Mary Frances D. Pate

Maintaining professional boundaries in the pediatric intensive care unit.

Team members in the PICU need to have an understanding of the potential for professional boundary violations. These lines are dynamic and easily blurred and may be crossed during well-intentioned interactions. We hope that knowledge of the warning signs will help health care providers and patients and families remain in the zone of helpfulness.(3)

Helping Children Say Goodbye to Loved Ones in Adult and Pediatric Intensive Care Units: Certified Child Life Specialist—Critical Care Nurse Partnership

I care units (ICUs) can be stressful places for adults to visit and may be especially distressing for children wanting to be near a loved one. The interprofessional collaboration between certified child life specialists (CCLSs) and critical care nurses (CCNs) has the potential to make a positive impact on children experiencing situations such as saying goodbye to a family member. Both disciplines are knowledgeable regarding principles of family-centered and developmentally appropriate care. Children with loved ones in pediatric and adult ICUs can benefit from CCLS and CCN partnerships.

INABILITY TO ALKALINIZE URINE IN A PATIENT AT RISK FOR TUMOR LYSIS SYNDROME: A Case Report

This report provides a description and discussion of a 19-year-old, 65-kg male, with a large mediastinal mass, right pleural effusion, and pericardial effusion, requiring urine alkalinization during a propofol infusion. The patient required NaHCO3 boluses, urine pH, electrolyte, arterial blood gas and lactate monitoring, and discontinuation of the propofol. The authors suggest that caution be used when prescribing a propofol infusion for patients who are at risk of tumor lysis syndrome and the need for urine alkalinization.