ABSTRACT
Pediatric intensivists often use an "analgosedation" approach in mechanically ventilated children. By prioritizing analgesia and minimizing sedation, patients experience less delirium. However, when COVID-19 surged, our pediatric intensive care unit providers were tasked with caring for adults with severe acute hypoxemic respiratory failure (AHRF). As documented in the literature, adults with COVID-19-AHRF received significantly higher doses of sedatives than matched cohorts with non-COVID-19 AHRF. Surprisingly, when the pediatric intensive care unit returned to caring for children, a quality review showed that we were unintentionally using far more sedatives than that prior to COVID-19. This experience is not unique to our institution, or to COVID-19. Lingering effects of crisis care can persist beyond the event itself. We seek to share our experience in order to extend the conversation regarding the unexpected effects of crises on best practices and to stress the need for high-quality research on interventions to support mental health and resilience in frontline healthcare providers.
Subject(s)
Asthma, Exercise-Induced/epidemiology , Adolescent , Adrenal Cortex Hormones/administration & dosage , Adult , Asthma, Exercise-Induced/diagnosis , Asthma, Exercise-Induced/drug therapy , Asthma, Exercise-Induced/physiopathology , Child , Cross-Over Studies , Double-Blind Method , Exercise Test , Female , Forced Expiratory Volume , Humans , Male , Middle Aged , Prevalence , Young AdultABSTRACT
Because of geographic distances, many youth transplant recipients do not have the opportunity to meet and form relationships with peers who have undergone similar experiences. This article explores the role of E-mentorship in virtual environments. Most specifically, by analyzing data from a study conducted with the Zora virtual world with pediatric transplant recipients, suggestions and recommendations are given for conceiving the role of virtual mentors and allocating the needed resources. Zora is a graphical virtual world designed to create a community that offers psychoeducational support and the possibility of participating in virtual activities following a curriculum explicitly designed to address issues of school transition and medical adherence. Activities are designed to foster relationships, teach technological skills, and facilitate the formation of a support network of peers and mentors.This article addresses the research question, "What makes a successful E-mentorship model in virtual worlds for children with serious illnesses?" by looking at E-mentoring patterns such as time spent online, chat analysis, initiation of conversation, initiation of activities, and out-of-world contact.
