Procedural Autonomy in PICU

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ghostbaby

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Are there any procedures more commonly done by pediatric intensivists that set them apart from other peds specialists (e.g. ED, anesthesia, surgery)? Procedures do seem like they’re more rare for intensivists nowadays.

Specifically, I know neonatologists get tons of UVCs, anesthesia gets tons of intubations, ED gets tons of lumbar punctures (sepsis rule outs), etc. But is there a certain type of procedure that’s more common in PICU than these other specialties that allows it to be called their niche/jam? I’m curious about chest tubes, central venous lines, A-lines, PALS. Or are these just all across the board more common in the other specialties?

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Are there any procedures more commonly done by pediatric intensivists that set them apart from other peds specialists (e.g. ED, anesthesia, surgery)? Procedures do seem like they’re more rare for intensivists nowadays.

Specifically, I know neonatologists get tons of UVCs, anesthesia gets tons of intubations, ED gets tons of lumbar punctures (sepsis rule outs), etc. But is there a certain type of procedure that’s more common in PICU than these other specialties that allows it to be called their niche/jam? I’m curious about chest tubes, central venous lines, A-lines, PALS. Or are these just all across the board more common in the other specialties?
The thing that sets them apart is that in PICU, you do all the procedures you just mentioned. Surgeons don't intubate, Anesthesiologists don't put in chest tubes, Emergency Medicine doesn't put in CVLs.

PICU is jack of all trades... master of none.
 
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Living in a college football obsessed part of the country I often times tell parents when it comes to intubations that I'm like a really good college team, but the anesthesiologists are Alabama, and the ENTs are the New England Patriots. A similar sort of hierarchy fits with the other procedures. Am I extremely competent? Yes. Are there fields that are by definition better than me? Absolutely.

The key is to stay humble and know when you need help. The worst thing you can do to a patient is get in over your depth and not recognize it.
 
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I was expecting a very different question based on the title! Not often there is a discussion of fully trained intensivist autonomy instead of trainee.

As an attending you can do whatever procedures you are well-trained enough and interested enough in to get credentialed. Although if you do procedures that your partners do not you will either get calls to do the procedure when you aren't on service or everyone will forget that you do it and consult another service before you even get to do the procedure -and probably both will happen on different days.
 
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