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Pediatric sedation

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https://www.readbyqxmd.com/read/29233853/variation-in-pediatric-procedural-sedations-across-children-s-hospital-emergency-departments
#1
Andrew F Miller, Michael C Monuteaux, Florence T Bourgeois, Eric W Fleegler
OBJECTIVES: Describe the trends in pediatric sedation use over time and determine variation in use of procedural sedation across children's hospital emergency departments (EDs). METHODS: We analyzed ED data from 35 hospitals within the Pediatric Health Information System for patients <19 years old who received sedation medications and were discharged from 2009 to 2014. Patients with chronic comorbidities or undergoing intubation were excluded. We determined frequency and trends in use of sedation and compared these between EDs...
December 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29228523/advanced-therapeutic-gastrointestinal-endoscopy-in-children-today-and-tomorrow
#2
Zaheer Nabi, Duvvur Nageshwar Reddy
Gastrointestinal (GI) endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories...
December 12, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29211141/hospitalizations-due-to-drug-poisoning-in-under-five-year-old-children-in-brazil-2003-2012
#3
Marta da Cunha Lobo Souto Maior, Claudia Garcia Serpa Osorio-de-Castro, Carla Lourenço Tavares de Andrade
OBJECTIVE: to describe hospitalizations due to drug poisonings in children under five years old, in Brazil, from 2003 to 2012. METHODS: descriptive study, with data from the National Hospital Information System (SIH/SUS); the drugs involved were divided into therapeutic classes, according to the Anatomical Therapeutic Chemical Classification (ATC). RESULTS: 17,725 hospitalizations were identified, from which 22,395 poisonings were identified, and 75 deaths; the most common therapeutic classes were unspecified drugs (38...
October 2017: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/29210720/massive-macroglossia-after-posterior-cranial-fossa-surgery-a-case-report
#4
Jennifer F Ha, Lisa N Vitale, Marie A Pfarr, Yu Kawai, David A Zopf
A 16-year-old boy with Chiari 1 malformation presented for an elective suboccipital craniectomy and C1 laminectomy. His intraoperative course was uneventful. At the conclusion of the procedure, he met extubation criteria and followed commands. After extubation, he developed progressive upper airway obstruction and became obtunded. He was reintubated via videolaryngoscopy, which showed edema not only to the tongue, but also to the posterior pharynx and blisters over the vocal folds and epiglottis. The patient was transferred to the pediatric intensive care unit intubated and sedated...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29192867/reduction-of-hyperthermia-in-pediatric-patients-with-severe-traumatic-brain-injury-a-quality-improvement-initiative
#5
Marlina E Lovett, Melissa Moore-Clingenpeel, Onsy Ayad, Nicole O'Brien
OBJECTIVE Severe traumatic brain injury remains a leading cause of morbidity and mortality in the pediatric population. Providers focus on reducing secondary brain injury by avoiding hypoxemia, avoiding hypotension, providing normoventilation, treating intracranial hypertension, and reducing cerebral metabolic demand. Hyperthermia is frequently present in patients with severe traumatic brain injury, contributes to cerebral metabolic demand, and is associated with prolonged hospital admission as well as impaired neurological outcome...
December 1, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29189706/unplanned-extubations-in-intensive-care-unit-evidences-for-risk-factors-a-literature-review
#6
Chiara Cosentino, Mattia Fama, Chiara Foà, Giorgia Bromuri, Serena Giannini, Marco Saraceno, Angela Spagnoletta, Mbemo Tenkue, Elena Trevisi, Leopoldo Sarli
BACKGROUND AND AIM: Unplanned extubations (UE) are getting more and more relevant in Critical Care, becoming a quality and care safeness outcome. This happens because after an UE the patient can face some complications concerning the airway management, respiratory and hemodynamic problems, lengthen in the hospital stay and in the mechanical ventilation time.  The aim of this review is identify and classify the factors that could increase UE risk. METHODOLOGY: A systematic review of scientific articles was performed consulting the databases PubMed, Cinahl, Medline, EBSCOhost and Google Scholar...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29187151/pediatric-premedication-a-double-blind-randomized-trial-of-dexmedetomidine-or-ketamine-alone-versus-a-combination-of-dexmedetomidine-and-ketamine
#7
Hui Qiao, Zhi Xie, Jie Jia
BACKGROUND: Preoperative anxiety is common in pediatric patients. When dexmedetomidine is used alone for sedation as premedication, children tend to awaken when separated from their parents, and body movements occur during invasive procedures. We tested the hypothesis that the combination of dexmedetomidine and ketamine may be a useful premedication to alleviate preoperative anxiety and improve cooperation during intravenous cannulation in pediatric patients, while producing minimal adverse events...
