ABSTRACT
INTRODUCTION: The use of minimal and moderate sedation in the pediatric population allows for the successful completion of many procedures in both hospital and outpatient settings without the risks involved with general anesthesia. Sanford Children's outpatient sedation clinic had been using oral midazolam for minimal sedation but began using inhaled nitrous oxide in January 2019. The current study examines patient experience and parent/guardian satisfaction with use of inhaled nitrous oxide for minimal sedation. DESIGN/METHODS: A survey was designed to evaluate parent/guardian satisfaction with nitrous oxide for pediatric sedation in various outpatient procedures. Parents'/ guardians' understanding of the sedation and procedural logistics were surveyed as well as their satisfaction with the child's comfort, recovery time, and overall satisfaction were assessed. RESULTS: Thirty-seven surveys completed by parents/guardians of patients ages 1-16 years were collected. Average age of the patient was 6 years old, with 22 female and 15 male patients. Outpatient procedures for which the nitrous oxide sedation was used included 30 botulinum toxin injections, 5 VCUG, 1 vaccine administration, and 1 IV placement. Mean survey results were 9.6 (95 percent CI, 9.3-9.9) for satisfaction of recovery time, 8.5 (95 percent CI, 7.7-9.3) for control of discomfort, and 9.1 (95 percent CI, 8.5-9.7) for overall satisfaction. CONCLUSIONS: When evaluating nitrous oxide as an agent for minimal sedation in pediatric procedures, parents/guardians were most satisfied with the recovery time and least satisfied with its ability to control discomfort. Overall, we concluded that nitrous oxide is a moderately good agent for pediatric patients receiving minimal sedation.
Subject(s)
Anesthetics, Inhalation , Nitrous Oxide , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Outpatients , Parents , Patient Outcome Assessment , Patient Satisfaction , Personal SatisfactionABSTRACT
Respiratory distress is a commonly encountered problem in newborn infants. Recognizing an infant with respiratory distress is not difficult, but determining the etiology and initiating proper management can be challenging. This review will focus on pulmonary causes of respiratory distress in the late preterm (34-366/7 weeks gestation) through late term (41-416/7 weeks gestation) infant with guidance for diagnosis and proper management of these infants. Many newborns with respiratory distress will require transfer to a higher level of care, but a select group may be safely managed at the delivery hospital.
Subject(s)
Respiratory Distress Syndrome, Newborn , Gestational Age , Humans , Infant , Infant, Newborn , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/therapyABSTRACT
Currently, 3-10 percent of pregnancies are complicated by abnormal glucose control, and the incidence of diabetes mellitus in the U.S. has risen with the obesity epidemic. Pregnancies affected by diabetes often result in abnormal fetal development, including altered growth and nutrient distribution as well as congenital malformations. Prenatal exposure to the diabetic environment places infants at risk for perinatal compromise, complications in the neonatal period, as well as long term metabolic and neurodevelopmental consequences. It is prudent for providers who care for these newborns to be cognizant of these potential complications in order to promptly and appropriately address them.
