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Training pediatric anesthesia

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https://read.qxmd.com/read/30617561/unifying-children-s-surgery-and-anesthesia-stakeholders-across-institutions-and-clinical-disciplines-challenges-and-solutions-from-uganda
#1
Phyllis Kisa, David F Grabski, Doruk Ozgediz, Margaret Ajiko, Raffaele Aspide, Robert Baird, Gillian Barker, Doreen Birabwa-Male, Geoffrey Blair, Brian Cameron, Maija Cheung, Bruno Cigliano, David Cunningham, Sergio D'Agostino, Damian Duffy, Faye Evans, Tamara N Fitzgerald, George Galiwango, Domenico Gerolmini, Marcello Gerolmini, Nasser Kakembo, Joyce B Kambugu, Kokila Lakhoo, Monica Langer, Moses Fisha Muhumuza, Arlene Muzira, Mary T Nabukenya, Bindi Naik-Mathuria, Doreen Nakku, Jolly Nankunda, Martin Ogwang, Innocent Okello, Norgrove Penny, Eleanor Reimer, Coleen Sabatini, John Sekabira, Martin Situma, Peter Ssenyonga, Janat Tumukunde, Gustavo Villalona
BACKGROUND: There is a significant unmet need for children's surgical care in low- and middle-income countries (LMICs). Multidisciplinary collaboration is required to advance the surgical and anesthesia care of children's surgical conditions such as congenital conditions, cancer and injuries. Nonetheless, there are limited examples of this process from LMICs. We describe the development and 3-year outcomes following a 2015 stakeholders' meeting in Uganda to catalyze multidisciplinary and multi-institutional collaboration...
January 7, 2019: World Journal of Surgery
https://read.qxmd.com/read/30584640/monitoring-of-sugammadex-dosing-at-a-large-tertiary-care-pediatric-hospital
#2
Faizaan Syed, Mehdi Trifa, Joshua C Uffman, Dmitry Tumin, Joseph D Tobias
Introduction: Anesthesiologists use sugammadex to reverse neuromuscular blockade (NMB) produced by rocuronium and vecuronium. Its mechanism involves encapsulation of the neuromuscular blocking agent. Sugammadex dosing is based on the depth of NMB, assessed by measuring the train-of-four (TOF). Methods: We retrospectively reviewed procedures under general anesthesia in patients older than 1 year of age if they included sugammadex reversal of rocuronium-induced NMB...
September 2018: Pediatric Quality & Safety
https://read.qxmd.com/read/30578214/a-novel-smartphone-app-to-support-learning-and-maintaining-competency-with-bier-blocks-for-pediatric-forearm-fracture-reductions-protocol-for-a-mixed-methods-study
#3
Brett Burstein, Adam Bretholz
BACKGROUND: Distal forearm fractures are among the most common injuries presenting to the pediatric emergency department (PED). Bier block (BB), or intravenous regional anesthesia, is a safe and effective alternative to procedural sedation for closed reduction of forearm fractures; it is associated with fewer adverse events, a shorter length of stay, and reduced costs. BB has long remained relatively underutilized; however, with an increasing emphasis on efficient resource use and patient-centered care, there is renewed interest in this technique...
December 21, 2018: JMIR Research Protocols
https://read.qxmd.com/read/30545502/how-to-recognize-avoid-or-get-out-of-trouble-in-pediatric-interventional-radiology
#4
Sudhen B Desai, Kamlesh U Kukreja
The average clinical practice of most interventional radiologists focuses on the care of adults (for practical purposes, defined as most patients over age 15). However, an increasing number of pediatric patients are being referred to Interventional Radiologists for evaluation and possible treatment. In some cases, these patients may not require significant deviation from the normal procedures of the lab (e.g., a 160 pound 14-year-old), although they may be designated as a pediatric patient by the anesthesia support team...
December 2018: Techniques in Vascular and Interventional Radiology
https://read.qxmd.com/read/30472794/a-follow-up-survey-of-total-intravenous-anesthesia-usage-in-children-in-the-u-k-and-ireland
#5
Nicole Goh, Oliver Bagshaw, Simon Courtman
BACKGROUND: Total intravenous anesthesia usage in children remains relatively unpopular in the UK and Ireland. A postal survey by Hill et al in 2008 indicated that only 26% of Consultants used a propofol infusion at least once a month. AIM: Following an increase in teaching and training opportunities in pediatric total intravenous anesthesia in the UK, we repeated the survey amongst Consultant members of Association of Paediatric Anaesthetists of Great Britain and Ireland and Society for Intravenous Anaesthesia, to see if this had affected total intravenous anesthesia usage in children and how practice may have changed...
