• 제목/요약/키워드: pediatric patient

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Ensuring Patient Safety in Pediatric Dental Care

  • Daewoo Lee
    • Journal of the korean academy of Pediatric Dentistry
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    • 제51권2호
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    • pp.109-131
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    • 2024
  • This review aims to examine safety concerns in pediatric dental care and underscore the need for comprehensive patient safety initiatives within the Korean Academy of Pediatric Dentistry. Drawing insights from the prevailing patient safety policies of the American Academy of Pediatric Dentistry, case reports, and systematic reviews, this review elucidates issues such as dental fires during sedation, ocular complications from local anesthesia, and surgical emphysema. This review highlights the significance of safety toolkits encompassing infection control, medical error reduction, dental unit waterline infection, and nitrous oxide safety in pediatric dental settings, underscoring the need to foster a safety culture. Furthermore, this study explores the curriculum for pediatric dentistry residency programs, emphasizing concepts such as high-reliability organizations and mortality and morbidity conferences. The study suggests the need for initiatives to enhance patient safety, including establishing safety committees, expanding reporting systems, policy development, and supporting research related to patient safety. In conclusion, this study underlines key messages, emphasizing the utmost priority of patient safety, acknowledging the inevitability of human error, promoting effective communication, and cultivating a patient safety culture. These principles are vital for advancing patient safety in pediatric dental care and improving outcomes among pediatric patients.

Korean Pediatric Patients' Preferences for Patient Room Design (한국 소아환자들의 병실색채 선호도에 관한 연구)

  • Park, Jin Gyu Phillip;Park, Changbae
    • Journal of The Korea Institute of Healthcare Architecture
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    • 제17권2호
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    • pp.45-52
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    • 2011
  • The visual sensory information in physical environments can induce or reduce occupants' stress. In healthcare settings, positive environmental stimulations can promote patient well-being by reducing their stress: poor health environments work against a patient's health. Changing the color in a patient room is an inexpensive process and thus finding better colors for healthcare settings is a cost effective method of improving healing environments. Color may have important implications for pediatric patients, but the investigation of Korean populations has been non-existent. The purpose of this study was to investigate Korean pediatric patients' color preferences for patient room design. The color preferences from 50 Korean pediatric patients were recorded and investigated for gender effects. A simulation method was used because of its reliability and feasibility, allowing for investigating the value of color in real contexts and controlling confounding variables. The overall color preferences from Korean pediatric patients showed that they preferred blue the most and white the least. Gender differences were found in red and purple. Girls preferred red and purple more than boys. The results from this study can help healthcare providers and designers better understand appropriate colors for Korean pediatric patient populations.

Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease

  • Cakir, Murat;Ersoz, Safak;Akbulut, Ulas Emre
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권1호
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    • pp.60-65
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    • 2015
  • We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

The Survey of Nausea-vomiting and Diet Patterns among Pediatric Cancer Patient Received Chemotherapy (화학요법을 받고 있는 암환아의 구토 및 식이양상)

  • Park Sung Hee
    • Child Health Nursing Research
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    • 제3권1호
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    • pp.62-70
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    • 1997
  • The incidence of chemothrapy related among pediatric cancer patient was 90.1%. Adequate oral intake and nutrition have been shown to be important. These consideration prompted the decision to survey by means of a questionaire. The questionaire were included nausea-vomiting peak time, causing factor, coping method, education need, diet pattern change and food preference. Results are fellow 1. Almost(90.1%) pediatric cancer patient experienced nausea-vomiting during chemotherapy and required coping method or reducing method. 2 . The food preference form were Identified. Those were fluid form, cold and small amout and frequentry eating form. The patients preferred noodles, chickens, soap, juice. The results of the survey indicate that nasea-vomiting relief nursing intervention are required pediatric cancer patient received chemotherapy. Health care personnels recognize the pediatric cancer patient's diet pattern and encourage the nutritional counselling. The care of patient should be multidisciplinary team approach and the nurse occupies a key position with in this team, which includes the pediatrician, nutrionist.

