Pediatric airway management in COVID-19 patients: consensus guidelines from the society for pediatric anesthesia's pediatric difficult intubation collaborative and the Canadian Pediatric Anesthesia Society.
Adolescent; Humans; Child; Preschool; Infant; Newborn; Guidelines as Topic; Pneumonia; Intubation; Infection Control; Infectious Disease Transmission; Consensus; Pandemics; Airway Management/ methods; Anesthesia/methods; Anesthesiology/ methods/standards; Coronavirus Infections/ therapy; Pediatrics/ methods/standards; Intratracheal/ methods/standards; Patient-to-Professional/prevention & control; Viral/ therapy
The severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) pandemic has challenged medical systems and clinicians globally to unforeseen levels. Rapid spread of COVID-19 has forced clinicians to care for patients with a highly contagious disease without evidence-based guidelines. Using a virtual modified nominal group technique, the Pediatric Difficult Intubation Collaborative (PeDI-C), which currently includes 35 hospitals from 6 countries, generated consensus guidelines on airway management in pediatric anesthesia based on expert opinion and early data about the disease. PeDI-C identified overarching goals during care, including minimizing aerosolized respiratory secretions, minimizing the number of clinicians in contact with a patient, and recognizing that undiagnosed asymptomatic patients may shed the virus and infect health care workers. Recommendations include administering anxiolytic medications, intravenous anesthetic inductions, tracheal intubation using video laryngoscopes and cuffed tracheal tubes, use of in-line suction catheters, and modifying workflow to recover patients from anesthesia in the operating room. Importantly, PeDI-C recommends that anesthesiologists consider using appropriate personal protective equipment when performing aerosol-generating medical procedures in asymptomatic children, in addition to known or suspected children with COVID-19. Airway procedures should be done in negative pressure rooms when available. Adequate time should be allowed for operating room cleaning and air filtration between surgical cases. Research using rigorous study designs is urgently needed to inform safe practices during the
Matava CT; Kovatsis PG; Lee JK; Castro P; Denning S; Yu J; Park R; Lockman JL; Von Ungern-Sternberg B; Sabato S; Lee LK; Ayad I; Mireles S; Lardner D; Whyte S; Szolnoki J; Jagannathan N; Thompson N; Stein ML; Dalesio N; Greenberg R; McCloskey J; Peyton J; Evans F; Haydar B; Reynolds P; Chiao F; Taicher B; Templeton T; Bhalla T; Raman VT; Garcia-Marcinkiewicz A; Gálvez J; Tan J; Rehman M; Crockett C; Olomu P; Szmuk P; Glover C; Matuszczak M; Galvez I; Hunyady A; Polaner D; Gooden C; Hsu G; Gumaney H; Pérez-Pradilla C; Kiss EE; Theroux MC; Lau J; Asaf S; Ingelmo P; Engelhardt T; Hervías M; Greenwood E; Javia L; Disma N; Yaster M; Fiadjoe JE
Anesthesia and Analgesia
2020
2020-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1213/ANE.0000000000004872" target="_blank" rel="noreferrer noopener">10.1213/ANE.0000000000004872</a>
The challenge of SARS: a clinical review.
Infection Control; Severe Acute Respiratory Syndrome – Diagnosis; Severe Acute Respiratory Syndrome – Epidemiology; Severe Acute Respiratory Syndrome – Radiography; Severe Acute Respiratory Syndrome – Symptoms
Severe acute respiratory syndrome (SARS) is a newly described emerging infection caused by a novel coronavirus, which can be highly contagious by close contact. Patients may present with an acute febrile illness that involves the lower respiratory tract. The most common complaints are fever and chills/rigors, but cough, myalgia, and rhinorrhea may also occur. Progressive disease is characterized by an acute respiratory distress syndrome, a need for ventilatory support, laboratory abnormalities (such as absolute lymphopenia), and a chest radiograph that shows progressive infiltrates. Diagnosis is confirmed when the SARS coronavirus is isolated, antibody to the virus is detected, or reverse transcriptase polymerase chain reaction (by appropriate criteria) is positive. No specific therapy is recommended; however, most patients have been treated with broad-spectrum antimicrobials, supplemental oxygen, intravenous fluids, and other supportive measures. Exposure prevention efforts should include a combination of standard, contact, and airborne precautions.
File T M Jr
Journal of Respiratory Diseases
2004
2004-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Evidence-Based Rationale.
Wound Healing; Debridement; Gels; Health Care Costs; Drug Interactions; Infection Control; Economic Aspects of Illness; Wound Care; Diabetes Mellitus – Complications; Diabetes Mellitus – Economics; Diabetic Foot – Diagnosis; Diabetic Foot – Drug Therapy; Diabetic Foot – Economics; Diabetic Foot – Epidemiology; Diabetic Foot – Mortality; Diabetic Foot – Therapy; Growth Substances – Administration and Dosage; Growth Substances – Adverse Effects; Growth Substances – Contraindications; Growth Substances – Pharmacodynamics; Growth Substances – Therapeutic Use
Mostow Eliot; Regulski Matthew
Wounds: A Compendium of Clinical Research & Practice
2014
2014-01-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Restricting Fluoroquinolone Use Reduces Clostridium difficile Infection More Than Infection Control Methods.
Infection Control; Treatment Outcomes; Clostridium Difficile; Antiinfective Agents; Clostridium Infections – Drug Therapy; Fluoroquinolone – Administration and Dosage; Fluoroquinolone – Adverse Effects; Fluoroquinolone – Pharmacodynamics
An observational study from England showed that restricting fluoroquinolone use reduced incidence of Clostridium difficile infection more than would be predicted by improved infection control methods alone.
Watkins Richard R
Infectious Disease Alert
2017
2017-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Impact of community-acquired methicillin-resistant Staphylococcus aureus in the hospital setting.
Humans; Hospitals; Community-Acquired Infections/epidemiology/microbiology/*prevention & control; Cross Infection/epidemiology/microbiology/*prevention & control; Infection Control; Methicillin Resistance/*genetics; Staphylococcal Infections/drug therapy/epidemiology/*prevention & control; Staphylococcus aureus/*drug effects/genetics; DNA; Bacterial
The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is undergoing a transformation as isolates of this historically health care-associated pathogen are reported with increasing frequency in otherwise healthy community-dwelling individuals. This article provides a brief review of the differences between health care-associated and community-acquired MRSA and discusses the potential impact of the changing epidemiology of MRSA on the hospital setting.
File Thomas M Jr
Cleveland Clinic journal of medicine
2007
2007-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3949/ccjm.74.suppl_4.s6" target="_blank" rel="noreferrer noopener">10.3949/ccjm.74.suppl_4.s6</a>
Severe acute respiratory syndrome: pertinent clinical characteristics and therapy.
Humans; Algorithms; Infection Control; *Severe Acute Respiratory Syndrome/*diagnosis/epidemiology/*therapy/transmission
Severe acute respiratory syndrome (SARS) is a newly emerged infection that is caused by a previously unrecognized virus - a novel coronavirus designated as
File Thomas M Jr; Tsang Kenneth W T
Treatments in respiratory medicine
2005
1905-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2165/00151829-200504020-00003" target="_blank" rel="noreferrer noopener">10.2165/00151829-200504020-00003</a>