Dan Ostlie

87 statements · 5 topics · summaries given as host listed separately

Featured statements

▶ Ep 1 · 3:51
once you have A defined uh emyema, i.e., oculations with, you know, greater than 100,000 white cells, then you're down the pathway. Is, is really antibiotics the right choice and probably not, honestly, you need to do something to get, get the, uh, the fibrinous X8 out of the chest
quote · Empyema
▶ Ep 20 · 15:50
93% of all pediatric surgeons in the United States are dependent on some sort of hospital support through affiliation agreements, directorships, or call contracts
epidemiological · Esophageal Atresia
▶ Ep 1 · 24:25
Before the era of VATS, the standard was to wait for a second pneumothorax before performing anterior thoracotomy for bleb resection and pleural abrasion
clinical · Empyema

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Dan's statements about Empyema 11 statements

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Empyema and Pneumothorax: Update Course 2014

▶ Ep 1 · 3:51
quote once you have A defined uh emyema, i.e., oculations with, you know, greater than 100,000 white cells, then you're down the pathway. Is, is really antibiotics the right choice and probably not, honestly, you need to do something to get, get the, uh, the fibrinous X8 out of the chest ↗
▶ Ep 1 · 3:51
clinical Once stage 2 empyema is present, antibiotics alone are insufficient and intervention is needed to remove fibrinous exudate ↗
▶ Ep 1 · 3:51
clinical Stage 2 empyema is defined by loculated pleural effusion with greater than 100,000 white cells ↗
▶ Ep 1 · 7:09
clinical The Kansas City trial using TPA showed length of stay 6.8 days, cost $11.6K, 7.5% complication rate, and 15% failure rate ↗
▶ Ep 1 · 8:14
clinical Both fibrinolytic trials demonstrate 85% success rate, meaning 15% of patients require subsequent surgical intervention ↗
▶ Ep 1 · 11:30
clinical In the Kansas City VATS cohort, 2 children required oscillator support and 1 developed renal failure requiring hemodialysis; no such complications occurred in the TPA arm ↗
▶ Ep 1 · 15:47
clinical Ultrasound can sometimes fail to distinguish intraparenchymal necrotic lung from pleural effusion, requiring CT for accurate diagnosis ↗
▶ Ep 1 · 24:25
clinical Before the era of VATS, the standard was to wait for a second pneumothorax before performing anterior thoracotomy for bleb resection and pleural abrasion ↗
▶ Ep 1 · 24:51
quote I don't think it makes a lot of sense to say you're going to prophylactically do the other side ↗
▶ Ep 1 · 26:34
quote the talc lap thoracoscopically just snows so beautifully everywhere ↗
▶ Ep 1 · 28:15
clinical Mechanical pleurodesis is considered adequate when small blood vessels become prominent on the pleural surface ↗
Dan's statements about Esophageal Atresia 19 statements

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#APSA 50: Robert E. Gross Debate

▶ Ep 16 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 16 · 16:20
epidemiological 93% of all pediatric surgeons in the United States depend on hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 16 · 17:00
epidemiological Hospital reimbursement is DRG-based (tied to Medicare), but pediatric surgeons operate in a Medicaid world where uninsured/Medicaid patients have increased from 30% to 70% in Miami over 25 years ↗
▶ Ep 16 · 17:45
epidemiological Phoenix Children's Hospital Medicaid percentage increased from 45% to 54% in just 4 years ↗
▶ Ep 16 · 18:05
quote I would say that we have a supply and demand conundrum in pediatric surgery. We believe there's demand for pediatric surgeons, so we're supplying them. But maybe we've got something a little bit worrisome that I would call a demand and supply crisis. ↗
▶ Ep 16 · 26:20
opinion RRC approves programs algorithmically based on criteria with minimal interest in pediatric surgery workforce health (0-5% interest level) ↗
▶ Ep 16 · 26:55
clinical American Board of Surgery only certifies whether individuals are safe surgeons, without regard to training program characteristics or workforce needs ↗
▶ Ep 16 · 48:20
opinion Academic success per capita in pediatric surgery is very high compared to other surgical specialties ↗
▶ Ep 16 · 53:40
quote If my son comes to me and says I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗

