The career of Dr Charles J. Coté covered a period of major advances in pediatric anesthesia patient safety. Dr Coté (1946 --), Professor Emeritus in Anaesthesia at Harvard Medical School, helped develop pediatric sedation guidelines, conducted influential clinical research, edited a major textbook, and promoted pediatric anesthesia training fellowships in low- and middle-income countries. Based on a series of interviews with Dr Coté, this article reviews the career of this Robert M. Smith Award winner through the lens of improvements in pediatric sedation and anesthesia patient safety.
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http://dx.doi.org/10.1111/pan.13999 | DOI Listing |
Pediatr Qual Saf
December 2024
From the Department of Radiology, Center for Clinical Excellence, Nationwide Children's Hospital, Columbus, Ohio.
Introduction: Many children require sedation for imaging. We aimed to reduce sedation for thoracic (chest and cardiac) computed tomography (CT) scans in children 0-4 years old from 65% to 20% by December 2018 and to sustain.
Methods: We counted baseline, intervention, and a follow-up period thoracic CT scans performed with sedation in children 0-4 years old.
Pediatr Qual Saf
December 2024
From the Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pa.
Introduction: Although associated with respiratory morbidity, elective endotracheal intubation (ETI) for laser photocoagulation for retinopathy of prematurity (ROP) is the standard practice at our institution, with 100% of patients undergoing preoperation ETI. To mitigate this risk, we strove to reduce the percentage of infants intubated for laser photocoagulation by 30% by June 2022.
Methods: We assembled a multidisciplinary team and implemented a deep sedation guideline utilizing dexmedetomidine, fentanyl, and midazolam with noninvasive ventilation support for laser photocoagulation in January 2020.
Pediatr Qual Saf
December 2024
Division of Neonatology, Department of Pediatrics, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack, N.J.
Introduction: Endotracheal intubation is frequent in the neonatal intensive care unit (NICU) but may result in neonatal distress and instability. Premedication reduces adverse effects, such as hypoxia, bradycardia, and pain. The Specific, Measurable, Achievable, Relevant and Time-Bound aim for this project was to increase premedication use for nonemergent neonatal intubation in a specific NICU from 22% to 80% from March 2021 to May 2023.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
December 2024
From the Department of Radiology (H.N.M., F.B.G.), Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
Background And Purpose: Congenital vertebral anomalies are commonly associated with underlying spinal cord anomaly which necessitates imaging both the spinal cord and the bony vertebral column to understand the extent of the deformity better. While MRI is the gold standard for spinal cord imaging, it does not provide CT-like bone details. Many MR bone imaging techniques have been tested in various adult spine conditions in the past decade but not much has been described on their reliability in pediatric spine.
View Article and Find Full Text PDFBrain Dev
December 2024
Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Background: Safe pediatric magnetic resonance imaging (MRI) ideally relies on non-sedative techniques, as avoiding risky sedation is inherently safer. However, in practice, sedation often becomes unavoidable, particularly for younger children or those with anxiety, to ensure motion-free, high-quality imaging. This narrative review explores the current practices and proposes strategies to enhance safety in pediatric MRI examinations.
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