Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2012
Randomized Controlled Trial Comparative StudyA randomized controlled trial comparing the AccuVein AV300 device to standard insertion technique for intravenous cannulation of anesthetized children.
To evaluate the efficacy of the AccuVein AV300 device in improving the first-time success rate of intravenous cannulation of anesthetized pediatric patients. ⋯ There were 146 patients with a median age of 4.6 years (range, 0.18-17.1 years), 46.6% were male, 80.8% were light skin colored, and 15.7% were younger than 2 years. The first-attempt success rates were 75% (95% CI, 63.8-84.2%) using AV300 and 73% (95% CI, 61.9-81.9%) using the standard method (P = 0.85). Patients with dark or medium skin color were 0.38 times less likely to have a successful first attempt than patients with light skin color. The difference between the two treatment groups in number of skin punctures and the time to insertion was not significant. Although the AV300 was easy to use and improved visualization of the veins, we found no evidence that it was superior to the standard method of intravenous cannulation in unselected pediatric patients under anesthesia.
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Paediatric anaesthesia · Sep 2012
Screening by pulse CO-oximetry for environmental tobacco smoke exposure in preanesthetic children.
The purpose of this study was to evaluate the ability of multiple wavelength pulse CO-oximetry (SpCO) to screen for environmental tobacco smoke (ETS) exposure in children. ⋯ The point-of-care multiple wavelength pulse CO-oximeter does not appear to be a useful preoperative screening tool for ETS exposure in children.
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Paediatric anaesthesia · Sep 2012
Novel real-time feedback and integrated simulation model for teaching and evaluating ultrasound-guided regional anesthesia skills in pediatric anesthesia trainees.
To assess, teach, and improve core competencies and skills sets associated with ultrasound-guided regional anesthesia (UGRA) of pediatric anesthesia trainees. ⋯ Implementing a multifaceted assessment and real-time feedback-based training has significantly improved UGRA-related cognitive and technical skills and proficiency of pediatric anesthesia trainees.
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Coaxial tomography (CT) and magnetic resonance imaging (MRI) scans are so much part of neurological investigation these days and provide such detailed information that even thorough neurological clinical examination may be neglected. The investigations in common use forty years ago were pneumoencephalography, ventriculography in babies with hydrocephalus, and carotid angiography with the injection of X-ray contrast to outline the arteries.