Articles: child.
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The issue of potentially harmful effects of neurotoxicity or anaesthesia management on children undergoing general anaesthesia is still not resolved. Studies have so far been limited by methodological problems. In a retrospective cohort study, a new noninvasive method was used to demonstrate visual processing changes in children with a single previous exposure to anaesthesia. We need new noninvasive methods that can be used before and after exposure to anaesthesia and surgery to detemine possible effects on long-term neurodevelopment.
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Critical care medicine · Nov 2024
Observational StudyFrequency of and Risk Factors for Increased Healthcare Utilization After Pediatric Sepsis Hospitalization.
To determine the frequency of and risk factors for increased post-sepsis healthcare utilization compared with pre-sepsis healthcare utilization. ⋯ In this nationally representative cohort of children who survived sepsis hospitalization in the United States, nearly one in three had increased healthcare utilization in the 90 days after discharge. Children with hospitalizations longer than 30 days and complex chronic conditions were more likely to experience increased healthcare utilization.
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There is a lack of uniformity across hospitals in applying inpatient versus observation status for short-stay (<48 h) pediatric hospitalizations, with negative financial implications associated with observation. Children with medical complexity (CMC) represent a growing population and incur high costs of care. The financial implications of inpatient and observation status for CMC have not been studied. ⋯ Government-paid observation encounters for CMC are associated with significant financial loss at children's hospitals. This reimbursement model may pose a threat to children's hospitals' ability to care for CMC.
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Children with positive blood cultures obtained in the emergency department (ED) prompt urgent actions due to the risk of bacteremia. This study aimed to validate the Hospital for Sick Children algorithm used for discriminating bacteremia from contaminants and identified variables associated with bacteremia in children with positive blood cultures. ⋯ The Hospital for Sick Children algorithm exhibits 100% sensitivity to detect children with bacteremia but demonstrated low specificity at 11%. We identified predictors to discriminate contaminants from bacteremia.
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In the United States (US), the quality of care provided to children during emergencies is highly variable. Following implementation of the National Pediatric Readiness Project (NPRP), inclusive of two national online assessments of Emergency Departments (EDs), national organizations involved in Emergency Medical Services (EMS) systems convened to launch the Prehospital Pediatric Readiness Project (PPRP). The PPRP seeks to ensure high-quality pediatric prehospital emergency care for all children. One of the first priorities of PPRP is to assess the current level of pediatric readiness in EMS systems. The development of the first comprehensive national assessment of pediatric readiness in EMS systems is described. ⋯ The inaugural PPRP Assessment was open access May through July 2024, and the results will be used to guide future PPRP efforts.