James Perucho, MD, MLS
@drjamesperucho.bsky.social
Pediatric Critical Care Medicine Fellow at UCSF. Long-term ventilation, complex care, health equity. Views are my own.
#PedsICU #PICU #CriticalCare #MedSky #Complexivist
#PedsICU #PICU #CriticalCare #MedSky #Complexivist
Reposted by James Perucho, MD, MLS
I have a f*ing doctorate in epidemiology and I’m still so confused about how to pick a health insurance plan. Open enrollment should not be this hard!
November 9, 2025 at 3:55 PM
I have a f*ing doctorate in epidemiology and I’m still so confused about how to pick a health insurance plan. Open enrollment should not be this hard!
Reposted by James Perucho, MD, MLS
Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Silva et al: Safety of Peripherally Administered 23.4% Sodium Chloride
Link: link.springer.com/ar...
@neurocritical #neurocritcare
Link: link.springer.com/ar...
@neurocritical #neurocritcare
Safety of Peripherally Administered 23.4% Sodium Chloride
Neurocritical Care - For patients with increased intracranial pressure, prompt initiation of hyperosmolar therapy with 23.4% sodium chloride may minimize permanent neurological damage and prevent...
link.springer.com
October 28, 2025 at 5:38 PM
Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Reposted by James Perucho, MD, MLS
Key point from my invasive CO talk the other day #CHEST2025
October 21, 2025 at 1:25 PM
Key point from my invasive CO talk the other day #CHEST2025
Got roomed in the kids’ room for my PCP appointment, do I really give off pediatrician vibes that much?? Anyway #GetVaccinated
#VaccinesSaveLives #VaccinesCauseAdults #pediatrician
#VaccinesSaveLives #VaccinesCauseAdults #pediatrician
October 17, 2025 at 6:33 PM
Got roomed in the kids’ room for my PCP appointment, do I really give off pediatrician vibes that much?? Anyway #GetVaccinated
#VaccinesSaveLives #VaccinesCauseAdults #pediatrician
#VaccinesSaveLives #VaccinesCauseAdults #pediatrician
Ha! Shout out to my former PICU fellow when I was resident for finding me out in the wild! Thanks to the @ameracadpeds.bsky.social Section on Critical Care for the award, excited to share my project soon! #PedsICU #PICU #Pediatrician #CriticalCare #PICUSky
October 5, 2025 at 10:47 PM
Ha! Shout out to my former PICU fellow when I was resident for finding me out in the wild! Thanks to the @ameracadpeds.bsky.social Section on Critical Care for the award, excited to share my project soon! #PedsICU #PICU #Pediatrician #CriticalCare #PICUSky
Reposted by James Perucho, MD, MLS
It's okay to primordial scream if you need to
October 2, 2025 at 2:06 AM
It's okay to primordial scream if you need to
Ty for my CICU crew, especially Kayla for organizing this cute birthday surprise and Peter for accidentally ruining it 😂🥳 #PedsICU #CICU #PICUSky @ucsfchildrens.bsky.social
October 2, 2025 at 4:13 AM
Ty for my CICU crew, especially Kayla for organizing this cute birthday surprise and Peter for accidentally ruining it 😂🥳 #PedsICU #CICU #PICUSky @ucsfchildrens.bsky.social
Reposted by James Perucho, MD, MLS
Our systematic review and meta-analysis of RCTs evaluating dexmedetomidine in critically ill mechanically ventilated children is live in Intensive Care Medicine-Paediatric and Neonatal @espnic.bsky.social
link.springer.com/article/10.1...
link.springer.com/article/10.1...
Efficacy and safety of analgosedation with dexmedetomidine in critically ill mechanically ventilated children: a systematic review and meta-analysis of randomized controlled trials - Intensive Care Medicine – Paediatric and Neonatal
Intensive Care Medicine – Paediatric and Neonatal - Dexmedetomidine is an increasingly popular analgosedative in critically ill children receiving invasive mechanical ventilation (IMV). We...
link.springer.com
September 24, 2025 at 8:30 PM
Our systematic review and meta-analysis of RCTs evaluating dexmedetomidine in critically ill mechanically ventilated children is live in Intensive Care Medicine-Paediatric and Neonatal @espnic.bsky.social
link.springer.com/article/10.1...
link.springer.com/article/10.1...
