Recommendations for developing clinical care protocols during pandemics: From theory and practice.

In 2019, a novel coronavirus called the severe acute respiratory syndrome coronavirus 2 led to the outbreak of the coronavirus disease 2019, which was deemed a pandemic by the World Health Organization in March 2020. Owing to the accelerated rate of mortality and utilization of hospital resources, health care systems had to adapt to these major changes. This affected patient care across all disciplines and specifically within the perioperative services.

An assessment of perioperative respiratory adverse events and difficult intubation in pediatric patients with Trisomy 21.

Introduction: Several prior studies have demonstrated an association between trisomy 21 and airway-related anesthetic complications. However, there is a paucity of large clinical studies characterizing the airway challenges associated with trisomy 21. In this analysis, we examine anesthetic-related airway complications in children with trisomy 21 and compare our findings to well-matched controls.

A predictive model for prolonged hospital length of stay in surgical burn patients.

Background: Improvement in the care of burn patients has led to decreased mortality. Length of stay (LOS) has been used as a marker for quality of care in this population. However, the historical association of LOS as correlating only with % burn surface area (BSA) injury has been questioned with retrospective data suggesting other factors may also be associated with LOS.

A population-based study of sociodemographic and clinical factors among children and adolescents with opioid overdose.

Study Objective: An upsurge of high-risk opioid misuse has contributed to the epidemic of opioid overdose in the United States. The primary aim was to report the rate of opioid overdose among the pediatric population and to report demographic and medical differences among POD versus IOD populations.

Design: Retrospective descriptive analysis of opioid overdose using the largest pediatric inpatient database in the United States.

Endoscopic Versus Open Repair for Craniosynostosis in Infants Using Propensity Score Matching to Compare Outcomes: A Multicenter Study from the Pediatric Craniofacial Collaborative Group.

Background: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis. We hypothesized that advantages of ESC from single-center studies would be validated based on combined data from a large multicenter registry.

Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction: A Multicenter Study from the Pediatric Craniofacial Collaborative Group.

Background: The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices.

Methods: Thirty-one institutions contributed data from June 2012 to September 2015.

Left mainstem bronchial intubation at an extremely short incisor-to-carina distance in a patient with severe ascites.

Unintentional left mainstem bronchial intubation after direct laryngoscopy is less common than unintentional right mainstem bronchial intubation, having only been referenced 3 times outside of the anesthesia literature. We report a case of unintentional left mainstem intubation at an extremely short incisor-to-carina distance. We hypothesize that the left mainstem intubation occurred because of a distortion of the anatomy of the tracheal bifurcation, caused by the patient's severe ascites, hepatomegaly, and collapsed right lower lobe, thus creating a shallower angle of the left mainstem bronchus from midline.

The sensitivity and specificity of the digital rectal examination for detecting spinal cord injury in adult patients with blunt trauma.

Study Objectives: The digital rectal examination (DRE) may assist physicians in detecting spinal cord injury in patients with blunt trauma. However, the test characteristics of the DRE for detecting spinal cord injury are unknown.

Methods: We conducted a retrospective review of consecutive adult patients with blunt trauma over a 2-year period.