Pediatrics
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Comparative Study
Major congenital anomalies place extremely low birth weight infants at higher risk for poor growth and developmental outcomes.
Studies of growth and neurodevelopmental impairment in extremely low birth weight infants often exclude infants with major congenital anomalies; thus, there are few outcome data available on these infants. ⋯ At 18 to 22 months' corrected age, extremely low birth weight infants born with major anomalies have nearly twice the risk for neurodevelopmental impairment, increased risk of poor growth, and > 3 times greater risk of rehospitalization when compared with extremely low birth weight infants without major anomalies. This information may be valuable for counseling parents regarding the outcomes of these infants and for the facilitation of appropriate support and intervention services.
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Clinical Trial
Propofol sedation: intensivists' experience with 7304 cases in a children's hospital.
The objective of this study was to determine the safety profile of propofol as a deep-sedation agent in a primarily outpatient program consisting of pediatric critical care physicians and specifically trained nurses with oversight provided by anesthesiology. One hypothesis was investigated: adverse events and/or airway interventions are more likely to occur in children with an abnormal airway score. ⋯ Propofol has an acceptable safety profile for deep sedation when used in the context of a program with critical care physicians, specifically trained nurses, and anesthesiology oversight. A preprocedure airway score can assist in identifying patients who may require airway interventions.
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Emergency departments play an important role in the care of children with asthma. Emergency department return-visit rates provide a measure of the quality of acute asthma care. ⋯ Emergency departments use a range of strategies to manage asthma in children. Preprinted order sheets and access to pediatricians are associated with important reductions in return-visit rates, and more emergency departments should consider using these strategies.
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Patient safety is a priority for all health care professionals, including those who work in emergency care. Unique aspects of pediatric care may increase the risk of medical error and harm to patients, especially in the emergency care setting. Although errors can happen despite the best human efforts, given the right set of circumstances, health care professionals must work proactively to improve safety in the pediatric emergency care system. Specific recommendations to improve pediatric patient safety in the emergency department are provided in this policy statement.