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An Innovative, Objective Tool for Assessing and Managing Narcotic Withdrawal in Newborn Infants 一种评估和管理新生儿麻醉品戒断的创新、客观工具
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.678-A
Jennifer Hammond, D. Garey, J. Isler, D. Bateman, R. Sahni
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引用次数: 0
Continuous Chest Compressions with Asynchronous Ventilations Increase Cerebral Blood Flow and Oxygen Delivery in the Perinatal Asphyxiated Cardiac Arrest Lamb Model 在围产期窒息性心脏骤停羔羊模型中,持续胸部按压加非同步通气增加脑血流量和氧输送
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.688
Payam Vali, Peggy Chen, Ziad Alhassen, Amy L. Lesneski, Morgan E Hardie, Deepika Sankaran, S. Lakshminrusimha
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引用次数: 0
Simulation As A Tool For COVID -19 Preparedness In Neonatal Intensive Care Unit 模拟作为新生儿重症监护病房COVID -19防范工具
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.731
Vilmaris Quiñones Cardona, S. Joshi, Swetha Madhavarapu, Ogechukwu R. Menkiti
Background: Recent emergence of COVID-19, a disease caused by the novel coronavirus SARS-CoV-2, has posed unprecedented challenges to various aspects of the healthcare system The complexity and acuity of NICU patients, along with extreme precautions needed to safeguard patients, families and healthcare workers (HCWs) from COVID-19 has motivated creative thinking and multidisciplinary collaboration We present the use of simulation to design, test and implement safety guidelines for COVID-19 preparedness in the NICU Objective: We hypothesize that a simulation-based intervention can be used to design, test and effectively implement practice guidelines for personal and team safety while caring for suspected or positive COVID-19 neonates Method: To examine operational issues and practicality of local infection control COVID-19 recommendations in the NICU workflow, we developed high fidelity in situ simulations with goal of assessing HCWs use of personal protective equipment (PPE) and to conduct cardiopulmonary resuscitation while observing strict droplet and airborne precautions A three-part simulation was designed to assess from (Table Presented) identification of COVID-19 exposure through transportation to negative pressure room and culminating in performance of emergent procedures in a level IV NICU at St Christopher's Hospital for Children Donning and doffing of PPE was evaluated amongst other safety procedures Debriefing included identification of failure modes, causes and actions to reduce the failure occurrence based on modified failure mode effect analysis (FMEA) Pre and post simulation surveys were administered to participants to elicit comfort level in managing a COVID-19 exposed neonate A COVID-19 exposure process-checklist was generated from this feedback We re-evaluated the comfort level of the providers after real-life code events in COVID-19 exposed neonates with post-experience surveys Results: Fifty-four survey responses were collected Participants included physicians (36%), nurses (18%), respiratory therapists (13%) and advanced practitioners (6%) Comfort level of providers in terms of general care of COVID-19 exposed neonates, donning and doffing PPE along with team dynamics in high acuity code was significantly higher after simulation This comfort level was maintained after a real-life code event (Table 1) In actual patient event, those who participated in simulation reported improvement in team dynamics during code events During debrief, participants suggested possible failures and actions to reduce failure occurrence (Table 2) Conclusion: Simulation based education was a useful tool to effectively test, identify potential failures and modify COVID-19 guidelines to enhance safety in the NICU High fidelity simulation improved comfort level and safety practices among HCWs which were maintained in real life emergent events
背景:由新型冠状病毒SARS-CoV-2引起的新型冠状病毒COVID-19最近出现,给医疗保健系统的各个方面带来了前所未有的挑战。新生儿重症监护病房患者的复杂性和急性程度,以及保护患者、家属和医护人员(HCWs)免受COVID-19侵害所需的极端预防措施,激发了创造性思维和多学科合作。目的:我们假设基于模拟的干预措施可用于设计、测试和有效实施个人和团队安全实践指南,同时照顾疑似或阳性的COVID-19新生儿。为了研究NICU工作流程中本地感染控制建议的操作问题和实用性,我们开发了高保真的现场模拟,目的是评估医护人员对个人防护装备(PPE)的使用情况,并在观察严格的液滴和空气传播预防措施的同时进行心肺复苏。设计了三部分模拟,以评估(表所示)在圣克里斯托弗儿童医院(St Christopher's Hospital for Children Donning and and)的IV级新生儿重症监护病房中,从通过运输到负压室识别COVID-19暴露,到最终执行紧急程序在其他安全程序中评估了个人防护装备的脱布情况,汇报内容包括识别故障模式;基于改进的失效模式效应分析(FMEA)对参与者进行模拟前和模拟后的调查,以获得管理COVID-19暴露新生儿的舒适度。根据反馈生成COVID-19暴露过程清单。我们通过事后调查重新评估了COVID-19暴露新生儿真实代码事件后提供者的舒适度。参与者包括医生(36%)、护士(18%)、呼吸治疗师(13%)和高级从业人员(6%)。模拟后,提供者在COVID-19暴露新生儿的一般护理方面的舒适度显著提高,在高灵敏度代码中穿戴和脱下PPE以及团队动态,这种舒适度在真实的代码事件后保持不变(表1)在汇报过程中,参与者提出了可能出现的故障和减少故障发生的措施(表2)。结论:基于模拟的教育是有效测试、识别潜在故障和修改COVID-19指南以提高NICU安全性的有用工具。高保真度模拟提高了现实生活中突发事件中医护人员的舒适度和安全实践
