RESUMO
Phase I caregiver visitation practice has been endorsed and encouraged by the American Society of PeriAnesthesia Nurses, yet implementation has not been widespread. Literature has described benefits of visitation for patients and their caregivers. This article reports on a Phase I caregiver visitation program at a specialty care hospital. The steps of implementation and guidelines for both the health care team and the patient's caregivers are outlined. Visitation is recognized as promoting patient safety during Phase I recovery. A discussion of additional benefits and obstacles is addressed.
Assuntos
Cuidadores , Política Organizacional , Sala de Recuperação , Visitas a Pacientes , Família , Hospitais Pediátricos/organização & administração , Humanos , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Equipe de Assistência ao Paciente , Assistência PerioperatóriaRESUMO
Ultrasound guided fascia iliaca compartment block (FICB) has not been previously described in pediatric patients. Reported here is an ultrasound guided long axis, in-plane needle technique used to perform FICB in three pediatric patients undergoing hip or femur surgery. Postoperative assessment revealed nerve blockade of the lateral femoral cutaneous, femoral, and obturator nerves or no requirement for narcotics in the PACU. FICB using this ultrasound guided technique was easy to perform and provided postoperative analgesia for hip and femur surgical procedures within the presumed distribution of the lateral femoral cutaneous, femoral, and obturator nerves.
Assuntos
Fáscia/diagnóstico por imagem , Bloqueio Nervoso/instrumentação , Ultrassonografia de Intervenção/métodos , Adolescente , Amidas/administração & dosagem , Anestésicos Locais/administração & dosagem , Criança , Fáscia/efeitos dos fármacos , Fêmur/cirurgia , Articulação do Quadril/cirurgia , Humanos , Agulhas , Bloqueio Nervoso/métodos , RopivacainaAssuntos
Artérias Carótidas/diagnóstico por imagem , Lesões das Artérias Carótidas/prevenção & controle , Cateterismo Venoso Central/métodos , Veias Jugulares/diagnóstico por imagem , Ultrassonografia de Intervenção , Lesões das Artérias Carótidas/etiologia , Cateterismo Venoso Central/efeitos adversos , HumanosRESUMO
This article describes the use and effectiveness of adjuvant propofol for pain control for pediatric oncology patients at the end of life. All patients experienced severe pain and agitation, not well controlled by continuous infusion opioids and benzodiazepines. Upon starting propofol, most patients had a temporary stabilization in the dose of opioids with subjective improvement in pain control, increased alertness, and improved ability to interact. Propofol infusions were continued until death in most patients. Two patients received propofol infusions at home. Subsequent increases in opioids in 6 patients and propofol in all patients were required for optimal pain control. Adverse effects included agitation in 5 patients and hallucinations in 2, which were controllable with benzodiazepines. One patient developed severe tetany, requiring propofol interruption; propofol was successfully restarted at a lower dose with an adjuvant benzodiazepine. The authors conclude that propofol is a useful and tolerable adjuvant agent for pain management in pediatric oncology patients at the end of life. It is a useful adjuvant if pain is unresponsive to continuous infusion opioids or if rapidly escalating doses of opioids are required.