Ask the expert: conscious sedation.

The case study illustrates safe use of conscious sedation and careful attention to prevention of complications as outlined in the AAP and ASA practice guidelines. Before implementation of a conscious sedation program, care providers need to have a clear idea of the goals of conscious sedation. These goals, as described by the American Academy of Pediatrics (1992) are: "1) to guard the patient's safety and welfare; 2) to minimize physical discomfort or pain; 3) to minimize negative psychologic responses to treatment by providing analgesia and to maximize the potential for amnesia; 4) to control behavior; and 5) to return the patient to a state in which safe discharge, as determined by recognized criteria, is possible" (p. 1,110). With careful attention to these goals, conscious sedation can be a valuable adjunct to pediatric care.

Separation of conjoined twins: a case study in critical care.

Conjoined twinning, one of the rarest and perhaps most fascinating congenital malformations in children, presents a major challenge to the healthcare team. This article describes a case study of the course of female omphalopagus twins. Favorable anatomy and the combined expertise of nurses, physicians, and supporting hospital staff during perinatal, neonatal, surgical, and postoperative care and management led to the successful separation of these conjoined twins.

Parent-to-parent links: building networks for parents of hospitalized children.

The experience of a pediatric clinical nurse specialist and clinical social worker with a hospital-based parent support group illustrates the dynamics of parent-to-parent support when the only apparent commonality shared is having a hospitalized child. The effectiveness of this approach is explored and evaluated with regard to planning family-centered care for the future.