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Pediatric resuscitation

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https://www.readbyqxmd.com/read/29140950/development-of-clinical-process-measures-for-pediatric-burn-care-understanding-variation-in-practice-patterns
#1
Lewis E Kazis, Robert L Sheridan, Gabriel D Shapiro, Austin F Lee, Matthew H Liang, Colleen M Ryan, Jeffrey C Schneider, Martha Lydon, Marina Soley-Bori, Lily A Sonis, Emily C Dore, Tina Palmieri, David Herndon, Walter Meyer, Petra Warner, Richard Kagan, Frederick J Stoddard, Michael Murphy, Ronald G Tompkins
BACKGROUND: There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#2
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29132580/the-kids-are-alright-pediatric-trauma-pearls
#3
REVIEW
Angelo Mikrogianakis, Vincent Grant
Pediatric patients with trauma pose unique challenges, both practical and cognitive, to front-line care providers. The combination of anatomic, physiologic, and metabolic factors leads to unique injury patterns with different approaches and responses to treatment compared with adults. A similar traumatic mechanism can lead to slightly different internal injuries with unique management and treatment strategies between the two groups. This article is intended for community, nonpediatric trauma centers, and emergency physicians who are frequently required to assess, resuscitate, and stabilize injured children before they can be safely transferred to a pediatric trauma center for ongoing definitive care and rehabilitation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29126550/trends-in-pediatric-adjusted-shock-index-predict-morbidity-and-mortality-in-children-with-severe-blunt-injuries
#4
Robert J Vandewalle, Julia K Peceny, Scott C Dolejs, Jodi L Raymond, Thomas M Rouse
PURPOSE: The utility of measuring the pediatric adjusted shock index (SIPA) at admission for predicting severity of blunt injury in pediatric patients has been previously reported. However, the utility of following SIPA after admission is not well described. METHODS: The trauma registry from a level-one pediatric trauma center was queried from January 1, 2010 to December 31, 2015. Patients were included if they were between 4 and 16years old at the time of admission, sustained a blunt injury with an Injury Severity Score≥15, and were admitted less than 12h after their injury (n=286)...
October 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29124022/outcomes-of-extracorporeal-membrane-oxygenation-in-children-an-11-year-single-center-experience-in-korea
#5
Hongsun Kim, Ji-Hyuk Yang, Yang Hyun Cho, Tae-Gook Jun, Kiick Sung, Woosik Han
Background: Extracorporeal membrane oxygenation (ECMO) has become an important treatment modality in pediatric patients with cardiopulmonary failure, but few studies have been conducted in Korea. Methods: We conducted a retrospective review of pediatric patients younger than 18 years who were placed on ECMO between January 2004 and December 2014 at Samsung Medical Center. Results: We identified 116 children on ECMO support. The overall rate of successful weaning was 51...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#6
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29117819/role-of-ultrasound-in-confirmation-of-endotracheal-tube-in-neonates-a-review
#7
Deepak Sharma, Seyyed Ahmad Tabatabaii, Nazanin Farahbakhsh
Tracheal intubation is a commonly done procedure in neonatal intensive care unit and delivery room during resuscitation. The confirmation of endotracheal tube (ETT) position should be done quickly as tube malposition is associated with various serious adverse outcomes like hypoxemia, right upper lobe collapse, atelectasis, air leak syndromes and esophageal intubation. ETT position can be confirmed by various methods like clinical sign, chest radiography, capnography, external digital tracheal palpation, ultrasonography (USG), respiratory function monitor, video-laryngoscope and fiberoptic devices...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29117092/the-development-and-validation-of-a-concise-instrument-for-formative-assessment-of-team-leader-performance-during-simulated-pediatric-resuscitations
#8
