Pediatr Crit Care Me
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Pediatr Crit Care Me · Aug 2018
ReviewLogistics of Withdrawal of Life-Sustaining Therapies in PICU.
To describe practical considerations and approaches to best practices for end-of-life care for critically ill children and families in the PICU. ⋯ Consequences of childhood death in the PICU extend beyond the events of dying and death. In the context of withdrawal of life-sustaining therapies, achieving a quality death is impactful both in the immediate and in the longer term for family and for the team. An individualized approach to withdrawal of life-sustaining therapies that is informed by empiric and practical knowledge will ensure best care of the child and support the emotional well-being of child, family, and the team. Adherence to the principles of holistic and compassionate end-of-life care and an ongoing commitment to provide the best possible experience for withdrawal of life-sustaining therapies can achieve optimal end-of-life care in the most challenging of circumstances.
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To discuss the role of investigations after death in children as part of a supplement on "Death and Dying in the PICU." ⋯ A multidisciplinary cliniciopathologic conference is important after the death of a child in order to help bring closure to the family and to attempt to address any concerns they may have about the care. It is also an important part of the quality of care process for a tertiary care institution and provides an unique opportunity for ongoing medical education. The model of a multidisciplinary cliniciopathologic conference used by the Ontario Coroner's Office to investigate sudden and unexpected deaths in children under 5 years old, which has been functioning for over 30 years, is described. Reports from this Pediatric Death Review Committee have been influential in improving the care of children in the province of Ontario.
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Pediatr Crit Care Me · Aug 2018
The Impact of Critical Care Nursing Certification on Pediatric Patient Outcomes.
To examine the relationship of nursing and unit characteristics including Critical Care Registered Nurse certification on patient complications for children undergoing congenital heart surgery in free-standing children's hospitals in the United States. ⋯ Bachelor of Science in Nursing education and Critical Care Registered Nurse certification significantly impact pediatric patient outcomes. Recognition of nursing and organizational characteristics that are associated with improved pediatric patient outcomes is important to patients, their families, and society. Clinical leaders must commit to facilitating pathways for hiring candidates with Bachelor of Science in Nursing as a minimum to practice in PICUs and supporting a culture of professional certification.
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Pediatr Crit Care Me · Aug 2018
Observational StudySafety and Efficacy of IV Lidocaine in the Treatment of Children and Adolescents With Status Migraine.
To evaluate the safety and efficacy of IV lidocaine in treating children and adolescents with status migraine. ⋯ In the appropriate patient population, IV lidocaine may be a safe and effective treatment for children and adolescents with status migraine. Larger prospective studies need to be done not only to evaluate safety and efficacy but also the analgesic longevity of IV lidocaine post discharge.
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Pediatr Crit Care Me · Aug 2018
Observational StudyParental Presence at the Bedside of Critically Ill Children in a Unit With Unrestricted Visitation.
To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. ⋯ Children had a parent present at the bedside approximately 60% of the time. The parents of younger, sicker children may benefit from supportive interventions during PICU admission. Further research is needed to examine both extrinsic and intrinsic factors affecting parental presence at the bedside.