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Pediatric hospital medicine

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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
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28282104/retrospective-analysis-of-emerging-drugs-use-in-a-quebec-women-s-and-children-s-university-hospital-and-perspectives-for-safe-and-optimal-drug-use
#5
Jennifer Corny, Elaine Pelletier, Denis Lebel, Jean-François Bussières
BACKGROUND: Only few medicines are licensed for children. The use of emerging drugs (unmarketed drug, off-label drug with poorly documented use, and/or costly drugs) might represent an essential alternative for pediatric patients. OBJECTIVES: The objective of the study was to assess emerging drug uses rate and profile in our women's and children's centre to support the implementation of an appropriate policy. METHODS: We identified retrospectively emerging drugs used between 2013-01-01 and 2014-02-28, using computerized pharmacist software extraction of drugs used...
March 10, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28273196/family-report-compared-to-clinician-documented-diagnoses-for-psychiatric-conditions-among-hospitalized-children
#6
Stephanie K Doupnik, Chris Feudtner, Steven C Marcus
BACKGROUND: Psychiatric comorbidity is common in pediatric medical and surgical hospitalizations and is associated with worse hospital outcomes. Integrating medical or surgical and psychiatric hospital care depends on accurate estimates of which hospitalized children have psychiatric comorbidity. OBJECTIVE: We conducted a study to determine agreement of family report (FR) and clinician documentation (CD) identification of psychiatric diagnoses in hospitalized children...
February 28, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28264021/antimicrobial-use-in-paediatric-patients-in-a-teaching-hospital-in-ethiopia
#7
Hafte Kahsay Kebede, Hailay Abrha Gesesew, Tewodros Eyob Woldehaimanot, Kabaye Kumela Goro
BACKGROUND: Antibiotics use in in children are different from adults due to a lack of data on pharmacokinetics, pharmacodynamics, efficacy and safety of drugs, different physiological spectrum, pediatrics populations being vulnerable to the majority of the illnesses, and the adverse effect of their irrational use is more serious. However, antibiotic use is not explored much in a paediatric population. The current study focused on antibiotic use among pediatric population using data from a tertiary hospital in Ethiopia...
2017: PloS One
https://www.readbyqxmd.com/read/28246349/pediatric-hospital-medicine-a-proposed-new-subspecialty
#8
Douglas J Barrett, Gail A McGuinness, Christopher A Cunha, S Jean Emans, William T Gerson, Mary F Hazinski, George Lister, Karen F Murray, Joseph W St Geme, Patricia N Whitley-Williams
Over the past 20 years, hospitalists have emerged as a distinct group of pediatric practitioners. In August of 2014, the American Board of Pediatrics (ABP) received a petition to consider recommending that pediatric hospital medicine (PHM) be recognized as a distinct new subspecialty. PHM as a formal subspecialty raises important considerations related to: (1) quality, cost, and access to pediatric health care; (2) current pediatric residency training; (3) the evolving body of knowledge in pediatrics; and (4) the impact on both primary care generalists and existing subspecialists...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28239452/intervening-with-healthcare-workers-hand-hygiene-compliance-knowledge-and-perception-in-a-limited-resource-hospital-in-indonesia-a-randomized-controlled-trial-study
#9
Dewi Santosaningsih, Dewi Erikawati, Sanarto Santoso, Noorhamdani Noorhamdani, Irene Ratridewi, Didi Candradikusuma, Iin N Chozin, Thomas E C J Huwae, Gwen van der Donk, Eva van Boven, Anne F Voor In 't Holt, Henri A Verbrugh, Juliëtte A Severin
BACKGROUND: Hand hygiene is recognized as an important measure to prevent healthcare-associated infections. Hand hygiene adherence among healthcare workers is associated with their knowledge and perception. This study aimed to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge, and perception among healthcare workers in a tertiary care hospital in Indonesia. METHODS: The study was performed from May to October 2014 and divided into a pre-intervention, intervention, and post-intervention phase...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28237002/congenital-hypothyroidism-role-of-nuclear-medicine
#10
REVIEW
Isabelle Keller-Petrot, Juliane Leger, Aline Sergent-Alaoui, Claire de Labriolle-Vaylet
Thyroid scintigraphy holds a key place in the etiologic workup of neonatal hypothyroidism. Routine screening for this disorder in maternity hospitals in industrialized countries, for nearly 40 years, has permitted early treatment and thereby helped to prevent its physical and mental complications. Neonatal hypothyroidism affects approximately 1 in 3000 births. The most common causes are abnormal thyroid gland development and defective hormone synthesis by an eutopic thyroid gland. The incidence of the latter has risen in recent years, for reasons that remain unclear...
