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Pediatric simulation

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https://www.readbyqxmd.com/read/29148002/targeting-zero-catheter-related-bloodstream-infections-in-pediatric-intensive-care-unit-a-retrospective-matched-case-control-study
#1
Daniele G Biasucci, Mauro Pittiruti, Alessandra Taddei, Enzo Picconi, Alessandro Pizza, Davide Celentano, Marco Piastra, Giancarlo Scoppettuolo, Giorgio Conti
INTRODUCTION: The aim of this study was to evaluate the effectiveness and safety of a new three-component 'bundle' for insertion and management of centrally inserted central catheters (CICCs), designed to minimize catheter-related bloodstream infections (CRBSIs) in critically ill children. METHODS: Our 'bundle' has three components: insertion, management, and education. Insertion and management recommendations include: skin antisepsis with 2% chlorhexidine; maximal barrier precautions; ultrasound-guided venipuncture; tunneling of the catheter when a long indwelling time is expected; glue on the exit site; sutureless securement; use of transparent dressing; chlorhexidine sponge dressing on the 7th day; neutral displacement needle-free connectors...
November 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29136270/60-seconds-to-survival-a-pilot-study-of-a-disaster-triage-video-game-for-prehospital-providers
#2
Mark X Cicero, Travis Whitfill, Kevin Munjal, Manu Madhok, Maria Carmen G Diaz, Daniel J Scherzer, Barbara M Walsh, Angela Bowen, Michael Redlener, Scott A Goldberg, Nadine Symons, James Burkett, Joseph C Santos, David Kessler, Ryan N Barnicle, Geno Paesano, Marc A Auerbach
INTRODUCTION: Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. METHODS: Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls...
April 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29135701/verification-of-the-optimal-chest-compression-depth-for-children-in-the-2015-american-heart-association-guidelines-computed-tomography-study
#3
Yong Hwan Kim, Jun Ho Lee, Kwang Won Cho, Dong Woo Lee, Mun Ju Kang, Kyoung Yul Lee, Joung Hun Byun, Young Hwan Lee, Seong Youn Hwang, Na Kyoung Lee
OBJECTIVE: The 2015 American Heart Association guidelines recommended pediatric rescue chest compressions of at least one-third the anteroposterior diameter of the chest, which equates to approximately 5 cm. This study evaluated the appropriateness of these two types by comparing their safeties in chest compression depth simulated by CT. DESIGN: Retrospective study with data analysis conducted from January 2005 to June 2015 SETTING:: Regional emergency center in South Korea...
November 11, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29124558/development-of-a-simple-device-enabling-percutaneous-flow-regulation-for-a-small-vascular-graft-for-a-blalock-taussig-shunt-capable-of-flow-regulation-complete-translation-of-a-review-article-originally-published-in-pediatric-cardiology-and-cardiac-surgery
#4
Yoshikazu Motohashi, Ryo Shimada, Tomoyasu Sasaki, Takahiro Katsumata, Kazunori Dan, Yasuhiro Tsutsui, Shintaro Nemoto
OBJECTIVES: The Blalock-Taussig shunt (BTS) operation is a cornerstone as initial palliative surgery for congenital heart disease with severely reduced pulmonary blood flow (PBF). The ideal PBF provided by BTS is crucial for an uneventful postoperative course, since excess PBF results in acute distress of the systemic circulation and insufficient PBF requires another BTS surgery. Therefore, the goal of this study was to develop a simple device to control the shunt graft flow percutaneously using a constrictor balloon connected to a subcutaneous port...
