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https://www.readbyqxmd.com/read/27931463/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#1
(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...
October 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#2
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27893516/caregiver-expectations-and-satisfaction-of-urgent-care-in-a-pediatric-emergency-department
#3
Greg P Marconi, Phung K Pham, Alan L Nager
Health care delivery expectations that may affect patient and caregiver satisfaction are not clearly understood. This study examined caregiver expectations and satisfaction with urgent care in a pediatric emergency department. Of 201 caregivers surveyed, we found that caregivers have specific expectations regarding clinical care of their child in terms of radiographic imaging, blood testing, antibiotics, pain management, and subspecialty consultation. Caregivers were generally less dissatisfied with the actual care provided than the urgent care physicians expected...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27872800/invisible-seams-preventing-childhood-obesity-through-an-improved-obstetrics-pediatrics-care-continuum
#4
EDITORIAL
Craig W Moscetti, Nicolaas P Pronk
Progress in altering the current obesity epidemic among children and adolescents remains elusive. Evidence continues to underscore the challenges of altering weight status as children age. Further, weight loss interventions among children and adults alike tend to demonstrate efficacy in the short-term, however individuals tend to slowly revert back to their original weight status over time. New understanding of obesity's early origins suggests the need to rethink current approaches, particularly within healthcare...
March 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/27846070/implementation-and-operational-research-an-integrated-and-comprehensive-service-delivery-model-to-improve-pediatric-and-maternal-hiv-care-in-rural-africa
#5
Anna Gamell, Tracy R Glass, Lameck B Luwanda, Herry Mapesi, Leila Samson, Tom Mtoi, Angelo Nyamtema, Lukas Muri, Alex Ntamatungiro, Marcel Tanner, Christoph Hatz, Manuel Battegay, Emilio Letang
BACKGROUND: Strategies to improve HIV diagnosis and linkage into care, antiretroviral treatment coverage, and treatment outcomes of mothers and children are urgently needed in sub-Saharan Africa. METHODS: From December 2012, we implemented an intervention package to improve prevention of mother-to-child transmission (PMTCT) and pediatric HIV care in our rural Tanzanian clinic, consisting of: (1) creation of a PMTCT and pediatric unit integrated within the reproductive and child health clinic; (2) implementation of electronic medical records; (3) provider-initiated HIV testing and counseling in the hospital wards; and (4) early infant diagnosis test performed locally...
December 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27812166/survival-outcomes-in-a-pediatric-antiretroviral-treatment-cohort-in-southern-malawi
#6
Jason C Brophy, Michael T Hawkes, Edson Mwinjiwa, Gabriel Mateyu, Sumeet K Sodhi, Adrienne K Chan
BACKGROUND: Pediatric uptake and outcomes in antiretroviral treatment (ART) programmes have lagged behind adult programmes. We describe outcomes from a population-based pediatric ART cohort in rural southern Malawi. METHODS: Data were analyzed on children who initiated ART from October/2003 -September/2011. Demographics and diagnoses were described and survival analyses conducted to assess the impact of age, presenting features at enrolment, and drug selection. RESULTS: The cohort consisted of 2203 children <15 years of age...
2016: PloS One
https://www.readbyqxmd.com/read/27801708/pediatric-critical-care-transport-as-a-conduit-to-terminal-extubation-at-home-a-case-series
#7
Corina Noje, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Sapna R Kudchadkar
OBJECTIVES: To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. DESIGN: We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. SETTING: All cases were identified from our institutional pediatric transport database. PATIENTS: Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes...
October 28, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27786589/current-management-of-severe-dengue-infection
#8
Tau Hong Lee, Linda Kay Lee, David Chien Lye, Yee Sin Leo
Traditionally a disease mainly affecting the pediatric population, dengue burden has increased significantly in recent decades and adults with severe disease may become more common. There is currently no effective anti-viral agent available for the treatment of dengue and supportive care is the mainstay of management. Areas covered: We present a review of current literature on dengue severity classification systems and the management of severe dengue in adults. In particular, emphasis was placed on organ impairment in dengue and management of elderly individuals with multiple medical problems...
