Journal of pediatric surgery
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Excessive crystalloid resuscitation of blunt injured adults is deleterious. We hypothesize that children, unlike adults, are resistant to the adverse effects of high volume resuscitation. ⋯ Excessive crystalloid resuscitation was associated with increased hospital LOS and need for mechanical ventilation. Increased rates of other complications including ARDS, ACS, and MOF were not observed. Injured children appear relatively resistant to some of the adverse effects of early high volume fluid resuscitation.
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Randomized Controlled Trial
Single shot intercostal block for pain management in pediatric patients undergoing the Nuss procedure: a double-blind, randomized, controlled study.
The aim of this study was to investigate the efficacy of a single shot intercostal block for pain control in pediatric patients undergoing the Nuss procedure. ⋯ A single shot IB is an effective additional treatment for pediatric patients undergoing the Nuss procedure and results in the reduced consumption of morphine, less postoperative pain, and fewer opioid-related adverse effects.
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Observational Study
Impact of newly adopted guidelines for management of children with isolated skull fracture.
In an effort to standardize practices and reduce unnecessary hospital resource utilization, we implemented guidelines for management of patients with isolated skull fractures (ISF). We sought to examine the impact of these guidelines. ⋯ Implementation of a new guideline for management of ISF resulted in a reduction of admissions without compromising patient safety. Young age remains a common concern for practitioners despite not being a criterion for admission. Interhospital transfer may be unnecessary in many cases.
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We compare radiation exposure from body CT imaging for blunt trauma performed at outside hospitals (OH) versus our children's hospital (CH). ⋯ Children receive significantly less radiation exposure with body CT imaging for blunt trauma when performed at our dedicated CH. CT scans were significantly more likely to be ordered with appropriate contrast at our CH.