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Pediatric hospital medicine

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https://www.readbyqxmd.com/read/28434851/long-term-audit-of-platelet-consumption-in-a-university-hospital
#1
A K Al-Ghumlas, A K Al Momen, M Badri, A G Abdel Gader
OBJECTIVES: To determine the long-term trend in platelet consumption in a university hospital. MATERIALS AND METHODS: The annual consumption of platelets concentrate (PC) was analyzed over 23 years (1985-2007) in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. RESULTS: The total 23 years consumption was 100,466 units of PC. Consumption went through 3 phases: the first, 1985-1994: the annual consumption increased from 1706 to 5912 which coincided with the increase in the number of patient admissions; the second, 1994-2003:featured a remarkable drop (48...
April 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28434470/complementary-and-alternative-medicine-among-hospitalized-pediatric-patients
#2
Adi Oren-Amit, Matitiahu Berkovitch, Hilla Bahat, Michael Goldman, Eran Kozer, Tomer Ziv-Baran, Ibrahim Abu-Kishk
OBJECTIVES: To estimate the prevalence and describe the characteristics of complementary and alternative medicine (CAM) use among hospitalized children, and to discover the awareness of medical staff regarding CAM use. DESIGN/SETTING: Parents of children aged 0-18 years admitted to the Pediatric Division at Assaf Harofeh Medical Center in Israel between January and July of 2015 (n=146) were provided a questionnaire regarding socio-economic status and evaluating the CAM use...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28434455/creating-a-pediatric-joint-council-to-promote-patient-safety-and-quality-governance-and-accountability-across-johns-hopkins-medicine
#3
Michael Rosen, Brigitta U Mueller, Aaron M Milstone, Denise R Remus, Renee Demski, Peter J Pronovost, Marlene R Miller
BACKGROUND: Large multihospital health systems with multiple children's hospitals are relatively few in number. With a paucity of national pediatric measures for quality and patient safety, there are unique challenges to ensuring consistent levels of care across diverse health care delivery settings. At Johns Hopkins Medicine, a Pediatric Joint Council was created to help ensure high-quality and safe care across a health system encompassing two full-service children's hospitals and two community hospitals with significant pediatric volumes across two states...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28421650/keeping-up-with-the-kids-diffusion-of-innovation-in-pediatric-emergency-medicine-among-emergency-physicians
#4
Robert L Cloutier, Rakesh D Mistry, Stephen Cico, Chris Merritt, Samuel H F Lam, Marc Auerbach, L Melissa Skaugset, Jean Klig, Meg Wolff, Myto Duong, Jennifer Walthall
With 30,000,000 emergency department (ED) visits annually, children account for nearly one fourth of all ED visits in the United States. Despite these statistics, EDs across the country remain underprepared to care for pediatric patients [1, 2]. Based on published data, only 45% of EDs report having a pediatric quality improvement plan in place, one third of hospitals do not weigh children in kilograms, less than half have disaster plans in place for pediatric patients and more than 15% are missing critical pediatric emergency equipment [1]...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28397979/the-obstetric-consultant-on-the-labour-ward-beyond-infancy-to-early-adolescence
#5
William F Rayburn
Hospital medicine has emerged over the last two decades into a practice pattern for those with generalist training in internal medicine, family medicine, and pediatrics. Their hospital consultative practices are now generally acceptable in light of a changing health care financial landscape, primary care physicians leaving the hospital workplace, and a push to improve the efficiency and effectiveness of systems-based hospital care. Today, several specialties are more involved in hospital consultant programs such as obstetrics, emergency medicine, surgery, and psychiatry...
April 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28390586/an-analysis-of-anaphylaxis-cases-at-a-single-pediatric-emergency-department-during-a-1-year-period
#6
Christopher D Wright, Mindy Longjohn, Phillip L Lieberman, Jay Adam Lieberman
BACKGROUND: Case series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few. OBJECTIVE: To describe confirmed cases of pediatric anaphylaxis in patients presenting to a pediatric hospital emergency department (ED). METHODS: We identified all ED visits with the International Classification of Diseases, Ninth Revision (ICD-9) codes 995...
April 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28370645/outcomes-of-a-failure-mode-and-effects-analysis-for-medication-errors-in-pediatric-anesthesia
#7
Lizabeth D Martin, Eliot B Grigg, Shilpa Verma, Gregory J Latham, Sally E Rampersad, Lynn D Martin
The Institute of Medicine has called for development of strategies to prevent medication errors, which are one important cause of preventable harm. Although the field of anesthesiology is considered a leader in patient safety, recent data suggest high medication error rates in anesthesia practice. Unfortunately, few error prevention strategies for anesthesia providers have been implemented. Using Toyota Production System quality improvement methodology, a multidisciplinary team observed 133 h of medication practice in the operating room at a tertiary care freestanding children's hospital...
