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Relevant bibliographies by topics / Pediatric healthcare

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Academic literature on the topic 'Pediatric healthcare'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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Journal articles on the topic "Pediatric healthcare"

1

Maiga, G., and P. L. Mutuwa. "An Integrating Model of Knowledge Management for Improved Pediatric Healthcare Practice." Journal of Information & Knowledge Management 14, no. 02 (June 2015): 1550001. http://dx.doi.org/10.1142/s021964921550001x.

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Pediatric care practitioners are faced with increasing amounts of data that is not matched by an equivalent ability to manage and apply it for improved healthcare. Contributing to this are lack of tools and systems to aid in knowledge management. This paper presents the results of a study on a model that focusses on integrating the Knowledge management processes that contribute to improved pediatric care delivery in the context of Uganda. A field survey was conducted to empirically test the model of knowledge management in Pediatric Healthcare (PHC). The requirements were used to extend existing Knowledge management models in order to describe one suitable for pediatrics knowledge management and practice. The study identified technology, People, Storage and pediatrics knowledge integration as important requirements for successful implementation of Knowledge management in PHC practice. Regression analysis was done to show the relationships in the proposed mode and the results indicate its suitability for knowledge management in pediatric practice.

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Krepper, Rebecca, Anne Yong, and Evonne Cumming. "Pediatric Home Healthcare A Paradox." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 12, no. 4 (July 1994): 15–19. http://dx.doi.org/10.1097/00004045-199407000-00003.

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Rizzolo, Denise, and Jonathan Bowser. "Update on pediatric oral healthcare." Journal of the American Academy of Physician Assistants 29, no. 8 (August 2016): 52–53. http://dx.doi.org/10.1097/01.jaa.0000484312.96684.d7.

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Stern, Molly. "Perspectives of LGBTQ Youth and Pediatricians in the Primary Care Setting: A Systematic Review." Journal of Primary Care & Community Health 12 (January 2021): 215013272110443. http://dx.doi.org/10.1177/21501327211044357.

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Objectives: Conduct a systematic review designed to determine needs and experiences of LGBTQ adolescents in the pediatric primary care setting and to the ability of primary care practitioners to provide the most inclusive care to LGBTQ adolescents. Methods: PubMed, CINAHL, and Embase searches using the following keywords: LGBTQ, Adolescents, Pediatrics, Sexual-Minority, Gender-Identity, and primary care, to identify peer-reviewed publications from 1998 to 2017 that focused on stigma in the healthcare setting related to LGBTQ youth and the knowledge of healthcare providers on enhancing care for their sexual and gender minority patients. Article inclusion criteria include: primary research studies conducted in a pediatric primary care describing LGBTQ patients, pediatric patients as described by the American Academy of Pediatrics (AAP), and written in the English language. Articles were excluded if they used inaccurate definitions for LGBTQ identity, inappropriate patient ages outside of those defined by the AAP, and studies not in a pediatric primary care setting. Results: Four articles were identified for the review. Of the included articles, the majority of LGBTQ adolescents experience stigma in the healthcare setting. A limited number of physicians providing care to LGBTQ adolescents felt equipped to care for their sexual-minority patients due to lack of education and resources. Conclusions: The education of physicians should include a more detailed approach to providing care to the LGBTQ population, particularly to those training to become pediatricians. A standard guide to treating LGBTQ adolescents could eliminate stigma in the healthcare setting.

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Trotochaud, Karen, Joyce Ramsey Coleman, Nicolas Krawiecki, and Courtney McCracken. "Moral Distress in Pediatric Healthcare Providers." Journal of Pediatric Nursing 30, no. 6 (November 2015): 908–14. http://dx.doi.org/10.1016/j.pedn.2015.03.001.

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Madigan, Elizabeth A., JoAnne Youngblut, and Clara Haruzivishe. "Pediatric Home Healthcare: Patients and Providers." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 17, no. 11 (November 1999): 699–706. http://dx.doi.org/10.1097/00004045-199911000-00005.

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Stabouli, Stella, Lazaros Sideras, Georgia Vareta, Marianna Eustratiadou, Nikoleta Printza, John Dotis, Vasilios Kotsis, and Fotios Papachristou. "Hypertension screening during healthcare pediatric visits." Journal of Hypertension 33, no. 5 (May 2015): 1064–68. http://dx.doi.org/10.1097/hjh.0000000000000505.

