Articles: pediatrics.
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Pediatric emergency care · May 2011
Randomized Controlled Trial Comparative StudyA randomized comparison of the GlideScope videolaryngoscope to the standard laryngoscopy for intubation by pediatric residents in simulated easy and difficult infant airway scenarios.
Videolaryngoscopy has been developed mainly to assist difficult airway intubation. However, there is a lack of studies demonstrating the real efficacy of its use in children. In this study, we tested the hypothesis that GlideScope (Verathon Inc, Bothell, Wash) videolaryngoscope improves tracheal intubation when used by pediatric residents in an advanced patient simulation model. ⋯ In simulated scenarios of infant NA and difficult airway, when used by pediatric residents, GlideScope did not improve intubation performance when compared with the standard laryngoscope. Nevertheless, GlideScope may be safer for upper jaw injury and could have advantages in the management of complicated airway. Further studies are needed to assess if specific training will improve GlideScope intubation performance and whether the "in simulator" results translate into clinical practice.
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Pediatr Crit Care Me · May 2011
Randomized Controlled TrialPediatric residents experience a significant decline in their response capabilities to simulated life-threatening events as their training frequency in cardiopulmonary resuscitation decreases.
To determine the frequency of cardiopulmonary resuscitation education using high-fidelity patient simulators during pediatric residency training. ⋯ Pediatric residents show a significantly slower response time to effectively manage episodes of apnea and cardiac arrest 8 months after their initial resuscitation training, when compared to 4 months after training. These results may indicate that residents require more frequent training than currently recommended.
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Randomized Controlled Trial Multicenter Study
A multifaceted intervention to implement guidelines and improve admission paediatric care in Kenyan district hospitals: a cluster randomised trial.
In developing countries referral of severely ill children from primary care to district hospitals is common, but hospital care is often of poor quality. However, strategies to change multiple paediatric care practices in rural hospitals have rarely been evaluated. ⋯ Specific efforts are needed to improve hospital care in developing countries. A full, multifaceted intervention was associated with greater changes in practice spanning multiple, high mortality conditions in rural Kenyan hospitals than a partial intervention, providing one model for bridging the evidence to practice gap and improving admission care in similar settings.
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Randomized Controlled Trial Comparative Study
A comparison of paediatric airway anatomy with the SimBaby high-fidelity patient simulator.
The SimBaby high-fidelity patient simulator is a widely used paediatric simulator for the training of standard and critical airway management scenarios. Furthermore this simulator is frequently used for the evaluation of different airway devices and techniques. However, the anatomic structures of the SimBaby have not been compared to actual patients' anatomy. ⋯ The anatomic features of the SimBaby do not adequately simulate the upper airway anatomy of infants. These results imply inadequate realism of this simulator for airway training and compromise the validity of comparative trials of different airway devices with the SimBaby as airway model.
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Emerg Med Australas · Apr 2011
Randomized Controlled TrialEquivalency of two concentrations of fentanyl administered by the intranasal route for acute analgesia in children in a paediatric emergency department: a randomized controlled trial.
Intranasal fentanyl's (INF) effectiveness is established using highly concentrated INF (HINF). Standard concentration INF (SINF) is more widely available. We aimed to illustrate the equivalence of SINF to HINF. ⋯ The two concentrations of INF were equivalent in reducing pain, with a trend to increased oral additional agents in the more dilute solution. The widespread use of this readily available analgesic in the standard concentration can be supported, particularly in patients <50 kg.