November 25, 2018: Paediatric Anaesthesia
https://read.qxmd.com/read/30458573/-management-of-pediatric-airway-in-anesthesia
#6
Martin Krebs, Lutz Müller-Lobeck, Roland C E Francis
Airway management is a major competence of clinical anesthesia. Knowledge of available materials and skills in the use of specific methods and techniques are essential and should be trained routinely. In 2011 the scientific working group in pediatric anesthesia (WAKKA) of the German Society for anesthesia and intensive care medicine (DGAI) published a treatment recommendation for the management of the unexpected difficult pediatric airway. Furthermore, a recommendation for the management of the expected difficult pediatric airway is currently being compiled and the draft is available on the WAKKA homepage...
November 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://read.qxmd.com/read/30397367/comparative-evaluation-of-mucosal-vibrator-with-topical-anesthetic-gel-to-reduce-pain-during-administration-of-local-anesthesia-in-pediatric-patients-an-in-vivo-study
#7
Sandeep Tandon, Garima Kalia, Meenakshi Sharma, Rinku Mathur, Khushboo Rathore, Mahima Gandhi
Introduction: Usually discomfort and pain are associated with dental work, especially for young patients. Pain control can be achieved by using anesthesia. Sight of injection can terrify any patient and if the patient is a child it is really difficult to convince them for injections. Alternatives to injections have been explored. Pediatric dentists are using anesthesia in the form of jelly and patch. Recently, the concept of mucosal vibration has been put forward to enhance the effectiveness of local anesthesia...
July 2018: International Journal of Clinical Pediatric Dentistry
https://read.qxmd.com/read/30365205/a-quality-improvement-project-to-reduce-post-operative-adverse-respiratory-events-and-increase-safety-in-the-post-anesthesia-care-unit-of-a-pediatric-institution
#8
Wenyan Xu, Yue Huang, Jie Bai, Anna M Varughese
BACKGROUND: Quality improvement methods can identify solutions and make dramatic improvements in patient safety during daily clinical care. The science of quality improvement in health care is still a very new concept in developing countries like China. AIM: We initiated a quality improvement project to minimize adverse respiratory events in our post-anesthesia care unit with the guidance of an experienced quality improvement expert from Cincinnati Children's Hospital Medical Center...
October 26, 2018: Paediatric Anaesthesia
https://read.qxmd.com/read/30292264/children-centered-care-minimizing-the-need-for-anesthesia-with-a-multi-faceted-concept-for-mri-in-children-aged-4-6
#9
Stine B Runge, Nicolaj L Christensen, Kim Jensen, Ib E Jensen
PURPOSE: To evaluate the need for general anesthesia (GA) in MRI in children aged 4-6 years, using a multi-faceted concept, Children Centered Care (CCC), compared to a standard setup. MATERIALS AND METHODS: In this prospective study of 81 children, we developed and tested a multi-faceted concept, CCC, for MRI in children aged 4-6 without GA, comparing it to a standard setup. The CCC included: 1) an interactive app, 2) a trained pediatric team, 3) a children's lounge with a toy-scanner, and 4) a child-friendly multimedia environment in the MRI room...
October 2018: European Journal of Radiology
https://read.qxmd.com/read/30251364/half-a-century-of-anesthesia-for-children-an-interview-with-dr-nishan-g-nick-goudsouzian
#10
Michael R King, Christine L Mai, Paul G Firth
The career of Dr Nishan Goudsouzian spanned half a century of pediatric anesthesia. His 50 years saw seminal contributions to the use of neuromuscular blocking agents in children, the development of proton beam therapy and magnetic resonance imaging for pediatric cancer, the introduction of the laryngeal mask airway, an explosion in the volume and depth of knowledge about pediatric anesthesia, the expansion of formal training in pediatric anesthesia, and the widening of academic efforts to improve anesthetic care for children worldwide...
November 2018: Paediatric Anaesthesia
https://read.qxmd.com/read/30243872/fellowship-training-in-pediatric-cardiac-anesthesia-history-maturation-and-current-status
#11
REVIEW
Viviane G Nasr, Nina A Guzzetta, Emad B Mossad
Pediatric cardiac anesthesia as a discipline has evolved over the years to become a well recognized sub-specialty. Education and training in the field has also continued to change and develop. In this review, the author outline the changes in the field over the years and suggest a structure for an organized fellowship training process.
