International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2016
ReviewAssessment and management of pain in pediatric otolaryngology.
Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction. ⋯ We present a global review about assessment and management of pain in pediatric otolaryngology, which leads to future specific reviews on each topic. Research gaps on pain assessment and pharmacological interventions in neonates, infants and children are very wide and it should be promoted ethical and safe research on pain control in this population.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2016
Long-standing inhaled foreign bodies in children: Characteristics and outcome.
Aspirated foreign bodies in children present a potentially life-threatening condition and can be challenging to diagnose. This study aims to elucidate the characteristics and outcome of children with long-standing aspirated foreign bodies. ⋯ Paediatric LSAFB poses an uncommon diagnostic dilemma as there is often no witnessed history of aspiration event; and signs, symptoms and chest X-Ray findings are often non-specific. Laryngobronchoscopy is made more difficult by the presence of granulation tissue and the sequelae of prolonged non-treatment is a higher rate of chronic respiratory disease.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2016
Observational StudyPediatric tracheostomy: Survival and long-term outcomes.
The objective of this study was to investigate if there were any differences in survival and long-term outcomes between pediatric patients with and without neurological impairment who underwent tracheostomy. ⋯ In children who underwent tracheostomy, the decannulation rate was lower in those with neurological impairment compared with that in those without neurological impairment. There were no significant differences in survival or ventilator weaning between the two groups.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2016
Randomized Controlled Trial Comparative StudyThe comparison of bleeding and pain after tonsillectomy in bipolar electrocautery vs cold dissection.
Although tonsillectomy is one of the most common surgeries performed in pediatric, it has potential major complications such as pain and bleeding. This study aimed to compare the bleeding and pain after tonsillectomy in bipolar electrocautery tonsillectomy versus cold dissection. ⋯ Our study showed that bipolar electrocautery tonsillectomy can significantly reduce the operation time and intraoperative blood loss; however, postoperative pain and blood loss were similar in both techniques. We recommend bipolar electrocautery as the most suitable alternative method for tonsillectomy, especially in children.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2016
Multicenter StudyQuality improvement utilizing in-situ simulation for a dual-hospital pediatric code response team.
Given the rarity of in-hospital pediatric emergency events, identification of gaps and inefficiencies in the code response can be difficult. In-situ, simulation-based medical education programs can identify unrecognized systems-based challenges. We hypothesized that developing an in-situ, simulation-based pediatric emergency response program would identify latent inefficiencies in a complex, dual-hospital pediatric code response system and allow rapid intervention testing to improve performance before implementation at an institutional level. ⋯ Utilizing the IHI's Breakthrough Model, we developed a simulation-based program to 1) successfully identify gaps and inefficiencies in a complex, dual-hospital, pediatric code response system and 2) provide an environment in which to safely test quality improvement interventions before institutional dissemination.