Reposted by James Perucho, MD, MLS
Today’s ACIP meeting promoted false claims and misguided information about vaccines. AAP will continue stepping up and working with our local, state and federal partners to make sure every child in every community continues to have access to immunizations.
bit.ly/4puP4uf
bit.ly/4puP4uf
September 18, 2025 at 10:38 PM
Today’s ACIP meeting promoted false claims and misguided information about vaccines. AAP will continue stepping up and working with our local, state and federal partners to make sure every child in every community continues to have access to immunizations.
bit.ly/4puP4uf
bit.ly/4puP4uf
Reposted by James Perucho, MD, MLS
Hello Senate Committee on Vaccine Effectiveness: YES, COVID vax decreases hospitalizations for <18 yo. In fact many studies like this in peer reviewed medical journals. #PedsICU pubmed.ncbi.nlm.nih.gov/34673751/
Effectiveness of Pfizer-BioNTech mRNA Vaccination Against COVID-19 Hospitalization Among Persons Aged 12-18 Years - United States, June-September 2021 - PubMed
Pfizer-BioNTech COVID-19 vaccine is authorized for use in children and adolescents aged 12-15 years and is licensed by the Food and Drug Administration (FDA) for persons aged ≥16 (1). A randomized pla...
pubmed.ncbi.nlm.nih.gov
September 18, 2025 at 1:57 PM
Hello Senate Committee on Vaccine Effectiveness: YES, COVID vax decreases hospitalizations for <18 yo. In fact many studies like this in peer reviewed medical journals. #PedsICU pubmed.ncbi.nlm.nih.gov/34673751/
Reposted by James Perucho, MD, MLS
@nsanchezpinto.bsky.social presenting with Dr. Anoop Bhalla of CHLA in the @palisinet.bsky.social main meeting on the new proposed #PIERCE study as a collaboration between multiple subgroups #PALISI25 #PEDAL #PREVENT and the PICU Data Collaborative 🤩🤩
September 10, 2025 at 2:55 PM
@nsanchezpinto.bsky.social presenting with Dr. Anoop Bhalla of CHLA in the @palisinet.bsky.social main meeting on the new proposed #PIERCE study as a collaboration between multiple subgroups #PALISI25 #PEDAL #PREVENT and the PICU Data Collaborative 🤩🤩
Reposted by James Perucho, MD, MLS
Champagne and oysters at @palisinet.bsky.social #PedsICU
September 9, 2025 at 10:05 PM
Champagne and oysters at @palisinet.bsky.social #PedsICU
Reposted by James Perucho, MD, MLS
If you are comparing childhood vaccination requirements with slavery
a) you neither understand vaccines nor slavery
b) you have no business being a “surgeon general” of any state
a) you neither understand vaccines nor slavery
b) you have no business being a “surgeon general” of any state
September 4, 2025 at 1:13 PM
If you are comparing childhood vaccination requirements with slavery
a) you neither understand vaccines nor slavery
b) you have no business being a “surgeon general” of any state
a) you neither understand vaccines nor slavery
b) you have no business being a “surgeon general” of any state
Reposted by James Perucho, MD, MLS
"I’m deeply alarmed, and we should all be, that critical vaccine policy decisions are being made without scientific rigor, eroding public trust and endangering our nation’s health. The unjustified removal of the CDC director & sidelining of experts in favor of non-specialists is unprecedented. (1/3)
August 29, 2025 at 9:14 PM
"I’m deeply alarmed, and we should all be, that critical vaccine policy decisions are being made without scientific rigor, eroding public trust and endangering our nation’s health. The unjustified removal of the CDC director & sidelining of experts in favor of non-specialists is unprecedented. (1/3)
Hi #PedsICU friends, just wondering if anyone has a “long stay rounds” type working group at their institution for complex discharges. Would love to know how others have theirs set up!
August 30, 2025 at 3:23 PM
Hi #PedsICU friends, just wondering if anyone has a “long stay rounds” type working group at their institution for complex discharges. Would love to know how others have theirs set up!
Reposted by James Perucho, MD, MLS
However bad you think things are at the CDC they are worse.
That's the takeaway from this well-reported story from Daniel Payne w/back-up from an all-star STAT team.
Must-read.
www.statnews.com/2025/08/28/c...
That's the takeaway from this well-reported story from Daniel Payne w/back-up from an all-star STAT team.
Must-read.
www.statnews.com/2025/08/28/c...
Inside the CDC director's ouster: Kennedy demanded acceptance of new vaccine policies; Susan Monarez refused
Susan Monarez’s resistance to Robert F. Kennedy Jr.’s moves to assert control over vaccine guidance is at the center of her dismissal as CDC director
www.statnews.com
August 28, 2025 at 4:41 PM
However bad you think things are at the CDC they are worse.
That's the takeaway from this well-reported story from Daniel Payne w/back-up from an all-star STAT team.
Must-read.
www.statnews.com/2025/08/28/c...
