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Pediatric Residents (pediatric + resident)

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Medical Sciences100%

Selected Abstracts

Comparison of Adverse Events during Procedural Sedation between Specially Trained Pediatric Residents and Pediatric Emergency Physicians in Israel

ACADEMIC EMERGENCY MEDICINE, Issue 7 2008
Itai Shavit MD
Abstract Objectives:, The aim was to compare the rate of procedural sedation,related adverse events of pediatric residents with specific training in "patient safety during sedation" and pediatric emergency physicians (PEPs) who completed the same course or were teaching faculty for it. Methods:, This prospective single-blinded, nonrandomized study was conducted in two university-affiliated pediatric emergency departments (PEDs) in Israel. Pediatric residents who were authorized to perform unsupervised sedations had previously completed a course in patient safety during sedation. Unsupervised sedations by residents were defined as sedations where the entire procedure was performed independently. Study subjects had autonomy in choosing medications for sedation. Adverse events were defined as transient hypoxia (oxygen saturation , 90%) or apnea. Adverse outcomes were situations where intubation or hospitalization directly related to sedation complications would occur. Sedations over 12 consecutive months were recorded, and rates of adverse events in each group were compared. Results:, A total of 984 eligible sedations were recorded, 635 by unsupervised residents and 349 by PEPs. A total of 512 (80.6%) sedations were performed by residents when attending physicians were not in the ED. The total adverse event rate was 24/984 (2.44%). When the two groups used a similar type drugs, residents had 8/635 (1.26%) events, compared to 11/328 (3.35%) by PEPs. There was no statistically significant difference in the rates of hypoxia or apnea between the two groups (p = 0.29 and p = 0.18, respectively). Adverse outcomes did not occur. Conclusions:, Unsupervised pediatric residents with training in patient safety during sedation performed procedural sedations with a rate of adverse events similar to that of PEPs. [source]

Can pediatricians accurately identify maternal depression at well-child visits?

PEDIATRICS INTERNATIONAL, Issue 2 2010
Hiroki Mishina
Abstract Background:, The feasibility of a two-item screening tool for maternal depression in a pediatric setting was recently reported. We assessed whether the accuracy of pediatrician recognition of maternal depression during the one-month well-child visit could be improved by an educational intervention using the two-item screening tool. Methods:, We conducted an educational intervention for pediatric residents in a suburban hospital in Tokyo, Japan, with outcome measurement before and after. Resident education included knowledge about postpartum depression and its impact on children, use of the two-item screening tool and available management strategies. Sixteen pediatric residents examined 267 mother,infant dyads during well-child visits. Residents documented the presence or absence of postpartum depressive symptoms on medical records. Depressive symptoms were also determined using the Edinburgh Postnatal Depression Scale (EPDS) survey; residents were not aware of the results. Using the EPDS as a "gold standard," improvement in sensitivity and specificity of resident recognition of maternal depressive symptoms was determined. Results:, The overall prevalence of postpartum depressive symptoms based on the EPDS was 15.4%. The sensitivity of resident recognition was 8% and specificity 98% before intervention, and 12% and 96% afterwards, respectively. The difference was not statistically significant. Residents indicated fear of maternal stigmatization and mothers' receptiveness to discussing depressive symptoms, as well as lack of time and skills, as major barriers to the identification of maternal depression. Conclusions:, A simple educational intervention using a two-item screening tool did not improve the pediatrician's accuracy in detecting depressive symptoms in mothers. Additional strategies to address perceived barriers may be needed. [source]

Comparison of Adverse Events during Procedural Sedation between Specially Trained Pediatric Residents and Pediatric Emergency Physicians in Israel

ACADEMIC EMERGENCY MEDICINE, Issue 7 2008
Itai Shavit MD
Abstract Objectives:, The aim was to compare the rate of procedural sedation,related adverse events of pediatric residents with specific training in "patient safety during sedation" and pediatric emergency physicians (PEPs) who completed the same course or were teaching faculty for it. Methods:, This prospective single-blinded, nonrandomized study was conducted in two university-affiliated pediatric emergency departments (PEDs) in Israel. Pediatric residents who were authorized to perform unsupervised sedations had previously completed a course in patient safety during sedation. Unsupervised sedations by residents were defined as sedations where the entire procedure was performed independently. Study subjects had autonomy in choosing medications for sedation. Adverse events were defined as transient hypoxia (oxygen saturation , 90%) or apnea. Adverse outcomes were situations where intubation or hospitalization directly related to sedation complications would occur. Sedations over 12 consecutive months were recorded, and rates of adverse events in each group were compared. Results:, A total of 984 eligible sedations were recorded, 635 by unsupervised residents and 349 by PEPs. A total of 512 (80.6%) sedations were performed by residents when attending physicians were not in the ED. The total adverse event rate was 24/984 (2.44%). When the two groups used a similar type drugs, residents had 8/635 (1.26%) events, compared to 11/328 (3.35%) by PEPs. There was no statistically significant difference in the rates of hypoxia or apnea between the two groups (p = 0.29 and p = 0.18, respectively). Adverse outcomes did not occur. Conclusions:, Unsupervised pediatric residents with training in patient safety during sedation performed procedural sedations with a rate of adverse events similar to that of PEPs. [source]

Knowledge and practical performance gained by Iraqi residents after participation to a neonatal resuscitation program course

ACTA PAEDIATRICA, Issue 8 2009
Maysoon M Jabir
Abstract Aim:, neonatal resuscitation program (NRP) course is effective in improving knowledge in participants coming from developed as well as developing countries; however, its impact on practical performances has not been yet formally evaluated in participants coming from developing countries. We evaluate the knowledge and the performance on clinical simulations gained by Iraqi residents following participation in the NRP course. Methods:, A 71-item questionnaire derived from the standard test contained in the American Heart Association and American Academy of Pediatrics Neonatal Resuscitation Manual was administered to participants before and after the course. All participants were tested with a final Mega code (Mega code A scenario,NRP textbook) to evaluate their performance on clinical simulations. Results:, Twenty-six obstetrical and 2 pediatric residents participated in the NRP course, respectively. The percentages of correct answers significantly improved from before (52 ± 14%) to immediately after the course (85 ± 7%); p < 0.001. Mean score obtained at the final Mega code was 68 ± 8%. Four out of 28 (14%) participants reached the minimum score required for passing the exam (80%). Conclusion:, Residents coming from a developing country (Iraq) significantly improved their knowledge attainment following participation in the NRP course; however, their performance on clinical simulations was unsatisfactory, suggesting that this aspect needs to be improved. [source]