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引用次数: 0
Prevention of Sepsis By Inhalation Nitrogen Oxide 吸入氧化氮预防败血症
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.723
M. G. Pukhtinskaya, V. Estrin
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引用次数: 0
Assessing 3 Bronchopulmonary Dysplasia Definitions: Associations between Room Air Challenge Results and Respiratory Outcomes 评估3种支气管肺发育不良定义:室内空气挑战结果与呼吸结果之间的关系
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.681
Samia Aleem, Barbara T. Do, M. Gantz, A. Hibbs, E. Jensen, C. Cotten, William F Malcolm, M. Walsh, R. Greenberg
Background: The Neonatal Research Network (NRN) has used 3 definitions for bronchopulmonary dysplasia (BPD): 1) a clinical definition based on supplemental oxygen at 36 weeks postmenstrual age (PMA) (clinBPD), 2) a physiologic definition inclusive of a room air challenge (RAC) at 36 weeks (physBPD), and 3) a pragmatic definition based on any respiratory support at 36 weeks (pragBPD). PragBPD has been shown to be strongly correlated …
背景:新生儿研究网络(NRN)对支气管肺发育不良(BPD)使用了3种定义:1)基于经后36周补充氧气(PMA)的临床定义(clinBPD), 2)包含36周室内空气挑战(RAC)的生理定义(physBPD), 3)基于36周任何呼吸支持的实用定义(pragBPD)。PragBPD已被证明与…
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引用次数: 2
Multidisciplinary Prenatal Consultation during the COVID-19 Pandemic: A Preferred Model for Many Providers COVID-19大流行期间的多学科产前咨询:许多提供者的首选模式
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.716
K. V. Leeuwen, Erica M. Weidler, L. Goncalves, J. Felts, A. Schmidt, Wayne J. Franklin, C. Lindblade, Gregory C. Martin, A. Patil
Purpose: Comprehensive fetal care centers address congenital anomalies by first performing advanced fetal imaging (e g ultrasound, echocardiography, fetal magnetic resonance imaging (MRI)) and later discussing those findings, the prognosis, pregnancy management, need for fetal intervention, delivery plan and postnatal management in a multi-disciplinary format This team approach to counseling can be logistically challenging due to the difficulty in assembling multiple providers from varied specialties on short notice To reduce exposure during the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services We assessed provider satisfaction with the rapid transition from in-person prenatal visits to multidisciplinary consultations via telehealth as an adaptive response to the pandemic Methods: Patients who were referred to a busy fetal care center during the first six weeks of the pandemic were connected to the appropriate pediatric subspecialists by videoconference Some patients underwent advanced fetal imaging and a telehealth consultation with radiology and other appropriate subspecialists took place immediately after imaging was complete In other instances, imaging occurred and a telehealth visit with all applicable subspecialties took place in the patient's home at a later time During multidisciplinary meetings, the images were reviewed with all participants via screen sharing In some cases, providers met to review images prior to admitting the patient to the video call Provider type is listed in Table 1 Provider satisfaction with the telehealth paradigm was assessed by convenience sampling using an electronic survey Results: 22 surveys were administered and 18 providers responded for a response rate of 82% Table 2 shows the overall satisfaction with connectivity and with the format compared to in-person visits 89% of providers were highly satisfied with the telehealth format 72% of providers would prefer the multidisciplinary telehealth format to an in-person visit for future visits after COVID-19 restrictions are lifted 22% of providers would leave the choice to the patient's family One provider preferred in-person visits Other providers stated that they find inperson visits better for comforting the patient and for the ability to draw pictures or show educational materials Conclusion: Providers were overwhelmingly in support of multidisciplinary telehealth conferences for prenatal consultations This study shows that a multidisciplinary telehealth visit can be done with a high degree of satisfaction for providers Specific benefits included the ability to review images together as a team, to review the delivery plan and to provide care coordination across specialties Further studies are needed to better analyze the multidisciplinary approach to telehealth visits for prenatal care
