Search

Perioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long‐term postoperative complications. This concise review outlines key research and clinically‐relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted. A literature review identified 11 articles with the following inclusion criteria: patients less than or equal to 18 years, perioperative anxiety or distress, and original studies with reliability or validity data. Although robust research‐based assessment tools to measure anxiety have been developed, such as the Modified Yale Preoperative Anxiety Scale, they are too complex and time‐consuming to complete by clinicians also providing anesthesia. Clinically‐based anxiety measurement scales tend to be easier to use, however they require further testing before widespread standard utilization. The HRAD ± scale (Happy, Relaxed, Anxious, Distressed, with a yes/no answer to cooperation) may be a promising observational anxiety scale that is efficient and includes an assessment of compliance. Further studies are needed to refine a clinically‐relevant anxiety assessment tool and appraise interventions that reduce perioperative distress. [ABSTRACT FROM AUTHOR]

Background: Vascular access is a minor procedure that is associated with reported pain and fear in pediatric patients, often resulting in procedural incompliance. Virtual reality has been shown to be effective in adult populations for reducing pain and anxiety in various medical settings, although large studies are lacking in pediatrics. Aims: The primary aim was to determine whether pain would be reduced in pediatric patients using virtual reality undergoing vascular access. The four secondary aims measured patient fear, procedural compliance, satisfaction, and adverse events. Methods: A prospective, randomized, controlled trial was completed at a pediatric hospital, enrolling children 7‐18 years old undergoing vascular access in a variety of clinical settings, randomized to virtual reality or standard of care. Pain scores were measured using a numeric pain faces scale. The secondary outcomes of patient fear, procedural compliance, satisfaction, and adverse events were measured with the Child Fear Scale, modified Induction Compliance Checklist, and satisfaction surveys, respectively. Chi‐squared, t tests, and regression models were used to analyze the results. Results: The analysis included 106 patients in the virtual reality group and 114 in the control. There were no significant differences in postprocedure pain (VR group estimated 0.11 points lower, 95% confidence interval: 0.50 points lower to 0.28 points greater, P =.59), postprocedure fear (VR group estimated 0.05 points lower, 95% confidence interval: 0.23 points lower to 0.13 points greater), or compliance (adjusted odds ratio 2.31, 95% confidence interval: 0.96‐5.56). Children in the virtual reality group were satisfied with the intervention. There were no adverse events. Conclusion: This study demonstrates no reduction in pain while using Virtual reality (VR) across a heterogeneous pediatric inpatient population undergoing vascular access. [ABSTRACT FROM AUTHOR]

The description of our fellowship DEI course sequence may serve as a template for other fellowships seeking to establish a formal course sequence within their own fellowship curriculum. Curriculum, diversity, education, equity, fellowship, inclusion Keywords: curriculum; diversity; education; equity; fellowship; inclusion EN curriculum diversity education equity fellowship inclusion 487 488 2 02/16/22 20220301 NES 220301 DATA AVAILABILITY STATEMENT Data sharing is not applicable to this article as no new data were created or analyzed in this study. [Extracted from the article]

The article discusses the measurement of cuff pressure after placement of an endotracheal tube (ETT) is standard practice for most pediatric anesthesiologists and low cuff pressures increase the risk of aspiration and ventilator-associated pneumonia. It mentions complications from under or over-pressurizing ETT cuffs and manometer that is applied to the pilot balloon to measure the ETT cuff pressure. It also offers information on Cufflator cuff pressure manometers from Posey.