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Branch, Carole, and Dean Klinkenberg. "Compassion Fatigue Among Pediatric Healthcare Providers." MCN, The American Journal of Maternal/Child Nursing 40, no. 3 (2015): 160–66. http://dx.doi.org/10.1097/nmc.0000000000000133.

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&NA;. "Compassion Fatigue Among Pediatric Healthcare Providers." MCN, The American Journal of Maternal/Child Nursing 40, no. 3 (2015): E13—E14. http://dx.doi.org/10.1097/nmc.0000000000000158.

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Podila, Pradeep S. B., Vikki Nolan, Anjelica Christina Saulsberry, Sheila Anderson, Jason R. Hodges, Jerlym Porter, and Jane S. Hankins. "Interruption in Care Continuity during Healthcare Transition from Pediatric to Adult Care Increases Acute Care Utilization." Blood 132, Supplement 1 (November 29, 2018): 2226. http://dx.doi.org/10.1182/blood-2018-99-115789.

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Abstract Background: Among youth with sickle cell disease (SCD), morbidity and mortality substantially increase following departure from pediatric care. Care continuity following transfer from pediatric to adult-centered care is paramount to ensure maintenance of health care delivery and reduce the risk of poor clinical outcomes. The American Academy of Pediatrics recommends matriculation in adult care within 6 months from leaving pediatric care for patients with special health care needs. Failure to transition from pediatric to adult care among youth with SCD may contribute to frequent disease complications and early death. No formal analysis has been conducted to quantify the risk of care interruption as youth transition from pediatric to adult care on the rate of acute health care utilization. We tested the hypothesis that patients who interrupted care for more than 6 months as they moved from the pediatric to the adult-centered care setting would have higher frequency of acute health care utilization. Methods: With IRB approval, we conducted a retrospective review of the rate of acute care utilization among patients with SCD who were transitioned from the pediatric sickle cell program at St. Jude Children's Research Hospital to the adult sickle cell program at Methodist University Hospital, Memphis TN between January 2014 and December 2017. We compared the rates of emergency department (ED) and inpatient utilization among those who established care >6 months from completing pediatric care (interrupted care continuity) and those who established adult care within 6 months from completing pediatric care (uninterrupted care continuity). We used person-time rates to compare the rates of emergency department and inpatient encounters per patient between the two care continuity groups. Results: Between January 2014 and December 2017 there were 172 patients with SCD who completed pediatric care and established adult care: 63 of them had a latency time from pediatric to adult care >6 months and 109 had a latency time from pediatric to adult care ≤6 months. Their follow-up since matriculation in adult care was 2245 and 2197 person-years for interrupted and uninterrupted care continuity groups, respectively The median (range) age upon establishing adult care was 20 (range, 20 to 24) years and 18 (range, 18 to 19) years for the interrupted and uninterrupted care continuity groups, respectively. Patients who interrupted care >6 months after leaving pediatric care had an incidence rate of 0.18 ED visits/person-year compared to 0.09 ED visits/person-year among those who completed the first visit within 6 months from leaving pediatric care (IRR 0.48, 95%CI 0.40-0.57, p<0.0001) (Figure panels A and B). Patients who interrupted care >6 months after leaving pediatric care had an incidence rate of 0.09 inpatient visits/person-year compared to 0.04 inpatient visits/person-year among those who completed the first visit within 6 months from leaving pediatric care (IRR 0.42 (95%CI 0.32-0.54, p<0.0001) (Figure panels C and D). Conclusions: The latency time from pediatric to adult care may impact the frequency of acute care utilization among youth with SCD. Patients who do not establish adult care within 6 months from leaving pediatric care, as recommended by the American Academy of Pediatrics, are at risk of experiencing greater ED and inpatient visits than those who establish care within 6 months from leaving pediatric care. Efforts to avoid care interruptions during the health care transition period are important to ensure optimal health outcomes among youth with SCD. Disclosures Hankins: NCQA: Consultancy; bluebird bio: Consultancy; Novartis: Research Funding; Global Blood Therapeutics: Research Funding.

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Dissertations / Theses on the topic "Pediatric healthcare"

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Gillespie, Gordon Lee II. "Violence Against Healthcare Workers in a Pediatric Emergency Department." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1212109392.

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Johnson, Kiana, Cuoghi Edens, Peter Chira, Aimee O. Hersh, Y. Ingrid Goh, Joyce Hui-Yuen, Rebecca E. Sadun, et al. "Differences in Healthcare Transition Views, Practices, and Barriers Among North American Pediatric Rheumatology Providers from 2010 to 2018." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7015.

