International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Mar 2019
Early hearing detection and intervention in South Africa: Exploring factors compromising service delivery as expressed by caregivers.
The main aim of this study was to explore factors compromising early intervention (EI) service delivery to hearing impaired children in South Africa, as expressed by their caregivers. ⋯ These findings have important clinical, training, policy, and advocacy implications within the South African context; if both access to and success within the EI services will be successful.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 2019
ReviewPortable, non-powered, suction-generating device for management of life-threatening aerodigestive tract foreign bodies: Novel prototype and literature review.
To present a novel approach for the emergent, pre-hospital management of life-threatening aerodigestive tract foreign body aspiration using a portable, non-powered, suction-generating device (PNSD), in the context of a literature review of emergent pre-hospital management of patients with foreign body airway obstruction. ⋯ PNSDs may play an important role in the emergent, non-operative, pre-hospital management of upper aerodigestive tract foreign body aspiration, particularly in settings and populations with high choking risk. Further characterization of effectiveness and safety in larger cadaveric or simulation studies mimicking physiologic conditions is indicated.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2019
Obstructive sleep apnea in children: How it affects parental psychological status?
The aim of this study was to evaluate the influence of obstructive sleep apnea (OSA) in children on maternal and paternal anxiety. ⋯ The results of our study suggest that obstructive sleep apnea in children is a disturbing symptom for parents and is associated with a significant level of anxiety that depends on OSA severity. After the surgical treatment of the children (adenoidectomy or adenotonsillectomy), the anxiety level of both parents decreased. We suggest that preoperative psychological intervention should be considered in selected cases for mothers and fathers of children with severe OSA in order to diminish the symptoms of anxiety that can compromise normal postoperative recovery in operated children.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2018
Case ReportsTo transfuse or not to transfuse? Jehovah's Witnesses and postoperative hemorrhage in pediatric otolaryngology.
Discuss the ethical issues in the management of postoperative hemorrhage in pediatric patients whose parents are Jehovah's Witnesses (JW) and 2) Describe a framework for shared decision making in this population. ⋯ The risks of hemorrhage should be discussed with JW parents of patients undergoing even routine otolaryngologic surgery. In these cases, early shared decision making with family, the JW Hospital Liaison committee, and hematology was pursued regarding mutually acceptable interventions. Aggressive non-transfusion based resuscitation was carried out to minimize the likelihood of transfusion. In the first case, danger to the patient's life eventually necessitated transfusion in accordance with the patient's best interest and previous case law. A defined framework involving all stake-holders, including Pastoral Care, in the event of postoperative hemorrhage is critical.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2018
Use of the pediatric intensive care unit for post-procedural monitoring in young children following microlaryngobronchoscopy: Impact on resource utilization and hospital cost.
To assess the frequency of post-procedural complications, medical interventions, and hospital costs associated with microlaryngobronchoscopy (MLB) in children prophylactically admitted for pediatric intensive care unit (PICU) monitoring for age ≤ 2 years. ⋯ In children ≤ 2 years of age prophylactically admitted for PICU observation, we did not observe severe complications or major interventions after MLB. Minor interventions and complications were noted early during post-procedural monitoring. PICU monitoring was substantially more expensive than same-day PACU observation. Young age as the sole criteria for prophylactic PICU monitoring after diagnostic or therapeutic MLB may be unjustified when comparable, cost-conscious care can be achieved in a PACU setting. Prior to pre-procedural selection of PICU monitoring, we recommend a broad contextual risk assessment including a review of comorbidities, operative plan, and intended anesthetic exposure.