Paediatric anaesthesia
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The International Organization for Standardization (ISO) recently published an International Standard (ISO 7376:2009) which specifies illuminance levels and tests for illumination from hook-on type laryngoscopes used for intubation. A clinical study examining luminance for laryngoscopy found that 100 cd·m(-2) was the minimum level acceptable for laryngoscopy. The purpose of this study was to measure the quality of light from laryngoscopes available for use by anesthetists in an anesthetic department and compare them to the ISO illuminance standard and published minimum acceptable luminance limits. ⋯ Laryngoscope light should be regularly audited. Results from these audits can be used to retire or repair substandard laryngoscopes to maintain acceptable standards of laryngoscope light. Audit results produce tangible evidence that is useful when applying for capital expenditure. Light measurements are not easy to make. There needs to be a convenient device to reliably measure laryngoscope illumination.
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Paediatric anaesthesia · Apr 2011
Case ReportsPreventing venous thrombosis in critically ill children: what is the right approach?
The incidence of venous thromboembolic (VTE) events in children has increased in recent years (J Neurosurg, 101, 2004, 32; J Thromb Haemost, 1, 2003, 1443) yet there is currently no consensus as to what VTE prophylaxis, if any, should be applied to the pediatric population. ⋯ There is no consensus in England and Wales as to which VTE prophylactic measures should be applied in patients <18 years of age. The National Institute for Health and Clinical Excellence (NICE) guidelines apply to adults only. Given the rarity of VTE events in children, it is unlikely that randomized controlled trials will provide the answer. We therefore propose that simple empirical measures be formally implemented in critically ill children to reduce the risk of developing this important but under-recognized condition.
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Paediatric anaesthesia · Apr 2011
A survey of blood transfusion practice in French-speaking pediatric anesthesiologists.
There are so far no existing consensus guidelines regarding red blood cell transfusion during pediatric surgery, and there is a little information regarding red blood cell transfusion policy among pediatric anesthesiologists. ⋯ This survey identifies significant differences in transfusion practice patterns among pediatric anesthesiologists with a median transfusion threshold of 7.6 [6.6-8.6] g·dl(-1) and a median PRBC volume transfusion of 11.7 [16.8-6.6] ml·kg(-1).
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We aimed to review the pain management in 100 episodes of severe mucositis in children and determine the incidence of associated side effects. ⋯ Children with severe mucositis who have escalating morphine requirements may benefit from the addition of ketamine to their morphine PCA.
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Paediatric anaesthesia · Apr 2011
Letter Case ReportsUnexpected foreign bodies in larynx: two cases report.