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Background/Purpose: Healthcare transition is the “purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health care systems.” The American College of Physicians has partnered with national organizations, including the ACR, to develop guidelines and tools to promote a smooth transition to adult care. We aim to assess current transition practices and beliefs among North American pediatric rheumatology providers and to identify differences from a 2010 provider survey published by Chira et al. Methods: In April 2018, Childhood Arthritis and Rheumatology Research Alliance (CARRA) members received a 25-item online survey about healthcare transition. Got Transition’s Current Assessment of Health Care Transition Activities for Transitioning Youth to Adult Health Care Providers was used to measure clinical transition processes on a scale of 1 (basic) to 4 (comprehensive). Bivariate data analysis was used to compare 2010 and 2018 survey findings. Results: Over half of CARRA members completed the 2018 survey. Participants included pediatric rheumatologists (74%), adult- and pediatric-trained rheumatologists (4%), pediatric rheumatology fellows (18%), and other (4%), including emeritus faculty and mid-level providers. Most belonged to university-affiliated practices (87%) in the U.S. (91%). Providers aim to transfer patients at age 18 (23%) or 21 (33%), but the actual age of transfer is often 21 or older (56%). The most common target age to begin transition planning was 15-17 (49%). Few providers use the ACR transition tools (31%) or have a dedicated transition clinic (23%). Only 17% have a transition policy in place; 63% do not consistently address healthcare transition. Transition outcomes of interest included an adult rheumatology visit within 6 months of the last pediatric visit (80%), adherence to medications and plan of care (78%), continuous insurance coverage (78%), and patient-reported gaps in access to care (76%). When compared to the 2010 survey, improvement was noted in 3 of 12 transition barriers: availability of adult primary care providers, availability of adult rheumatologists, and transition knowledge and skills of pediatric staff (p<0.001). However, more providers cited the close bond among adolescents, parents and pediatric providers as a barrier (Figure 1). Conclusion: This survey of pediatric rheumatology providersdemonstrates some improvement in transition barriers since 2010, though most practices still maintain minimal support for patients and providers around healthcare transition. Further research is needed to understand how to effectively facilitate transition to adult care for young adults with childhood-onset rheumatic diseases.

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Sun, Pei-Chen Angela. "Paediatric pharmacovigilance : utility of routinely acquired healthcare data." Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=225729.

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Dutro, Anna R. "An Art-Light Mosaic Light Distraction for the Pediatric Healthcare Environment." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/73543.

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In his classic book, Experiencing Architecture, Rasmussen (1959) noted that architects inspired by addressing problems in built environments created buildings with a special spirit: a distinctive stamp. Recent problems in healthcare facilities, specifically those related to reducing stress and anxiety, have inspired designers to create positive, uplifting distractions to redirect a patient's attention from a sterile environment and/or noxious event. In doing so, healthcare facilities have become special environments with a caring spirit. This study examined a specific aspect of creating a caring environment: determining whether or not a positive distraction, a child's art-light mosaic movie developed by the researcher, would lower pain and distress in children 4, 5, and 6 years old during an immunization procedure. The researcher conducted a randomized controlled study in two locations using a child's self-report pain scale, heart rate, parent/guardian report, and nurse report measures. After collecting and analyzing data from 76 well-participants receiving one to five immunizations, the researcher found no statistically significant difference between the conditions for any of the measures. Thus, the null hypothesis, the art-light mosaic image would not assist in lowering pain and distress in pediatric patients, 4 to 6 years old, during an immunization procedure, was not rejected. From these results, the researcher recommended future studies incorporate training the parent and child on how to use the distraction, combine the distraction with a topical analgesic, provide a clear understanding of pain and distress from the child's point of view, and develop more sensitive self-report measures of pain for children.
Ph. D.

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Park, Jin Gyu. "Environmental color for pediatric patient room design." Thesis, [College Station, Tex. : Texas A&M University, 2007. http://hdl.handle.net/1969.1/ETD-TAMU-2420.

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Tong, Amanda Kai-Lai. "Brilliant Baby Brainiacs (BBB) - Pediatric Brain Tumors: Assessing Healthcare Provider Knowledge." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/593599.

