Dutch paediatrician’s opinions about acute care for critically ill children in general hospitals

Sambeeck, Sam J. van; Martens, S.; Hundscheid, Tim; Janssen, Edwin; Vos, Gijs D.

doi:10.1007/s00431-014-2439-7

Cited by 2 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Endotracheal intubation (ETI) is the golden standard for securing the airway in situations where the provider is unable to ventilate the patient adequately with a bag-and-mask or by a supraglottic airway device, or if an open airway is compromised [20, 24]. Unsuccessful intubation attempts lead to complications, resulting in a high morbidity/mortality rate [1, 2, 18, 21].…”

Section: Introductionmentioning

confidence: 99%

Endotracheal intubation skills of pediatricians versus anesthetists in neonates and children

et al. 2019

Self Cite

View full text Add to dashboard Cite

This study compares the performance of pediatricians and anesthetists in neonatal and pediatric endotracheal intubations (ETI) during simulated settings. Participants completed a questionnaire and performed an ETI scenario on a neonatal and a child manikin. The procedures were recorded with head cameras and cameras attached to standard laryngoscope blades. The outcomes were successful intubation, time to successful intubation, number of attempts, complications, total performance score, end-assessment rating, and an assessment whether the participant was sufficiently able to perform an ETI. Fifty-two pediatricians and 52 anesthetists were included. For the neonatal ETI, the rate of successful intubation was in favor of anesthetists although not significant. Anesthetists performed significantly better in all other outcomes. Of the pediatricians, 65% was rated sufficiently adept to perform a neonatal ETI vs 100% of the anesthetists. Pediatricians (29%) overestimated while anesthetists (33%) underestimated their performance in neonatal ETI. For the pediatric ETI, all outcomes were significantly better for anesthetists. Only 15% of all pediatricians were considered sufficiently able to perform pediatric ETI vs 94% of the anesthetists. Conclusion : Anesthetists are far more adept in performing ETI in neonates and children compared with pediatricians in a simulated setting. Complications are expected to occur less frequently and less seriously when anesthetists perform ETI. What is Known: • Endotracheal intubation (ETI) performed by inexperienced care providers can lead to unsuccessful and/or prolonged intubation attempts. This can cause complications such as hypoxemia, trauma to the oropharynx and larynx, and prolonged interruption of resuscitation, which results in a high morbidity/mortality. • Fifty to 60 real-life ETI procedures are needed before ETI can be performed with a 90% success rate. Despite this, 18% of providers still require some assistance even after performing 80 intubations. Skill fade will occur if there is too little exposure. What is New: • This study shows that, on both neonatal and child manikins, anesthetists perform better in ETI compared with pediatricians. Besides this, complications are expected to occur less frequently and less seriously when anesthetists are performing the ETIs on neonates and children. • In those countries where there are no clear interprofessional agreements made in general hospitals on who will perform ETI on neonates and children in acute care settings, these agreements are urgently necessary. Electronic supplementary material The online version of this article (10.1007/s00431-019-03395-8) contains supplementary material, which is available to authorized user...

show abstract

Section: Introductionmentioning

confidence: 99%

Endotracheal intubation skills of pediatricians versus anesthetists in neonates and children

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

Current management of pediatric soft tissue sarcomas

Sangkhathat¹

2015

WJCP

View full text Add to dashboard Cite

Pediatric soft tissue sarcomas are a group of malignant neoplasms arising within embryonic mesenchymal tissues during the process of differentiation into muscle, fascia and fat. The tumors have a biphasic peak for age of incidence. Rhabdomyosarcoma (RMS) is diagnosed more frequently in younger children, whereas adult-type non-RMS soft tissue sarcoma is predominately observed in adolescents. The latter group comprises a variety of rare tumors for which diagnosis can be difficult and typically requires special studies, including immunohistochemistry and molecular genetic analysis. Current management for the majority of pediatric sarcomas is based on the data from large multi-institutional trials, which has led to great improvements in outcomes over recent decades. Although surgery remains the mainstay of treatment, the curative aim cannot be achieved without adjuvant treatment. Pre-treatment staging and risk classification are of prime importance in selecting an effective treatment protocol. Tumor resectability, the response to induction chemotherapy, and radiation generally determine the risk-group, and these factors are functions of tumor site, size and biology. Surgery provides the best choice of local control of small resectable tumors in a favorable site. Radiation therapy is added when surgery leaves residual disease or there is evidence of regional spread. Chemotherapy aims to reduce the risk of relapse and improve overall survival. In addition, upfront chemotherapy reduces the aggressiveness of the required surgery and helps preserve organ function in a number of cases. Long-term survival in low-risk sarcomas is feasible, and the intensity of treatment can be reduced. In high-risk sarcoma, current research is allowing more effective disease control.

show abstract

Dutch paediatrician’s opinions about acute care for critically ill children in general hospitals

Cited by 2 publications

References 20 publications

Endotracheal intubation skills of pediatricians versus anesthetists in neonates and children

Endotracheal intubation skills of pediatricians versus anesthetists in neonates and children

Current management of pediatric soft tissue sarcomas

Contact Info

Product

Resources

About