South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Practice Guideline
Guideline for the diagnosis, prevention and treatment of paediatric ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) has been poorly studied in South Africa, but is likely to be a significant problem, with resulting increased morbidity and mortality in the paediatric intensive care unit population. This guideline is intended to review the evidence and recommendations for prevention and management of VAP in children and to provide, where possible, clear advice to aid the care of these children, to limit costly and unnecessary therapies and--importantly--limit inappropriate use of antimicrobial agents, ⋯ Evidence-based clinical practice guidelines are provided for VAP diagnosis and prevention in South Africa. In addition, the current status of antimicrobial use has been reviewed and clear recommendations are set out.
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To determine the insertional and positional complications encountered by the placement of intercostal chest drains (ICDs) for trauma and whether further training is warranted in operators inserting intercostal chest drains outside level 1 trauma unit settings. ⋯ Operators at the referral hospitals have received insufficient training in the technique for insertion of ICDs for chest trauma and would benefit from more structured instruction and closer supervision of ICD insertion.