Two Paeds In A Pod

Dr Ian Lewins
  • 5.0 (1)
  • MEDICINE

2 Paeds in a Pod is a clinical paediatrics podcast exploring the decisions, dilemmas, and systems that shape everyday practice. While rooted in paediatric emergency medicine, the conversations range across the breadth of paediatrics — from acute presentations and diagnostic uncertainty to wider service design, professional development, and the evolving evidence base. Each episode brings structured discussion to real-world clinical questions. Alongside practical case-based reflection, we highlight research that has caught our eye and consider how emerging evidence should — or should not — influence frontline care. This podcast is for paediatric consultants, trainees, advanced practitioners, and clinicians who want thoughtful, evidence-aware conversation grounded in the realities of modern practice. This podcast is for medical education purposes only and should not replace advice you have received from a medical practitioner.

  1. IV Aminophylline in Acute Severe Asthma: Does It Still Have a Role in Paediatric Emergency Care?

    10/25/2025

    IV Aminophylline in Acute Severe Asthma: Does It Still Have a Role in Paediatric Emergency Care?

    Clinical Question In children presenting with acute severe asthma, does intravenous aminophylline improve meaningful clinical outcomes compared to standard therapy? ⸻ Background IV aminophylline has historically been used as a second-line infusion in severe paediatric asthma. However, contemporary escalation strategies increasingly prioritise: • Oxygen • High-dose nebulised salbutamol • Systemic corticosteroids • IV magnesium sulphate This raises the question: does aminophylline still offer incremental benefit? ⸻ The Evidence Reviewed A systematic review published in Archives of Disease in Childhood analysed: • 9 randomised controlled trials • 466 children • Standard therapy ± IV aminophylline Outcomes assessed: • Asthma severity scores • Length of stay • Admission rates • PICU admission • Intubation rates • Adverse effects ⸻ Key Findings No significant benefit in: • Speed of clinical improvement • Admission rates • PICU transfer • Intubation rates • Length of hospital stay Significant increase in adverse effects: • Nausea and vomiting (3–5x higher) • Headache • Tremor • Irritability • Arrhythmias Overall: No improvement in meaningful outcomes, with increased morbidity. ⸻ Important Caveat A 1998 study (Young & South) suggested possible benefit in the most critically unwell, treatment-refractory children, including: • Reduced duration of intubation • Potential improvement in lung function This suggests a potential narrow rescue-therapy window. ⸻ Implications for Paediatric Emergency Practice (2025) Current best evidence supports: 1. Oxygen 2. Nebulised salbutamol 3. Systemic corticosteroids 4. IV magnesium 5. Structured escalation planning IV aminophylline should be considered: • A rescue therapy of last resort • Not routine second-line treatment ⸻ Take-Home Message IV aminophylline has historical presence but limited modern evidence of benefit. For most children with acute severe asthma, it increases adverse effects without improving outcomes. Its role in 2025: rare, selective, and critically contextual.

    3 min
  2. Episode 82: The FIDO study

    12/21/2024

    Episode 82: The FIDO study

    In this episode we talk to Dr Etimbuk Umana, the lead author of the FIDO study looking at the management of febrile infants in the Emergency Department. FIDO is a PERUKI sponsored study and was recently published in The Lancet: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00540-6/fulltext

    31 min
  3. Episode 81: Priority Setting in PEM research with PERUKI

    05/12/2024

    Episode 81: Priority Setting in PEM research with PERUKI

    2 Paeds returns with a fresh new look, new in association with team at PERUKI. In our first collaboration we talk to Dr Charlotte Sloane about the current major PERUKI project - establishing the current research priorities for the next 5 years in paediatric emergency medicine. If you want to get involved go to www.peruki.org.uk or email Charlotte at csloane04@qub.ac.uk You can also watch us on YouTube

    26 min
  4. Episode 80: Dexmedetomidine for paediatric sedation

    05/08/2022

    Episode 80: Dexmedetomidine for paediatric sedation

    We talk to Dr Tom Jackson about his article in Archives of Disease in Childhood looking at the use of Dexmedetomidine as a sedative agent fro children undergoing MRI scans in a district general hospital. Is it better the NICE recommended medications? Article can be found here: https://adc.bmj.com/content/early/2022/03/10/archdischild-2021-322734

    27 min
  5. Episode 79: Infant Milks and Formulae

    04/03/2022

    Episode 79: Infant Milks and Formulae

    There are so many infant milks and formulae available that it can be confusing to healthcare professionals, let alone parents. Where did they come from, what do they contain and what about specialist prescription-only formulae. Host Dr Ashley Reece takes a deep dive into all these issues with our special guest Bahee Van de Bor - dietician and spokesperson of the British Dietetic Association. You can explore more about Bahee's work at www.ukkidsnutrition.com

    42 min
  6. Episode 78: Climate Change and paediatrics

    11/14/2021

    Episode 78: Climate Change and paediatrics

    We are all busy professionals with lots to do in a very limited amount of time, so why should we be concerned about climate change? That's nothing to do with paediatricians surely? Dr Katie Knight explains why its everything to do with paediatricians and the number one public health emergency for our patients not just tomorrow but today.

    21 min
  7. Episode 77: Magnesium And Migraine

    10/31/2021

    Episode 77: Magnesium And Migraine

    We are joined by Dr Lucie Etheridge and Julia Avery to discuss their recent article in the October 2021 edition of 'Archives of Disease in Childhood' looking at whether magnesium supplementation is helpful in adolescents with migraine.

    24 min
  8. Episode 76: Advanced Neonatal Practice

    10/10/2021

    Episode 76: Advanced Neonatal Practice

    We are really proud to introduce another episode from our Advanced Practitioner team, this time from the ANNPs. Rhian Smith, Becky Joyce and Dr Vicky Payne discuss the past, present and future of Advanced Neonatal Nurse Practitioners in the UK.

    24 min
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About

2 Paeds in a Pod is a clinical paediatrics podcast exploring the decisions, dilemmas, and systems that shape everyday practice. While rooted in paediatric emergency medicine, the conversations range across the breadth of paediatrics — from acute presentations and diagnostic uncertainty to wider service design, professional development, and the evolving evidence base. Each episode brings structured discussion to real-world clinical questions. Alongside practical case-based reflection, we highlight research that has caught our eye and consider how emerging evidence should — or should not — influence frontline care. This podcast is for paediatric consultants, trainees, advanced practitioners, and clinicians who want thoughtful, evidence-aware conversation grounded in the realities of modern practice. This podcast is for medical education purposes only and should not replace advice you have received from a medical practitioner.

Information

  • Creator
    Dr Ian Lewins
  • Years Active
    2017 - 2025
  • Episodes
    83
  • Rating
    Clean
  • Copyright
    © All rights reserved
  • Show Website
    Two Paeds In A Pod

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