That's the takeaway from this well-reported story from Daniel Payne w/back-up from an all-star STAT team.
Must-read.
www.statnews.com/2025/08/28/c...
Reposted by James Perucho, MD, MLS
Not getting better with further politicization of #healthcare and #publichealth. Those #at-risk will incur the most #morbidity and #mortality, but everyone will be impacted.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Influenza and COVID-19 Vaccination in Children Receiving Long-Term Ventilation
This cohort study examines rates of vaccination for COVID-19 and for influenza among children receiving long-term home ventilation.
jamanetwork.com
August 29, 2025 at 11:44 AM
Not getting better with further politicization of #healthcare and #publichealth. Those #at-risk will incur the most #morbidity and #mortality, but everyone will be impacted.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Reposted by James Perucho, MD, MLS
“The study did not measure how common it is for clinicians to show bias against children with disability, but it exposes a serious problem, said lead author Dr. Stefanie Ames, a critical care physician at U of U Health.”
https://consumer.healthday.com/disability-child-2661926069.html
https://consumer.healthday.com/disability-child-2661926069.html
'Like She Was Not Even There': Children With Disabilities Face Discrimination in Health Care
Children with disabilities, and their families, may face discrimination in in the hospitals and clinics they visit for their health care, according to a new study led by researchers at University of U...
consumer.healthday.com
July 24, 2023 at 10:15 PM
“The study did not measure how common it is for clinicians to show bias against children with disability, but it exposes a serious problem, said lead author Dr. Stefanie Ames, a critical care physician at U of U Health.”
https://consumer.healthday.com/disability-child-2661926069.html
https://consumer.healthday.com/disability-child-2661926069.html
Reposted by James Perucho, MD, MLS
Reposted by James Perucho, MD, MLS
Sadly, this warning by @peterhotezmdphd.bsky.social was prescient
It won’t end with COVID: Countering the next phase of American antivaccine activism 2025–29
journals.plos.org/globalpublic...
It won’t end with COVID: Countering the next phase of American antivaccine activism 2025–29
journals.plos.org/globalpublic...
August 15, 2025 at 10:50 PM
Sadly, this warning by @peterhotezmdphd.bsky.social was prescient
It won’t end with COVID: Countering the next phase of American antivaccine activism 2025–29
journals.plos.org/globalpublic...
It won’t end with COVID: Countering the next phase of American antivaccine activism 2025–29
journals.plos.org/globalpublic...
Reposted by James Perucho, MD, MLS
Bodega ramps are all over New York City. The humble, concrete blobs ease entry into delis and other stores — and affirm the civic compact. nyti.ms/3UnFivI
August 13, 2025 at 5:18 PM
Bodega ramps are all over New York City. The humble, concrete blobs ease entry into delis and other stores — and affirm the civic compact. nyti.ms/3UnFivI
Specific q’s:
• scope of the fellow in CICU (FLP vs supervisory, or hybrid)
• Procedure division btw fellow/ APP
• Expectations for unit-wide awareness vs assigned pt’s, duties for transports, RRTs, or bed flow
• Wknd/PM coverage
• Anything else?
#PedsICU (2/2)
• scope of the fellow in CICU (FLP vs supervisory, or hybrid)
• Procedure division btw fellow/ APP
• Expectations for unit-wide awareness vs assigned pt’s, duties for transports, RRTs, or bed flow
• Wknd/PM coverage
• Anything else?
#PedsICU (2/2)
August 13, 2025 at 7:19 PM
Specific q’s:
• scope of the fellow in CICU (FLP vs supervisory, or hybrid)
• Procedure division btw fellow/ APP
• Expectations for unit-wide awareness vs assigned pt’s, duties for transports, RRTs, or bed flow
• Wknd/PM coverage
• Anything else?
#PedsICU (2/2)
• scope of the fellow in CICU (FLP vs supervisory, or hybrid)
• Procedure division btw fellow/ APP
• Expectations for unit-wide awareness vs assigned pt’s, duties for transports, RRTs, or bed flow
• Wknd/PM coverage
• Anything else?
#PedsICU (2/2)
Love the warm welcome from the #PedsICU folks! Quick q: I’m one of the 4th yr chiefs and my fellowship program is transitioning the fellow role in the CICU from supervisory to frontline provider to be more in line with other programs. I was wondering if I could pick your collective brains (1/2)
August 13, 2025 at 7:15 PM
Love the warm welcome from the #PedsICU folks! Quick q: I’m one of the 4th yr chiefs and my fellowship program is transitioning the fellow role in the CICU from supervisory to frontline provider to be more in line with other programs. I was wondering if I could pick your collective brains (1/2)