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Training pediatric anesthesia

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https://www.readbyqxmd.com/read/30292264/children-centered-care-minimizing-the-need-for-anesthesia-with-a-multi-faceted-concept-for-mri-in-children-aged-4-6
#1
Stine B Runge, Nicolaj L Christensen, Kim Jensen, Ib E Jensen
PURPOSE: To evaluate the need for general anesthesia (GA) in MRI in children aged 4-6 years, using a multi-faceted concept, Children Centered Care (CCC), compared to a standard setup. MATERIALS AND METHODS: In this prospective study of 81 children, we developed and tested a multi-faceted concept, CCC, for MRI in children aged 4-6 without GA, comparing it to a standard setup. The CCC included: 1) an interactive app, 2) a trained pediatric team, 3) a children's lounge with a toy-scanner, and 4) a child-friendly multimedia environment in the MRI room...
October 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/30251364/half-a-century-of-anesthesia-for-children-an-interview-with-dr-nishan-g-nick-goudsouzian
#2
Michael R King, Christine L Mai, Paul G Firth
The career of Dr Nishan Goudsouzian spanned half a century of pediatric anesthesia. His 50 years saw seminal contributions to the use of neuromuscular blocking agents in children, the development of proton beam therapy and magnetic resonance imaging for pediatric cancer, the introduction of the laryngeal mask airway, an explosion in the volume and depth of knowledge about pediatric anesthesia, the expansion of formal training in pediatric anesthesia, and the widening of academic efforts to improve anesthetic care for children worldwide...
September 24, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/30243872/fellowship-training-in-pediatric-cardiac-anesthesia-history-maturation-and-current-status
#3
REVIEW
Viviane G Nasr, Nina A Guzzetta, Emad B Mossad
Pediatric cardiac anesthesia as a discipline has evolved over the years to become a well recognized sub-specialty. Education and training in the field has also continued to change and develop. In this review, the author outline the changes in the field over the years and suggest a structure for an organized fellowship training process.
August 11, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/30233961/single-leg-spica-cast-application-for-treatment-of-pediatric-femoral-fracture
#4
M Catherine Sargent
Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation...
September 28, 2017: JBJS Essential Surgical Techniques
https://www.readbyqxmd.com/read/30169412/building-a-bridge-between-pediatric-anesthesiologists-and-pediatric-intensive-care
#5
Mckenna M Longacre, Brian M Cummings, Angela M Bader
Despite the aligned histories, development, and contemporary practices, today, pediatric anesthesiologists are largely absent from pediatric intensive care units. Contributing to this divide are deficits in exposure to pediatric intensive care at all levels of training in anesthesia and significant credentialing barriers. These observations have led us to consider, does the current structure of training lead to the ability to optimally innovate and collaborate in the delivery of pediatric critical care? We consider how redesigning the pediatric critical care training pathway available for pediatric anesthesiologists may improve care of children both in and out of the operating room by facilitating further sharing of skills, research, and clinical experience...
August 29, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30133332/minimally-invasive-pediatric-surgery-during-remote-humanitarian-missions-is-feasible-safe-and-effective
#6
Jeffrey Lukish, Jasmine Ellis Davy, David Lanning, Bharati Datta, Jonathan DeAntonio
PURPOSE: There remains a critical need for the provision for pediatric humanitarian aid worldwide. Historically, the emphasis of global pediatric health needs has been focused on infectious diseases. Today, we are witnessing a shift in this paradigm, with growing attention being paid toward the surgical needs of children. The use and deployment of minimally invasive surgery (MIS) in these austere environments with its concomitant reduction in length of hospitalization, pain, and morbidity is logical...
August 22, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/30113400/informed-consent-in-pediatric-anesthesia-a-narrative-review
#7
Max M Feinstein, Anthony E Pannunzio, Samuel Lobell, Eric Kodish
Informed consent for pediatric anesthesia challenges practitioners to navigate complex ethical, medical, and legal ambiguities. A patient's status as a minor does not negate the importance of his or her participation in the decision-making process but, rather, necessitates a nuanced evaluation of age and development to involve the patient to an appropriate extent. Given the complexities involved with pediatric informed consent in anesthesia practice and research, it is important to understand the experience of key stakeholders involved...
