Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2016
Randomized Controlled TrialThe effectiveness of nasal mask vs face mask ventilation in anesthetized, apneic pediatric subjects over 2 years of age: a randomized controlled trial.
We hypothesized that anesthetized, apneic children could be ventilated equivalently or more efficiently by nasal mask ventilation (NMV) than face mask ventilation (FMV). The aim of this randomized controlled study was to test this hypothesis by comparing the expiratory tidal volume (Vte) between NMV and FMV. ⋯ In anesthetized, apneic children greater than 2 years of age ventilated with an anesthesia ventilator and neck extension, FMV established a greater Vte than NMV regardless of mouth status. NMV could not maintain the set PEEP level due to an air leak from the mouth. The MCM increased the Vte and PEEP.
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Paediatric anaesthesia · Feb 2016
Observational StudyCerebral oxygen saturation and tissue hemoglobin concentration as predictive markers of early postoperative outcomes after pediatric cardiac surgery.
Near-infrared spectroscopy (NIRS) provides an assessment of cerebral oxygenation and tissue hemoglobin concentration. ⋯ Lower TOI or higher [HHb] at the end of surgery and higher RACHS-1 category predicted worse outcomes.
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Paediatric anaesthesia · Feb 2016
Observational StudyStructured intervention for management of pain following day surgery in children.
Ambulatory surgery forms a large part of pediatric surgical practice. Several studies indicate that postoperative pain is poorly managed with more than 30% of children having moderate to severe pain. In a busy outpatient clinic contact between healthcare professionals and the family is increasingly limited calling for a global and efficient pain management regime. ⋯ After thorough information of the parents we have successfully implemented a surgery-specific regime of primarily around-the-clock dosing of drug formulations acceptable for the specific child with dispensed medication ready available for the family.
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Paediatric anaesthesia · Feb 2016
Interventions designed using quality improvement methods reduce the incidence of serious airway events and airway cardiac arrests during pediatric anesthesia.
Although serious complications during pediatric anesthesia are less common than they were 20 years ago, serious airway events continue to occur. Based on Quality Improvement (QI) data from our institution, a QI project was designed to reduce the incidence of serious airway events and airway cardiac arrests. ⋯ We utilized QI methodology to design and implement a project which led to greater standardization of clinical practice within a large pediatric anesthesia group. Based on an understanding of system issues impacting our clinical practice, we designed and tested interventions that led to a significant reduction in the incidence of serious airway events and airway cardiac arrests.
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Paediatric anaesthesia · Feb 2016
Outpatient outcomes and satisfaction in pediatric population: data from the postoperative phone call.
Quality and patient/parent satisfaction are goals for pediatric perioperative services. As part of the implementation of our operating room electronic medical record (EMR), a postoperative phone call questionnaire was developed to assess patients discharged after outpatient surgery. The goal of this initiative was to determine the rate of common postoperative complications and understand reasons for patient/parent dissatisfaction. ⋯ A postoperative phone survey is cost-effective and appreciated by patients. We found that satisfaction with our perioperative services was not related to the rates of reported complications. Although reducing complications is of utmost importance, improvements in wait times and other operational issues would yield greater improvements in satisfaction.