March 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28367192/correlation-between-maternal-and-childhood-vitb12-folic-acid-and-ferritin-levels
#8
Fatima Zeeshan, Attia Bari, Saima Farhan, Uzma Jabeen, Ahsan Waheed Rathore
OBJECTIVE: To determine the correlation between serum folic acid, vitamin B12 and ferritin of mother and child and to study various neonatal risk factors as a cause of anemia in children. METHODS: One hundred eighty children two months to two years of age admitted in the department of Pediatric Medicine of The Children's Hospital and The Institute of Child Health Lahore from January 2013 to January 2015 with common medical conditions having anemia were included...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28367018/blood-transfusion-practices-in-a-tertiary-care-center-in-northern-india
#9
Sonam Kumari
BACKGROUND: Blood transfusion plays vital roles in the medical and surgical practice. To achieve optimum use of blood, transfusion has to be appropriate and judicious consuming minimal resources and manpower. OBJECTIVE: To evaluate the pattern of blood transfusion requests and utilization with the aim of determining transfusion practice. MATERIALS AND METHODS: Blood request forms and cross-match worksheets at the blood bank were analyzed over a 6-month period...
April 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28357130/off-label-drug-use-in-hospitalized-children-a-prospective-observational-study-at-gondar-university-referral-hospital-northwestern-ethiopia
#10
Yonas G Tefera, Begashaw M Gebresillassie, Abebe B Mekuria, Tamrat B Abebe, Daniel A Erku, Nurahmed Seid, Habiba B Beshir
Most of the medications which are currently used for the treatment of childhood diseases are either not licensed or being prescribed outside the terms of the product license (off-label prescribing). This study aimed at determining the extent of unlicensed and off-label drug uses and associated factors in children hospitalized in Gondar University Referral Hospital, Northwest Ethiopia. An institution-based prospective cross-sectional study was employed from April 15 to July 15, 2016. A total of 243 pediatric patients admitted to Gondar university referral hospital were included in the study using simple random sampling method...
April 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28343637/investigation-of-preoperative-fasting-times-in-children
#11
Eda Dolgun, Meryem Yavuz, Birsen Eroğlu, Ayşe Islamoğlu
PURPOSE: The aim of this study was to investigate preoperative fasting times of children. DESIGN: A prospective and descriptive design was used. METHODS: The study was carried out in the pediatric surgery departments of a University Faculty of Medicine Hospital, between January 1 and May 31, 2012. The sample included 332 pediatric patients having surgery with general anesthesia and their family. Data were collected via patient and family interview using a 28-item questionnaire developed by the researchers...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28341949/complications-and-outcomes-after-gynecomastia-surgery-analysis-of-204-pediatric-and-1583-adult-cases-from-a-national-multi-center-database
#12
Dmitry Zavlin, Kevin T Jubbal, Jeffrey D Friedman, Anthony Echo
BACKGROUND: Gynecomastia is a common disease that is prevalent across all age groups of boys and men. Although benign in nature, it can lead to psychological and social distress, prompting affected patients to seek medical attention. Management strategies include observation and drug therapy, yet surgical procedures remain the hallmark of treatment. The goal of this study was to analyze patient demographics, outcomes, and complication rates of gynecomastia surgery in a large multi-institutional cohort...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341087/the-impact-of-a-pediatric-emergency-department-facility-verification-system-on-pediatric-mortality-rates-in-arizona
#13
Amber Rice, Jennifer Dudek, Toni Gross, Tomi St Mars, Dale Woolridge
BACKGROUND: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. OBJECTIVE: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28328691/factors-associated-with-discharge-home-after-transfer-to-a-pediatric-emergency-department
#14
Erin R Peebles, Michael R Miller, Tim P Lynch, Janice A Tijssen
OBJECTIVES: The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building. METHODS: We conducted a retrospective chart review of all patients (aged 0-17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28322168/pediatric-off-label-and-unlicensed-drug-use-and-its-implications
#15
Rajeshwari Gore, Preeta Kaur Chugh, Chakra Dhar Tripathi, Yangshen Lhamo, Sandhya Gautam
BACKGROUND: Worldwide, in the absence of standard pediatric prescribing information, clinicians often use medicines in children in a dosage form or for an indication that has not been approved for use. Inadequate clinical trials increase exposure to drugs that lack safety-efficacy data in pediatric population. Hence, off-label and unlicensed drug use must be regarded as a patient safety-issue that is known to be associated with increased risks of adverse drug reactions apart from under- or over-dosing due to lack of pharmacokinetic data...
March 17, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28321802/sepsis-risk-factors-in-infants-with-congenital-diaphragmatic-hernia
#16
Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli, Pierre Tissieres
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown. METHODS: This prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#17
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#18
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28291130/making-the-pediatric-perioperative-surgical-home-come-to-life-by-leveraging-existing-health-information-technology
#19
Izabela C Leahy, Rachel Borczuk, Lynne R Ferrari
PURPOSE OF REVIEW: To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. RECENT FINDINGS: By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#20
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
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