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29114010/2017-international-consensus-on-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care-science-with-treatment-recommendations-summary
#9
REVIEW
Theresa M Olasveengen, Allan R de Caen, Mary E Mancini, Ian K Maconochie, Richard Aickin, Dianne L Atkins, Robert A Berg, Robert M Bingham, Steven C Brooks, Maaret Castrén, Sung Phil Chung, Julie Considine, Thomaz Bittencourt Couto, Raffo Escalante, Raúl J Gazmuri, Anne-Marie Guerguerian, Tetsuo Hatanaka, Rudolph W Koster, Peter J Kudenchuk, Eddy Lang, Swee Han Lim, Bo Løfgren, Peter A Meaney, William H Montgomery, Peter T Morley, Laurie J Morrison, Kevin J Nation, Kee-Chong Ng, Vinay M Nadkarni, Chika Nishiyama, Gabrielle Nuthall, Gene Yong-Kwang Ong, Gavin D Perkins, Amelia G Reis, Giuseppe Ristagno, Tetsuyo Sakamoto, Michael R Sayre, Stephen M Schexnayder, Alfredo F Sierra, Eunice M Singletary, Naoki Shimizu, Michael A Smyth, David Stanton, Janice A Tijssen, Andrew Travers, Christian Vaillancourt, Patrick Van de Voorde, Mary Fran Hazinski, Jerry P Nolan
The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29114009/2017-american-heart-association-focused-update-on-pediatric-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#10
REVIEW
Dianne L Atkins, Allan R de Caen, Stuart Berger, Ricardo A Samson, Stephen M Schexnayder, Benny L Joyner, Blair L Bigham, Dana E Niles, Jonathan P Duff, Elizabeth A Hunt, Peter A Meaney
This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29111081/timing-of-mortality-in-pediatric-trauma-patients-a-national-trauma-data-bank-analysis
#11
Cory McLaughlin, Jessica A Zagory, Michael Fenlon, Caron Park, Christianne J Lane, Daniella Meeker, Randall S Burd, Henri R Ford, Jeffrey S Upperman, Aaron R Jensen
BACKGROUND/PURPOSE: The classic "trimodal" distribution of death has been described in adult patients, but the timing of mortality in injured children is not well understood. The purpose of this study was to define the temporal distribution of mortality in pediatric trauma patients. METHODS: A retrospective cohort of patients with mortality from the National Trauma Data Bank (2007-2014) was analyzed. Categorical comparison of 'dead on arrival', 'death in the emergency department', and early (≤24h) or late (>24h) inpatient death was performed...
October 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103789/an-in-situ-simulation-based-educational-outreach-project-for-pediatric-trauma-care-in-a-rural-trauma-system
#12
Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, Shannon W Longshore
BACKGROUND: Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. METHODS: Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29099872/a-pilot-randomized-controlled-trial-of-ekg-for-neonatal-resuscitation
#13
Anup Katheria, Kathy Arnell, Melissa Brown, Kasim Hassen, Mauricio Maldonado, Wade Rich, Neil Finer
BACKGROUND: The seventh edition of the American Academy of Pediatrics Neonatal Resuscitation Program recommends the use of a cardiac monitor in infants that need resuscitation. Previous trials have shown that EKG heart rate is available before pulse rate from a pulse oximeter. To date no trial has looked at how the availability of electrocardiogram (EKG) affects clinical interventions in the delivery room. OBJECTIVE: To determine whether the availability of an EKG heart rate value and tracing to the clinical team has an effect on physiologic measures and related interventions during the stabilization of preterm infants...
2017: PloS One
https://www.readbyqxmd.com/read/29097614/two-year-neurodevelopmental-outcome-of-an-infant-born-at-21-weeks-4-days-gestation
#14
Kaashif A Ahmad, Charlotte S Frey, Mario A Fierro, Alexander B Kenton, Frank X Placencia
Recent literature confirms that, at the lower limit of extrauterine survival, substantial intercenter variability exists in resuscitation practice. The reasons for this variability are unclear, but may be related to disagreement on how to apply the best interests standard to extremely premature infants. Currently, both obstetric and pediatric societies recommend against assessing for viability or attempting resuscitation before 22 weeks' gestation. In this context, we report the unimpaired 2-year outcome of a female infant resuscitated after delivery at 21 weeks' 4 days' gestation and 410 g birth weight...
