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Background: The Women's Empowerment and Leadership Initiative in the Society for Pediatric Anesthesia was established to support women's efforts to achieve promotion, leadership positions, and equity in pediatric anesthesiology through coaching, mentoring, sponsorship, and networking. Career advancement relies on the establishment of mentoring relationships within institutions and at regional and national levels. Prior to the SARS‐CoV‐2 (COVID‐19) pandemic, networking was primarily conducted at large national meetings. Aims: When national meetings were canceled by the COVID‐19 pandemic, the Women's Empowerment and Leadership Initiative sought to reduce networking barriers by creating a pilot program called "Grow and Advance through Intentional Networking" (GAIN). Materials & Methods: Monthly 1‐h virtual GAIN sessions were developed based on topics requested by the Women's Empowerment and Leadership Initiative members. Faculty facilitated psychologically safe small‐group discussions to maximize engagement. Results: We present an overview of our pilot GAIN program, which has been well received by the Women's Empowerment and Leadership Initiative members and met with continuous demand for more sessions. Discussion: Professional networking is critical for career advancement and for developing and maintaining a sense of community and well‐being. Early‐ and mid‐career physicians depend on these relationships to facilitate academic productivity and promotion. Conclusion: Programs like the Women's Empowerment and Leadership Initiative GAIN are critical for advancing our specialty and supporting the well‐being of pediatric anesthesiologists. GAIN addresses barriers to professional networking, including during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Children undergoing tonsillectomy for sleep‐disordered breathing are at risk for respiratory compromise when narcotics are administered. Severe complications resulting from hypoxia can include neuro‐devastation and death. The objective of this prospective study was to evaluate the feasibility, accuracy, and utility of transcutaneous carbon dioxide (tcPCO2) monitoring during and after adenotonsillectomy. Study Design: Prospective, Observational study. Methods: Twenty‐nine children with sleep‐disordered breathing scheduled for adenotonsillectomy were included in the study. Peri‐operative measurements of tcPCO2 were compared against a single venous blood sample (PaCO2) and end‐tidal (ET) CO2. The differences between ETCO2, tcPCO2 measures, and PaCO2 were examined using non‐paired t‐tests and linear regression. Parameters from PSG were recorded and associations with tcPCO2 values were performed using linear regression analysis. Group comparisons were made between pre‐, intra‐, and post‐operative tcPCO2 measurements. Results: Similar to ETCO2, there was good correlation of tcPCO2 to PaCO2. Children with lower oxygen (O2) saturation nadirs had higher peak CO2 levels during surgery and spent a greater proportion of time with CO2 > 50 mmHg in the recovery room (P <.01 and P <.08). Other PSG measures (apnea‐hypopnea index, O2 desaturation index, and peak CO2) did not have any significant correlation. Frequent episodes of hypercapnia were noted intra‐ and post‐operatively and mean tcPCO2 values during both periods were significantly higher than baseline (P <.001). Conclusions: tcPCO2 monitoring is viable in children undergoing adenotonsillectomy and can provide a good estimate of hypoventilation. tcPCO2 measurements may have particular benefit in the post‐operative setting and may assist in identifying children at greater risk for respiratory complications. Level of Evidence: 4 Laryngoscope, 131:1410–1415, 2021 [ABSTRACT FROM AUTHOR]

Struggling learners often require interventions that are time‐consuming and emotionally exhausting for both the trainee and faculty. Numerous barriers, including lack of resources, faculty development, and fear of legal retribution, can impede medical educators from developing and implementing robust remediation plans. Despite the large volume of literature citing professionalism education and the "hidden curriculum" as problem areas in medical education, frontline educators lack practical tools and empowerment to address unprofessionalism in trainees. The paucity of resources in this arena has led to decreased job satisfaction, increased burnout, and an exodus from academic medicine. Department leadership acknowledgment and investment in training faculty on remediation strategies for learners in difficulty and providing tools to meet these challenging job demands will improve faculty's job satisfaction and overall well‐being. The authors review salient literature and methodology for diagnosing learners in difficulty, with focus on a high‐yield, pragmatic approach that can be taken by medical training programs, including those that lack a robust medical education infrastructure. