Amanda Estravit

Pediatric CVICU nurse, @ASUnursing DNP AC-PNP student, wife to a #USMC vet, mom to Mason, #dogmom x 3 #ASUACPNP24 #ACPNP

[Amanda Estravit @AmandaEstravit]

@dukeacpnp @awatkinsPNP Coordination with our #primarycare colleagues to get these kids prompt diagnosis and care to help outcomes 📈 @DaniSebbens @AimeeBucci #ASUACPNP2024 #ACPNPChat

[Amanda Estravit @AmandaEstravit]

@hillaryd_dnp @lizespinoza_dnp We are so lucky 🍀 at #PhoenixChildrens to have a great liver transplant team! @DaniSebbens @AimeeBucci #ASUACPNP2024 #ACPNPChat

[Amanda Estravit @AmandaEstravit]

@awatkinsPNP @lizespinoza_dnp In my PICU clinical time I saw several kiddos 🧒👧👶 with liver failure due to biliary atresia post op from a Kasai procedure. I was so shocked by the degree of jaundice in these kids! 🌝 @DaniSebbens @AimeeBucci #ACPNPChat #ASUACPNP2024

[Amanda Estravit @AmandaEstravit]

@laura_kawasaki @AimeeBucci @DaniSebbens Def. a great outside the 📦 assessment tool to keep in 🧠 ‼️ #ACPNPChat #ASUACPNP24 @DaniSebbens @AimeeBucci

[Amanda Estravit @AmandaEstravit]

Squires, J., et al. 2022. NASPGHAN Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure. Journal of Pediatric Gastroenterology and Nutrition, 74(1). (3/3) #ACPNPChat #ASUACPNP24 @DaniSebbens @AimeeBucci

[Amanda Estravit @AmandaEstravit]

Nearly 50% of pediatric acute liver failure (PALF) patients are < 4 years old (Squires et al., 2022). Research shows that initial management should include labs 🩸 and assessment 🔍 at least ✌️ a day. (1/3)

[Amanda Estravit @AmandaEstravit]

With the majority of patients being so young, frequent 🩸 draws causes a challenge related to 🩸 volume loss. Does your institution have a protocol for 🔍 and management of these patients with special attention to mitigating 🩸 loss from labs? (2/3)

[Amanda Estravit @AmandaEstravit]

@MMilnerPNP @MARmPNP @DaniSebbens @AimeeBucci @lizespinoza_dnp @brownam130 What a great way to #empower parents 👨‍👩‍👦‍👦 to give appropriate doses when their kiddo 👶 is sick 😷this upcoming #viralillness 🦠season #ACPNPChat #ASUACPNP24

[Amanda Estravit @AmandaEstravit]

@phoebepnp @BrittanyC_NP We have equal access to NS and PL however we seem to always reach for PL first. We also wet-prime our #ECMO circuits with PL. In almost 8 years I don’t think I’ve ever used LR in #CVICU, #PICU, or #NICU @DaniSebbens @AimeeBucci #ACPNPChat #ASUACPNP24

[Amanda Estravit @AmandaEstravit]

@DaniSebbens @AAgemak @NickiRLemieux @MelissaVodicka @laura_kawasaki Barriers include lack of availability or delayed delivery from pharmacy, inadequate IV access, and decreased engagement by medical staff. #ACPNPChat #ASUACPNP24

[Amanda Estravit @AmandaEstravit]

3/3 What does your institution do to improve sepsis identification and response time? @DaniSebbens @AimeeBucci @AAgemak #ACPNPChat #ASUACPNP24 https://t.co/PzCiwQkadP

[Amanda Estravit @AmandaEstravit]

1/ At one institution, approx. 60% of rapid response activations for #PediatricSepticShock occurred in oncology. They identified 🔎 4 drivers to improve sepsis response time. One intervention was the use of a #QRCode for easier access to the #SepsisAlgorithm

[Amanda Estravit @AmandaEstravit]

2/ They also encouraged floor + ICU debriefing, bolus tip sheet, and a sepsis bundle order set. This decreased #SepsisBundle completion time from 2.47 hrs → 1.05 hrs 🥇 Completion of the #SepsisBundle was 68% compared to 49% in non-onc departments