scholarly journals Chloral Hydrate Sedation in a Dexmedetomidine Era

2019 ◽  
Vol 55 (4) ◽  
pp. 236-239
Author(s):  
Kimberley M. Farr ◽  
Brady S. Moffett ◽  
Jennifer L. Jones ◽  
Amber P. Rogers ◽  
Corrie E. Chumpitazi
Keyword(s):  
Retrospective Study ◽  
Hospital Pharmacy ◽  
Chloral Hydrate ◽  
Commercial Production ◽  
Large Majority ◽  
Procedural Sedation ◽  
Liquid Formulation ◽  
Billing Data ◽  
Free Standing ◽  
Primary Agent

Brief Overview: The use of chloral hydrate as the primary sedation agent has declined across the nation after commercial production of the liquid formulation ceased. Although alternative sedatives have gained popularity, some pharmacies have continued to provide oral chloral hydrate by compounding it from raw ingredients. Thus, oral chloral hydrate use has continued in children despite the availability of alternative effective agents. Objective: The purpose of this investigation was to evaluate institutional chloral hydrate utilization as the primary agent for procedural sedation. Design/Methods: We conducted a retrospective study of patients given chloral hydrate for procedural sedation from October 2010 to December 2016. The hospital pharmacy database of chloral hydrate use at our 2 free-standing children’s hospitals was reviewed and matched to procedure billing data. Results: There were 5874 chloral hydrate administrations for procedural sedation during the study period. The highest rates of use occurred in 2014, when there were 1420 chloral hydrate orders within our hospital. The large majority of sedations were for cardiac studies/procedures (n = 4250, 72.4%). Conclusions: Despite significant declines in use of chloral hydrate for procedural sedation across the country, local utilization of oral chloral hydrate remains high. Recent declines may be due to high-use clinical sites transitioning to alternative sedatives such as intranasal dexmedetomidine.

Intravenous fluids

1967 ◽  
Vol 5 (4) ◽  
pp. 13-15
Keyword(s):  
Peritoneal Dialysis ◽  
Hospital Pharmacy ◽  
Commercial Production ◽  
Intravenous Fluids ◽  
Operating Theatres ◽  
Increasing Demand

Many hospitals are currently having difficulties in obtaining adequate supplies of i. v. fluids. Staff shortages and increased demand for special sterile bottled solutions for other purposes, for example in operating theatres, for peritoneal dialysis and for haemodialysis, have compelled many hospital pharmacy departments to reduce their output of i. v. fluids. Commercial production of i.v. fluids has not kept pace with the rapidly increasing demand. The quality of i.v. fluids varies considerably:1 pharmacopoeial standards are often not stringently applied, and some of them need revision.

scholarly journals Melatonin versus chloral hydrate as the sedating agent in performing electroencephalogram in paediatric patients

2017 ◽  
Vol 04 (01) ◽  
pp. 051-054 ◽  
Author(s):  
C. Yuen ◽  
W. Cherk ◽  
T. Fung ◽  
C. Ho ◽  
K. Chan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Detection Rate ◽  
Chloral Hydrate ◽  
Epileptic Activity ◽  
Regional Hospital ◽  
High Quality ◽  
Safe Alternative ◽  
Chi Squared ◽  
Patients With Epilepsy ◽  
Abnormal Eegs

AbstractElectroencephalography (EEG) is a valuable tool in the diagnosis of epilepsy. The attainment of a high quality EEG requires patient's co-operation which is particularly difficult in children. Chloral hydrate has been used as a sedating agent in EEGs but it has potential serious adverse effects and anti-epileptic activity. Melatonin is used increasingly in different investigations as a safe alternative. Our study is to compare their effectiveness as sedating agents in performing EEGs and the detection rate of abnormal EEGs. This is a retrospective study performed in a regional hospital in Hong Kong. One hundred and ninety two EEG studies were included from December 2010 to July 2014. One hundred and two children were given chloral hydrate (50 mg/Kg) in the first half of the period and 90 children were given melatonin (3 mg for =< 5 years or 6 mg for >= 5 year) in the later half. The two groups are compared with Pearson's Chi-squared test with Yates’ continuity correction. The successful rate in sedation was similar between the two groups while the pick up rate of abnormal EEGs was 52.56% in the melatonin group and 21.57% in the chloral hydrate group (p < 0.05). Subgroup analysis among patients with epilepsy or mental retardation and intellectual disability shared same findings with higher detection rate of abnormal EEGs in the melatonin group. No side effect was documented in the study. Compare with chloral hydrate, melatonin is a safe and effective alternative and probably has less interference with the electrographic activity.

