41 A Survey of Regional Paediatricians' CT/MRI Sedation Practices: Are we Following Published Guidelines?
Notice bibliographique
Résumé
Paediatric CT and MRI imaging procedures often require sedation in order to increase patient comfort and quality of the study. To improve sedation outcomes and prevent complications, the American Academy of Pediatrics (AAP) and the American Society of Anesthesiologists (ASA) Committee on Drugs have issued guidelines for monitoring and managing paediatric patients during and after sedation. Evidence has shown that the application of these guidelines leads to a reduction in adverse outcomes. Currently, no Canadian guidelines are available. Therefore, many centres have developed their own protocols for pediatric sedation for imaging procedures. However, little is known about the pediatric sedation practices in smaller regional centers as CT and MRI are becoming increasingly available. Canadian physicians may not be aware of the published American guidelines. We performed a survey of paediatricians practicing in regional centres located outside a 50 km radius from any of the 5 Ontario Medical Schools. The survey consisted of an 18-item questionnaire. This study was designed to assess adherence to AAP/ASA guidelines, the agents that paediatricians commonly use for paediatric sedation, their comfort level with these agents, and their desire for additional information. Seventy-three surveys were faxed to paediatricians and 46 responses were received, resulting a response rate of 63%. Of the physicians who responded, 72% reported providing conscious sedation. Although most physicians followed some of the AAP/ASA guidelines, only 12% followed all seven of the guidelines we tested. Specifically, 82% maintained patients NPO, 82% documented a pertinent medical history, 73% recorded vital signs, 64% documented consent, 21% documented the child's ASA status and no patients were left unsupervised during or after the procedure. The two most commonly used agents for sedating paediatric patients were chloral hydrate (91%) and midazolam (58%). These were the two agents that physicians were most comfortable using with comfort levels of 6.5 and 6.2 respectively on a 7-point Likert scale. While pentobarbital was the next most commonly used sedative (33%), it only rated a comfort level of 4.7. Most physicians reported a need for additional information regarding paediatric conscious sedation (18% strongly agree, 46% agree). The preferred mode for relaying this information was professional guidelines (4.6 on a 5-point Likert scale). The results of this study suggest that a set of national guidelines for conscious sedation or greater dissemination of the existing AAP/ASA guidelines may improve future outcomes for Canadian children undergoing diagnostic imaging.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».