Abstract:
OBJECTIVE:As the number of diagnostic imaging studies performed has increased, the demand for sedation in support of these radiologic tests has also increased. Our objectives were to (1) assess the safety and efficacy of a radiology sedation service that is staffed exclusively by pediatric emergency medicine (PEM) physicians, (2) determine the frequency and the type of commonly performed pediatric imaging studies that require procedural sedation, and (3) assess the average duration of procedural sedation for commonly performed radiologic studies. METHODS:We conducted a retrospective observational study of patient encounters in 2004 involving procedural sedation to facilitate diagnostic imaging. We are a university-affiliated group of PEM physicians that provide a radiology sedation service during weekdays at a freestanding urban children's hospital. RESULTS:The sedation service participated in 1285 patient encounters during the study period. Deep sedation was provided to 1027 patients. Moderate sedation was administered to 258 patients. Procedural sedation times for the most frequently performed imaging studies ranged from 5 to 183 minutes. Agents that were used to provide deep sedation were pentobarbital (with midazolam, fentanyl, or both) in 65% of cases, propofol in 31%, and ketamine (with or without midazolam) in 4%. Moderate sedation was achieved with chloral hydrate in 86% and oral diazepam in 14% of the cases. A total of 99.1% of the imaging studies were completed successfully. Six imaging studies were aborted because of failed sedation or occurrence of adverse event. Five patients who were deemed high risk on their presedation evaluation were referred electively for general anesthesia. CONCLUSIONS:Our data suggest that a dedicated sedation team in support of diagnostic imaging services, staffed exclusively by PEM physicians, can be a successful clinical enterprise. The service consumes significant resources and physician time.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Pershad J,Gilmore Bdoi
10.1542/peds.2005-1385subject
Has Abstractpub_date
2006-03-01 00:00:00pages
e413-22issue
3eissn
0031-4005issn
1098-4275pii
117/3/e413journal_volume
117pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract:BACKGROUND:We recently reported that electrocardiographic abnormalities are common in adults with monosomy X (Turner syndrome), but this issue has not been investigated in girls with Turner syndrome. PATIENTS AND METHODS:We analyzed electrocardiograms in 78 girls with Turner syndrome and 50 age-matched control girls. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-0776
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Previous research has documented racial/ethnic disparities in diabetes treatments and outcomes. It remains controversial whether these disparities result from differences in socioeconomic status (SES) or other factors. We examined racial/ethnic disparities in therapeutic modalities and diabete...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2014-1774
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between specific television-viewing habits and both sleep habits and sleep disturbances in school children. METHODS:The parents of 495 children in grades kindergarten through fourth grade in three public elementary schools completed two retrospective survey questionnaires, one...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.104.3.e27
更新日期:1999-09-01 00:00:00
abstract::Hyperphenylalaninemia is a variant of phenylketonuria, and debate remains as to what, if any, active management of this condition is required to preserve cognitive function and psychological well-being. This study is the first to examine longitudinally the executive function (EF) in adolescents with hyperphenylalanine...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-4200
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:We evaluated the accuracy of parental recall of children's immunization histories as compared with provider records and examined how errors in parental recall correlate with sociodemographic characteristics. DESIGN:The validation study was part of a population-based household survey designed to assess immuni...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.99.5.e3
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVES:This study was conducted to determine the prevalence of posterior fossae of the brain, arterial anomalies, cardiac anomalies, and eye anomalies (PHACE) in infants with large facial hemangiomas. The extracutaneous manifestations of PHACE may be associated with significant morbidity, and the prevalence of PHAC...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-3166
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVES:The distinct effect of exclusive and predominant breastfeeding on primary dentition malocclusions is still unclear. We hypothesized that exclusive breastfeeding presents a higher protective effect against malocclusions than predominant breastfeeding and that the use of a pacifier modifies the association bet...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-3276
更新日期:2015-07-01 00:00:00
abstract::One of the most divisive issues in pediatrics today concerns the proper response by pediatricians to parents who refuse routine childhood immunizations for their children. Many pediatricians refuse to care for such families. Others continue to provide care and continue to try to convince parents that the benefits of i...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-1597
更新日期:2016-10-01 00:00:00
abstract::A 4-year-old girl presented to a medical clinic with a painless right facial swelling. The treating physician ordered a radiograph of the sinuses and received a report of "maxillary sinusitis." After appropriate antibiotic treatment, the facial swelling increased, and the mother took the child to her community pediatr...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-1940
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Hospital billing data are frequently used for quality measures and research, but the accuracy of the use of discharge codes to identify urinary tract infections (UTIs) is unknown. OBJECTIVE:To determine the accuracy of International Classification of Diseases, 9th revision (ICD-9) discharge codes to identif...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2010-2064
更新日期:2011-08-01 00:00:00
abstract::Commercially available mouse monoclonal antibodies to human IgG subclass (IgG1 to IgG4) were applied to an enzyme-linked immunosorbent assay to measure IgG subclass-specific antibodies to varicella-zoster virus in children naturally infected with varicella-zoster virus and in varicella vaccine recipients. In children ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVE:Methylmalonic acidemia (MMA) is a metabolic disorder with a poorly defined long-term neurocognitive phenotype. We studied the neuropsychological outcomes of patients and examined clinical covariates that influenced cognition. METHODS:A diverse cohort with mut, cblA, or cblB subtypes of isolated MMA (N = 43),...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章
doi:10.1542/peds.2011-1715
更新日期:2012-06-01 00:00:00
abstract::We have examined the suppression of urinary pregnanetriol and 17-ketosteroids during treatment with cortisol, cortisone, prednisone, and dexamethasone in eight patients with congenital adrenal hyperplasia. A large individual variation in response to each agent was observed. In some individuals, cortisone is less effec...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract::The appropriate determination of adequate tissue perfusion and the best approach to treatment of perceived abnormalities in blood pressure in the neonate remain controversial. There is no consensus regarding the actual definition of hypotension in the neonate or how best to raise perceived low blood pressure. In addit...
