Hospital pediatrics
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Hospital pediatrics · Feb 2015
Randomized Controlled TrialA presedation fluid bolus does not decrease the incidence of propofol-induced hypotension in pediatric patients.
Propofol is commonly used in pediatric sedation, which may cause hypotension during induction. Our goal was to determine the effect of a preinduction 20-mL/kg isotonic fluid bolus on propofol-induced hypotension, assess clinical signs of hypoperfusion during hypotension, and evaluate for age-related propofol dosing differences. ⋯ A 20-mL/kg preinduction isotonic saline bolus does not prevent propofol-induced hypotension. No clinical signs of hypoperfusion were noted with induced hypotension, and infants≤12 months old need significantly more propofol per kilogram for procedures.
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Hospital pediatrics · Feb 2015
Comparative StudyComputed tomography vs magnetic resonance imaging for identifying acute lesions in pediatric traumatic brain injury.
Pediatric traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. Computed tomography (CT) is the modality of choice to screen for brain injuries. MRI may provide more clinically relevant information. The purpose of this study was to compare lesion detection between CT and MRI after TBI. ⋯ Compared with CT, MRI identified significantly more intraparenchymal lesions in pediatric TBI, particularly in children with abusive head trauma. The prognostic value of identification of intraparenchymal lesions by MRI is unknown but warrants additional inquiry. Risks and benefits from early MRI (including sedation, time, and lack of radiation exposure) compared with CT should be weighed by clinicians.
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Hospital pediatrics · Feb 2015
Evaluating simulation education via electronic surveys immediately following live critical events: a pilot study.
Simulation-based medical education has become popular in postgraduate training for medical emergencies; however, the direct impact on learners' clinical performances during live critical events is unknown. Our goal was to evaluate the perceived impact of simulation-based education on pediatric emergencies by auditing pediatric residents immediately after involvement in actual emergency clinical events. ⋯ A novel electronic survey was successfully piloted to measure residents' perceptions of simulation education compared with live critical events. Residents perceived that their experiences in earlier similar simulations positively affected their performances during emergencies.