | Leave a Comment

“See one, do one, teach one” goes global

[Ed. note: Tune in to the livestream Monday at 9:30 a.m. ET]

Can the inventors of Watson help save sick children in the developing world? A “cloud-based” pediatric learning module, conceived by Children’s Hospital Boston and built by IBM Interactive, is being beta-tested this year in 20 countries. Provisionally called OpenPediatrics, it will give 1,000 doctors and nurses on five continents the next best thing to hands-on training. (Above is just a preview).

Read Full Story | Leave a Comment

Brains, babies and battlefields: Taking pediatric neurocritical care to the bedside

Evacuation of a soldier injured by a roadside bomb, June 17, 2011, Kandahar province of Afghanistan (DVIDSHUB/Flickr)

From the time he was 11, Robert Tasker knew he wanted to be a doctor. The son of a serviceman, he was drawn to battlefield surgery, evacuations and managing traumatic injuries. Instead, he ended up on a different kind of battlefield, where what’s at stake are the highly vulnerable, still developing brains of infants and children – and where it’s critical to be mobile and show up on time.

Tasker directs the Pediatric NeuroCritical Care program at Children’s Hospital Boston, the first of its kind in the world. His goal is to protect brain function not only in children suffering direct head injury, but children undergoing major surgery, children with stroke, children hospitalized for critical illness, children on ventilators, children with nervous-system infections like meningitis and more.

Born in Hong Kong and raised throughout the globe,

Read Full Story | Leave a Comment

Peeking into the black box of lung ventilation

As the lungs expand, the glow blue in this movie made using EIT; areas that are underinflated appear red.
Can we monitor a child's lungs when they're on a ventilator without actually taking a picture? Yes, with a technology called EIT; click the image above to see for yourself. (Courtesy Camille Gómez-Laberge)

Every year, thousands of children in intensive care units across the United States are put on mechanical ventilation to help them breathe. But while this technology has saved countless lives, it can also cause or worsen lung injury.

“A child’s injured lungs don’t often inflate uniformly under ventilation,” says Gerhard Wolf, a critical care doctor in Children’s Hospital Boston’s Department of Anesthesia. “So one part of the lung may be nearly collapsed while another is overinflated. We need to be able to see that so we don’t cause further damage.”

Read Full Story | Leave a Comment

Removing global bottlenecks in medical training

This post, final of a three-part series, is adapted from a talk by Jeffrey P. Burns, MD, MPH, Chief of the Division of Critical Care Medicine at Children’s Hospital Boston, at the IBM Impact 2011 Global Conference. (See posts one and two.)

We have a healthcare gap in the United States and around the globe: There aren’t enough doctors and nurses trained in how to take care of a critically ill child. Children are not little adults; you can’t just cut the doses.

So we need a solution. But the solution that we need in a resource-limited environment is not the same solution that we need in a resource-advantaged environment. We need to find a platform that addresses the needs of both.

Several years ago, one of my colleagues, Traci Wolbrink, went to a camp in sub-Saharan Africa,

Read Full Story | Leave a Comment

Can web-based technology save critically ill children?

(This post, the first of three, is adapted from a talk Jeffrey Burns, MD, MPH, gave at IBM’s Impact 2011 Global Conference in April. For the full talk, jump to 44:37 in this video.)

Right now, valuable information is bottlenecked in an old paradigm. Expert training on how to treat children with life-threatening illnesses is available at relatively few hospitals across the world, and access to this training remains anchored to an apprenticeship model – see one, do one, teach one – that’s now nearly 100 years old.

We need to change that paradigm.

Read Full Story | Leave a Comment

Housecalls: Back to the future

This week I attended an Innovator’s Forum, part of a new Innovation Acceleration Program at Children’s Hospital Boston. The program, spearheaded by the hospital’s new Chief Innovation Officer, Naomi Fried, PhD, seeks to empower clinical innovators in developing and testing their novel ideas by providing resources and support. The monthly Forum allows innovators to meet, tell their stories, form a community and support one another through the challenges of translating new ideas from the cocktail napkin to hospital operating procedure.

Read Full Story | Leave a Comment