目的:综合胎儿护理中心通过首先进行先进的胎儿成像(如超声、超声心动图、胎儿磁共振成像(MRI)),然后讨论这些发现、预后、妊娠管理、胎儿干预的必要性,由于难以在短时间内召集来自不同专业的多名提供者,因此这种团队咨询方法在后勤方面可能具有挑战性。医疗保险和医疗补助服务中心(CMS)扩大了远程医疗服务的可及性我们评估了提供者对通过远程医疗从亲自产前检查到多学科咨询的快速转变的满意度,作为对大流行的适应性反应。在大流行的前六周被转诊到繁忙的胎儿护理中心的患者通过视频会议与适当的儿科专科医生联系。一些患者接受了先进的胎儿成像,并在成像完成后立即与放射科和其他适当的专科医生进行了远程保健咨询。在多学科会议期间,通过屏幕共享与所有参与者一起审查图像。在某些情况下,供应商在收治患者进行视频通话之前会面审查图像。供应商类型列于表1。通过使用电子调查的便利抽样评估供应商对远程医疗范式的满意度。结果:表2显示了与面对面就诊相比,对连通性和格式的总体满意度,89%的提供者对远程医疗格式非常满意,72%的提供者在COVID-19限制解除后更倾向于多学科远程医疗格式,而不是面对面就诊,22%的提供者将选择留给患者家属其他医疗服务提供者表示,他们发现面对面的探视更能安慰病人,也能画画或展示教育材料。提供者压倒性地支持多学科远程医疗会议进行产前咨询。这项研究表明,多学科远程医疗访问可以以提供者的高度满意度完成。具体的好处包括能够作为一个团队一起审查图像。审查分娩计划并提供跨专业的护理协调,需要进一步研究以更好地分析产前护理远程保健访问的多学科方法
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引用次数: 0
Trends in Tracheostomy Placement and Resource Use in Preterm Infants with Bronchopulmonary Dysplasia in the United States, 2008 - 2017 2008 - 2017年美国支气管肺发育不良早产儿气管造口置入和资源使用趋势
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.745
F. Dapaah‐Siakwan, P. Bhatt, K. Donda, N. A. Adjetey, Christfelly N. Opoku-Agyemang, A. Agyekum, Nimitariyie Princewill, M. Ayensu, Leonita R. Bray, Priyank Yagnik
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引用次数: 0
A Randomized Controlled Trial: How Do Flipped Classrooms and Traditional Didactics Compare for Knowledge Acquisition and Retention among Neonatal-Perinatal Medicine Fellows? 一项随机对照试验:如何比较翻转课堂和传统教学在新生儿-围产期医学研究员的知识获取和保留?
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.761
R. Dadiz, M. Gray, Eric Zucker, S. Izatt, M. Gillam-Krakauer, Melissa M. Carbajal, L. Johnston, Alison J Falck, E. Bonachea, Margarita M. Vasquez, H. Karpen, Allison H. Payne, P. Chess, AnnaMarie Arias-Shah, Carly Gisondo, Matthew Huber, H. French
{"title":"A Randomized Controlled Trial: How Do Flipped Classrooms and Traditional Didactics Compare for Knowledge Acquisition and Retention among Neonatal-Perinatal Medicine Fellows?","authors":"R. Dadiz, M. Gray, Eric Zucker, S. Izatt, M. Gillam-Krakauer, Melissa M. Carbajal, L. Johnston, Alison J Falck, E. Bonachea, Margarita M. Vasquez, H. Karpen, Allison H. Payne, P. Chess, AnnaMarie Arias-Shah, Carly Gisondo, Matthew Huber, H. French","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.761","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.761","url":null,"abstract":"","PeriodicalId":275302,"journal":{"name":"Section on Neonatal-Perinatal Medicine Program","volume":"280 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121074191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Variation Of Ductus Arteriosus Treatment In Very Low Birth Weight Infants 极低出生体重儿动脉导管治疗的变化
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.750
K. Runte, J. Flyer, Erika M. Edwards, R. Soll, J. Horbar, S. Yeager
{"title":"Variation Of Ductus Arteriosus Treatment In Very Low Birth Weight Infants","authors":"K. Runte, J. Flyer, Erika M. Edwards, R. Soll, J. Horbar, S. Yeager","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.750","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.750","url":null,"abstract":"","PeriodicalId":275302,"journal":{"name":"Section on Neonatal-Perinatal Medicine Program","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121311802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Standardized Instructional Method on Learner Perceptions, Preferences, and Classroom Experience in a National GME Curriculum 标准化教学方法对国家GME课程中学习者感知、偏好和课堂体验的影响
Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.709
M. Gillam-Krakauer, R. Dadiz, Carly Gisondo, E. Bonachea, H. French, Margarita M. Vasquez, P. Chess, L. Johnston, Allison H. Payne, S. Izatt, H. Karpen, Melissa M. Carbajal, AnnaMarie Arias-Shah, Alison J Falck, Eric Zucker, M. Gray
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引用次数: 0
期刊
Section on Neonatal-Perinatal Medicine Program
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