Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2019
Noninvasive Ventilation During Pediatric and Neonatal Critical Care Transport: A Systematic Review.
Noninvasive ventilation is increasingly used in neonatal and pediatric patients, but the intensive care transport setting is lagging in terms of availability of noninvasive ventilation for children. The objective of this systematic review of the literature was to answer the question: In children 0 days to 18 years old, who are hospitalized with acute respiratory distress and require critical care transport, is noninvasive ventilation effective and safe during transport? ⋯ This review found observational study evidence of a rate of intubation or escalation of 0.4% during noninvasive ventilation transport of children 0-18 years old, with an in-transport adverse event rate of 1-4%. Further studies are required. If randomized trials are not possible, it is suggested that well-conducted observational studies are reported in a more standardized manner.
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Pediatr Crit Care Me · Jan 2019
Protocol-Driven Management of Convulsive Status Epilepticus at a Tertiary Children's Hospital: A Quality Improvement Initiative.
Convulsive status epilepticus is a medical emergency. Prompt treatment has been shown to decrease progression to refractory convulsive status epilepticus. We aimed to reduce time to second-line anti-seizure medication through implementation of a standardized treatment protocol. ⋯ A standardized treatment protocol for convulsive status epilepticus decreased time to administration of second-line therapy by 60%, but there was no statistically significant decrease in total seizure time.
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Pediatr Crit Care Me · Jan 2019
Observational StudyDevelopment and Implementation of a Bedside Peripherally Inserted Central Catheter Service in a PICU.
To create a bedside peripherally inserted central catheter service to increase placement of bedside peripherally inserted central catheter in PICU patients. ⋯ Bedside peripherally inserted central catheter service implementation increased bedside peripherally inserted central catheter placement and employed a patient-centered and timely process. Balancing metrics including central line-associated bloodstream infection and venous thromboembolism rates were not significantly different between peripherally inserted central catheters placed by bedside peripherally inserted central catheter service and those placed in interventional radiology.