Practicing Surgeon's Curriculum

Introduction

This collection of visual abstracts is generated by the APSA educational committee as a curriculum to keep currently practicing surgeons up to date.

Please submit your questions, comments and feedback (including suggestions for future topics) to think@eapsa.org.

Infographics

In which areas of pediatric surgery can you impact the inappropriate use of antibiotics?

antibiotic stewardship
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[1][2][3] (for more see Surgical Infection)

video link Antibiotic Stewardship 2019 Top Educational Content talk

What is the correct transfusion threshold in critically ill or injured children?

conservative transfusion threshold
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[4][5][6][7][8] (for more see Transfusion and Coagulation Therapy)

video links Hemostatic Transfusion and Goal Directed Transfusion from the APSA 2020 virtual meeting

Which children truly need cervical spine imaging after trauma?

cervical spine injury imaging
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[9][10] (for more see Cervical Spine Trauma)

video link Cervical Spine Trauma Imaging 2019 Top Educational Content talk

How does one determine if a patient with inflammatory bowel disease will require surgery?

indications for surgery in IBD
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[11][12][13] (for more see Crohn Disease and Ulcerative Colitis)

video link The effect of biologics in the surgical management of IBD 2020 Top Educational Content talk

How do you prevent, detect and treat neonatal gas embolism during laparoscopy?

gas embolus during infant laparoscopy
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[14][15][16][17]

video link Infant Gas Embolus 2020 Top Educational Contentt talk

How does hospital acquired hyponatremia occur and what is the best way to prevent it?

isotonic maintenance fluids
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[18][19] (for more see Fluid and Electrolytes)

How can we optimize ovarian preservation in patients with ovarian masses?

ovarian preservation
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[20][21][22] (for more see Ovarian Tumors )

What are the current pediatric surviving sepsis guidelines?

surviving sepsis guidelines
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[23][24] (for more see Surgical Infection)

video link Surviving Sepsis Guidelines 2019 Top Educational Contnet talk)

What factors lead to physician burnout and what impact can it have?

surgeon wellness
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[25][26][27]

What are the most current APSA evidence-based guidelines regarding blunt solid organ injuries in children?

solid organ injury guidelines
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[8][28][29][30] (for more see Liver and Spleen Trauma)

Does every primary spontaneous pneumothorax require an intervention?

spontaneous pneumothorax
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[31][32] (for more see Spontaneous Pneumothorax)

What criteria do you use to determine when an infant with congenital diaphragmatic hernia is ready for surgical repair?

surgery for CDH
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[33][34] (for more see Congenital Diaphragmatic Hernia)

How do you use a viscoelastic assay to guide transfusion requirements in bleeding patients?

viscoelastic assay
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[35][36] (for more see Transfusion and Coagulation Therapy )

