A Standardized Protocol to Improve Acute Seizure Management in Hospitalized Pediatric Patients

✓ The congenital osseous abnormalities associated with achondroplasia include stenosis of the foramen magnum and the upper cervical spinal canal. In the pediatric achondroplastic patient, such stenosis may lead to cervicomedullary compression with serious sequelae, including paresis, hypertonia, delayed motor milestones, and respiratory compromise. Using a standardized protocol the authors have treated 15 young achondroplastic patients with documented cervicomedullary compression by craniocervical decompression and duroplasty. Following this procedure, significant improvement in presenting neurological or respiratory complaints was noted in all patients. The mortality rate in this series was zero. The major cause of morbidity associated with this procedure was perioperative cerebrospinal fluid (CSF) leakage from the surgical wound, presumably related to coexisting abnormalities of CSF dynamics. This problem was successfully managed by temporary or, when necessary, permanent CSF diversion procedures. It is concluded that craniocervical decompression is an effective and safe treatment for young achondroplastic patients with cervicomedullary compression.

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A hospital-based study on caregiver preferences on acute seizure rescue medications in pediatric patients with epilepsy: Intranasal midazolam versus rectal diazepam

Epilepsy & Behavior ◽

10.1016/j.yebeh.2018.12.007 ◽

2019 ◽

Vol 92 ◽

pp. 53-56 ◽

Cited By ~ 7

Author(s):

Sunjay Nunley ◽

Peter Glynn ◽

Steve Rust ◽

Jorge Vidaurre ◽

Dara V.F. Albert ◽

...

Keyword(s):

Pediatric Patients ◽

Rectal Diazepam ◽

Acute Seizure ◽

Patients With Epilepsy ◽

Intranasal Midazolam

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Rapid Recovery of Liver Transplantation Recipients by Implementation of Fast-Track Care Steps: What Is Holding Us Back?

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253218761124 ◽

2018 ◽

Vol 22 (2) ◽

pp. 191-196 ◽

Cited By ~ 7

Author(s):

Gianni Biancofiore ◽

Dana Rodica Tomescu ◽

M. Susan Mandell

Keyword(s):

Liver Transplantation ◽

Cost Effectiveness ◽

Perioperative Care ◽

Fast Track ◽

Pediatric Patients ◽

Cost Effective ◽

Early Extubation ◽

Best Interest ◽

Fast Tracking ◽

Standardized Protocol

A body of scientific studies has shown that early extubation is safe and cost-effective in a large number of liver transplant (LT) recipients including pediatric patients. However, fast-track practices are not universally accepted, and debate still lingers about whether these interventions are safe and serve the patients’ best interest. In this article, we focus on reasons why physicians still have a persistent, although diminishing, reluctance to adopt fast-track protocols. We stress the importance of collection/analysis of perioperative data, adoption of a consensus-based standardized protocol for perioperative care, and formation of LT anesthesia focused teams and leadership. We conclude that the practice of early extubation and fast-tracking after LT surgery could help improve anesthesia performance, safety, and cost-effectiveness.

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Audiology Service Models in a Family Physician Practice Setting

Perspectives on Audiology ◽

10.1044/poa6.1.24 ◽

2010 ◽

Vol 6 (1) ◽

pp. 24-32 ◽

Cited By ~ 2

Author(s):

Sridhar Krishnamurti

Keyword(s):

Pediatric Patients ◽

Practice Patterns ◽

Healthcare Delivery ◽

Direct Consequence ◽

Direct Access ◽

Practice Setting ◽

Pediatric Populations ◽

Family Practice Physicians ◽

Primary Focus ◽

Balance Problems

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.

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