Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2014
Variations in inpatient pediatric anesthesia in California from 2000 to 2009: a caseload and geographic analysis.
Regional referral systems are considered important for children hospitalized for surgery, but there is little information on existing systems. ⋯ Many urban California hospitals maintained low annual inpatient anesthetic caseloads for children ≤6 years while conducting potentially more complex procedures. Further efforts are necessary to define the scope of pediatric anesthetic care at urban low- and intermediate-volume hospitals in California.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled Trial Comparative StudyPositive-pressure ventilation during transport: a randomized crossover study of self-inflating and flow-inflating resuscitators in a simulation model.
Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device. Of these devices, self-inflating resuscitators (SIR) and flow-inflating resuscitators (FIR) constitute the two major types used. Selection of a particular device for transport, however, remains largely an institutional practice. ⋯ Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled TrialTablet-based Interactive Distraction (TBID) vs oral midazolam to minimize perioperative anxiety in pediatric patients: a noninferiority randomized trial.
Perioperative anxiety is a common and undesirable outcome in pediatric surgical patients. The use of interactive tools to minimize perioperative anxiety is vastly understudied. The main objective of the current investigation was to compare the effects of a tablet-based interactive distraction (TBID) tool to oral midazolam on perioperative anxiety. We hypothesized that the TBID tool was not inferior to midazolam to reduce perioperative anxiety. ⋯ A TBID tool reduces perioperative anxiety, emergence delirium, and time-to-discharge and increases parental satisfaction when compared to midazolam in pediatric patients undergoing ambulatory surgery.
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Paediatric anaesthesia · Dec 2014
Observational StudyEndotracheal intubation in the pediatric emergency department.
Prospective safety data on emergency department (ED) intubation in children are limited. We aimed to describe the practice and adverse events associated with endotracheal intubation in a large urban pediatric ED. ⋯ Intubation of children in the ED is a low-frequency, high-risk procedure. The incidence of adverse events, particularly desaturation and hypotension, is high. The incidence of difficult laryngoscopy is low. First pass success rate without desaturation or hypotension is low. Strategies to avoid desaturation and hypotension in the peri-intubation setting should be prioritized.