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Background: Brain tumors are the most common solid tumors found in children. Current research is determining whether diagnosing brain tumors earlier will help improve prognosis and reduce long-term deficits; however, childhood brain tumors are often diagnosed late with a median time of 1-4 months from onset of symptoms. Prolonged symptom intervals before diagnosis have been associated with life-threatening risks, neuro-cognitive disabilities, and detrimental professional relationships between healthcare providers and families. Pediatric brain tumor clinical presentations are often non-specific and resemble less serious illnesses; therefore, healthcare providers are failing to include this in their differential diagnoses list. Purpose: To assess healthcare provider knowledge of signs and symptoms of pediatric brain tumors using The Brain Pathways Guideline. Methods: A one group pre-test and post-test e-mailed separately to nurse practitioners that have active membership in National Association of Pediatric Nurse Practitioners (NAPNAP) Arizona Chapter. Results: The Wilcoxon Signed Rank Test revealed that the matched test scores were not statistically significant (p=0.157) after viewing The Brain Pathways Guideline educational materials. Conclusion: The results of this study did not show a statistically significant difference in the test scores and therefore it cannot be concluded that presenting an evidence-based guideline to assist healthcare providers to assess and diagnose patients with brain tumors will be helpful to improve pre-diagnostic symptom intervals.

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Sacks, William Andrew. "Healthcare providers' experience of chronic grief in a pediatric subacute facility." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/2034.

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The purpose of this study was: (1) to evaluate the level of grief experienced by healthcare providers in a pediatric subacute facility, (2) to compare the levels of grief between different groups of healthcare providers (Certified Nurses' Aides, Licensed Nurses, and Respiratory Care Practitioners), and (3) to describe the personality/demographic factors that influence a healthcare provider's ability to cope effectively with compound grief.

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Merianos, Ashley L. "Healthcare Resource Utilization and Tobacco Smoke Exposure among Pediatric Emergency Department Patients." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1563272489318599.

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Meyer, Aja M. "Pediatric healthcare providers' screening practices : impact of training on early identification of autism." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001687.

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Vindrola, Padros Cecilia. "The Participation Of NGOs In Healthcare: The Case Of Pediatric Cancer Treatment In Argentina." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0002864.

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Books on the topic "Pediatric healthcare"

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Forman, Susan G., and Jeffrey D. Shahidullah, eds. Handbook of Pediatric Behavioral Healthcare. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-030-00791-1.

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Schwartz, David D., and Marni E. Axelrad. Healthcare Partnerships for Pediatric Adherence. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-13668-4.

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Alshryda, Sattar, Lisa Jackson, Nandu Thalange, and Ali AlHammadi, eds. Pediatric Orthopedics for Primary Healthcare. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-65214-2.

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Hallas, Donna, ed. Behavioral Pediatric Healthcare for Nurse Practitioners. New York, NY: Springer Publishing Company, 2018. http://dx.doi.org/10.1891/9780826116819.

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Linnard-Palmer, Luanne. When parents say no: Religious and cultural influences on pediatric healthcare treatment. Indianapolis, IN: Sigma Theta Tau International, 2006.

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Betz, Cecily L., and Imelda T. Coyne, eds. Transition from Pediatric to Adult Healthcare Services for Adolescents and Young Adults with Long-term Conditions. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-23384-6.

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Esamai, Fabian Omoding'. Child healthcare in the 21st century and beyond: The role of preventive interventions, clinical evidence, and research. Eldoret, Kenya: Moi University Press, 2007.

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Esamai, Fabian Omoding'. Child healthcare in the 21st century and beyond: The role of preventive interventions, clinical evidence, and research. Eldoret, Kenya: Moi University Press, 2007.

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Grant, Vincent J., and Adam Cheng, eds. Comprehensive Healthcare Simulation: Pediatrics. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-24187-6.

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Misra, Sanghamitra M., and Ana Maria Verissimo. A Guide to Integrative Pediatrics for the Healthcare Professional. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-06835-0.

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Book chapters on the topic "Pediatric healthcare"

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van der Jagt, Elise W., and S. Rhodes Proctor Short. "Healthcare-Associated Infections." In Pediatric Critical Care, 1105–43. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-53363-2_37.

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Schwartz, David D., and Marni E. Axelrad. "Healthcare Partnerships." In Healthcare Partnerships for Pediatric Adherence, 135–47. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-13668-4_11.

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Eckert, Diane, and Deborah Goebert. "Addressing Healthcare Disparities." In Pediatric Consultation-Liaison Psychiatry, 365–76. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-89488-1_20.