October 27, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27757471/appointment-lead-time-policy-development-to-improve-patient-access-to-care
#9
Yu-Li Huang, Sarah M Bach
BACKGROUND: Patient access to care has been a known and continuing struggle for many health care providers. In spite of appointment lead time policies set by government or clinics, the problem persists. Justification for how lead time policies are determined is lacking. OBJECTIVES: This paper proposed a data-driven approach for how to best set feasible appointment target lead times given a clinic's capacity and appointment requests. METHODS: The proposed approach reallocates patient visits to minimize the deviation between actual appointment lead time and a feasible target lead time...
October 19, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27753717/pediatric-referrals-to-an-emergency-department-from-urgent-care-centers
#10
Robert P Olympia, Robert Wilkinson, Jennifer Dunnick, Brendan J Dougherty, Debra Zauner
OBJECTIVE: The aims of this study were to describe pediatric emergency department (ED) referrals from urgent care centers and to determine the percentage of referrals considered essential and serious. METHODS: A prospective study was conducted between April 2013 and April 2015 on patients younger than 21 years referred directly to an ED in central Pennsylvania from surrounding urgent care centers. Referrals were considered essential or serious based on investigations/procedures performed or medications/consultations received in the ED...
October 8, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27748332/implementation-of-a-pediatric-emergency-triage-system-in-xiamen-china
#11
Gang-Xi Lin, Yin-Ling Yang, Denise Kudirka, Colleen Church, Collin K K Yong, Fiona Reilly, Qi-Yi Zeng
BACKGROUND: Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale. METHODS: In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27672551/use-of-fungal-diagnostics-and-therapy-in-pediatric-cancer-patients-in-resource-limited-settings
#12
Sheena Mukkada, Jeannette Kirby, Nopporn Apiwattanakul, Randall T Hayden, Miguela A Caniza
Fungal diseases are an important cause of mortality in immunocompromised hosts, and their incidence in pediatric cancer patients in low- to middle-income countries is underestimated. In this review, we present relevant, up-to-date information about the most common opportunistic and endemic fungal diseases among children with cancer, their geographic distribution, and recommended diagnostics and treatment. Efforts to improve the care of children with cancer and fungal disease must address the urgent need for sustainable and cost-effective solutions that improve training, fungal disease testing capability, and the use of available resources...
September 2016: Current Clinical Microbiology Reports
https://www.readbyqxmd.com/read/27668922/system-stresses-in-2-pediatric-emergency-departments-and-2-pediatric-urgent-care-centers-during-the-2014-enterovirus-d68-outbreak
#13
Gregory P Conners, Stacy J Doyle, Milton A Fowler, Lisa L Schroeder, Thomas W Tryon
OBJECTIVE: To describe the association of an unprecedented large-scale Enterovirus-D68 outbreak in 2014 with changes in patient volume and acuity and system stress in 2 pediatric emergency departments and 2 pediatric urgent care centers of a single children's hospital. METHODS: We compared measures of patient volume, acuity, and system stress during the 2014 Enterovirus-D68 outbreak and the corresponding dates of the previous year. RESULTS: Both settings experienced large census increases during the Enterovirus-D68 outbreak; patient census increased significantly more in the pediatric urgent care setting (20...
September 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27614548/virtual-gaming-to-develop-students-pediatric-nursing-skills-a-usability-test
#14
Margaret Verkuyl, Lynda Atack, Paula Mastrilli, Daria Romaniuk
BACKGROUND: As competition for specialty clinical placements increases, there is an urgent need to create safe, stimulating, alternative learning environments for students. OBJECTIVE: To address that clinical gap, our team developed a virtual game-based simulation to help nursing students develop their pediatric nursing skills. DESIGN: A usability study was conducted using the Technology Acceptance Model as a research framework. SETTING AND PARTICIPANTS: The study was conducted at a community college and included nursing students, nursing faculty/clinicians and two gaming experts...