November 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29117093/death-of-a-simulated-pediatric-patient-toward-a-more-robust-theoretical-framework
#5
Mary E McBride, Dana Aronson Schinasi, Michael Alice Moga, Shreepada Tripathy, Aaron Calhoun
INTRODUCTION: A theoretical framework was recently proposed that encapsulates learner responses to simulated death due to action or inaction in the pediatric context. This framework, however, was developed at an institution that allows simulated death and thus does not address the experience of those centers at which this technique is not used. To address this, we performed a parallel qualitative study with the intent of augmenting the initial framework. METHODS: We conducted focus groups, using a constructivist grounded theory approach, using physicians and nurses who have experienced a simulated cardiac arrest...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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
#6
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/29117090/building-a-community-of-practice-for-researchers-the-international-network-for-simulation-based-pediatric-innovation-research-and-education
#7
Adam Cheng, Marc Auerbach, Aaron Calhoun, Ralph Mackinnon, Todd P Chang, Vinay Nadkarni, Elizabeth A Hunt, Jordan Duval-Arnould, Nicola Peiris, David Kessler
The scope and breadth of simulation-based research is growing rapidly; however, few mechanisms exist for conducting multicenter, collaborative research. Failure to foster collaborative research efforts is a critical gap that lies in the path of advancing healthcare simulation. The 2017 Research Summit hosted by the Society for Simulation in Healthcare highlighted how simulation-based research networks can produce studies that positively impact the delivery of healthcare. In 2011, the International Network for Simulation-based Pediatric Innovation, Research and Education (INSPIRE) was formed to facilitate multicenter, collaborative simulation-based research with the aim of developing a community of practice for simulation researchers...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29115052/dose-selection-based-on-modeling-and-simulation-for-rivipansel-in-pediatric-patients-aged-6-to-11-years-with-sickle-cell-disease
#8
Brinda K Tammara, Lutz O Harnisch
This modeling and simulation exercise aimed to provide dosing recommendations for rivipansel phase 3 studies in children aged 6 to 11 years with sickle cell disease (SCD). Pharmacokinetic data from 109 patients aged 12 to 51 years who received rivipansel (2-40 mg/kg) in previous studies (3 phase 1, one phase 2) were integrated to build a 3-compartmental simulation model. Renal clearance simulations across the age range accounted for renal function development and postulated hyperfiltration in SCD. Simulated demographic distributions for the pediatric SCD population were used to predict concentration-time profiles from 3 dosing regimens, which were then compared against efficacious average steady-state concentrations observed in phase 2...
November 8, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/29114011/albuterol-delivery-efficiency-in-a-pediatric-model-of-noninvasive-ventilation-with-double-limb-circuit
#9
Jeanne Velasco, Ariel Berlinski
BACKGROUND: Noninvasive ventilation (NIV) is used to treat respiratory failure in patients with concomitant need for aerosol delivery. Limited pediatric data are available on aerosol delivery efficiency, and none at all regarding aerosol delivery efficiency with a double-limb circuit. We compared the effect of position in the double-limb ventilator circuit, types of nebulizer, and ventilator settings on aerosol delivery efficiency in a pediatric model of NIV. We hypothesized that placing a vibrating mesh nebulizer at the ventilator and using the highest inspiratory pressures would increase aerosol delivery efficiency...
November 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29111198/cumulative-effective-dose-and-cancer-risk-of-pediatric-population-in-repetitive-whole-body-scan-using-dual-energy-x-ray-absorptiometry
#10
Martin Law, Wang-Kei Ma, Eva Chan, Candy Mui, Vivian Ma, Wai-Yin Ho, Lawrance Yip, Wendy Lam
This study aims to quantitatively evaluate the cumulative effective dose and associated cancer risk of pediatric patients of US and Hong Kong population undergoing repetitive whole-body scans with dual-energy X-ray absorptiometry (DXA) during their diagnosis and follow-up periods. Organ-absorbed doses of pediatric patients undergoing DXA whole-body scan have been computer simulated using patient imaging parameters input to the Monte Carlo software PCXMC. Gender- and age-specific effective doses have been calculated with the simulated organ-absorbed doses using the ICRP-103 approach...
September 29, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29104056/taste-evaluation-of-a-novel-midazolam-tablet-for-pediatric-patients-in-vitro-drug-dissolution-in-vivo-animal-taste-aversion-and-clinical-taste-perception-profiles
#11
Laurence C Cheung, Minh Nguyen, Edith Tang, Britta S von Ungern Sternberg, Sam Salman, Catherine Tuleu, Abeer H A Mohamed Ahmed, Jessica Soto, Lee Yong Lim
Harmonized methodologies are urgently required for the taste evaluation of novel pediatric medicines. This study utilized in vitro, in vivo and clinical data to evaluate the palatability of a novel midazolam chocolate tablet. In vitro dissolution experiments showed the crushed tablet to release within 5 min 1.68 mg of midazolam into simulated saliva. This translated to a drug level of 0.84 mg/ml in the oral cavity, which would be higher than the midazolam bitterness detection threshold concentration of 0...