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Overly, Frank, Marleny Franco, and Linda L. Brown. "Pediatric Emergency Medicine." In Comprehensive Healthcare Simulation: Emergency Medicine, 197–204. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-57367-6_19.

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Everett, Tobias, John Zhong, and M. Dylan Bould. "Simulation for Pediatric Anesthesia." In Comprehensive Healthcare Simulation: Pediatrics, 265–76. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-24187-6_21.

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Calhoun, Aaron William, Aaron Donoghue, and Mark Adler. "Assessment in Pediatric Simulation." In Comprehensive Healthcare Simulation: Pediatrics, 77–92. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-24187-6_7.

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Power, Sarah, and Melinda Gronen. "Pediatric Healthcare Social Work Practice." In Social Work Practice in Healthcare: Advanced Approaches and Emerging Trends, 315–56. 2455 Teller Road, Thousand Oaks California 91320: SAGE Publications, Inc, 2016. http://dx.doi.org/10.4135/9781483398532.n13.

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Long, Lindsay, and Suzette Cooke. "Simulation for Pediatric Hospital Medicine." In Comprehensive Healthcare Simulation: Pediatrics, 211–17. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-24187-6_16.

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Grant, David J., Vincent J. Grant, and Adam Cheng. "The Future of Pediatric Simulation." In Comprehensive Healthcare Simulation: Pediatrics, 401–10. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-24187-6_31.

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Rappazzo, Christina A., and Catherine L. Turk. "Clinical Feeding-Swallowing Evaluation: Overview for the Healthcare Provider." In Pediatric Dysphagia, 49–65. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-97025-7_4.

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Conference papers on the topic "Pediatric healthcare"

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Vu, Tam. "Pediatric mobile healthcare." In SoICT '16: Seventh International Symposium on Information and Communication Technology. New York, NY, USA: ACM, 2016. http://dx.doi.org/10.1145/3011077.3011082.

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Deshmukh, Shantanu, and Natalia Khuri. "PediatricDB: Data Analytics Platform for Pediatric Healthcare." In 2018 Thirteenth International Conference on Digital Information Management (ICDIM). IEEE, 2018. http://dx.doi.org/10.1109/icdim.2018.8847072.

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House, Samantha A., Eric Coon, Alan Schroeder, and Shawn Ralston. "The Quality of Pediatric Healthcare: What Are We Measuring?" In Selection of Abstracts From NCE 2016. American Academy of Pediatrics, 2018. http://dx.doi.org/10.1542/peds.141.1_meetingabstract.440.

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Dukes, Lauren Cairco, Nancy Meehan, and Larry F. Hodges. "Usability Evaluation of a Pediatric Virtual Patient Creation Tool." In 2016 IEEE International Conference on Healthcare Informatics (ICHI). IEEE, 2016. http://dx.doi.org/10.1109/ichi.2016.20.

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Dukes, Lauren Cairco, Nancy Meehan, and Larry F. Hodges. "Participatory Design of a Pediatric Virtual Patient Creation Tool." In 2016 IEEE International Conference on Healthcare Informatics (ICHI). IEEE, 2016. http://dx.doi.org/10.1109/ichi.2016.84.

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Shi, Jia, Xiaoliang Fan, Jinzhun Wu, Jian Chen, and Wenbo Chen. "DeepDiagnosis: DNN-Based Diagnosis Prediction from Pediatric Big Healthcare Data." In 2018 Sixth International Conference on Advanced Cloud and Big Data (CBD). IEEE, 2018. http://dx.doi.org/10.1109/cbd.2018.00058.

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Pulcini, Christian D., Monika K. Goyal, Matt Hall, Joel Fein, Sofia S. Chaudhary, Heidi Gruhler, Elizabeth Alpern, and Eric W. Fleegler. "Firearm Injuries: Pediatric long-term health outcomes and healthcare expenditures." In AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.98-a.

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Tsvyatkova, Damyanka, and Cristiano Storni. "Investigating issues related to pediatric diabetes education: problems and barriers." In 8th International Conference on Pervasive Computing Technologies for Healthcare. ICST, 2014. http://dx.doi.org/10.4108/icst.pervasivehealth.2014.254935.

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Virgolin, Marco, Ziyuan Wang, Tanja Alderliesten, and Peter A. N. Bosman. "Machine learning for automatic construction of pediatric abdominal phantoms for radiation dose reconstruction." In Imaging Informatics for Healthcare, Research, and Applications, edited by Thomas M. Deserno and Po-Hao Chen. SPIE, 2020. http://dx.doi.org/10.1117/12.2548969.