References

  1. Fry DE. Prevention of Infection at the Surgical Site. Surg Infect (Larchmt). 2017;18(4):377-378.  [PMID:28541805]
  2. Rogers SO. Surgical Perspective: Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection 2017. Surg Infect (Larchmt). 2017;18(4):383-384.  [PMID:28541803]
  3. Sartelli M, Duane TM, Catena F, et al. Antimicrobial Stewardship: A Call to Action for Surgeons. Surg Infect (Larchmt). 2016;17(6):625-631.  [PMID:27828764]
  4. Valentine SL, Bembea MM, Muszynski JA, et al. Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatr Crit Care Med. 2018;19(9):884-898.  [PMID:30180125]
  5. Steiner ME, Zantek ND, Stanworth SJ, et al. Recommendations on RBC Transfusion Support in Children With Hematologic and Oncologic Diagnoses From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatr Crit Care Med. 2018;19(9S Suppl 1):S149-S156.  [PMID:30161070]
  6. Rouette J, Trottier H, Ducruet T, et al. Red blood cell transfusion threshold in postsurgical pediatric intensive care patients: a randomized clinical trial. Ann Surg. 2010;251(3):421-7.  [PMID:20118780]
  7. Lacroix J, Hébert PC, Hutchison JS, et al. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med. 2007;356(16):1609-19.  [PMID:17442904]
  8. Notrica DM, Eubanks JW, Tuggle DW, et al. Nonoperative management of blunt liver and spleen injury in children: Evaluation of the ATOMAC guideline using GRADE. J Trauma Acute Care Surg. 2015;79(4):683-93.  [PMID:26402546]
  9. Hale DF, Fitzpatrick CM, Doski JJ, et al. Absence of clinical findings reliably excludes unstable cervical spine injuries in children 5 years or younger. J Trauma Acute Care Surg. 2015;78(5):943-8.  [PMID:25909413]
  10. Rosati SF, Maarouf R, Wolfe L, et al. Implementation of pediatric cervical spine clearance guidelines at a combined trauma center: Twelve-month impact. J Trauma Acute Care Surg. 2015;78(6):1117-21.  [PMID:26151510]
  11. Fumery M, Pariente B, Sarter H, et al. Long-term outcome of pediatric-onset Crohn's disease: A population-based cohort study. Dig Liver Dis. 2019;51(4):496-502.  [PMID:30611597]
  12. Gower-Rousseau C, Dauchet L, Vernier-Massouille G, et al. The natural history of pediatric ulcerative colitis: a population-based cohort study. Am J Gastroenterol. 2009;104(8):2080-8.  [PMID:19436273]
  13. Rinawi F, Assa A, Eliakim R, et al. Risk of Colectomy in Patients With Pediatric-onset Ulcerative Colitis. J Pediatr Gastroenterol Nutr. 2017;65(4):410-415.  [PMID:28207474]
  14. Kudsi OY, Jones SA, Brenn BR. Carbon dioxide embolism in a 3-week-old neonate during laparoscopic pyloromyotomy: a case report. J Pediatr Surg. 2009;44(4):842-5.  [PMID:19361651]
  15. DiChiacchio L, Cappiello CD, Greenspon J. Extracorporeal cardiopulmonary resuscitation in a neonate after air embolism during insufflation for laparoscopic peritoneal dialysis catheter placement. J Surg Case Rep. 2018;2018(6):rjy119.  [PMID:29942470]
  16. Taylor SP, Hoffman GM. Gas embolus and cardiac arrest during laparoscopic pyloromyotomy in an infant. Can J Anaesth. 2010;57(8):774-8.  [PMID:20431981]
  17. Olsen M, Avery N, Khurana S, et al. Pneumoperitoneum for neonatal laparoscopy: how safe is it? Paediatr Anaesth. 2013;23(5):457-9.  [PMID:23577821]
  18. McNab S, Ware RS, Neville KA, et al. Isotonic versus hypotonic solutions for maintenance intravenous fluid administration in children. Cochrane Database Syst Rev. 2014.  [PMID:25519949]
  19. Feld LG, Neuspiel DR, Foster BA, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics. 2018;142(6).  [PMID:30478247]
  20. Renaud EJ, Sømme S, Islam S, et al. Ovarian masses in the child and adolescent: An American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee systematic review. J Pediatr Surg. 2019;54(3):369-377.  [PMID:30220452]
  21. Lawrence AE, Fallat ME, Hewitt G, et al. Understanding the Value of Tumor Markers in Pediatric Ovarian Neoplasms. J Pediatr Surg. 2020;55(1):122-125.  [PMID:31677824]
  22. Abbas PI, Elder SC, Mehollin-Ray AR, et al. Ovarian lesion volumes as a screening tool for malignancy in adolescent ovarian tumors. J Pediatr Surg. 2015;50(11):1933-6.  [PMID:26242572]
  23. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132-49.  [PMID:26695473]
  24. Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clin Proc. 2017;92(1):129-146.  [PMID:27871627]
  25. Shanafelt TD, Schein E, Minor LB, et al. Healing the Professional Culture of Medicine. Mayo Clin Proc. 2019;94(8):1556-1566.  [PMID:31303431]
  26. Gates RL, Price M, Cameron DB, et al. Non-operative management of solid organ injuries in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review. J Pediatr Surg. 2019;54(8):1519-1526.  [PMID:30773395]
  27. Ingram MC, Siddharthan RV, Morris AD, et al. Hepatic and splenic blush on computed tomography in children following blunt abdominal trauma: Is intervention necessary? J Trauma Acute Care Surg. 2016;81(2):266-70.  [PMID:27257698]
  28. St Peter SD, Aguayo P, Juang D, et al. Follow up of prospective validation of an abbreviated bedrest protocol in the management of blunt spleen and liver injury in children. J Pediatr Surg. 2013;48(12):2437-41.  [PMID:24314183]
  29. Brown SGA, Ball EL, Perrin K, et al. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med. 2020;382(5):405-415.  [PMID:31995686]
  30. Leys CM, Hirschl RB, Kohler JE, et al. Changing the Paradigm for Management of Pediatric Primary Spontaneous Pneumothorax: A Simple Aspiration Test Predicts Need for Operation. J Pediatr Surg. 2020;55(1):169-175.  [PMID:31706614]
  31. Canadian Congenital Diaphragmatic Hernia Collaborative, Puligandla PS, Skarsgard ED, et al. Diagnosis and management of congenital diaphragmatic hernia: a clinical practice guideline. CMAJ. 2018;190(4):E103-E112.  [PMID:29378870]
  32. Beres AL, Puligandla PS, Brindle ME, et al. Stability prior to surgery in Congenital Diaphragmatic Hernia: is it necessary? J Pediatr Surg. 2013;48(5):919-23.  [PMID:23701760]
  33. Gonzalez E, Moore EE, Moore HB, et al. Goal-directed Hemostatic Resuscitation of Trauma-induced Coagulopathy: A Pragmatic Randomized Clinical Trial Comparing a Viscoelastic Assay to Conventional Coagulation Assays. Ann Surg. 2016;263(6):1051-9.  [PMID:26720428]
  34. Leeper CM, Gaines BA. Viscoelastic hemostatic assays in the management of the pediatric trauma patient. Semin Pediatr Surg. 2017;26(1):8-13.  [PMID:28302286]