August 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29859572/intraoperative-pediatric-acupuncture-is-widely-accepted-by-parents
#8
James W Ochi, Andrew C Richardson
OBJECTIVE: Medical acupuncture is increasingly recognized for reducing postoperative pain, nausea and emergence agitation. Anesthetic induction is an ideal time to perform acupuncture in an effort to reduce the adverse side effects of surgery. Acupuncture is safe, inexpensive and does not lengthen the duration of anesthesia. There are however no published reports of how often patients will choose intraoperative acupuncture when given the opportunity to do so. METHODS: A retrospective review of all surgical procedures performed by one surgeon over 12 months was done...
July 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#9
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
July 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29677057/newborn-resuscitation-skills-in-health-care-providers-at-a-zambian-tertiary-center-and-comparison-to-world-health-organization-standards
#10
Sara C Mistry, Richard Lin, Hazel Mumphansha, Laura C Kettley, Janaki A Pearson, Sonia Akrimi, David J Mayne, Wonder Hangoma, M Dylan Bould
BACKGROUND: Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower-middle income country...
July 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#11
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/29622311/anesthesia-for-the-pediatric-oral-and-maxillofacial-surgery-patient
#12
REVIEW
Deepak G Krishnan
Pediatric patients present to the oral and maxillofacial surgeon for surgical services that can be performed safely and efficiently. Children and parents tend to be anxious; achieving cooperation is paramount for successful procedures. Several techniques can be used to alleviate anxiety and provide analgesia and anesthesia. This article outlines the anatomy and physiology of children and the preoperative anesthetic preparation and techniques unique to pediatric anesthesia. It discusses standards in training in pediatric anesthesia and current recommendations for monitoring...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#13
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29548354/preoperative-anesthesia-evaluation
#14
REVIEW
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29547425/are-short-subspecialty-courses-the-educational-answer
#15
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29547424/education-the-heart-of-the-matter
#16
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29543640/anesthesia-for-percutaneous-pulmonary-valve-implantation-a-case-series
#17
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
July 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29526348/interventions-in-the-operating-room-for-children-near-end-of-life-a-multidisciplinary-approach
#18
Marianne Goudreault, Nago Humbert, France Gauvin, Monia Marzouki, Catherine K Beaumier, Dickens St-Vil, Nelson Piché
INTRODUCTION: Pediatric surgeons are often involved in the management of severely or terminally ill patients. However, articles addressing their specific roles in the context of palliative care are almost inexistent. We sought to characterize the involvement of pediatric surgeons caring for children near end of life. METHODS: Chart review of children who had a procedure under general anesthesia within 6months of their death over a five-year period at a tertiary children's hospital (excluding traumas and neonatology cases)...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29516316/anterior-segment-ultrasound-biomicroscopy-image-analysis-using-imagej-software-intra-observer-repeatability-and-inter-observer-agreement
#19
Azam Qureshi, Haoxing Chen, Osamah Saeedi, Mona A Kaleem, Gianna Stoleru, Jordan Margo, Sachin Kalarn, Janet L Alexander
PURPOSE: In this novel study, we demonstrate a standardized imaging and measurement protocol of anterior segment (AS) structures with reliability analysis using ultrasound biomicroscopy (UBM) and ImageJ software. METHODS: Ten pediatric and young adult patients undergoing examination under anesthesia for AS pathology were imaged using UBM. Four trained observers analyzed 20 images using ImageJ. Forty-five structural parameters were measured. Those that relied on the trabecular-iris angle (TIA) as a reference landmark were labeled TIA-dependent (TD) and all others were labeled non-TIA dependent (NTD)...
March 7, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29483054/the-utility-of-the-modified-yale-preoperative-anxiety-scale-for-predicting-success-in-pediatric-patients-undergoing-mri-without-the-use-of-anesthesia
#20
Arlyne Thung, Dmitry Tumin, Joshua C Uffman, Joseph D Tobias, Tricia Buskirk, Whitney Garrett, Arleen Karczewski, Haleh Saadat
PURPOSE: MRI is a common modality for diagnostic imaging. In children, general anesthesia is often required to complete MRI examinations. Simulation training can reduce the need for anesthesia in some children. Reliable screening tools to select who could benefit from practice MRI sessions are lacking. This study evaluates the use of the modified Yale Preoperative Anxiety Scale (mYPAS) in effectively identifying patients who may benefit from simulation-based training. METHODS: Children aged 5 and older who were originally scheduled for MRI with anesthesia in 2015 to 2016 were prospectively recruited for simulation-based training...
September 2018: Journal of the American College of Radiology: JACR
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