scholarly journals Professional Skills and Competence for Safe and Effective Procedural Sedation in Children: Recommendations Based on a Systematic Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-16 ◽  
Author(s):  
Piet L. J. M. Leroy ◽  
Daphne M. Schipper ◽  
Hans (J.) T. A. Knape

Objectives. To investigate which skills and competence are imperative to assure optimal effectiveness and safety of procedural sedation (PS) in children and to analyze the underlying levels of evidence.Study Design and methods. Systematic review of literature published between 1993 and March 2009. Selected papers were classified according to their methodological quality and summarized in evidence-based conclusions. Next, conclusions were used to formulate recommendations.Results. Although the safety profiles vary among PS drugs, the possibility of potentially serious adverse events and the predictability of depth and duration of sedation define the imperative skills and competence necessary for a timely recognition and appropriate management. The level of effectiveness is mainly determined by the ability to apply titratable PS, including deep sedation using short-acting anesthetics for invasive procedures and nitrous oxide for minor painful procedures, and the implementation of non-pharmacological techniques.Conclusions. PS related safety and effectiveness are determined by the circumstances and professional skills rather than by specific pharmacologic characteristics. Evidence based recommendations regarding necessary skills and competence should be used to set up training programs and to define which professionals can and cannot be credentialed for PS in children.

2021 ◽  
Author(s):  
Milou Sep ◽  
Marijn Vellinga ◽  
R. Angela Sarabdjitsingh ◽  
Marian Joëls

Environmental information plays an important role in remembering events. Information about stable aspects of the environment (here referred to as ‘context’) and the event are combined by the hippocampal system and stored as context-dependent memory. In rodents (such as rats and mice), context-dependent memory is often investigated with the object-in-context task. However, the implementation and interpretation of this task varies considerably across studies. This variation hampers the comparison between studies and - for those who design a new experiment or carry out pilot experiments – the estimation of whether observed behavior is within the expected range. Also, it is currently unclear which of the variables critically influence the outcome of the task. To address these issues, we carried out a preregistered systematic review (PROSPERO CRD42020191340) and provide an up-to-date overview of the animal-, task-, and protocol-related variations in the object-in-context task for rodents. Using a data-driven explorative meta-analysis we next identified critical factors influencing the outcome of this task, such as sex, testbox size and the delay between the learning trials. Based on these observations we provide recommendations to create more consensus in the set-up, procedure and interpretation of the object-in-context task for rodents. This could contribute to a more robust and evidence-based design in future animal experiments.


2010 ◽  
Vol 15 (2) ◽  
pp. 58-63 ◽  
Author(s):  
Linda Bartock

Abstract Peripherally inserted central venous catheters (PICCs) are known to have difficulties with catheter occlusions. This paper evaluates the scope of PICC occlusions, their prevalence and severity, and potential interventions to decrease incidence. A systematic review of the literature is performed and demonstrates three potential interventions: utilization of a dedicated PICC insertion team, implementation of a valved PICC, and nursing education of PICC care. The evidence from the literature is evaluated, and implementation of the proposed interventions is discussed.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0249102
Author(s):  
Milou S. C. Sep ◽  
Marijn Vellinga ◽  
R. Angela Sarabdjitsingh ◽  
Marian Joëls

Environmental information plays an important role in remembering events. Information about stable aspects of the environment (here referred to as ‘context’) and the event are combined by the hippocampal system and stored as context-dependent memory. In rodents (such as rats and mice), context-dependent memory is often investigated with the object-in-context task. However, the implementation and interpretation of this task varies considerably across studies. This variation hampers the comparison between studies and—for those who design a new experiment or carry out pilot experiments–the estimation of whether observed behavior is within the expected range. Also, it is currently unclear which of the variables critically influence the outcome of the task. To address these issues, we carried out a preregistered systematic review (PROSPERO CRD42020191340) and provide an up-to-date overview of the animal-, task-, and protocol-related variations in the object-in-context task for rodents. Using a data-driven explorative meta-analysis we next identified critical factors influencing the outcome of this task, such as sex, testbox size and the delay between the learning trials. Based on these observations we provide recommendations on sex, strain, prior arousal, context (size, walls, shape, etc.) and timing (habituation, learning, and memory phase) to create more consensus in the set-up, procedure, and interpretation of the object-in-context task for rodents. This could contribute to a more robust and evidence-based design in future animal experiments.


Author(s):  
Salvatore Grisanti ◽  
Vittorio D. Ferrari ◽  
Michela Buglione ◽  
Giorgio M. Agazzi ◽  
Roberto Liserre ◽  
...  

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