Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2011
Toward the inclusion of parents on pediatric critical care unit rounds.
Inclusion of parents on interprofessional patient rounds is increasingly recognized as a parental right and as a marker of quality care in pediatric intensive care units. Creating policies and practices that welcome parents and their contributions into patient rounds has proven challenging in many settings. ⋯ The participants in this study believed that parents' participation on rounds is an important consideration. For inclusion of parents to be effective and sustainable, policy and practice change in this direction requires measures to recognize parents as important contributors to pediatric intensive care unit rounds while accounting for the complex responsibility of healthcare providers in the physical and social space of the pediatric intensive care unit.
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Pediatr Crit Care Me · Nov 2011
Case ReportsNeurogenic stunned myocardium presenting as left ventricular hypertrabeculation in childhood: a variant of Takotsubo cardiomyopathy?
To report the first case of neurogenic stunned myocardium presenting with heart left ventricle noncompaction requiring intensive care in the perioperative period of tension tumor-induced hydrocephalus. ⋯ This report describes a unique presentation of myocardial stunning in association with an intracranial illness, namely, a hypertensive hydrocephalus complicating an intracranial neoplasm.
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Pediatr Crit Care Me · Nov 2011
Pediatric intensive care unit family conferences: one mode of communication for discussing end-of-life care decisions.
To examine clinicians' and parents' reflections on pediatric intensive care unit family conferences in the context of discussion about end-of-life care decision making. ⋯ Pediatric intensive care unit clinicians in this study perceive family conferences as having an important role in end-of-life care decision making. The paucity of data from parents, an important finding itself, limits our ability to comment on parents' perceptions of family conferences. Prospective research of pediatric intensive care unit family conferences, with specific attention to parents' experiences and to all aspects of family conferences, including pre- and postconference events, should seek to understand the role and impact of this mode of communication on end-of-life care decision making and to determine the need for improvement to family conferences.
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Pediatr Crit Care Me · Nov 2011
Neonatal and pediatric regionalized systems in pediatric emergency mass critical care.
Improved health outcomes are associated with neonatal and pediatric critical care in well-organized, cohesive, regionalized systems that are prepared to support and rehabilitate critically ill victims of a mass casualty event. However, present systems lack adequate surge capacity for neonatal and pediatric mass critical care. In this document, we outline the present reality and suggest alternative approaches. ⋯ States and regions (facilitated by federal partners) should review current emergency operations and devise appropriate plans to address the population-based needs of infants and children in large-scale disasters. Action at the state, regional, and federal levels should address legal, operational, and information systems to provide effective pediatric mass critical care through: 1) predisaster/mass casualty planning, management, and assessment with input from child health professionals; 2) close cooperation, agreements, public-private partnerships, and unique delivery systems; and 3) use of existing public health data to assess pediatric populations at risk and to model graded response plans based on increasing patient volume and acuity.