#APSA 50: Robert E. Gross Debate

▶ Ep 20 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 20 · 15:50
epidemiological 93% of all pediatric surgeons in the United States are dependent on some sort of hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 20 · 16:20
clinical Hospital reimbursement is DRG-based, not professional fees, and DRGs are based on Medicare ↗
▶ Ep 20 · 17:10
epidemiological In Miami, uninsured Medicaid patients in children's hospitals have gone from 30% to 70% over the last 25 years ↗
▶ Ep 20 · 17:40
epidemiological Phoenix Children's Hospital Medicaid population increased from 45% to 54% in the last 4 years, an 18% increase ↗
▶ Ep 20 · 18:05
quote I have a demand and supply crisis because we have a demand in this country to provide highly trained, incredibly competent pediatric surgeons, and I'm not sure we can actually supply it, given our current environment in pediatric surgery over the next two decades. ↗
▶ Ep 20 · 25:00
epidemiological In 20 years, concerns about fellowship numbers growing have been heard at program directors meetings and from the RRC and American Board of Surgery, but nothing has been done ↗
▶ Ep 20 · 26:20
opinion The RRC approves programs based on algorithmic criteria with 0-5% interest in the health of pediatric surgery as a specialty ↗
▶ Ep 20 · 26:45
clinical The American Board of Surgery's entire goal is to certify whether individuals are safe surgeons, regardless of where or how they trained ↗
▶ Ep 20 · 53:40
quote If my son comes to me and says, or my daughter comes to me and says, I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗
Dan's statements about Esophageal Atresia 19 statements

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#APSA 50: Robert E. Gross Debate

▶ Ep 19 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 19 · 16:20
epidemiological 93% of all pediatric surgeons in the United States depend on hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 19 · 17:00
epidemiological Hospital reimbursement is DRG-based (tied to Medicare), but pediatric surgeons operate in a Medicaid world where uninsured/Medicaid patients have increased from 30% to 70% in Miami over 25 years ↗
▶ Ep 19 · 17:45
epidemiological Phoenix Children's Hospital Medicaid percentage increased from 45% to 54% in just 4 years ↗
▶ Ep 19 · 18:05
quote I would say that we have a supply and demand conundrum in pediatric surgery. We believe there's demand for pediatric surgeons, so we're supplying them. But maybe we've got something a little bit worrisome that I would call a demand and supply crisis. ↗
▶ Ep 19 · 26:20
opinion RRC approves programs algorithmically based on criteria with minimal interest in pediatric surgery workforce health (0-5% interest level) ↗
▶ Ep 19 · 26:55
clinical American Board of Surgery only certifies whether individuals are safe surgeons, without regard to training program characteristics or workforce needs ↗
▶ Ep 19 · 48:20
opinion Academic success per capita in pediatric surgery is very high compared to other surgical specialties ↗
▶ Ep 19 · 53:40
quote If my son comes to me and says I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗

#APSA 50: Robert E. Gross Debate

▶ Ep 25 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 25 · 15:50
epidemiological 93% of all pediatric surgeons in the United States are dependent on some sort of hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 25 · 16:20
clinical Hospital reimbursement is DRG-based, not professional fees, and DRGs are based on Medicare ↗
▶ Ep 25 · 17:10
epidemiological In Miami, uninsured Medicaid patients in children's hospitals have gone from 30% to 70% over the last 25 years ↗
▶ Ep 25 · 17:40
epidemiological Phoenix Children's Hospital Medicaid population increased from 45% to 54% in the last 4 years, an 18% increase ↗
▶ Ep 25 · 18:05
quote I have a demand and supply crisis because we have a demand in this country to provide highly trained, incredibly competent pediatric surgeons, and I'm not sure we can actually supply it, given our current environment in pediatric surgery over the next two decades. ↗
▶ Ep 25 · 25:00
epidemiological In 20 years, concerns about fellowship numbers growing have been heard at program directors meetings and from the RRC and American Board of Surgery, but nothing has been done ↗
▶ Ep 25 · 26:20
opinion The RRC approves programs based on algorithmic criteria with 0-5% interest in the health of pediatric surgery as a specialty ↗
▶ Ep 25 · 26:45
clinical The American Board of Surgery's entire goal is to certify whether individuals are safe surgeons, regardless of where or how they trained ↗
▶ Ep 25 · 53:40
quote If my son comes to me and says, or my daughter comes to me and says, I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗
Dan's statements about Necrotizing Enterocolitis 19 statements