November 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29181580/ionizing-radiation-from-computed-tomography-versus-anesthesia-for-magnetic-resonance-imaging-in-infants-and-children-patient-safety-considerations
#8
REVIEW
Michael J Callahan, Robert D MacDougall, Sarah D Bixby, Stephan D Voss, Richard L Robertson, Joseph P Cravero
In the context of health care, risk assessment is the identification, evaluation and estimation of risk related to a particular clinical situation or intervention compared to accepted medical practice standards. The goal of risk assessment is to determine an acceptable level of risk for a given clinical treatment or intervention in association with the provided clinical circumstances for a patient or group of patients. In spite of the inherent challenges related to risk assessment in pediatric cross-sectional imaging, the potential risks of ionizing radiation and sedation/anesthesia in the pediatric population are thought to be quite small...
November 27, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29179370/use-of-anesthesia-providers-in-the-administration-of-office-based-deep-sedation-general-anesthesia-to-the-pediatric-dental-patient
#9
(no author information available yet)
No abstract text is available yet for this article.
September 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29179369/monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#10
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
September 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29178963/chloral-hydrate-enteral-infusion-for-sedation-in-ventilated-children-the-chosen-pilot-study
#11
Ari R Joffe, Jessica Hogan, Cathy Sheppard, Gerda Tawfik, Jonathan P Duff, Gonzalo Garcia Guerra
BACKGROUND: We aimed to test a novel method of delivery of chloral hydrate (CH) sedation in ventilated critically ill young children. METHODS: Children < 12 years old, within 72 hours of admission, who were ventilated, receiving enteral tube-feeds, with intermittent CH ordered were enrolled after signed consent. Patients received a CH loading-dose of 10 mg/kg enterally, then a syringe-pump enteral infusion at 5 mg/kg/hour, increasing to a maximum of 9 mg/kg/hour...
November 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29174849/-the-advantages-in-using-cyanoacrylate-glue-over-skin-staples-as-a-method-of-skin-graft-fixation-in-the-pediatric-burns-population
#12
P Curings, P-L Vincent, R Viard, P Gir, J-P Comparin, D Voulliaume
INTRODUCTION: Local postoperative care and burn wound management can present with a certain degree of difficulty in the pediatric population. While the use of skin staples as a method of skin graft fixation is a well-known, rapid and simple method, their removal can be painful and may necessitate some sedation or even general anesthesia. We studied in this article the advantages and economic value of using the cyanoacrylate glue as a fixation method for skin grafts. MATERIALS AND METHODS: A comparative study was carried out from 2012 to 2016...
November 23, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29170943/asenapine-treatment-in-pediatric-patients-with-bipolar-i-disorder-or-schizophrenia-a-review
#13
REVIEW
Ekaterina Stepanova, Bradley Grant, Robert L Findling
Asenapine, administered as a twice-daily (BID) sublingual tablet, is approved in the US as monotherapy for the acute treatment of manic and mixed episodes of bipolar I disorder in children and adolescents aged 10-17 years based on the positive results of one 3-week, double-blind, placebo-controlled study; the recommended dose is 2.5-10 mg BID. Although asenapine has been studied in pediatric patients with schizophrenia, it is not approved for this indication. Asenapine is not approved for pediatric use in bipolar I disorder or schizophrenia in other major markets...
November 23, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29169819/use-of-capnography-to-optimize-procedural-sedation-in-the-emergency-department-pediatric-population
#14
Leonie Rose Bovino, Christina Brainard, Kristen Beaumier, Victoria Concetti, Nicole Lefurge, Emily Mittelstadt, Tabea Wilson, Melissa L Langhan
No abstract text is available yet for this article.
