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What’s inside the box? Or shall we think outside the box?

With the deadly and highly transmissible SARS-CoV-2 virus causing the COVID-19 pandemic, there is global concern about the danger of contaminating healthcare workers (HCW), particularly during airway management of infected patients.

Preoperative identification of children at high risk of obstructive sleep apnea

Obstructive sleep apnea poses as an anesthetic challenge, and it is a well-known risk factor for perioperative adverse events

The impact of social determinants of health on paediatric perioperative adverse events - a narrative review

The social determinants of health, as described by the World Health Organisation (WHO), are 'the non-medical factors' that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. According to the WHO, social determinants of health account for between 30-55% of health outcomes, and children can be particularly vulnerable to their impacts. 

Pre-surgery fasting tablet helping to keep kids comfortable

The Perioperative Medicine team has developed a unique chewable tablet that gives the child the sensation of having a full stomach, without compromising their fasting regime.

Improving Outcome Reporting in Paediatric Airway Management in Clinical Trials (IMPACT): A Study Protocol for Core Outcomes and Clinical Endpoints

Although clinical trials are fundamental to advancing evidence-based practice, significant heterogeneity in outcome reporting poses a considerable challenge to the validity of systematic reviews. This inconsistency impedes the ability to compare, synthesise and interpret research findings effectively. In the field of paediatric airway management, this issue is particularly relevant because of the low incidence of critical events and the related high morbidity and mortality. The issue of inadequate and variable outcome reporting in clinical trials has been widely acknowledged, necessitating initiatives to enhance the quality of future research.

Numerical simulation of aerosolised medicine delivery through tracheostomy airways

The administration of inhaled antibiotics to patients with upper or lower respiratory infections is sometimes conducted via a tracheostomy airway. However, precise dosing via this route remains uncertain, especially in spontaneously breathing paediatric patients. 

Association of preoperative nocturnal hypoxaemia nadir and fentanyl ventilatory sensitivity in children with obstructive sleep apnoea undergoing general anaesthesia

Obstructive sleep apnoea (OSA) has been thought to increase the risk of respiratory depression from opioids. The primary aim of this study was to assess whether preoperative hypoxaemia by sleep study pulse oximetry imparts greater opioid sensitivity.

Patient-related factors impact the implementation of inpatient antibiotic allergy delabeling

The clinical consequences of an antibiotic allergy label are detrimental, impacting health care delivery and patient outcomes. We assessed hospital inpatients with intent to offer free antibiotic allergy labeling assessment within a randomized controlled trial. We sought to determine the feasibility of establishing an adult antibiotic allergy delabeling service in a Western Australian tertiary public hospital.  

Jet versus vibrating mesh nebulizer for tobramycin aerosol in spontaneously breathing children with tracheostomies: A simulation study

Tracheostomy tubes act as foreign bodies, predisposing the surrounding airway to respiratory infections. Initial treatment for infections is topical - nebulized tobramycin - although guidelines for standardized treatment are lacking.

Quantitative electroencephalogram and machine learning to predict expired sevoflurane concentration in infants

Processed electroencephalography (EEG) indices used to guide anesthetic dosing in adults are not validated in young infants. Raw EEG can be processed mathematically, yielding quantitative EEG parameters (qEEG). We hypothesized that machine learning combined with qEEG can accurately classify expired sevoflurane concentrations in young infants. Knowledge from this may contribute to development of future infant-specific EEG algorithms.