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Penetrating gallbladder injury in a pediatric patient in the United States: a case report

  • Nelimar Cruz-Centeno;Shai Stewart;Derek R. Marlor;Charlene Dekonenko;Richard J. Hendrickson
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.295-297
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    • 2023
  • Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

General Anesthesia for Dental Treatment of a Pediatric Patient with Marfan Syndrome (마판 증후군 소아 환자의 전신마취 하 치과치료)

  • Kim, Kyung Jin;Bak, Soyeon;Hyun, Hong-Keun;Shin, Teo-Jeon;Kim, Jung-Wook
    • Journal of The Korean Dental Society of Anesthesiology
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    • 제13권4호
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    • pp.209-214
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    • 2013
  • Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

Impact of preoperative nutritional status on surgical outcomes in patients with pediatric gastrointestinal surgery

  • El Koofy, Nehal;Eldin, Hadeer Mohamed Nasr;Mohamed, Wesam;Gad, Mostafa;Tarek, Sara;El Tagy, Gamal
    • Clinical and Experimental Pediatrics
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    • 제64권9호
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    • pp.473-479
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    • 2021
  • Background: Malnutrition has a high incidence among pediatric surgical patients and contributes to increased risks of postoperative complications and extended hospital stays. Purpose: The present study aimed to determine the influence of preoperative nutritional status on the postoperative outcomes of pediatric patients who underwent elective gastrointestinal (GI) surgery. Methods: This prospective observational study was conducted at Cairo University Specialized Pediatric Hospital. According to the designated inclusion criteria, 75 surgical cases of both sexes were included. A structured questionnaire was developed and administered. This questionnaire included 3 main sections: demographic data and nutritional status parameters at admission and discharge. Pre- and postoperative nutritional statuses were compared. Results: According to both the subjective global nutritional assessment and STRONGKIDS score Questioner, more than 60% of patients in the upper GI patient group were at risk of malnutrition. Wasting status was most common in the upper GI patient group (67%; vs. 39.1% in the lower GI group). Underweight status was more common in the hepatobiliary and upper GI patient groups (nearly 50% for each group) than in the lower GI group (30.4%). On the other hand, stunted patients had a higher incidence of complications and a prolonged hospital stay (P=0.003 and P=0.037, respectively), while underweight lower GI patients experienced a prolonged hospital stay (P=0.02). A higher proportion of patients with preoperative anemia than those without preoperative anemia required a blood transfusion (P=0.003). Conclusion: Nutritional assessment is a crucial component of pediatric surgical patient management. Both underweight and wasting statuses were more common among hepatobiliary and upper GI patients. Postoperative complications and a long hospital stay were more common among stunted patients.

Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia in children and adolescents: a single center experience

  • Hyun, Myung Chul
    • Clinical and Experimental Pediatrics
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    • 제60권12호
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    • pp.390-394
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    • 2017
  • Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

Midazolam and Ketamine Intramuscular Premedication in Attention Deficit Hyperactivity Disorder Patient with Poor Cooperability (치과 진료에 비협조적인 주의력 결핍 과잉행동 장애 증후군 환자에서의 전처치로서의 미다졸람 케타민의 근육투여)

  • Kim, Young-Jae;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Hyun-Jeong;Seo, Kwang-Suk;Lee, Jung-Man;Shin, Soonyoung
    • Journal of The Korean Dental Society of Anesthesiology
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    • 제12권2호
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    • pp.111-114
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    • 2012
  • Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity, and hyperactivity. Given high incidence of ADHD, many children with ADHD is likely to present for anesthesia. This case report suggests intramuscular premedication as an alternative method for anesthetic induction. A 9-year-old male patient with ADHD was transferred for dental treatment under general anesthesia. The patient refused to go into dental clinic office. Oral midazolam was given to the patient, however, he was resistant to take midazolam via oral route. Instead, we administer midazolam and ketamine via intramuscular route. After less than 10 miniutes, the patient became drowsy and was transferred to dental chair. Intravenous access and mask inhalation was possible. The patient received dental treatment under general anesthesia and recovered in a non-complicated way. In this case, intramuscular sedation with midazolam and ketamine was used as a premedication in highly uncoopearive patient refused to take oral sedative medication.

How to Manage the Pediatric Nutritional Support Team: Updates

  • Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제15권2호
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    • pp.79-84
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    • 2012
  • Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.