Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2016
Early Electroencephalographic Findings Correlate With Neurologic Outcome in Children Following Cardiac Arrest.
To determine the clinical and electroencephalographic findings associated with prognosis in nonneonate children following cardiac arrest. ⋯ Following pediatric cardiac arrest, an initially normal electroencephalography or generalized slowing of the electroencephalographic background was associated with good neurologic outcome at hospital discharge.
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Pediatr Crit Care Me · Jul 2016
Does Simulation Improve Recognition and Management of Pediatric Septic Shock, and If One Simulation Is Good, Is More Simulation Better?
Determine whether serial simulation training sessions improve resident recognition and initial septic shock management in a critically ill simulated septic shock patient, and to determine whether serial simulations further improve resident task performance when compared with a single simulation session. ⋯ Simulations significantly improved resident performance scores in the management of septic shock with repetitive simulation showing significant ongoing improvements. Further studies are needed to determine long-term impact on knowledge and skill retention and whether results attained in a simulation environment are translatable into clinical practice in improving bedside care.
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Pediatr Crit Care Me · Jul 2016
Learning From Experience: Improving Early Tracheal Extubation Success After Congenital Cardiac Surgery.
The many advantages of early tracheal extubation following congenital cardiac surgery in young infants and children are now widely recognized. Benefits include avoiding the morbidity associated with prolonged intubation and the consequences of sedation and positive pressure ventilation in the setting of altered cardiopulmonary physiology. Our practice of tracheal extubation of young infants in the operating room following cardiac surgery has evolved and new challenges in the arena of postoperative sedation and pain management have appeared. ⋯ As a result of this review, we have instituted changes in our cardiothoracic ICU postoperative care plans. We have developed a neonatal delirium score, and have adopted the "Kangaroo Care" approach that was first popularized in neonatal ICUs. This provision allows for the early parental holding of infants following admission to the cardiothoracic ICU and allows for appropriately selected parents to sleep in the same beds alongside their postoperative children.
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Pediatr Crit Care Me · Jul 2016
Improving Communication During Cardiac ICU Multidisciplinary Rounds Through Visual Display of Patient Daily Goals.
To improve communication during daily cardiac ICU multidisciplinary rounds. ⋯ Visual display of patient daily goals via a write-down/read-back process improves comprehension of goals by all team members and improves parent satisfaction. The daily goal whiteboard facilitates consistent development of a comprehensive plan of care for each patient, fosters goal-directed care, and provides a checklist for providers and parents to review throughout the day.
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Pediatr Crit Care Me · Jul 2016
Observational StudyThe Association of Central-Line-Associated Bloodstream Infections With Central-Line Utilization Rate and Maintenance Bundle Compliance Among Types of PICUs.
Central-line-associated bloodstream infections comprise 25% of device-associated infections. Compared with other units, PICUs demonstrate a higher central-line-associated bloodstream infections prevalence. Prior studies have not investigated the association of central-line-associated bloodstream infections prevalence, central-line utilization, or maintenance bundle compliance between specific types of PICUs. ⋯ Although this unit-level analysis did not demonstrate an association between central-line-associated bloodstream infections prevalence and central-line utilization and maintenance bundle compliance, optimization of both should continue, further decreasing central-line-associated bloodstream infections prevalence. In addition, investigation of patient-specific factors may aid in further central-line-associated bloodstream infections eradication.