November 11, 2017: International Journal of Pharmaceutics
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/29099727/supplemental-computational-phantoms-to-estimate-out-of-field-absorbed-dose-in-photon-radiotherapy
#13
Kyle Joseph Gallagher, Jaad Tannous, Racile Nabha, Joelle Ann Feghali, Zeina Ayoub, Wassim T Jalbout, Bassem Youssef, Phillip J Taddei
The purpose of this study was to develop a straightforward method of supplementing patient anatomy and estimating out-of-field absorbed dose for a cohort of pediatric radiotherapy patients with limited recorded anatomy. A cohort of nine children, aged 2 to 14 years, who received three-dimensional conformal radiotherapy for low grade localized brain tumors (LBTs), were randomly selected for this study. The extents of these patients' computed tomography simulation image sets were cranial only. To approximate their missing anatomy, we supplemented the LBT patients' image sets with computed tomography images of patients in a previous study with larger extents of matched sex, height, and mass and for whom contours of organs at risk for radiogenic cancer had already been delineated...
November 3, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29099461/the-authors-reply
#14
Nnenna O Chime, Elizabeth A Hunt
No abstract text is available yet for this article.
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29097448/using-simulation-to-develop-care-models-for-rapid-response-and-code-teams-at-a-satellite-facility
#15
Amy R L Rule, Julie Snider, Cheryl Marshall, Kathleen Kramer, Gary L Geis, Ken Tegtmeyer, Craig H Gosdin
BACKGROUND: Our institution recently completed an expansion of an acute care inpatient unit within a satellite hospital that does not include an on-site ICU or PICU. Because of expected increases in volume and acuity, new care models for Rapid Response Teams (RRTs) and Code Blue Teams were necessary. OBJECTIVES: Using simulation-based training, our objectives were to define the optimal roles and responsibilities for team members (including ICU physicians via telemedicine), refine the staffing of RRTs and code Teams, and identify latent safety threats (LSTs) before opening the expanded inpatient unit...
November 2, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29093039/virtual-reality-in-pediatric-psychology
#16
REVIEW
Thomas D Parsons, Giuseppe Riva, Sarah Parsons, Fabrizia Mantovani, Nigel Newbutt, Lin Lin, Eva Venturini, Trevor Hall
Virtual reality (VR) technologies allow for controlled simulations of affectively engaging background narratives. These virtual environments offer promise for enhancing emotionally relevant experiences and social interactions. Within this context, VR can allow instructors, therapists, neuropsychologists, and service providers to offer safe, repeatable, and diversifiable interventions that can benefit assessments and learning in both typically developing children and children with disabilities. Research has also pointed to VR's capacity to reduce children's experience of aversive stimuli and reduce anxiety levels...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29093006/rapid-intraoperative-diagnosis-of-pediatric-brain-tumors-using-stimulated-raman-histology
#17
Todd C Hollon, Spencer Lewis, Balaji Pandian, Yashar S Niknafs, Mia R Garrard, Hugh Garton, Cormac O Maher, Kathryn McFadden, Matija Snuderl, Andrew P Lieberman, Karin Muraszko, Sandra Camelo-Piragua, Daniel A Orringer
Accurate histopathologic diagnosis is essential for providing optimal surgical management of pediatric brain tumors. Current methods for intraoperative histology are time- and labor-intensive and often introduce artifacts that limit interpretation. Stimulated Raman histology (SRH) is a novel label-free imaging technique that provides intraoperative histologic images of fresh, unprocessed surgical specimens. Here we evaluate the capacity of SRH for use in the intraoperative diagnosis of pediatric type brain tumors...
November 1, 2017: Cancer Research
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/29076969/compatibility-of-zoll-defibrillators-in-simulation-based-training
#19
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
https://www.readbyqxmd.com/read/29076967/the-call-and-the-challenge-of-pediatric-resuscitation-and-simulation-research-in-low-resource-settings
#20
Amy R L Rule, Meredith Tabangin, David Cheruiyot, Priscilla Mueri, Beena D Kamath-Rayne
The greatest burden of younger than 5 years mortality is in low- and middle-income nations where education resources are often few. The World Health Organization recommends scale-up of simulation in these settings, but it has been poorly studied. Although there has been an increase of contextualized resuscitation simulation programs designed for these settings, sustaining clinical outcomes and provider skill retention have remained research gaps. Our team designed a study to evaluate skill retention after an initial Helping Babies Breathe training at a rural Kenya referral hospital between randomized learner groups receiving supervised mock codes with debriefing versus just-in-time training with a peer...
October 25, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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