November 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/29095938/challenges-to-code-status-discussions-for-pediatric-patients
#15
Katherine E Kruse, Jason Batten, Melissa L Constantine, Saraswati Kache, David Magnus
OBJECTIVES: In the context of serious or life-limiting illness, pediatric patients and their families are faced with difficult decisions surrounding appropriate resuscitation efforts in the event of a cardiopulmonary arrest. Code status orders are one way to inform end-of-life medical decision making. The objectives of this study are to evaluate the extent to which pediatric providers have knowledge of code status options and explore the association of provider role with (1) knowledge of code status options, (2) perception of timing of code status discussions, (3) perception of family receptivity to code status discussions, and (4) comfort carrying out code status discussions...
2017: PloS One
https://www.readbyqxmd.com/read/29095382/recognition-and-management-of-pediatric-salt-toxicity
#16
Eike Blohm, Amy Goldberg, Ann Salerno, Carole Jenny, Edward Boyer, Kavita Babu
OBJECTIVES: Immediate recognition of salt toxicity and aggressive resuscitative measures are critical in the treatment of this lethal poisoning. Despite heroic measures, pediatric deaths due to salt toxicity still occur from irreversible neurological damage. The objective of this article is to review the relevant literature and offer a therapeutic algorithm for the management of pediatric patients presenting with salt toxicity. METHODS: A literature search for cases of salt toxicity was conducted...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29092771/development-and-validation-of-a-new-pediatric-resuscitation-and-trauma-outcome-presto-model-using-the-u-s-national-trauma-data-bank
#17
Etienne St-Louis, David Bracco, James Hanley, Tarek Razek, Robert Baird
BACKGROUND: There is a need for a pediatric trauma outcomes benchmarking model that is adapted for Low-and-Middle-Income Countries (LMICs). We used the National-Trauma-Data-Bank (NTDB) and applied constraints specific to resource-poor environments to develop and validate an LMIC-specific pediatric trauma score. METHODS: We selected a sample of pediatric trauma patients aged 0-14years in the NTDB from 2007 to 2012. Primary outcome was in-hospital death. Logistic regression was used to create the Pediatric Resuscitation and Trauma Outcome (PRESTO) score, which includes only low-tech predictor variables - those easily obtainable at point-of-care...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29084067/a-randomized-control-trial-of-cardiopulmonary-feedback-devices-and-their-impact-on-infant-chest-compression-quality-a-simulation-study
#18
Andrea L Austin, Carmen N Spalding, Katrina N Landa, Brian R Myer, Cure Donald, Jason E Smith, Gerald Platt, Heather C King
OBJECTIVES: In effort to improve chest compression quality among health care providers, numerous feedback devices have been developed. Few studies, however, have focused on the use of cardiopulmonary resuscitation feedback devices for infants and children. This study evaluated the quality of chest compressions with standard team-leader coaching, a metronome (MetroTimer by ONYX Apps), and visual feedback (SkillGuide Cardiopulmonary Feedback Device) during simulated infant cardiopulmonary resuscitation...
October 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29084038/brain-magnetic-resonance-imaging-findings-in-pediatric-patients-post-extracorporeal-membrane-oxygenation
#19
Venessa L Pinto, Sumit Pruthi, Ashly C Westrick, Chevis N Shannon, Brian C Bridges, Truc M Le
Neurologic complications can occur with extracorporeal membrane oxygenation (ECMO) due to several factors. Prior studies identified neonates as having unique risk factors and neuroimaging findings post ECMO. The aim of this study is to describe brain magnetic resonance imaging findings of pediatric patients treated with ECMO. We conducted a retrospective study of nonneonatal pediatric patients who underwent a comprehensive brain magnetic resonance imaging after ECMO between January 2000 and July 2015. We identified 47 pediatric patients in the study cohort with a median age of 8 months (interquartile range 3-170 months) and a median ECMO run duration of 7...
November 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29076969/compatibility-of-zoll-defibrillators-in-simulation-based-training
#20
Jamie Leigh Shoemaker, Olivia T Duty, Kenneth J Martin, Gary L Geis
INTRODUCTION: In response to the need for high-quality cardiopulmonary resuscitation (CPR) during cardiac arrest, our institution recently purchased ZOLL R Series monitor/defibrillators. This defibrillator provides CPR quality metrics and displays a filtered rhythm through compressions. Purchase of this defibrillator resulted in a practice change and heavily impacted our simulation-based training courses by requiring providers to practice CPR and defibrillation in as close to the real environment as possible...
October 25, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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