March 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#11
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28198756/utility-of-assessing-cytokine-levels-for-the-differential-diagnosis-of-pneumonia-in-a-pediatric-population
#12
Jian-Ming Zhou, Qing Ye
OBJECTIVES: Although pneumonia is easily diagnosed, determining the causative agent is difficult due to low pathogen detection rates. We performed a prospective observational study to evaluate the utility of measuring inflammatory cytokine levels to discriminate between pneumonia caused by typical bacteria, respiratory syncytial virus, or Mycoplasma pneumoniae in a pediatric population. DESIGN: Serum inflammatory cytokine levels at early stages of the disease were evaluated for pneumonia caused by the three different pathogenic microorganisms...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28182805/assessment-of-readability-understandability-and-completeness-of-pediatric-hospital-medicine-discharge-instructions
#13
Ndidi I Unaka, Angela Statile, Julianne Haney, Andrew F Beck, Patrick W Brady, Karen E Jerardi
The average American adult reads at an 8th-grade level. Discharge instructions written above this level might increase the risk of adverse outcomes for children as they transition from hospital to home. We conducted a cross-sectional study at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. Two hundred charts for patients discharged from the hospital medicine service were randomly selected for review...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28165417/characteristics-of-traditional-chinese-medicine-use-in-pediatric-dislocations-sprains-and-strains
#14
Chung-Yen Lu, Hen-Hong Chang, Fung-Chang Sung, Pei-Chun Chen
BACKGROUND AND OBJECTIVES: Dislocations, sprains and strains are common childhood musculoskeletal injuries, requiring medical attention. We investigated the characteristics associated with using traditional Chinese medicine (TCM) for children suffering from these injuries. METHODS: From a nationwide representative insurance database of Taiwan, this cross-sectional study identified 50,769 children with dislocations, sprains and strains under 18 years of age, newly diagnosed between 1999 and 2009, without previous TCM experience...
February 4, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28164411/medical-care-focused-time-study-of-the-care-for-medically-dependent-smid
#15
Tadashi Matsubasa, Hiroshi Mitsubuchi, Akihiko Kimura, Makoto Shinohara, Fumio Endo
BACKGROUND: Improvements in neonatal medicine and pediatric emergency medicine has led to increasing number of children with severe disabilities requiring medical care, such as tracheal suction, on a daily basis. Most of these children, discharged directly from hospitals to their parents' homes, need home medical support. To provide data for the establishment of appropriate support systems we analyzed the care for such children through a time study conducted at an institution. METHODS: We performed a minute-by -minute time study of the work of 33 staff members in a ward for patients (medically-dependent SMID) requiring frequent medical care over 48 hours in order to analyze patient care...
February 6, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28163912/the-benefits-of-youth-are-lost-on-the-young-cardiac-arrest-patient
#16
REVIEW
Brian Griffith, Patrick Kochanek, Cameron Dezfulian
Children and young adults tend to have reduced mortality and disability after acquired brain injuries such as trauma or stroke and across other disease processes seen in critical care medicine. However, after out-of-hospital cardiac arrest (OHCA), outcomes are remarkably similar across age groups. The consistent lack of witnessed arrests and a high incidence of asphyxial or respiratory etiology arrests among pediatric and young adult patients with OHCA account for a substantial portion of the difference in outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28146046/brazilian-specialists-perspectives-on-the-patient-referral-process
#17
Carmen Juliani, Maura MacPhee, Wilza Spiri
Since 1988, healthcare has been considered a citizen's right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world's fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo...
January 29, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28146012/identification-of-optic-nerve-swelling-using-point-of-care-ocular-ultrasound-in-children
#18
Ronald F Marchese, Rakesh D Mistry, Gil Binenbaum, Grant T Liu, Richard J Scarfone, Ashley L Woodford, Aaron E Chen
OBJECTIVE: The aim of this study was to determine the feasibility and accuracy of point-of-care (POC) ocular ultrasound (US) when performed by a pediatric emergency medicine (PEM) physician to detect optic nerve abnormalities concerning for swelling, as compared with the fundus examination performed by an ophthalmologist. METHODS: This was a single-center, prospective cohort pilot study of children aged 12 months to 18 years who required optic disc evaluation by an ophthalmologist...
January 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28144123/state-of-simulation-in-healthcare-education-an-initial-survey-in-beijing
#19
Zichen Zhao, Pengfei Niu, Xiang Ji, Robert M Sweet
BACKGROUND AND OBJECTIVES: In 2013, medical error was the third leading cause of death in the United States.(1) In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. METHODS: This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28132766/piloting-a-pediatric-trauma-course-in-western-jamaica-lessons-learned-and-future-directions
#20
Hadley K Wesson, Valerie Plant, Marieka Helou, Karen Wharton, Delroy Fray, Jeffrey Haynes, Charles Bagwell
INTRODUCTION: Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development...
January 10, 2017: Journal of Pediatric Surgery
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