Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2009
Clinical TrialUsing acupuncture for acute pain in hospitalized children.
Clinical study to determine the acceptability and feasibility of acupuncture for acute postoperative pain control in hospitalized children. ⋯ Our results support that acupuncture is highly accepted and feasible in critically ill, postoperative pediatric patients with acute pain. Our findings suggest that acupuncture may be a potentially useful adjunctive tool for acute pediatric postoperative pain management. A randomized, controlled clinical trial is warranted to confirm these findings.
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Pediatr Crit Care Me · May 2009
Difficult conversations: improving communication skills and relational abilities in health care.
Communication skills and relational abilities are essential core competencies that are associated with improved health outcomes, better patient adherence, fewer malpractice claims, and enhanced satisfaction with care. Yet, corresponding educational opportunities are sorely underrepresented and undervalued. ⋯ A 1-day experiential learning paradigm focused on communication skills and relational abilities was highly valued, clinically useful, and logistically feasible. Participants reported better preparation, improved communication and relational skills, greater confidence, and reduced anxiety. Participants deepened their understanding of family perspectives, recognized valuable existing competencies, and strengthened their commitment to interdisciplinary teamwork.
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To determine the indications and complications of external ventricular drain (EVD) placement in pediatric patients. ⋯ EVDs were placed for TBI, ventriculoperitoneal shunt failure and new-onset hydrocephalus. The overall complication rate was 26%. Complication rates were similar in TBI and hydrocephalus patients, and with EVDs inserted in either the PCCU or OR. Prophylactic antibiotics or antimicrobial-impregnated catheters directed against coagulase-negative Staphylococcus may reduce EVD infections.
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Pediatr Crit Care Me · May 2009
Case ReportsInfantile iron poisoning: challenges in diagnosis and management.
To describe the clinical course and treatment of an infant with iron poisoning. ⋯ This case illustrates the importance of including toxic exposure in the differential diagnosis of neonatal shock of unknown etiology. Because of physiologic immaturity, iron poisoning in young infants poses special diagnostic and therapeutic challenges.
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Pediatr Crit Care Me · May 2009
Severe invasive community-associated methicillin-resistant Staphylococcus aureus infections in previously healthy children.
An increase in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections has been reported in the literature. Most severe, life-threatening infections were previously thought to be associated with chronically ill or frail patients. Our pediatric intensive care unit (PICU) has seen a recent dramatic increase in primary, severe invasive CA-MRSA infections in healthy children. ⋯ Severe CA-MRSA infections in healthy children are increasing at an alarming rate in our institution. This acute rise in incidence, coupled with an alarmingly high associated mortality rate, raises important questions about the initial empirical antibiotic therapy we use in caring for patients presenting with suspected life-threatening CA-MRSA disease. Vancomycin monotherapy may not be adequate treatment for severe CA-MRSA infections.