Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2007
ReviewDexmedetomidine: applications in pediatric critical care and pediatric anesthesiology.
To provide a general descriptive account of the end-organ effects of dexmedetomidine and to provide an evidence-based review of the literature regarding its use in infants and children. ⋯ The literature contains reports of the use of dexmedetomidine in approximately 800 pediatric patients. Given its favorable sedative and anxiolytic properties combined with its limited effects on hemodynamic and respiratory function, there is growing interest in and reports of its use in the pediatric population in various clinical scenarios.
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Pediatr Crit Care Me · Mar 2007
ReviewEffect of fatigue, workload, and environment on patient safety in the pediatric intensive care unit.
Pediatric intensive care unit patient care occurs in an unpredictable, technology-rich environment that is dependent on highly skilled providers who need constant communication-all features providing the setting for potential error. This review examines basic principles of human error and sleep physiology and evaluates the evidence for potential effects of fatigued healthcare workers and workload on medical error. BODY: The pediatric intensive care unit setting, examined from a human factors engineering standpoint, is a highly complex environment in which fatigue and excessive workload can provide potential "holes" that may allow errors to occur. A large body of evidence is examined that suggests sleep deprivation can impair medical and surgical performance and can be improved with scheduling intervention. Nursing fatigue and workload have documented effects on increasing intensive care unit error, infections, and cost. Specific environmental factors such as distractions and communication barriers are also associated with greater error. ⋯ Fatigue, excessive workload, and the pediatric intensive care unit environment can adversely affect the performance of physicians and nurses working in the pediatric intensive care unit. The weight of the evidence suggests that these factors have the potential to contribute to medical error in the pediatric intensive care unit.