August 11, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/30233961/single-leg-spica-cast-application-for-treatment-of-pediatric-femoral-fracture
#12
M Catherine Sargent
Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation...
September 28, 2017: JBJS Essential Surgical Techniques
https://read.qxmd.com/read/30169412/building-a-bridge-between-pediatric-anesthesiologists-and-pediatric-intensive-care
#13
Mckenna M Longacre, Brian M Cummings, Angela M Bader
Despite the aligned histories, development, and contemporary practices, today, pediatric anesthesiologists are largely absent from pediatric intensive care units. Contributing to this divide are deficits in exposure to pediatric intensive care at all levels of training in anesthesia and significant credentialing barriers. These observations have led us to consider, does the current structure of training lead to the ability to optimally innovate and collaborate in the delivery of pediatric critical care? We consider how redesigning the pediatric critical care training pathway available for pediatric anesthesiologists may improve care of children both in and out of the operating room by facilitating further sharing of skills, research, and clinical experience...
August 29, 2018: Anesthesia and Analgesia
https://read.qxmd.com/read/30133332/minimally-invasive-pediatric-surgery-during-remote-humanitarian-missions-is-feasible-safe-and-effective
#14
Jeffrey Lukish, Jasmine Ellis Davy, David Lanning, Bharati Datta, Jonathan DeAntonio
PURPOSE: There remains a critical need for the provision for pediatric humanitarian aid worldwide. Historically, the emphasis of global pediatric health needs has been focused on infectious diseases. Today, we are witnessing a shift in this paradigm, with growing attention being paid toward the surgical needs of children. The use and deployment of minimally invasive surgery (MIS) in these austere environments with its concomitant reduction in length of hospitalization, pain, and morbidity is logical...
August 22, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://read.qxmd.com/read/30113400/informed-consent-in-pediatric-anesthesia-a-narrative-review
#15
Max M Feinstein, Anthony E Pannunzio, Samuel Lobell, Eric Kodish
Informed consent for pediatric anesthesia challenges practitioners to navigate complex ethical, medical, and legal ambiguities. A patient's status as a minor does not negate the importance of his or her participation in the decision-making process but, rather, necessitates a nuanced evaluation of age and development to involve the patient to an appropriate extent. Given the complexities involved with pediatric informed consent in anesthesia practice and research, it is important to understand the experience of key stakeholders involved...
December 2018: Anesthesia and Analgesia
https://read.qxmd.com/read/29859572/intraoperative-pediatric-acupuncture-is-widely-accepted-by-parents
#16
James W Ochi, Andrew C Richardson
OBJECTIVE: Medical acupuncture is increasingly recognized for reducing postoperative pain, nausea and emergence agitation. Anesthetic induction is an ideal time to perform acupuncture in an effort to reduce the adverse side effects of surgery. Acupuncture is safe, inexpensive and does not lengthen the duration of anesthesia. There are however no published reports of how often patients will choose intraoperative acupuncture when given the opportunity to do so. METHODS: A retrospective review of all surgical procedures performed by one surgeon over 12 months was done...
July 2018: International Journal of Pediatric Otorhinolaryngology
https://read.qxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#17
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
July 2018: Paediatric Anaesthesia
https://read.qxmd.com/read/29677057/newborn-resuscitation-skills-in-health-care-providers-at-a-zambian-tertiary-center-and-comparison-to-world-health-organization-standards
#18
Sara C Mistry, Richard Lin, Hazel Mumphansha, Laura C Kettley, Janaki A Pearson, Sonia Akrimi, David J Mayne, Wonder Hangoma, M Dylan Bould
BACKGROUND: Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower-middle income country...
July 2018: Anesthesia and Analgesia
https://read.qxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#19
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://read.qxmd.com/read/29622311/anesthesia-for-the-pediatric-oral-and-maxillofacial-surgery-patient
#20
REVIEW
Deepak G Krishnan
Pediatric patients present to the oral and maxillofacial surgeon for surgical services that can be performed safely and efficiently. Children and parents tend to be anxious; achieving cooperation is paramount for successful procedures. Several techniques can be used to alleviate anxiety and provide analgesia and anesthesia. This article outlines the anatomy and physiology of children and the preoperative anesthetic preparation and techniques unique to pediatric anesthesia. It discusses standards in training in pediatric anesthesia and current recommendations for monitoring...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
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