Paed Child Healt Can
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Paed Child Healt Can · Jul 2017
Canada's eight-component vaccine safety system: A primer for health care workers.
Concerns about vaccine safety make some parents hesitant about immunization. Health care providers are pivotal in helping parents understand that Canada is a leader in vaccine safety. The present practice point provides an update on the eight components of Canada's vaccine safety system: (1) an evidence-based pre-license review and approval process; (2) strong regulations for manufacturers; (3) independent evidence-based vaccine use recommendations; (4) immunization competency training and standards for health care providers; (5) pharmacovigilance programs to detect and (6) determine causality of adverse events following immunization (AEFIs); (7) a program for vaccine safety and efficacy signal detection; and (8) the Canadian Immunization Research Network's special immunization clinics for children who have experienced serious AEFIs.
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Paed Child Healt Can · Jul 2017
Management of term infants at increased risk for early-onset bacterial sepsis.
Early-onset neonatal bacterial sepsis (EOS) is sepsis occurring within the first 7 days of life. This statement provides updated recommendations for the care of term (≥37 weeks' gestational age) newborns at risk of EOS, during the first 24 hours of life. Maternal Group B streptococcus (GBS) colonization in the current pregnancy, GBS bacteriuria, a previous infant with invasive GBS disease, prolonged rupture of membranes (≥18 hours) and maternal fever (temperature ≥38°C) are the factors most commonly associated with EOS. ⋯ The management of well-appearing, at-risk term infants depends on the number of risk factors (including maternal GBS colonization) and whether maternal intrapartum antibiotic prophylaxis for GBS was used. In some cases, management should be individualized. Careful assessment and observation of these at-risk infants are a fundamental component of appropriate care.
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Paed Child Healt Can · Jun 2017
The Canadian Hospital Injury Reporting and Prevention Program: Captured versus uncaptured injuries for patients presenting at a paediatric tertiary care centre.
The Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) is an injury surveillance program that informs prevention policy locally and nationally. It is of import that it is reflective of the underlying population. The objective of this study was to describe differences between those injuries that were captured by the program, and those that were not. ⋯ There is an under-representation of seriously injured patients by CHIRPP at the IWK. This data may underestimate the true severity of injuries. It may also under-represent injuries that involve incidents of self-harm or drugs. Effort must be expended to increase the capture rate of CHIRPP.
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Croup is one of the most common causes of upper airway obstruction in young children. It is characterized by sudden onset of barky cough, hoarse voice, inspiratory stridor and respiratory distress caused by upper airway inflammation secondary to a viral infection. ⋯ Despite the evidence supporting the use of steroids as the cornerstone of croup treatment, there is significant practice variation among physicians treating croup in the ED. This practice point discusses evidence-based management of typical croup in the ED.
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Paed Child Healt Can · Mar 2017
Effect of measuring vital signs on recognition and treatment of septic children.
A majority of children presenting with sepsis do not receive adequate fluid resuscitation and have a delay in antibiotic administration despite recommendations from the Surviving Sepsis Campaign. The objective of this study was to evaluate the association of measuring a complete set of five vital signs in the emergency department (ED) with recognition and treatment of septic children presenting to the ED. ⋯ In our study population, the measurement of all vital signs in the ED, including blood pressure, was associated with faster administration of antibiotics and improved compliance with existing fluid bolus recommendations, which may have been the result of better recognition of sepsis in children through vital signs measurement.