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Nonoyama, Mika, Sherri Katz, Reshma Amin, Douglas Mckim, Denise Guerriere, Peter Coyte, Marina Wasilewski, Brandon Zagorski, and Louise Rose. "Healthcare utilization and costs of pediatric home mechanical ventilation in Canada." In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa1043.

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Reports on the topic "Pediatric healthcare"

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Inscore, Stephen C. BAMC-DACH Pediatric Sub-Specialty Telemedicine Healthcare Program. Fort Belvoir, VA: Defense Technical Information Center, October 2001. http://dx.doi.org/10.21236/ada396469.

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Inscore, Stephen. BAMC-DACH Pediatric Sub-Specialty Telemedicine Healthcare Program. Fort Belvoir, VA: Defense Technical Information Center, May 2000. http://dx.doi.org/10.21236/ada392709.

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Carney, Nancy, Tamara Cheney, Annette M. Totten, Rebecca Jungbauer, Matthew R. Neth, Chandler Weeks, Cynthia Davis-O'Reilly, et al. Prehospital Airway Management: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccer243.

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Objective. To assess the comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) by emergency medical services in the prehospital setting, and how the benefits and harms differ based on patient characteristics, techniques, and devices. Data sources. We searched electronic citation databases (Ovid® MEDLINE®, CINAHL®, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus®) from 1990 to September 2020 and reference lists, and posted a Federal Register notice request for data. Review methods. Review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center Program methods guidance. Using pre-established criteria, studies were selected and dual reviewed, data were abstracted, and studies were evaluated for risk of bias. Meta-analyses using profile-likelihood random effects models were conducted when data were available from studies reporting on similar outcomes, with analyses stratified by study design, emergency type, and age. We qualitatively synthesized results when meta-analysis was not indicated. Strength of evidence (SOE) was assessed for primary outcomes (survival, neurological function, return of spontaneous circulation [ROSC], and successful advanced airway insertion [for SGA and ETI only]). Results. We included 99 studies (22 randomized controlled trials and 77 observational studies) involving 630,397 patients. Overall, we found few differences in primary outcomes when airway management approaches were compared. • For survival, there was moderate SOE for findings of no difference for BVM versus ETI in adult and mixed-age cardiac arrest patients. There was low SOE for no difference in these patients for BVM versus SGA and SGA versus ETI. There was low SOE for all three comparisons in pediatric cardiac arrest patients, and low SOE in adult trauma patients when BVM was compared with ETI. • For neurological function, there was moderate SOE for no difference for BVM compared with ETI in adults with cardiac arrest. There was low SOE for no difference in pediatric cardiac arrest for BVM versus ETI and SGA versus ETI. In adults with cardiac arrest, neurological function was better for BVM and ETI compared with SGA (both low SOE). • ROSC was applicable only in cardiac arrest. For adults, there was low SOE that ROSC was more frequent with SGA compared with ETI, and no difference for BVM versus SGA or BVM versus ETI. In pediatric patients there was low SOE of no difference for BVM versus ETI and SGA versus ETI. • For successful advanced airway insertion, low SOE supported better first-pass success with SGA in adult and pediatric cardiac arrest patients and adult patients in studies that mixed emergency types. Low SOE also supported no difference for first-pass success in adult medical patients. For overall success, there was moderate SOE of no difference for adults with cardiac arrest, medical, and mixed emergency types. • While harms were not always measured or reported, moderate SOE supported all available findings. There were no differences in harms for BVM versus SGA or ETI. When SGA was compared with ETI, there were no differences for aspiration, oral/airway trauma, and regurgitation; SGA was better for multiple insertion attempts; and ETI was better for inadequate ventilation. Conclusions. The most common findings, across emergency types and age groups, were of no differences in primary outcomes when prehospital airway management approaches were compared. As most of the included studies were observational, these findings may reflect study design and methodological limitations. Due to the dynamic nature of the prehospital environment, the results are susceptible to indication and survival biases as well as confounding; however, the current evidence does not favor more invasive airway approaches. No conclusion was supported by high SOE for any comparison and patient group. This supports the need for high-quality randomized controlled trials designed to account for the variability and dynamic nature of prehospital airway management to advance and inform clinical practice as well as emergency medical services education and policy, and to improve patient-centered outcomes.

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