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https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#1
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29671836/children-s-experience-of-symptoms-narratives-through-words-and-images
#2
REVIEW
Barbara M Sourkes
Children who live with a complex chronic or life-threatening illness face extraordinary challenges. Whether they are receiving disease-oriented treatment (aimed at potential cure or prolongation of life) or palliative treatment-or both concurrently-our challenge is to enhance their comfort and minimize their distress. Symptom management is thus a critical component of pediatric palliative care. Symptoms may be either physical or psychological in nature (or a confluence of both) and their effective management has a direct impact on the child's quality of life...
April 19, 2018: Children
https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#3
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#4
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29656703/the-ethics-of-concurrent-care-for-children-a-social-justice-perspective
#5
Kim Mooney-Doyle, Jessica Keim-Malpass, Lisa C Lindley
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life-including fatigue, pain, dyspnea, and anxiety-with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#6
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652750/a-needs-assessment-of-brain-death-education-in-pediatric-critical-care-medicine-fellowships
#7
Andrew M Ausmus, Pippa M Simpson, Liyun Zhang, Tara L Petersen
OBJECTIVES: To assess the current training in brain death examination provided during pediatric critical care medicine fellowship. DESIGN: Internet-based survey. SETTING: United States pediatric critical care medicine fellowship programs. SUBJECTS: Sixty-four pediatric critical care medicine fellowship program directors and 230 current pediatric critical care medicine fellows/recent graduates were invited to participate...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29648880/evolving-challenges-in-pediatric-pulmonary-medicine-new-opportunities-to-re-invigorate-the-field
#8
Joseph M Collaco, Steven H Abman
Thirty years after the first board certification examination for pediatric pulmonology was administered there remain substantial challenges in attracting trainees and sustaining and retaining clinician-scientists in the field. In fact, significant workforce shortages are predicted to exist with current fellowship graduation rates and the aging of the existing workforce. However, the rapid diagnostic and therapeutic advances occurring in the field should serve as draw for trainees. In addition, pediatric pulmonologists provide unique expertise for the diversity and severity of respiratory conditions that is not duplicated by generalists, allergists, intensivists, or neonatologists...
April 12, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#9
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628400/-prevalence-and-prognostic-value-of-non-thyroidal-illness-syndrome-among-critically-ill-children
#10
Sohair Sayed Abu El-Ella, Muhammad Said El-Mekkawy, Mohamed Abdelrahman El-Dihemey
INTRODUCTION: Alterations in thyroid hormones during critical illness, known as non-thyroidal illness syndrome (NTIS), were suggested to have a prognostic value. However, pediatric data is limited. The aim of this study was to assess prevalence and prognostic value of NTIS among critically ill children. MATERIALS AND METHODS: A prospective observational study conducted on 70 critically ill children admitted into pediatric intensive care unit (PICU). Free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were measured within 24hours of PICU admission...
April 5, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29625940/incidence-of-drug-interactions-in-intensive-care-units-in-tertiary-care-settings-classification-facts-and-measures
#11
Hina Hasnain, Huma Ali, Farya Zafar, Ali Akbar Sial, Shazia Alam, Anwar Ejaz Beg, Rabia Bushra, Mehwish Rizvi, Maqsood Ahmed Khan, Huma Shareef, Ghazala R Naqvi, Anum Tariq
Drug-drug interactions (DDIs) are extremely significant concern, particularly in sensitive population including pediatric and geriatric. Propensity for the development of DDIs is high in patients admitted at intensive care units (ICU). This study was conducted to evaluate the DDIs incidence, facts and measures in ICU. From a total of 150 cases studied for ICU patients, with the mean age of 56.37±12.45 years, 55.33% were male and the rest were female 44.66%. The demographic information like age, gender and main diagnosis details of study participants that were extracted from the patients' clinical record...
March 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29623289/support-for-self-management-and-prenatal-health-behavior-change-implications-for-pediatric-promotion-of-interconception-care
#12
Emily F Gregory, Charmaine S Wright, Meredith Matone, David M Rubin, Scott A Lorch
Pediatricians increasingly endorse a dual generation approach to health, in which parental health behaviors are recognized as critical to promoting child health. Positive parental behaviors often emerge during pregnancy, for reasons that remain incompletely described. We surveyed mothers in the immediate postpartum period to identify beliefs about health behavior change and characteristics of prenatal care associated with successful change. Sampling at a tertiary care hospital captured an English-speaking adult population with healthy infants...
2018: Global Pediatric Health
https://www.readbyqxmd.com/read/29617846/eresearch-in-acute-kidney-injury-a-primer-for-electronic-health-record-research
#13
Emily L Joyce, Dilhari R DeAlmeida, Dana Y Fuhrman, Priyanka Priyanka, John A Kellum
Acute kidney injury (AKI) has a significant impact on patient morbidity and mortality as well as overall health care costs. eResearch, which integrates information technology and information management to optimize research strategies, provides a perfect platform for necessary ongoing AKI research. With the recent adoption of a widely accepted definition of AKI and near-universal use of electronic health records, eResearch is becoming an important tool in AKI research. Conducting eResearch in AKI should ideally be based on a relatively uniform methodology...