November 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27599265/effects-of-social-needs-screening-and-in-person-service-navigation-on-child-health-a-randomized-clinical-trial
#15
Laura M Gottlieb, Danielle Hessler, Dayna Long, Ellen Laves, Abigail R Burns, Anais Amaya, Patricia Sweeney, Christine Schudel, Nancy E Adler
Importance: Social determinants of health shape both children's immediate health and their lifetime risk for disease. Increasingly, pediatric health care organizations are intervening to address family social adversity. However, little evidence is available on the effectiveness of related interventions. Objective: To evaluate the effects of social needs screening and in-person resource navigation services on social needs and child health. Design, Setting, and Participants: Patients were randomized to intervention or active control conditions by the day of the week...
September 6, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27599004/an-integrated-and-comprehensive-service-delivery-model-to-improve-pediatric-and-maternal-hiv-care-in-rural-africa
#16
Anna Gamell, Tracy R Glass, Lameck B Luwanda, Herry Mapesi, Leila Samson, Tom Mtoi, Angelo Nyamtema, Lukas Muri, Alex Ntamatungiro, Marcel Tanner, Christoph Hatz, Manuel Battegay, Emilio Letang
BACKGROUND: Strategies to improve HIV diagnosis and linkage into care, antiretroviral treatment coverage and treatment outcomes of mothers and children are urgently needed in sub-Saharan Africa. METHODS: From 12/2012, we implemented an intervention package to improve Prevention of Mother-To-Child Transmission (PMTCT) and pediatric HIV care in our rural Tanzanian clinic, consisting of: a) creation of a PMTCT and pediatric unit integrated within the reproductive and child health clinic; b) implementation of electronic medical records; c) provider-initiated HIV testing and counseling in the hospital wards; and d) early infant diagnosis test performed locally...
September 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27585904/clinical-pharmacology-studies-in-critically-ill-children
#17
Nilay Thakkar, Sara Salerno, Christoph P Hornik, Daniel Gonzalez
Developmental and physiological changes in children contribute to variation in drug disposition with age. Additionally, critically ill children suffer from various life-threatening conditions that can lead to pathophysiological alterations that further affect pharmacokinetics (PK). Some factors that can alter PK in this patient population include variability in tissue distribution caused by protein binding changes and fluid shifts, altered drug elimination due to organ dysfunction, and use of medical interventions that can affect drug disposition (e...
September 1, 2016: Pharmaceutical Research
https://www.readbyqxmd.com/read/27579934/manchester-triage-system-main-flowcharts-discriminators-and-outcomes-of-a-pediatric-emergency-care
#18
Camila Amthauer, Maria Luzia Chollopetz da Cunha
OBJETIVE: to characterize the care services performed through risk rating by the Manchester Triage System, identifying demographics (age, gender), main flowcharts, discriminators and outcomes in pediatric emergency. METHOD: cross-sectional quantitative study. Data on risk classification were obtained through a search of computerized registration data from medical records of patients treated in the pediatric emergency within one year. Descriptive statistics with absolute and relative frequencies was used for the analysis...
2016: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/27567148/impact-of-an-educational-intervention-to-improve-antibiotic-prescribing-for-nurse-practitioners-in-a-pediatric-urgent-care-center
#19
Gina Weddle, Jennifer Goldman, Angela Myers, Jason Newland
BACKGROUND: Up to 21% of pediatric visits result in an antibiotic prescription, and a large portion of these are unnecessary. OBJECTIVE: To determine if educational sessions would reduce inappropriate antibiotic use. METHODS: Intervention study evaluating antibiotic prescribing following educational sessions for urinary tract infection, skin and soft tissue infection, pharyngitis, upper respiratory tract infection, acute otitis media, and acute bacterial sinusitis...
August 23, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/27557912/guidelines-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#20
Charles J Coté, Stephen Wilson
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 the potential 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...
2016: Pediatric Dentistry
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