scholarly journals Correlation of Oxygen Consumption and Patient Day with Invasive Mechanical Ventilation in a Hospital in Sao Paulo during Covid-19 Pandemic

2021 ◽  
Vol 6 (11) ◽  
pp. 835-839
Author(s):  
Kaio Jia Bin ◽  
Luana Alcantara Machado ◽  
Nivaldo Fracacio Junior ◽  
Francis Mironescu Tomazini ◽  
Paula Cristina Souto De Camargo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Oxygen Consumption ◽  
Retrospective Study ◽  
Strong Correlation ◽  
Oxygen Therapy ◽  
Invasive Mechanical Ventilation ◽  
Single Center ◽  
Billing Data ◽  
Central Institute ◽  
The World

Background: The new coronavirus led the world into the pandemic known as COVID-19. Still, without any effective treatment, oxygen therapy is the most used treatment for patients. Without proper management of this medicinal gas, lives can be lost for lack of it. Aim: Find an indicator of a strong correlation with oxygen consumption. Methods: A single-center retrospective study, that evaluated the oxygen consumption billing data and patient-day indicator of Central Institute of HCFMUSP between 2019 and 2020. Results: A total of 380,245 patient days were analyzed. A strong correlation was identified between oxygen consumption and patient day with invasive mechanical ventilation (0.92). An average of 41.6 (± 7.8) cubic meters per patient day with invasive mechanical ventilation was found. Conclusion: There is a strong correlation between oxygen consumption in cubic meters and patient days with invasive mechanical ventilation at the Central Institute of HCFMUSP. The average values of consumption per patient day can help in planning oxygen management in other hospitals.

The Implications of Transfer to an Acute Care Surgical Tertiary Service

2017 ◽  
Vol 83 (12) ◽  
pp. 1422-1426 ◽  
Author(s):  
Rebecca Britt ◽  
Pamela Davis ◽  
Anjali Gresens ◽  
Leonard Weireter ◽  
T.J. Novosel ◽  
...  
Keyword(s):  
Acute Care ◽  
Surgical Care ◽  
Acute Care Surgery ◽  
Billing Data ◽  
Free Standing ◽  
Hospital Transfer ◽  
Tertiary Hospitals ◽  
Transfer Group ◽  
Care Surgery ◽  
The Impact

Tertiary hospitals are increasingly called on by smaller hospitals and free-standing emergency rooms (ERs) to provide surgical care for complex patients. This study assesses patients transferred to an acute care surgery service. The ER and transfer center logs, as well as billing data, were reviewed for 12 months for all cases evaluated by acute care surgery. The charts were reviewed for demographics, comorbidities, and outcomes. A total of 111 transferred patients with complete data were identified, with 59 transferred from another hospital and 52 from a free-standing ER. The hospital transfer patients were older with more comorbidities, had a longer length of stay, and were more likely discharged to skilled care. There was no difference in the percent of patients requiring a procedure; however, significantly more procedures in the hospital transfer group were done by nonsurgical specialties Better infrastructure to monitor the impact of hospital transfers is warranted in the setting of the complex patient population transferred to tertiary hospitals.

