Hospital pediatrics
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Hospital pediatrics · Jan 2019
Multicenter Study Observational StudyThe Incidence and Nature of Allergic and Anaphylactic Reactions During Pediatric Procedural Sedation: A Report From the Pediatric Sedation Research Consortium.
Anaphylaxis is rare but life-threatening. Its incidence during pediatric procedural sedation outside of the operating room is unknown. We used data from the Pediatric Sedation Research Consortium (PSRC) to determine the incidence and nature of allergic and anaphylactic reactions in this practice. ⋯ Allergic reactions and anaphylaxis during pediatric procedural sedation are rare. In this study, the development of allergic reactions was significantly associated with the use of midazolam, ketamine, methohexital, and morphine.
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Hospital pediatrics · Jan 2019
Variation in Antibiotic Selection and Clinical Outcomes in Infants <60 Days Hospitalized With Skin and Soft Tissue Infections.
To describe variation in empirical antibiotic selection in infants <60 days old who are hospitalized with skin and soft-tissue infections (SSTIs) and to determine associations with outcomes, including length of stay (LOS), 30-day returns (emergency department revisit or readmission), and standardized cost. ⋯ Infants who are hospitalized with SSTI experience wide variation in empirical antibiotic selection. Combination therapy was associated with increased LOS and cost, with no difference in returns. Our findings reveal the need to identify treatment strategies that can be used to optimize resource use for infants with SSTI.
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Hospital pediatrics · Dec 2018
Retrospective Application of BRUE Criteria to Patients Presenting With ALTE.
To apply recently published brief resolved unexplained events (BRUE) guidelines to patients who presented with apparent life-threatening event (ALTE) to determine: (1) characteristics of these patients; (2) which patients meet BRUE criteria, including risk stratification; and (3) patient outcomes. ⋯ The majority of patients with ALTE presenting to this institution did not meet the BRUE definition primarily because of ongoing symptoms and/or a specific diagnosis explaining the event. With this finding, we highlight the importance of characterizing the events on the basis of history and physical examination when diagnosing and caring for these patients.
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Hospital pediatrics · Dec 2018
Length of Stay and Complications Associated With Febrile Infants <90 Days of Age Hospitalized in the United States, 2000-2012.
It is not known how changes in the epidemiology of serious bacterial infection (SBI) and greater availability of rapid viral diagnostic tests have impacted the hospital length of stay (LOS) and associated complications among young infants with suspected SBI. ⋯ Despite the changing epidemiology of SBI and increased availability of viral diagnostic testing, we did not detect a clinically significant change in LOS for febrile infants with suspected SBI. Complications associated with hospitalization of these infants was associated with increased LOS.
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Hospital pediatrics · Nov 2018
Increasing Timely Family Meetings in Neonatal Intensive Care: A Quality Improvement Project.
Timely multidisciplinary family meetings (TMFMs) promote shared decision-making. Despite guidelines that recommend meetings for all patients with serious illness, our NICU TMFM rate was 10%. In this study, we aimed to document a meeting within 5 days of hospitalization for 50% of all new NICU patients hospitalized for ≥5 days within 1 year of introducing interventions. ⋯ An academic, quaternary-care NICU tripled TMFM documentation after introducing a multifaceted intervention. This improvement may represent changes in professionals' attitudes about providing and documenting family meetings.