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Propofol is an effective sedative for magnetic resonance imaging. Nevertheless, it may cause hemodynamic and respiratory complications in a dose dependent fashion. We investigated the role of low‐dose dexmedetomidine (0.5 μg/kg) as an adjuvant to propofol sedation for children undergoing magnetic resonance imaging. We hypothesized that dexmedetomidine would decrease the propofol dose required, airway complications, and hemodynamic instability. Methods: We performed a retrospective chart review of patients’ age of 1 month to 20 years. Children were divided into 2 groups; group P received only propofol; group D + P received intravenous bolus of dexmedetomidine (0.5 μg/kg) and propofol. Results: We reviewed 172 children in P and 129 in D + P (dexmedetomidine dose, median: 0.50 μg/kg (IQR: 0.45‐0.62). An additional dexmedetomidine bolus was given to 17 children for sedation lasting longer than 2 hours. Total propofol dose (μg/kg/min) was significantly higher in group P than D + P; 215.0 (182.6‐253.8) vs 147.6 (127.5‐180.9); Median Diff = −67.8; 95%CI = −80.6, −54.9; P < .0001. There was no difference in recovery time (minutes); P: 28 (17‐39) vs D + P: 27 (18‐41); Median Diff = −1; 95%CI = −6.0, 4.0; P = .694. The need for airway support was significantly greater in P compared to D + P; 15/172 vs 3/129; OR = 0.25; 95%CI = 0.07 to 0.90; P = .02 (2‐sample proportions test). Mean arterial pressure was significantly lower in P compared to D + P across time over 60 minutes after induction (coef = −0.06, 95%CI = −0.11, −0.02, P = .004). Discussion & Conclusion: A low‐dose bolus of dexmedetomidine (0.5 μg/kg) used as an adjuvant can decrease the propofol requirement for children undergoing sedation for magnetic resonance imaging. This may decrease the need for airway support and contribute to improved hemodynamic stability without prolonging recovery time. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Children undergoing tonsillectomy for sleep-disordered breathing are at risk for respiratory compromise when narcotics are administered. Severe complications resulting from hypoxia can include neuro-devastation and death. The objective of this prospective study was to evaluate the feasibility, accuracy, and utility of transcutaneous carbon dioxide (tcPCO2) monitoring during and after adenotonsillectomy., Study Design: Prospective, Observational study., Methods: Twenty-nine children with sleep-disordered breathing scheduled for adenotonsillectomy were included in the study. Peri-operative measurements of tcPCO2 were compared against a single venous blood sample (PaCO2) and end-tidal (ET) CO2. The differences between ETCO2, tcPCO2 measures, and PaCO2 were examined using non-paired t-tests and linear regression. Parameters from PSG were recorded and associations with tcPCO2 values were performed using linear regression analysis. Group comparisons were made between pre-, intra-, and post-operative tcPCO2 measurements., Results: Similar to ETCO2, there was good correlation of tcPCO2 to PaCO2. Children with lower oxygen (O2) saturation nadirs had higher peak CO2 levels during surgery and spent a greater proportion of time with CO2 > 50 mmHg in the recovery room (P < .01 and P < .08). Other PSG measures (apnea-hypopnea index, O2 desaturation index, and peak CO2) did not have any significant correlation. Frequent episodes of hypercapnia were noted intra- and post-operatively and mean tcPCO2 values during both periods were significantly higher than baseline (P < .001)., Conclusions: tcPCO2 monitoring is viable in children undergoing adenotonsillectomy and can provide a good estimate of hypoventilation. tcPCO2 measurements may have particular benefit in the post-operative setting and may assist in identifying children at greater risk for respiratory complications., Level of Evidence: 4 Laryngoscope, 131:1410-1415, 2021., (© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)