International Pediatric Emergency Medicine and Critical Care Fellow Education: Utilizing Virtual Resuscitation Simulation in Settings With Differing Resources.

Pediatric Emergency and Critical Care-Kenya (PECC-Kenya) is an international collaboration between the University of Nairobi and the University of Washington (UW) supporting a combined fellowship program in pediatric emergency medicine (PEM) and pediatric critical care medicine (PCCM) in Kenya. Typically, PEM/PCCM faculty from UW travel to Kenya to support in-person simulation, which was cancelled due to COVID-19 travel restrictions. This presented a need for alternative modalities to continue simulation-based education. This technical report describes the use of virtual simulation for pediatric emergency and critical care fellow education on the management of hypovolemic and septic shock, utilizing international guidelines and being based on resource availability.

Congenital Heart Disease in East Africa.

Congenital Heart Disease (CHD) is an enormous problem in Low Middle Income Countries and particularly in sub-Saharan Africa. There is an estimated 500,000 children born in Africa with CHD each year with a major proportion of this in sub-Saharan Africa. The vast majority of these children receive sub-optimal or no care at all. In East Africa: Kenya, Tanzania, and Uganda have all attempted to create a CHD service for the last 20 years with minimal success due to various factors. Visiting cardiac missions have made considerable contributions in the development of CHD services in these countries, however there remains a significant number of children with lack of care. We explore the positive aspects of the current projects, the various factors that hinder growth in this area, and what can be done to promote CHD service growth in these countries.

Isolated septic non-otogenic lateral sinus thrombosis complicating nasopharyngitis in a 2-month-old infant: a case report.

Nasopharyngeal infections are among the commonest diagnosed infections in infants. Largely treated supportively, these infections are considered harmless. These can however lead to serious complications from local spread and septicemia. With local extension, inflammatory neck masses (abscesses) can swiftly lead to life-threatening complications including mediastinitis, airway compromise and sinovenous thrombosis. Here, we report a 2-month-old infant with initial rhinopharyngitis and subsequent extensive deep neck abscesses with consequent dural sinus thrombosis successfully managed with antibiotics, anticoagulants and drainage. While such cases have been presented before, it is the pathophysiology and extent of sinus thrombosis in our case that is eccentric.