A Randomized Controlled Trial Comparing Intranasal Midazolam and Chloral Hydrate for Procedural Sedation in Children

2015 ◽  
Vol 153 (6) ◽  
pp. 1042-1050 ◽  
Author(s):  
Marie Christy Sharafine Stephen ◽  
John Mathew ◽  
Ajoy Mathew Varghese ◽  
Mary Kurien ◽  
George Ani Mathew
Keyword(s):  
Randomized Controlled Trial ◽  
Chloral Hydrate ◽  
Controlled Trial ◽  
Procedural Sedation ◽  
Randomized Controlled ◽  
Intranasal Midazolam

scholarly journals Sleep deprivation did not enhance the success rate of chloral hydrate sedation for non-invasive procedural sedation in pediatric patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245338
Author(s):  
Yu Cui ◽  
Langtao Guo ◽  
Qixia Mu ◽  
Qin Cheng ◽  
Lu Kang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Sleep Deprivation ◽  
Failure Rate ◽  
Chloral Hydrate ◽  
Propensity Score Analysis ◽  
Procedural Sedation ◽  
Invasive Procedures ◽  
Study Objective ◽  
Non Invasive ◽  
Score Analysis

Study objective In Asian countries, oral chloral hydrate is the most commonly used sedative for non-invasive procedures. Theoretically, mild sleep deprivation could be considered as one of assisted techniques. However, there is no consensus on sleep deprivation facilitating the sedation during non-painful procedures in children. The aim of our study is to analyze the clinical data of children undergoing non-invasive procedural sedation retrospectively and to evaluate the association between mild sleep deprivation and sedative effects in non-invasive procedures. Measurements Consecutive patients undergoing chloral hydrate sedation for non-invasive procedures between December 1, 2019 to June 30, 2020 were included in this study. The propensity score analysis with 1: 1 ratio was used to match the baseline variables between patients with sleep deprivation and non-sleep deprivation. The primary outcome was the failure rate of sedation with the initial dose. The secondary outcomes included the failure rate of sedation after supplementation of chloral hydrate, the incidence of major and minor adverse events, initial and supplemental dose of chloral hydrate, and the length of sedation time. Main results Of the 7789 patients undergoing chloral hydrate sedation, 6352 were treated with sleep deprivation and 1437 with non-sleep deprivation. After propensity score matching, 1437 pairs were produced. The failure rate of sedation with initial chlorate hydrate was not significantly different in two groups (8.6% [123/1437] vs. 10.6% [152/1437], p = 0.08), nor were the failure rates with supplemental chlorate hydrate (0.8% [12/1437] vs. 0.9% [13/1437], p = 1) and the length of sedation time (58 [45, 75] vs. 58 [45, 75] min; p = 0.93). Conclusions The current results do not support sleep deprivation have a beneficial effect in reducing the pediatric chloral hydrate sedation failure rate. The routine use of sleep deprivation for pediatric sedation is unnecessary.

Depicted Immorality Influences the Perceived Applicability of the Phrase "Committed Suicide"

Crisis ◽  
2021 ◽  
pp. 1-7
Author(s):  
Andrew J. Howell ◽  
Emilee R. H. Cowan-Nelson ◽  
Victoria D. Cobuz
Keyword(s):  
Undergraduate Students ◽  
Help Seeking ◽  
Large Majority ◽  
Suicide Method ◽  
Free Standing ◽  
Stigma Reduction ◽  
Suicide Death ◽  
Empirical Basis

Abstract. Background: "Committed suicide" is often deemed less acceptable than alternative phrases, but such judgments vary widely across individuals. Aim: We tested whether the endorsement of statements containing "committed suicide" is greater when a suicide death is depicted as immoral. We also assessed the degree of immorality suggested by the free-standing phrases "committed suicide" and "died by suicide." Method: Undergraduate participants ( N = 154) read scenarios of a suicide depicted as immoral and one depicted more neutrally and judged the applicability of statements employing either "committed suicide" or "died by suicide" to each scenario. Participants next chose between the free-standing phrases "committed suicide" or "died by suicide" in terms of which connoted immorality and provided written justifications for their choices. Results: Participants judged "committed suicide" statements to be most applicable to the immoral-suicide scenario. A large majority of participants chose "committed suicide" over "died by suicide" as connoting immorality and participants' justifications for this choice revealed several meaningful themes. Limitations: Our manipulation of immorality employed religious overtones and our participants were undergraduate students. Conclusions: Findings contribute to the empirical basis for concerns regarding the phrase "committed suicide," with implications for stigma reduction and help-seeking.

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