Implementation of a standardized oral screening tool by paediatric cardiologists.

Background: An examination of invasive procedure cancellations found that the lack of pre-procedural oral screening was a preventable cause, for children with congenital heart disease. The purpose of this study was to implement an oral screening tool within the paediatric cardiology clinic, with referral to paediatric dental providers for positive screens. The target population were children aged ≥6 months to <18 years old, being referred for cardiac procedures.

Rapid physical assessment of the injured child.

Traumatic injuries that involve the dentition and maxillofacial region may occur as isolated events in pediatric patients but are often associated with multisystem injuries and traumatic brain injuries. The primary trauma survey serves to identify and treat life-threatening injuries. The secondary trauma survey is a complete examination of the patient after the stabilization of physiological parameters.

Rapid physical assessment of the injured child.

Traumatic injuries that involve the dentition and maxillofacial region may occur as isolated events in pediatric patients but are often associated with multisystem injuries and traumatic brain injuries. The primary trauma survey serves to identify and treat life-threatening injuries. The secondary trauma survey is a complete examination of the patient after the stabilization of physiological parameters.

Oral surgery in a child with a prosthetic aortic valve and pulmonary artery stent at risk for thromboembolism.

Children with prosthetic cardiac valves and other invasive mechanical devices that direct blood flow require anticoagulant medication for prevention of thrombosis. Dental surgery for these children has historically consisted of decreasing and/or discontinuing the oral anticoagulant and instituting heparin therapy prior to the planned dental procedure, which can result in thromboembolism and increased morbidity and mortality. This case report demonstrates that oral anticoagulation need not be decreased or discontinued prior to extraction of multiple carious primary teeth in a child at risk for thromboembolism.

Inability to alkalinize urine in a patient at risk for tumor lysis syndrome: a case report.

This report provides a description and discussion of a 19-year-old, 65-kg male, with a large mediastinal mass, right pleural effusion, and pericardial effusion, requiring urine alkalinization during a propofol infusion. The patient required NaHCO3 boluses, urine pH, electrolyte, arterial blood gas and lactate monitoring, and discontinuation of the propofol. The authors suggest that caution be used when prescribing a propofol infusion for patients who are at risk of tumor lysis syndrome and the need for urine alkalinization.

Questions unanswered: propofol use in the pediatric intensive care unit.

As professionals who care for the sickest children, we want to provide the best evidence-based care available. While there are questions still to be answered, it is clear that when propofol is administered to children, it should be done in a manner that is intentional, well planned, and consistent with national guidelines and regulatory groups. Haphazard administration of propofol will place children at risk.

Subcutaneous emphysema during restorative dentistry.

Background: Subcutaneous emphysema is a rare occurrence in the dental setting. When it does occur, the entity may be mistaken for an anaphylactic reaction to a local anaesthetic agent or other medications used in dental surgery.

Case Report: During restorative treatment of a left second primary molar air was introduced under an operculum.

Gingival colonization with selective HACEK microbes in children with congenital heart disease.

It was previously shown that children with congenital heart disease (CHD) harbored Hemophilus, Actinobacillus, Cardiobacter, Eikenella, and Kingella (HACEK) microbes to a greater extent and had more severe gingival inflammation than a normal group of children. The purpose of this study was to determine if HACEK microbes are more prevalent in children with CHD than in normal children when there is no difference in gingival inflammation. Two groups of 12 children were matched with respect to gingival inflammation.

Extracorporeal CO2 removal in a child with a single ventricle by the addition of an oxygenator to a dialysis circuit.

Objective: To optimize CO2 removal in a child with a single ventricle.

Design: Case report.

Setting: A ten-bed pediatric intensive care unit in a university-affiliated hospital.