March 30, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29616202/pediatric-critical-care-in-resource-limited-settings-overview-and-lessons-learned
#14
REVIEW
Tina M Slusher, Andrew W Kiragu, Louise T Day, Ashley R Bjorklund, Arianna Shirk, Colleen Johannsen, Scott A Hagen
Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU) and high dependency areas...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29615480/improving-anaphylaxis-care-the-impact-of-a-clinical-pathway
#15
Juhee Lee, Bonnie Rodio, Jane Lavelle, Megan Ott Lewis, Rachel English, Sarah Hadley, Jennifer Molnar, Cynthia Jacobstein, Antonella Cianferoni, Jonathan Spergel, Lisa Zielinski, Nicholas Tsarouhas, Terri Brown-Whitehorn
BACKGROUND: Recommended durations of observation after anaphylaxis have been widely variable, with many ranging from 4 to 24 hours. Prolonged durations often prompt admission for ongoing observation. METHODS: In a multidisciplinary quality improvement initiative, we revised our emergency department (ED) anaphylaxis clinical pathway. Our primary aim was to safely decrease the recommended length of observation from 8 to 4 hours and thereby decrease unnecessary hospitalizations...
April 3, 2018: Pediatrics
https://www.readbyqxmd.com/read/29615134/improving-outcomes-after-pediatric-cardiac-arrest-the-icu-resuscitation-project-study-protocol-for-a-randomized-controlled-trial
#16
Ron W Reeder, Alan Girling, Heather Wolfe, Richard Holubkov, Robert A Berg, Maryam Y Naim, Kathleen L Meert, Bradley Tilford, Joseph A Carcillo, Melinda Hamilton, Matthew Bochkoris, Mark Hall, Tensing Maa, Andrew R Yates, Anil Sapru, Robert Kelly, Myke Federman, J Michael Dean, Patrick S McQuillen, Deborah Franzon, Murray M Pollack, Ashley Siems, John Diddle, David L Wessel, Peter M Mourani, Carleen Zebuhr, Robert Bishop, Stuart Friess, Candice Burns, Shirley Viteri, David A Hehir, R Whitney Coleman, Tammara L Jenkins, Daniel A Notterman, Robert F Tamburro, Robert M Sutton
BACKGROUND: Quality of cardiopulmonary resuscitation (CPR) is associated with survival, but recommended guidelines are often not met, and less than half the children with an in-hospital arrest will survive to discharge. A single-center before-and-after study demonstrated that outcomes may be improved with a novel training program in which all pediatric intensive care unit staff are encouraged to participate in frequent CPR refresher training and regular, structured resuscitation debriefings focused on patient-centric physiology...
April 3, 2018: Trials
https://www.readbyqxmd.com/read/29614569/-relationship-between-continuous-renal-replacement-therapy-and-hypophosphatemia-in-critically-ill-children
#17
T Sun, Y Q Ren, F Wang, H J Miao, Y J Shan, C X Wang, Y C Zhang
Objective: To investigate the incidence and prognosis of hypophosphatemia in critically ill children treated with continuous blood purification (CBP). Methods: The medical records of the critically ill patients, who were treated with CBP, admitted to pediatric intensive care unit (PICU) of Shanghai Children's Hospital from May 2014 to April 2017 were retrospectively analyzed. The serum phosphorus levels were tested before CBP, at 48-72 h during CBP, at the end of CBP and on the next day after CBP finished. Phosphorus supplement was given to the children with severe hypophosphatemia...
April 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29610416/a-health-care-transition-curriculum-for-primary-care-residents-identifying-goals-and-objectives
#18
Alice A Kuo, Mary R Ciccarelli, Niraj Sharma, Debra S Lotstein
BACKGROUND AND OBJECTIVES: The transition from pediatric to adult health care is a vulnerable period for youth with special health care needs. Although successful transitions are recognized as critical for improving adult outcomes and reducing health care utilization and cost, an educational gap in health care transitions for physicians persists. Our aim with this project was to develop a national health care transition residency curriculum for primary care physicians, using an expert-based, consensus-building process...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29604150/neurophysiological-study-of-critical-illness-polyneuropathy-and-myopathy-in-mechanically-ventilated-children-additional-aspect-into-pediatric-critical-illness-comorbidities
#19
Ahmed Thabet Mahmoud, Maha A M Tawfik, Sameh Abdallah Abd El Naby, Wafaa Moustafa M Abo El Fotoh, Nagwan Yossery Saleh, Nahla M Said Abd El Hady
BACKGROUND: Critical illness polyneuropathy and myopathy (CIP/CIM) is being increasingly recognized as a significant clinical problem in critically ill children especially who have spent long periods in the intensive care unit. So we aimed to determine the frequency of CIP/CIM among mechanically ventilated children and to analyze the associated risk factors and drawbacks frequently encountered in this cohort. METHODS: The study included 105 patients admitted to the pediatric intensive care unit and underwent mechanical ventilation for ≥7 days...
March 31, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29600241/a-standardized-needs-assessment-tool-to-inform-the-curriculum-development-process-for-pediatric-resuscitation-simulation-based-education-in-resource-limited-settings
#20
Nicole Shilkofski, Amanda Crichlow, Julie Rice, Leslie Cope, Ye Myint Kyaw, Thazin Mon, Sarah Kiguli, Julianna Jung
Introduction: Under five mortality rates (UFMR) remain high for children in low- and middle-income countries (LMICs) in the developing world. Education for practitioners in these environments is a key factor to improve outcomes that will address United Nations Sustainable Development Goals 3 and 10 (good health and well being and reduced inequalities). In order to appropriately contextualize a curriculum using simulation, it is necessary to first conduct a needs assessment of the target learner population...
2018: Frontiers in Pediatrics
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