Articles: pediatrics.
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Preventive medicine · Aug 2008
Randomized Controlled TrialThe pediatric residency training on tobacco project: four-year parent outcome findings.
To assess parent behavioral change and perception of resident intervention on tobacco. ⋯ The results support the efficacy of the special training program and underscore the importance of preparing pediatric residents to address tobacco.
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Randomized Controlled Trial
Training medical staff for pediatric disaster victims: a comparison of different teaching methods.
The goal of this study was to assess the effectiveness of the different types of healthcare worker training in pediatric disaster medicine knowledge over time and to analyze the effects of training type on healthcare workers' attitude toward pediatric disaster medicine. ⋯ Didactic lecture and tabletop exercises both increase healthcare worker's knowledge of pediatric disaster medical topics. This knowledge seems to be retained for at least 6 months postintervention. The addition of the tabletop exercise to a standard didactic lecture may increase a learner's sense of knowledge and comfort with disaster topics, which may in turn lead to increased staff participation in the event of an actual disaster.
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Preventive medicine · Dec 2007
Randomized Controlled Trial Multicenter StudyThe pediatric residency training on tobacco project: four-year resident outcome findings.
To evaluate the efficacy of a special program for training pediatric residents to address tobacco. ⋯ The special training program, with Solutions for Smoking as its centerpiece, was found to be effective for training pediatric residents to address tobacco, and it may serve as a model for pediatric residency training programs. Ways of improving the program are discussed.
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Paediatric anaesthesia · Dec 2007
Randomized Controlled Trial Comparative StudyThe optimum initial pediatric epidural bolus: a comparison of four local anesthetic solutions.
There is no consensus on the concentration or type of local anesthetic used for initiation of epidural anesthesia. The aim of this randomized, double-blind, controlled trial was to compare the clinical effectiveness of epidural administration of both levobupivacaine and bupivacaine in 0.2% and 0.25% concentrations in pediatric patients undergoing abdominal and urological surgery. ⋯ While there is no difference in the proportion of effective surgical anesthesia, the lower incidence of pain and distress with the 0.25% solutions suggests that this concentration has clinical advantages over the 0.2% solutions for pediatric epidural anesthesia.
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Randomized Controlled Trial
Rapid fluid resuscitation in pediatrics: testing the American College of Critical Care Medicine guideline.
The 2002 American College of Critical Care Medicine (ACCM) guidelines for the resuscitation of pediatric septic shock suggest that 20 mL/kg of bolus intravenous fluid be given within 5 minutes. Of 3 commonly used, inexpensive methods of fluid delivery, we hypothesized that only use of a manual push-pull system will permit guideline adherence. ⋯ The ACCM guideline for rapid fluid resuscitation is feasible for many children, especially those weighing less than 40 kg. Contrary to our hypothesis, the use of a pressure bag and a manual push-pull system both appear to be acceptable methods of rapid fluid delivery. Administration of bolus fluid by gravity likely has a limited role in acute pediatric resuscitation.