Thromboelastography and Its Use in Pediatric Trauma Patients.

Background/purpose: Thromboelastography's (TEG's) use in pediatric trauma patients is not widely studied. Identifying clotting cascade defects can direct decision making regarding blood product transfusion.

Methods: We performed a single-center retrospective review of all level 1 pediatric trauma patients.

Children's hospital quality ratings: where are we and can we do better?

Objective: Hospital quality ratings are intended to guide patients and payers to the highest quality hospitals. Their success in achieving this goal has been limited by inconsistencies between ratings and questionable data collection methods. Despite these shortcomings, their popularity and importance are increasing.

Pediatric inpatient hospital care.

Pediatrics is a field of medical specialty that focuses on children and their potential to successfully grow and develop into healthy adults. The articles in this special edition of Hospital Practice span a range of issues that affect children and their health care in the inpatient hospital setting, including equity and bias mitigation in health care, efficiency in patient rounding, using patient and family complaints to drive improvement efforts, the diagnostic process and avoiding fundamental diagnostic errors, pediatric palliative care, rapidly identifying and treating sepsis in children, the care and management of children on home ventilation, instituting a rapid response team in the pediatric environment, and quality rating systems for children's hospitals.

Diagnostic error in the pediatric hospital: a narrative review.

Introduction: Diagnostic error is a prevalent type of medical error that is associated with considerable patient harm and increased medical costs. The majority of literature guiding the current understanding of diagnostic error in the hospital setting is from adult studies. However, there is research to suggest this type of error is also prevalent in the pediatric specialty.

Using patient complaints to drive healthcare improvement: a narrative overview.

Patient complaints are directly related to patient experience and safety. While complaints have the potential to be a major driving force in quality improvement, there is little evidence-based structure to use as a guide. The existing literature draws attention to the significant variability in complaint reporting and analysis systems as major barriers.

Implementation of a Weight-Based High-Flow Nasal Cannula Protocol for Children With Bronchiolitis.

Objectives: To determine if the implementation of a weight-based high-flow nasal cannula (HFNC) protocol for infants with bronchiolitis was associated with improved outcomes, including decreased ICU use.

Methods: We implemented a weight-based HFNC protocol across a tertiary care children's hospital and 2 community hospitals that admit pediatric patients on HFNC. We included all patients who were <2 years old and had a discharge diagnosis of bronchiolitis or viral pneumonia during the preimplementation (November 2013 to April 2018) and postimplementation (November 2018 to April 2020) respiratory seasons.

Oculocardiac Reflex in A 15-Year-Old With Orbital Fractures and Epidural Hematoma.

The oculocardiac reflex has been well described in the literature and was first defined in 1908 by Aschner. The phenomenon involves the afferent limb of the ophthalmic division of the trigeminal nerve as well as the efferent pathway involving the vagal nerve leading to negative chronotropic effects. It results in a decrease in heart rate and oftentimes a decrease in blood pressure associated with compression of the eye or traction of the extraocular muscles.

A Retrospective Review of Physician-related Patient Complaints from a Tertiary Pediatric Hospital.

Background: Trends in patient concerns can identify systematic problems in health care delivery that may not be detected when addressing individual concerns. It can be difficult identifying trends without using a standardized taxonomy. The study objectives were to describe patient complaints from a tertiary care pediatric hospital and categorize them using a standardized complaint taxonomy.

Pediatric Bacterial Tracheitis-A Variable Entity: Case Series with Literature Review.

Objective: To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis.

Study Design: Case series with literature review.

Setting: Tertiary children's hospital and available literature.

Ondansetron Oral Dissolve Tab vs. Oral Solution in Children Presenting to the Emergency Department with Gastroenteritis.

Background: Ondansetron is often used in the emergency department (ED) to promote oral rehydration in children with acute gastroenteritis (AGE), yet medication solutions administered orally may be poorly tolerated in this population.

Objectives: We compared the tolerability of ondansetron oral dissolve tab (ODT) to oral solution (OS) in children presenting to the ED with AGE.

Methods: Using alternate-day controlled clinical trial design, children aged 3 months to 10 years received either ondansetron ODT or OS.