November 20, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29168371/congenital-insensitivity-to-pain-how-should-anesthesia-be-managed
#15
Özlem Özmete, Mesut Şener, Çağla Bali, Esra Çalışkan, Anış Arıboğan
Özmete Ö, Şener M, Bali Ç, Çalışkan E, Arıboğan A. Congenital insensitivity to pain: How should anesthesia be managed? Turk J Pediatr 2017; 59: 87-89. Congenital insensitivity to pain syndrome is a rare, sensorial and autonomic neuropathy characterized by unexplained fever, insensitivity to pain and anhidrosis. Patients may require anesthesia even for minor surgical procedures due to mental retardation and trauma arising from self- mutilating behavior. A child diagnosed with congenital insensitivity to pain syndrome was scheduled for gastric endoscopy under sedation due to suspected ingestion of a household cleaning disinfectant...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29168364/aggressive-periodontitis-associated-with-kindler-syndrome-in-a-large-kindler-syndrome-pedigree
#16
Tuba Talo Yıldırım, Filiz Acun Kaya, Mustafa Taşkesen, Serkan Dündar, Alihan Bozoğlan, Gülücağ Giray Tekin, Sedat Akdeniz
Talo-Yıldırım T, Acun-Kaya F, Taşkesen M, Dündar S, Bozoğlan A, Tekin GG, Akdeniz S. Aggressive periodontitis associated with Kindler syndrome in a large Kindler syndrome pedigree. Turk J Pediatr 2017; 59: 56-61. Kindler syndrome (KS) is a rare genetic disorder. The clinical features include aggressive periodontal disease and severe desquamative gingivitis. Five individuals with KS were assessed by oral examination, radiographic analysis and periodontal measurements. All the patients' indexes were recorded prior to periodontal treatment and at the end of the 1th, 3th , 6th, 9th and 12th month respectively...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29166296/emergency-intubations-in-a-high-volume-pediatric-emergency-department
#17
Jen Heng Pek, Gene Yong-Kwang Ong
INTRODUCTION: Resuscitation of critically ill children can be chaotic, and emergency airway management is often fraught with difficulties. This study aimed to characterize the Singaporean landscape of tracheal intubation in a pediatric emergency unit, placing emphasis on safety outcomes, procedural process of care, and provider training. METHODS: A retrospective review of all cases presented to the KK Women's and Children's Hospital from January 2009 to December 2013 with intubation carried out within the pediatric emergency unit was done...
November 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#18
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152464/intensivist-based-deep-sedation-using-propofol-for-pediatric-outpatient-flexible-bronchoscopy
#19
Kamal Abulebda, Samer Abu-Sultaneh, Sheikh Sohail Ahmed, Elizabeth A S Moser, Renee C McKinney, Riad Lutfi
AIM: To evaluate the safety and efficacy of sedating pediatric patients for outpatient flexible bronchoscopy. METHODS: A retrospective chart review was conducted for all children, age 17 years or under who underwent flexible bronchoscopy under deep sedation in an outpatient hospital-based setting. Two sedation regimens were used; propofol only or ketamine prior to propofol. Patients were divided into three age groups; infants (less than 12 mo), toddlers (1-3 years) and children (4-17 years)...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142969/elucidation-of-renal-scars-in-children-with%C3%A2-vesicoureteral-reflux-using-contrast-enhanced-ultrasound-a-pilot%C3%A2-study
#20
David S Hains, Harris L Cohen, M Beth McCarville, Ellen E Ellison, Amy Huffman, Stacey Glass, Aslam H Qureshi, Keith R Pierce, Ashlyn L Cahill, Ashley Dixon, Noel Delos Santos
Introduction: Vesicoureteral reflux is a common disorder in children but can result in kidney scarring following acute pyelonephritis. The gold standard diagnostic to detect renal scars in children is (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy. DMSA has a number of limitations including radiation exposure, need for sedation, and radiotracer supply shortages. Contrast-enhanced ultrasound (CEUS) is a technique whereby biocompatible microspheres of inert gas are administered i.v...
May 2017: KI Reports
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