The Journal of pediatrics
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The Journal of pediatrics · Dec 2013
A comprehensive patient safety program can significantly reduce preventable harm, associated costs, and hospital mortality.
To evaluate the effectiveness of a hospital-wide initiative to improve patient safety by implementing high-reliability practices as part of a quality improvement (QI) program aimed at reducing all preventable harm. ⋯ Substantial reductions in serious safety event rate, preventable harm, hospital mortality, and cost were seen after implementation of our multifaceted approach. Measurable improvements in the safety culture were noted as well.
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The Journal of pediatrics · Dec 2013
Diagnostic testing and treatment of pediatric headache in the emergency department.
To describe the variability in diagnostic testing and treatment of headaches in children presenting to the emergency department (ED) with use of a nationally representative sample. ⋯ There is significant variability in the evaluation and treatment of pediatric headache in the ED. Despite evidence-based clinical guidelines for migraine headache, a large number of children continue to receive opioids and ionizing radiation in the ED.
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The Journal of pediatrics · Dec 2013
Comparative StudyDistinguishing cardiac syncope from vasovagal syncope in a referral population.
To identify characteristics that distinguish cardiac from vasovagal syncope. ⋯ Cardiac and vasovagal syncope have dramatic differences in presentation. A screening rule that uses historic features, physical examination findings, and electrocardiogram will accurately separate patients requiring further evaluation for cardiac etiology from those with vasovagal syncope in whom cardiology referral is unnecessary.
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The Journal of pediatrics · Dec 2013
Multicenter StudyTiming of interventions in the delivery room: does reality compare with neonatal resuscitation guidelines?
To determine the proportion of infants who had the tasks recommended in the neonatal resuscitation guidelines performed within 30 and 60 seconds of birth, and the time taken to perform each task. ⋯ Most newborns were not managed within the time frame recommended in resuscitation guidelines. The recommended 30- and 60-second intervals may be too short.
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The Journal of pediatrics · Dec 2013
Observational StudyReference ranges for regional cerebral tissue oxygen saturation and fractional oxygen extraction in neonates during immediate transition after birth.
To define reference ranges for regional cerebral tissue oxygen saturation (crSO2) and regional cerebral fractional tissue oxygen extraction (cFTOE) during the first 15 minutes after birth in neonates requiring no medical support. ⋯ We report reference ranges of crSO2 and cFTOE in neonates requiring no medical support during transition immediately after birth. The use of cerebral oxygenation monitoring and use of these reference ranges in neonates during transition may help to guide oxygen delivery and avoid cerebral hypo-oxygenation and hyperoxygenation.