Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2007
Regional and central venous oxygen saturation monitoring following pediatric cardiac surgery: concordance and association with clinical variables.
To compare changes in regional cerebral or flank oxygen saturation measured by near-infrared spectroscopy with changes in central venous oxygen saturation (ScvO2) and to determine clinical variables associated with these changes. ⋯ Neither individual values nor changes in rSO2 are interchangeable measures of ScvO2 in postoperative pediatric cardiac patients. The unique relationship between changes in PaCO2 and cerebral rSO2 supports the hypothesis that cerebral near-infrared spectroscopy monitors regional cerebral oxygenation. Clinical application of this monitor must include recognition of the clinical variables that affect regional brain oxygenation.
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Pediatr Crit Care Me · Mar 2007
Validity and reliability of the Behavioural Observational Pain Scale for postoperative pain measurement in children 1-7 years of age.
Pain measurement is a necessity in pain treatment but can be difficult in young children. The aim of this study was to evaluate the validity and reliability of the Behavioural Observational Pain Scale (BOPS) as a postoperative pain measurement scale for children aged 1-7 yrs. The scale assesses three elements of pain behaviors: facial expression, verbalization, and body position. ⋯ With BOPS, the caretaker can evaluate and document pain with high reliability and validity and thereby improve postoperative pain treatment in preschool children. The simple scoring system makes BOPS easy to incorporate in a postoperative unit.
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Pediatr Crit Care Me · Mar 2007
Determining pediatric intensive care unit quality indicators for measuring pediatric intensive care unit safety.
The measurement of quality and patient safety continues to gain increasing importance, as these measures are used for both healthcare improvement and accountability. Pediatric care, particularly that provided in pediatric intensive care units, is sufficiently different from adult care that specific metrics are required. BODY: Pediatric critical care requires specific measures for both quality and safety. Factors that may affect measures are identified, including data sources, risk adjustment, intended use, reliability, validity, and the usability of measures. The 18-month process to develop seven pediatric critical care measures proposed for national use is described. Specific patient safety metrics that can be applied to pediatric intensive care units include error-, injury-, and risk-based approaches. ⋯ Measurement of pediatric critical care quality and safety will likely continue to evolve. Opportunities exist for intensivists to contribute and lead in the development and refinement of measures.
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Pediatr Crit Care Me · Mar 2007
Case ReportsHyperkalemia and cardiac arrest following succinylcholine administration in a 16-year-old boy with acute nonlymphoblastic leukemia and sepsis.
To report a case of potentially lethal hyperkalemia related to succinylcholine administration. ⋯ Succinylcholine may cause dangerous arrhythmias in septic and immobilized children. The alternative nondepolarizing agents should be used in such cases.
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The climate within the United States is rapidly changing with respect to patient and family knowledge of medical error and their expectations of the events that should occur after an error. ⋯ It seems that if disclosure of medical error is made with compassion, in a timely manner, and with good communication skills both during and after the disclosure process, patients and their families are at least no more likely to seek legal action and some lawsuits may actually be avoided.