International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2016
Multicenter StudyQuality improvement utilizing in-situ simulation for a dual-hospital pediatric code response team.
Given the rarity of in-hospital pediatric emergency events, identification of gaps and inefficiencies in the code response can be difficult. In-situ, simulation-based medical education programs can identify unrecognized systems-based challenges. We hypothesized that developing an in-situ, simulation-based pediatric emergency response program would identify latent inefficiencies in a complex, dual-hospital pediatric code response system and allow rapid intervention testing to improve performance before implementation at an institutional level. ⋯ Utilizing the IHI's Breakthrough Model, we developed a simulation-based program to 1) successfully identify gaps and inefficiencies in a complex, dual-hospital, pediatric code response system and 2) provide an environment in which to safely test quality improvement interventions before institutional dissemination.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2016
Tonsillectomies and respiratory complications in children: A look at pre-op polysomnography risk factors and post-op admissions.
To identify predictors of post-operative respiratory complications in children undergoing tonsillectomy. ⋯ Our results indicate an association between an AHI ≥40 and respiratory complications following an adenotonsillectomy, but we were not able to observe any significant difference at a cutoff of 25. An association between BMI or O2 nadir and postoperative respiratory complication was not able to be identified. Our results support the importance of AHI as a predictor of postoperative respiratory complications in children undergoing tonsillectomy for OSA.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2016
Pediatric head and neck injuries due to golf cart trauma.
Golf carts are increasingly used off the golf course and are often viewed as innocuous modes of transportation. However, research has shown they can cause significant injuries, particularly to children. ⋯ Children are more vulnerable to golf cart related injuries, specifically to the head and neck.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2016
To anticoagulate? Controversy in the management of thrombotic complications of head & neck infections.
To review the thrombotic complications of head and neck infections, including Lemierre's syndrome, and their management. ⋯ Anticoagulation remains controversial in the management of thrombotic complications from head and neck infections. Based on this case series, certain recommendations can be made regarding the benefits of anticoagulation, which appear to outweigh the risks. Further research is required to establish evidence for consensus in the antithrombotic management of thrombotic sequelae of head and neck infections.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2016
Presentation and management of nasal foreign bodies at a tertiary children's hospital in an American metro area.
To examine rates of otolaryngology intervention in children presenting to our emergency department with nasal foreign bodies, factors associated with otolaryngology involvement, rates of complications, and details on nasal button battery exposure. ⋯ While emergency department providers are comfortable attempting removal of nasal foreign bodies, there was a high rate of otolaryngology intervention. Based on this data, there is a need to educate emergency room providers on nasal anatomy and techniques for nasal foreign body removal.