Pediatric emergency care
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Pediatric emergency care · Oct 2010
Comparative StudyComparison of the GlideScope Videolaryngoscope to the standard Macintosh for intubation by pediatric residents in simulated child airway scenarios.
Videolaryngoscopy may facilitate tracheal intubation in difficult airway scenarios. Our objective was to compare the ability of residents to intubate a child manikin using the standard Macintosh laryngoscope and the novel GlideScope. ⋯ Without specific training, videolaryngoscope-guided intubation did not improve intubation performance by pediatric residents in this manikin model of normal and simulated difficult intubation caused by a cervical collar in place. To achieve skills with videolaryngoscope intubation in children, a specific training program is needed.
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Up to 3 million US children are cared for by emergency medical services (EMSs) annually. Limited research exists on pediatric prehospital care. The Pediatric Emergency Care Applied Research Network (PECARN) mission is to perform high-quality research for children, including prehospital research. Our objective was to develop a pediatric-specific prehospital research agenda. ⋯ PECARN has identified high-priority EMS research topics for children using a consensus-derived method. These research priorities include novel EMS system topics. The PECARN EMS pediatric research priority list will help focus future pediatric prehospital research both within and outside the network.
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Pediatric emergency care · Oct 2010
Sedation provider practice variation: a survey analysis of pediatric emergency subspecialists and fellows.
Pediatric emergency physicians use various techniques and medications when performing procedural sedation and analgesia. The goals of our study were to assess US pediatric emergency medicine subspecialists and fellows (PEMSSFs) for individual practice variation and to evaluate (1) the use of supplemental oxygen and capnography monitoring and (2) adverse sedation events (ADSEs). ⋯ This group of PEMSSFs reported a wide spectrum of medication sedation strategies, dichotomous approaches to the use of oxygen supplementation and capnography monitoring, and a low rate of ADSEs.
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Pediatric emergency care · Oct 2010
Comparative StudyAlignment of cricoid cartilage and esophagus and its potential influence on the effectiveness of Sellick maneuver in children.
The effectiveness of cricoid pressure in preventing aspiration of gastric contents during rapid sequence intubation may be limited if the esophagus is laterally displaced from the trachea at the level of the cricoid cartilage. Esophageal lateral displacement has been reported to occur in 50% to 90% of adults. Children 8 years and older assume the anatomic airway characteristics of adults, and therefore, we hypothesized that esophageal displacement would be significantly more common in older versus younger children. The purposes of this study were to determine the alignment of the trachea to the esophagus at the level of the cricoid cartilage on cervical spine or neck computed tomographic (CT) scans and to compare the frequency and quantity of esophageal displacement between children younger than 8 years and children 8 years and older. ⋯ This is the first pediatric study on the rate and degree of esophageal displacement from the airway at the level of the cricoid cartilage. Lateral displacement of the esophagus occurred at a significantly greater rate in the younger (45%) compared with the older (15%) children, which was directly opposite of our hypothesis. Of the 36 children (30%) with esophageal displacement, all had displacement to the left of the cricoid cartilage.