Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2019
A quality improvement project to reduce postoperative adverse respiratory events and increase safety in the postanesthesia care unit of a pediatric institution.
Quality improvement methods can identify solutions and make dramatic improvements in patient safety during daily clinical care. The science of quality improvement in healthcare is still a very new concept in developing countries like China. ⋯ Using quality improvement methods, we successfully reduced the percentage of respiratory adverse events in the postanesthesia care unit. This helped to establish a safety culture among the anesthesia staff. Quality and safety improvement can be successfully implemented in developing countries like China with collaboration with quality improvement experts from more experienced institutions.
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Paediatric anaesthesia · Feb 2019
Quality control and stability of ketamine, remifentanil, and sufentanil syringes in a pediatric operating theater.
Transforming a drug from its commercial form into a ready-to-use drug is common practice, especially in pediatrics. However, the risk of compounding error is real and data on drug stability in practice are not always available. ⋯ The study shows that stock solution syringes prepared in advance are chemically stable throughout the day, unlike certain serial dilution syringes, indicating that the latter should be prepared just before administration to ensure chemical stability. Our results show that the error rate for serial dilution syringes is twice that of stock solution. Different safety measures are under discussion and have to be further studied.
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Paediatric anaesthesia · Feb 2019
ReviewPain relief in the palm of your hand: Harnessing mobile health to manage pediatric pain.
The development and implementation of mobile health (mHealth) interventions provide an opportunity for more optimal management of pediatric pain in the home setting. Leveraging the popularity, mobility, and technological capabilities of digital mobile devices may reduce pediatric pain. Several mHealth applications have already been developed that target the reduction of acute and chronic pediatric pain by digitally delivering intervention strategies in an engaging manner, accumulating pain assessment data, facilitating patient-provider communication, and providing interactive training. ⋯ Recommendations are provided that advocate for continued advancement of pediatric pain mHealth implementation with an emphasis on robust scientific evaluation, a structured approach to development and design elements that enhance engagement. Increased awareness about the positive influence of mHealth along with the encouragement of researchers and healthcare providers to promote and develop mHealth programs has the potential to transform pediatric pain management. This merger of evidence-based pain management strategies and digital technology positions pediatric mHealth to have a profound impact by effectively augmenting standard of care and benefiting healthcare providers, parents, and especially children in need.
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Paediatric anaesthesia · Feb 2019
Observational StudyPostoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study.
The perioperative period can be psychologically challenging, and children may exhibit behavioral changes following surgical anesthesia. It is unknown whether children in China have additional risk factors associated with negative behavioral changes. ⋯ For children undergoing hypospadias repair surgery in our institution, approximately three in five showed postoperative behavioral changes. In addition to a younger age and a higher maternal education, an emotional temperament is associated with a high incidence of negative postoperative behavioral changes.