Current opinion in pediatrics
-
Curr. Opin. Pediatr. · Jun 2003
ReviewFamily member presence in the pediatric emergency department.
Traditionally, family members were excluded from viewing invasive procedures and cardiopulmonary resuscitation in the pediatric emergency department. The concept of family-centered care in the emergency department has now become more widespread. Consequently, family member presence during routine invasive procedures such as venipuncture, intravenous cannulation, urethral catheterization, and lumbar puncture has become more accepted. ⋯ Variations in approval of witnessed resuscitation are influenced by occupation, level of training and experience, and prior exposure to family member presence practices. Although several organizations formally support family presence policies, citing benefits for grieving relatives, critics point to a lack of rigor in a large body of the research cited to underpin these endorsements. We review the literature from the perspective of pediatric emergency physicians, offer suggestions for family member presence, and provide directions for future study.
-
In 1981, the Report of the Medical Consultants on the Diagnosis of Death established guidelines for the diagnosis of brain death and, in 1995, the American Academy of Neurology published practice parameters to standardize determination of brain death. In 1987, the American Academy of Pediatrics established guidelines for determining brain death in children. Despite the establishment of these guidelines, the declaration of "death" based on the cessation of brain function remains complex and controversial. In this review are discussed the current guiding principles and the controversies in the diagnosis of brain death in children.
-
Children commonly present for medical care after sustaining head trauma. In children younger than 2 years of age, the practitioner must distinguish accidental head injury from abusive head injury. The following article discusses the evaluation of children with head injury and how to make the distinction between accidental and abusive head injury.