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https://www.readbyqxmd.com/read/27826208/sedation-with-a-remifentanil-infusion-to-facilitate-rapid-awakening-and-tracheal-extubation-in-an-infant-with-a-potentially-compromised-airway
#1
Jeffrey Naples, Mark W Hall, Joseph D Tobias
Sedation is generally required during endotracheal intubation and mechanical ventilation in infants and children. While there are many options for the provision of sedation, the most commonly used agents such as midazolam and fentanyl demonstrate a context-sensitive half-life, which may result in a prolonged effect when these agents are discontinued following a continuous infusion. We present a 20-month-old infant who required endotracheal intubation due to respiratory failure following seizures. At the referring hospital, multiple laryngoscopies were performed with the potential for airway trauma...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/26808349/unnecessary-use-of-red-lights-and-sirens-in-pediatric-transport
#2
Beech Burns, Matthew L Hansen, Stacy Valenzuela, Caitlin Summers, Joshua Van Otterloo, Barbara Skarica, Craig Warden, Jeanne-Marie Guise
INTRODUCTION: Approximately 25.5 million pediatric patients are treated in Emergency Departments around the United States annually. Roughly 7% of these patients are transported by ambulance; of these, approximately 7% arrive in ambulances running red lights and sirens (RLS). Compared to those transporting without RLS, emergency vehicles employing RLS are involved in more accidents and are associated with more fatalities. OBJECTIVE: To characterize the use of RLS in pediatric transports and identify factors associated with unnecessary use of RLS...
May 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/25658967/prehospital-pediatric-care-opportunities-for-training-treatment-and-research
#3
Patrick C Drayna, Lorin R Browne, Clare E Guse, David C Brousseau, E Brooke Lerner
OBJECTIVE: Pediatric transports comprise approximately 10% of emergency medical services (EMS) requests for aid, but little is known about the clinical characteristics of pediatric EMS patients and the interventions they receive. Our objective was to describe the pediatric prehospital patient cohort in a large metropolitan EMS system. METHODS: This retrospective analysis of all pediatric (age <19 years) EMS patients transported from October 2011 to September 2013 was conducted by reviewing a system-wide National EMS Information System (NEMSIS)-compliant database of all EMS patient encounters...
July 2015: Prehospital Emergency Care
https://www.readbyqxmd.com/read/25523319/-pediatric-emergencies-in-the-emergency-medical-service
#4
REVIEW
C Silbereisen, F Hoffmann
Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies...
January 2015: Der Anaesthesist
https://www.readbyqxmd.com/read/24391412/demographic-profile-and-outcome-analysis-of-pediatric-intensive-care-patients
#5
E Volakli, M Sdougka, M Tamiolaki, C Tsonidis, M Reizoglou, M Giala
BACKGROUND: Demographic profile and outcome can vary in pediatric intensive care unit (PICU) patients. The aim of our study was to analyze demographic profile and outcome in a Greek PICU. METHODS: Prospective observational study. DATA COLLECTED: demographic profile; co morbidities; source and diagnosis at admission; Pediatric Risk of Mortality (PRISM III-24); Glasgow Coma Scale (GCS, pediatric); Injury Severity Score (ISS); procedures; treatment; mechanical ventilation (MV); MV days; length of stay (LOS) and the outcome at PICU discharge...
October 2011: Hippokratia
https://www.readbyqxmd.com/read/22532511/risk-factors-and-outcome-of-ventilator-associated-tracheitis-vat-in-pediatric-trauma-patients
#6
Maroun J Mhanna, Ibrahim S Elsheikh, Dennis M Super
We sought to investigate the risk factors and outcome of Ventilator Associated Tracheitis (VAT) according to the Center for Disease Control (CDC) definition in pediatric trauma patients who were ventilated for ≥48 hr. In a retrospective cohort study, medical records of all pediatric trauma patients admitted to our Pediatric Intensive Care Unit (PICU) between April 2002 and April 2007 were reviewed. Medical records were reviewed for patients' demographics, Trauma Injury Severity Score (TISS), Glasgow Coma Scale (GCS), type of trauma, and other potential risk factors prior to the development of VAT (such as hyperglycemia, rate of re-intubation and tracheotomy, presence of chest tubes and central lines, urinary tract infection, seizures, need for cardiopulmonary resuscitation, use of total parental nutrition, transfusion, use of H(2) blockers, steroids, and pressors/inotropes)...
February 2013: Pediatric Pulmonology
https://www.readbyqxmd.com/read/21435314/resuscitation-interventions-in-a-tertiary-level-pediatric-emergency-department-implications-for-maintenance-of-skills
#7
F Jonathan Guilfoyle, Ruth Milner, Niranjan Kissoon
OBJECTIVE: To describe the frequency and proportion of successful resuscitation interventions in a pediatric emergency department (PED). METHODS AND MATERIAL: This was a retrospective chart review of children at the BC Children's Hospital (BCCH) PED who were admitted to the BCCH pediatric intensive care unit (PICU) in 2004 and 2005. Demographic data, diagnosis, and resuscitation interventions in the PED and within the first 24 hours of PICU admission were recorded...