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#APSA 50: Robert E. Gross Debate

▶ Ep 6 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 6 · 16:20
epidemiological 93% of all pediatric surgeons in the United States depend on hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 6 · 17:00
epidemiological Hospital reimbursement is DRG-based (tied to Medicare), but pediatric surgeons operate in a Medicaid world where uninsured/Medicaid patients have increased from 30% to 70% in Miami over 25 years ↗
▶ Ep 6 · 17:45
epidemiological Phoenix Children's Hospital Medicaid percentage increased from 45% to 54% in just 4 years ↗
▶ Ep 6 · 18:05
quote I would say that we have a supply and demand conundrum in pediatric surgery. We believe there's demand for pediatric surgeons, so we're supplying them. But maybe we've got something a little bit worrisome that I would call a demand and supply crisis. ↗
▶ Ep 6 · 26:20
opinion RRC approves programs algorithmically based on criteria with minimal interest in pediatric surgery workforce health (0-5% interest level) ↗
▶ Ep 6 · 26:55
clinical American Board of Surgery only certifies whether individuals are safe surgeons, without regard to training program characteristics or workforce needs ↗
▶ Ep 6 · 48:20
opinion Academic success per capita in pediatric surgery is very high compared to other surgical specialties ↗
▶ Ep 6 · 53:40
quote If my son comes to me and says I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗

#APSA 50: Robert E. Gross Debate

▶ Ep 8 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 8 · 15:50
epidemiological 93% of all pediatric surgeons in the United States are dependent on some sort of hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 8 · 16:20
clinical Hospital reimbursement is DRG-based, not professional fees, and DRGs are based on Medicare ↗
▶ Ep 8 · 17:10
epidemiological In Miami, uninsured Medicaid patients in children's hospitals have gone from 30% to 70% over the last 25 years ↗
▶ Ep 8 · 17:40
epidemiological Phoenix Children's Hospital Medicaid population increased from 45% to 54% in the last 4 years, an 18% increase ↗
▶ Ep 8 · 18:05
quote I have a demand and supply crisis because we have a demand in this country to provide highly trained, incredibly competent pediatric surgeons, and I'm not sure we can actually supply it, given our current environment in pediatric surgery over the next two decades. ↗
▶ Ep 8 · 25:00
epidemiological In 20 years, concerns about fellowship numbers growing have been heard at program directors meetings and from the RRC and American Board of Surgery, but nothing has been done ↗
▶ Ep 8 · 26:20
opinion The RRC approves programs based on algorithmic criteria with 0-5% interest in the health of pediatric surgery as a specialty ↗
▶ Ep 8 · 26:45
clinical The American Board of Surgery's entire goal is to certify whether individuals are safe surgeons, regardless of where or how they trained ↗
▶ Ep 8 · 53:40
quote If my son comes to me and says, or my daughter comes to me and says, I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗
Dan's statements about Necrotizing Enterocolitis 19 statements

Open the Necrotizing Enterocolitis collection →

#APSA 50: Robert E. Gross Debate

▶ Ep 6 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 6 · 16:20
epidemiological 93% of all pediatric surgeons in the United States depend on hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 6 · 17:00
epidemiological Hospital reimbursement is DRG-based (tied to Medicare), but pediatric surgeons operate in a Medicaid world where uninsured/Medicaid patients have increased from 30% to 70% in Miami over 25 years ↗
▶ Ep 6 · 17:45
epidemiological Phoenix Children's Hospital Medicaid percentage increased from 45% to 54% in just 4 years ↗
▶ Ep 6 · 18:05
quote I would say that we have a supply and demand conundrum in pediatric surgery. We believe there's demand for pediatric surgeons, so we're supplying them. But maybe we've got something a little bit worrisome that I would call a demand and supply crisis. ↗
▶ Ep 6 · 26:20
opinion RRC approves programs algorithmically based on criteria with minimal interest in pediatric surgery workforce health (0-5% interest level) ↗
▶ Ep 6 · 26:55
clinical American Board of Surgery only certifies whether individuals are safe surgeons, without regard to training program characteristics or workforce needs ↗
▶ Ep 6 · 48:20
opinion Academic success per capita in pediatric surgery is very high compared to other surgical specialties ↗
▶ Ep 6 · 53:40
quote If my son comes to me and says I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗

#APSA 50: Robert E. Gross Debate

▶ Ep 8 · 14:10
epidemiological One-third of pediatric surgery cases come from being on call ↗
▶ Ep 8 · 15:50
epidemiological 93% of all pediatric surgeons in the United States are dependent on some sort of hospital support through affiliation agreements, directorships, or call contracts ↗
▶ Ep 8 · 16:20
clinical Hospital reimbursement is DRG-based, not professional fees, and DRGs are based on Medicare ↗
▶ Ep 8 · 17:10
epidemiological In Miami, uninsured Medicaid patients in children's hospitals have gone from 30% to 70% over the last 25 years ↗
▶ Ep 8 · 17:40
epidemiological Phoenix Children's Hospital Medicaid population increased from 45% to 54% in the last 4 years, an 18% increase ↗
▶ Ep 8 · 18:05
quote I have a demand and supply crisis because we have a demand in this country to provide highly trained, incredibly competent pediatric surgeons, and I'm not sure we can actually supply it, given our current environment in pediatric surgery over the next two decades. ↗
▶ Ep 8 · 25:00
epidemiological In 20 years, concerns about fellowship numbers growing have been heard at program directors meetings and from the RRC and American Board of Surgery, but nothing has been done ↗
▶ Ep 8 · 26:20
opinion The RRC approves programs based on algorithmic criteria with 0-5% interest in the health of pediatric surgery as a specialty ↗
▶ Ep 8 · 26:45
clinical The American Board of Surgery's entire goal is to certify whether individuals are safe surgeons, regardless of where or how they trained ↗
▶ Ep 8 · 53:40
quote If my son comes to me and says, or my daughter comes to me and says, I want to be a pediatric surgeon, that does not mean that I have any intention to not support them down that pathway. But you can be darn sure that they're going to know every single thing that I shared with you today. ↗

Summaries Dan gave as host · 6 summaries

Recaps of other experts' statements, not Dan's own clinical position.

Summaries Dan gave as host · Empyema 6 summaries

Open the Empyema collection →

Empyema and Pneumothorax: Update Course 2014

▶ Ep 1 · 5:32
host summary Dan Ostlie summarizing the discussion: A meta-analysis of 170 patients showed primary VATS (M3 arm) had better outcomes than chest tube with fibrinolytic followed by delayed thoracoscopy/thoracotomy, but the VATS cases were concentrated in later years creating temporal bias ↗
▶ Ep 1 · 7:09
host summary Dan Ostlie summarizing the discussion: A trial of 60 patients comparing urokinase versus saline with small versus large drains showed small tube with urokinase performed better than other combinations, with no operations required ↗
▶ Ep 1 · 7:09
host summary Dan Ostlie summarizing the discussion: The London (Great Ormond Street) trial using urokinase showed length of stay 6 days, cost 13 (units unclear), 9% complication rate, and 16% failure rate ↗
▶ Ep 1 · 19:50
host summary Dan Ostlie summarizing the discussion: A Cochrane review (2007) with one RCT comparing manual aspiration versus chest tube in patients aged 16 and older showed 59% immediate success rate with aspiration, 50% avoided hospitalization, and no difference in overall hospital stay or recurrence rate ↗
▶ Ep 1 · 19:50
host summary Dan Ostlie summarizing the discussion: 2010 British Thoracic Society guidelines recommend simple aspiration as first-line therapy for pneumothorax ↗
▶ Ep 1 · 19:50
host summary Dan Ostlie summarizing the discussion: 2001 Adelphi consensus guidelines stated there was no role for simple aspiration in pneumothorax management ↗