journal_title:Pediatrics
pub_type:
doi:10.1542/peds.2005-0620F
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:A total of 20% of sudden infant death syndrome (SIDS) cases in the 1990s occurred in child care settings. This is much higher than the 8% expected from Census Bureau data. Factors that were associated with child care SIDS included older age; white race; older, more educated mothers; and unaccustomed prone pos...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-0924
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to determine the impact of different volume-targeted levels on the work of breathing and to investigate whether a level that reduced the work of breathing below that experienced during ventilatory support without volume targeting could be determined. METHODS:The transdiaphr...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2008-2635
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Low cortisol concentrations in premature infants have been correlated with increased severity of illness, hypotension, mortality, and development of bronchopulmonary dysplasia. A total of 360 mechanically ventilated infants with a birth weight of 500 to 999 g were enrolled in a randomized, multicenter trial ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2006-3158
更新日期:2007-07-01 00:00:00
abstract::As newer treatment modalities become available for patients with severe lupus nephritis, it becomes increasingly important to identify patients at risk for renal failure. In this study, the records of 90 children presenting with systemic lupus erythematosus over a 13-year period were reviewed. Nineteen were lost to fo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::Age at diagnosis is a modifiable risk factor in outcomes after hepatoportoenterostomy in biliary atresia; however, distinguishing biliary atresia from other more common causes of prolonged neonatal jaundice can be difficult. To focus attention on diagnosis of biliary atresia, we analyzed secular trends in the age at d...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-2709
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:As newborn screening (NBS) programs expand to include conditions that challenge traditional public health criteria, little is known about what influences physicians' attitudes toward screening. We examined the effect of state policy and perceived state policy on pediatricians' attitudes toward screening. MET...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-1990
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:Health-e-Access, a telemedicine service providing care for acute illnesses in children, has delivered >6500 telemedicine visits from 10 primary care practices in Rochester, New York, by using telemedicine access at 22 child care and school sites. The goal was to assess the hypotheses that children served by H...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-2698
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Sedation sometimes is necessary to perform an electroencephalogram (EEG) on a child. A dramatic decline in the need to use conscious sedation in our EEG laboratory prompted this review of our sedation experience. The purpose of this review was to determine the incidence of adverse sedation effects and to dete...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.108.1.163
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Family-centered rounds (FCRs) have become standard of care, despite the limited evaluation of FCRs' benefits or interventions to support high-quality FCR delivery. This work examines the impact of the FCR checklist intervention, a checklist and associated provider training, on performance of F...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2016-1688
更新日期:2017-05-01 00:00:00
abstract::Very little is known about the alcohol elimination rates of newborns who have had chronic alcohol exposure in utero. In these case reports, blood alcohol levels were taken immediately before delivery, at delivery, and postdelivery for 2 mothers who drank alcohol during their pregnancies and 3 single-birth newborns. Ne...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-1400
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:The goals of this study were to: (1) determine if management according to a standardized clinical management pathway/algorithm (compared with usual treatment) improves clinical outcomes by 6 weeks; and (2) assess the reliability and validity of a standardized clinical management pathway for chronic cough in ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2012-3318
更新日期:2013-05-01 00:00:00
abstract::Fourteen term newborn infants have been recognized as having transient tricuspid insufficiency associated with significant perinatal stress. Five of these infants underwent cardiac catheterization for presumed congenital heart disease, but had only massive tricuspid valve insufficiency. The other nine infants were dia...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract:OBJECTIVES:To examine the independent contribution of major depressive disorder (MDD), generalized anxiety disorder (GAD), and selective serotonin reuptake inhibitors (SSRIs) to changes in body composition in older adolescents. METHODS:Medically healthy 15- to 20-year-olds who were unmedicated or within 1 month of sta...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-3943
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To examine beneficial or detrimental effects of protease inhibitor (PI)-containing antiretroviral regimens on height and weight growth in children with human immunodeficiency virus (HIV) infection. METHODS:A prospective cohort study was conducted of 906 HIV-infected children, from pediatric research clinics ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.108.4.e72
更新日期:2001-10-01 00:00:00
abstract::A recent population-based study in the Canadian province of British Columbia showed that, since the mid-1960s, there has been a significant increase in the incidence of retinopathy of prematurity-induced blindness in infants weighing 750 to 999 g at birth. To determine the impact of changing birth weight-specific surv...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiologic, clinical, neuroimaging, and laboratory features; treatment; and outcome in a cohort of children with acute disseminated encephalomyelitis (ADEM). METHODS:A 6-year retrospective chart review of children with the diagnosis of ADEM was conducted. RESULTS:Eighteen cases were ident...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.110.2.e21
更新日期:2002-08-01 00:00:00