Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2013
Observational StudyA prospective observational quality improvement study of the sustained effects of a program to reduce unplanned extubations in a pediatric intensive care unit.
The use of endotracheal intubation is routine in the care of critically ill children. Unplanned extubation exposes the patient to morbidity and mortality over and above that associated with the patient's underlying disease. All unplanned extubations are unacceptable because of their potential for causing unnecessary harm to the patient. ⋯ In the 9 years since implementation, our program has remained successful in decreasing unplanned extubations. It is important to periodically reevaluate quality improvement programs to determine whether they have continued to achieve their intended goals. The initiative is reported here using the Standards for Quality Improvement Reporting Excellence (SQUIRE).
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Paediatric anaesthesia · Jul 2013
Incidence and causes of perioperative endotracheal reintubation in children: a review of 28,208 anesthetics.
To determine the incidence, risk factors, and causes of endotracheal reintubation in children and identify methods to reduce the occurrence. ⋯ The incidence of endotracheal reintubation in children is low, but can result in significant morbidity. Because of the high frequency of inadvertent extubation, a significant number of reintubations could be prevented with greater care during transfer of patients with endotracheal tubes, and in procedures near the airway. Increased vigilance in younger children is also recommended as children under 3 years old required the majority of the reintubations.
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Paediatric anaesthesia · Jul 2013
Improving on-time starts for patients scheduled with general anesthesia in a MRI suite.
We applied quality improvement methodology to identify unnecessary, redundant parts of processes that can lead to delayed on-time starts for patients scheduled with general anesthesia (GA) in the radiology department. ⋯ Process improvement projects in anesthesia can yield positive results, using small incremental standardized changes. We used a quality improvement methods to successfully improve on-time start for patients scheduled with GA in high-volume MRI suite.
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Paediatric anaesthesia · Jul 2013
Biography Historical ArticleAlan Conn; his role in the development of the anesthesia department at Toronto SickKids.
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Paediatric anaesthesia · Jul 2013
Video observation of anesthesia practice: a useful and reliable tool for quality improvement initiatives.
Patients with central venous catheters who are transferred out of the Intensive Care Unit to the care of an anesthesiology team for an operation or interventional radiology procedure had excessive rates of catheter associated blood stream infection (CABSI). ⋯ Although video recording has been used to evaluate adherence to resuscitation protocols in both trauma and in neonatal resuscitation, (Pediatric Emergency Care, 26, 2010, 803; Pediatrics, 117, 2006, 658; Pediatrics, 106, 2000, 654) we believe this is the first time that video has been used to record before and after behaviors for an anesthesia quality improvement initiative.