Consensus Perioperative Management Best Practices for Patients on Transdermal Fentanyl Patches Undergoing Surgery

2019 ◽  
Vol 23 (7) ◽  
Author(s):  
Alan David Kaye ◽  
Bethany L. Menard ◽  
Ken P. Ehrhardt ◽  
Sonja A. Gennuso ◽  
Eva C. Okereke ◽  
...  
2019 ◽  
Vol 129 (1) ◽  
pp. 55-62
Author(s):  
Christopher Roberts ◽  
Raihanah Al Sayegh ◽  
Pavithra Ranganathan Ellison ◽  
Khaled Sedeek ◽  
Michele M. Carr

Objective: The purpose of this study was to describe typical anesthesia practices for children with obstructive sleep apnea (OSA). Study Design: Online survey. Method: A sample of pediatric anesthesiologists received the survey by email. Results: 110 respondents were included. 46.4% worked in a free-standing children’s hospital and 32.7% worked in a children’s facility within a general hospital. 73.6% taught residents. 44.4% saw at least one child with OSA per week, 25.5% saw them daily. On a 100-mm visual analog scale, respondents rated their comfort with managing these children as 84.94 (SD 17.59). For children with severe OSA, 53.6% gave oral midazolam preoperatively, but 24.5% typically withheld premedication and had the parent present for induction. 68.2% would typically use nitrous oxide for inhalational induction. 68.2% used fentanyl intraoperatively, while 20.0% used morphine. 61.5% reduced their intraop narcotic dose for children with OSA. 98.2% used intraoperative dexamethasone, 58.2% used 0.5 mg/kg for the dose. 98.2% used ondansetron, 62.7% used IV acetaminophen, and 8.2% used IV NSAIDs. 83.6% extubated awake. 27.3% of respondents stated that their institution had standardized guidelines for perioperative management of children with OSA undergoing adenotonsillectomy. People who worked in children’s hospitals, who had >10 years of experience, or who saw children with OSA frequently were significantly more comfortable dealing with children with OSA ( P < 0.05). Conclusion: Apart from using intraoperative dexamethasone and ondansetron, management varied. These children would likely benefit from best practices perioperative management guidelines.


2020 ◽  
Vol 39 (5) ◽  
pp. 1264-1275
Author(s):  
Amy Nemirovsky ◽  
Amber S. Herbert ◽  
Emily F. Gorman ◽  
Rena D. Malik

Author(s):  
Kristen Izaryk ◽  
Robin Edge ◽  
Dawn Lechwar

Purpose The purpose of this article is to explore and describe the approaches and specific assessment tools that speech-language pathologists are currently using to assess social communication disorders (SCDs) in children, in relation to current best practices. Method Ninety-four speech-language pathologists completed an online survey asking them to identify which of the following approaches they use to assess children with SCD: parent/teacher report, naturalistic observation, formal assessment, language sample analysis, interviews, semistructured tasks, and peer/self-report. Participants were also asked to identify specific assessment tools they use within each approach. Results Participants most commonly assess SCDs by combining interviews, naturalistic observation, language sampling, parent/teacher report, and formal assessment. Semistructured tasks and peer/self-report tools were less frequently utilized. Several established parent/teacher report and formal assessment tools were commonly identified for assessing SCDs. Most participants use an informal approach for interviews, language sampling, and naturalistic observations in their SCD assessment process. Conclusions Generally, participants follow best practices for assessing SCDs by combining several different approaches. Some considerations for future assessment are identified, including the use of established protocols in the place of informal approaches in order to make the assessment of SCDs more systematic. Future directions for research are discussed.


Author(s):  
Elena Dukhovny ◽  
E. Betsy Kelly

According to the 2010 U.S. Census, over 20% of Americans speak a language other than English in the home, with Spanish, Chinese, and French being the languages most commonly spoken, aside from English. However, few augmentative and alternative communication (AAC) systems offer multilingual support for individuals with limited functional speech. There has been much discussion in the AAC community about best practices in AAC system design and intervention strategies, but limited resources exist to help us provide robust, flexible systems for users who speak languages other than English. We must provide services that take into consideration the unique needs of culturally and linguistically diverse users of AAC and help them reach their full communication potential. This article outlines basic guidelines for best practices in AAC design and selection, and presents practical applications of these best practices to multilingual/multicultural clients.


2009 ◽  
Vol 18 (4) ◽  
pp. 137-145 ◽  
Author(s):  
Samuel Sennott ◽  
Adam Bowker

People with ASD often need to access AAC in situations where a tabletop digital device is not practical. Recent advancements have made more powerful, portable, and affordable communication technologies available to these individuals. Proloquo2Go is a new portable augmentative and alternative communication system that runs on an iPhone or iPod touch and can be used to meet the diverse needs of individuals with autism spectrum disorders (ASD) who are ambulatory and have difficulty using speech to meet their full daily communication needs. This article examines Proloquo2Go in light of the best practices in AAC for individuals with ASD such as symbols, visual supports, voice output, and inclusion.


2016 ◽  
Vol 1 (6) ◽  
pp. 47-54 ◽  
Author(s):  
Jeffrey J. DiGiovanni ◽  
Travis L. Riffle

The search for best practices in hearing aid fittings and aural rehabilitation has generally used the audiogram and function stemming from peripheral sensitivity. In recent years, however, we have learned that individuals respond differently to various hearing aid and aural rehabilitation techniques based on cognitive abilities. In this paper, we review basic concepts of working memory and the literature driving our knowledge in newer concepts of hearing aid fitting and aural rehabilitation.


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