March 2011: CJEM
https://www.readbyqxmd.com/read/20805780/extreme-stress-hyperglycemia-during-acute-illness-in-a-pediatric-emergency-department
#8
Scott L Weiss, Jamin Alexander, Michael S D Agus
OBJECTIVES: Although mild stress hyperglycemia in pediatric illness is common, severe hyperglycemic responses (≥300 mg/dL [16.7 mmol/L]) to stress are unusual. We sought to determine the incidence and course of extreme stress hyperglycemia (ESH) in acute pediatric illness, including whether it is a marker of increased mortality or associated with subsequent development of diabetes mellitus (DM). METHODS: We retrospectively reviewed a cohort of 55,120 consecutive visits over 6 years to a pediatric emergency department at which blood glucose concentrations were measured and report on visits with laboratory glucose 300 mg/dL (16...
September 2010: Pediatric Emergency Care
https://www.readbyqxmd.com/read/17175623/management-and-outcomes-of-pediatric-patients-transported-by-emergency-medical-services-in-a-canadian-prehospital-system
#9
Julie Richard, Martin H Osmond, Lisa Nesbitt, Ian G Stiell
OBJECTIVES: There is uncertainty around the types of interventions that are provided by emergency medical services (EMS) to children during prehospital transport. We describe the patient characteristics, events, interventions provided and outcomes of a cohort of children transported by EMS. METHODS: This prospective cohort study was conducted in a city of 750 000 people with a 2-tiered EMS system. All children <16 years of age who were attended by EMS during a 6-month period were enrolled...
January 2006: CJEM
https://www.readbyqxmd.com/read/16177896/-pediatric-cases-in-preclinical-emergency-medicine-critical-aspects-in-the-range-of-missions-covered-by-ground-ambulance-and-air-rescue-services
#10
T Schlechtriemen, R Masson, K Burghofer, C K Lackner, K H Altemeyer
BACKGROUND: The aim of this study was to demonstrate differences in structure and severity of pediatric emergencies treated by aeromedical (air rescue) or ground ambulances services. Conclusions for the training of emergency physicians are discussed. PATIENTS AND METHODS: In a 3-year study period, a total of 9,274 pediatric emergencies covered by the ADAC air rescue service are compared to 4,344 pediatric patients of ground ambulance services in Saarland. RESULTS: In aeromedical services pediatric emergencies are more frequent (12...
March 2006: Der Anaesthesist
https://www.readbyqxmd.com/read/12538542/shaken-baby-syndrome-in-canada-clinical-characteristics-and-outcomes-of-hospital-cases
#11
MULTICENTER STUDY
W James King, Morag MacKay, Angela Sirnick
BACKGROUND: Shaken baby syndrome is an extremely serious form of abusive head trauma, the extent of which is unknown in Canada. Our objective was to describe, from a national perspective, the clinical characteristics and outcome of children admitted to hospital with shaken baby syndrome. METHODS: We performed a retrospective chart review, for the years 1988-1998, of the cases of shaken baby syndrome that were reported to the child protection teams of 11 pediatric tertiary care hospitals in Canada...
January 21, 2003: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/10966338/uses-and-complications-of-central-venous-catheters-inserted-in-a-pediatric-emergency-department
#12
V W Chiang, M N Baskin
OBJECTIVE: To describe the incidence, indications, insertion sites, duration, and complications of central venous catheter (CVC) insertion in patients in a pediatric emergency department (ED). METHODS: HASH(0x4a0cf08) DESIGN: Retrospective chart review. SETTING: ED of an urban pediatric teaching hospital. SUBJECTS: Patients who had a CVC inserted in the ED from January 1992 to July 1997. RESULTS: During the 5...
August 2000: Pediatric Emergency Care
https://www.readbyqxmd.com/read/8806138/pediatric-prehospital-care-provided-by-a-physician-staffed-emergency-medical-helicopter-unit-in-finland
#13
P Suominen, T Silfvast, R Korpela, J Erosuo
During an 18-month period ending on March 15, 1994, data on all patients treated by the Helsinki Area Emergency Medical Air Service (HEMS) in Southern Finland were collected. The HEMS operates a physician-staffed helicopter unit which is dispatched by alarm centers connected to a national 112 emergency phone system. Of 1481 emergency missions during the study period, 89 (8%) involved children less than 17 years old. Common pediatric emergencies were trauma (31%), seizures (29%), respiratory problems (14%), and cardiac arrest (9%)...
June 1996: Pediatric Emergency Care
https://www.readbyqxmd.com/read/6394284/emergency-management-of-pediatric-head-injuries
#14
REVIEW
N P Rosman, E Y Oppenheimer, J F O'Connor
About a quarter of a million children are hospitalized each year in the United States because of head injuries, with many more than that treated outside the hospital. Although the majority of children with head trauma appear to recover fully, with or without treatment, a significant minority suffer neurologic residua and several thousand such children die annually. Thus, especially in more seriously injured children, the emergency treatment of the child may be crucial to the eventual outcome. In this review, an approach to the emergency management of pediatric head injuries is presented...
April 1983: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/1836869/a-one-year-series-of-pediatric-prehospital-care-i-ambulance-runs-ii-prehospital-communication-iii-interhospital-transport-services
#15
L G Yamamoto, R A Wiebe, D M Maiava, C J Merry
During a 12-month period ending on November 30, 1988, all ambulance arrivals at a pediatric emergency department (ED), all prehospital communications with this ED, all first-responder ambulance runs on Oahu and the state of Hawaii, and all neonatal/pediatric interhospital transports were examined to evaluate pediatric prehospital care. Handicapped patients were more likely to use an ambulance, and their care was more likely to be perceived as a weakness on the part of ambulance personnel. Poorer communication clarity was associated with longer duration of communication...
August 1991: Pediatric Emergency Care
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