Recent discussions
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Виктория Антонова
We have T-fans available in the delivery rooms, and when they have respiratory discomfort and, although they sometimes need surfactant, the clinical evolution is better, that is, more favorable for these babies. Unfortunately we know that it is not the reality of most newborns in our country. -
Виктория Антонова
In a DEVELOPING country like Brazil, larger than the continental US, with a population close to 210 million inhabitants and a very heterogeneous health care resources, the self-inflating bag, used correctly, remains a better choice to Neonatal Resuscitation in most of delivery rooms. Certainly, the T-piece resuscitator is the best choice for developed areas, with well trained personel and adequate gas flow supply -
Виктория Антонова
In the services I work on, we have T-fans available in the delivery rooms, thus improving the reception of premature infants who have respiratory discomfort and, although they sometimes need surfactant, the clinical evolution is better, that is, more favorable for these babies. Unfortunately we know that it is not the reality of most newborns in our country. -
Виктория Антонова
Would appreciate if you consider use of improvised tourniquets (TQs) in this study or future study and also about the width of TQs. -
Виктория Антонова
There is no evidence that any of the current designs available for children is problematic or has resulted clinically in inadequate bleeding control. Since research bandwidth is necessarily limited, the question of the efficacy of one tourniquet design relative to another does not seem to rise to the level of warranting research funding investment. Studies outlining the scope of the clinical problem to be solved or demonstrating evidence of any clinical failure of existing treatment methodologies should precede any further investment in studies addressing the comparative effectiveness of one commercial brand of tourniquet or one commercial tourniquet design over another. -
Виктория Антонова
Consider adding in the pediatric trauma society position statement on this topic https://pubmed.ncbi.nlm.nih.gov/29462083/ Also consider statement about training in application and availability -
John Mouw
A review of technique should be considered when providing prone CPR. For example, the two-handed technique in which the performer places two hands together at the midline at the T7- T10 level, or placing a hand at either side of the thoracic spine at the same level, and the over the head (OTH) technique. -
Виктория Антонова
Although with short number of patients, It is important to recommend that for patients with cardiac arrest occurring while in the prone position without an advanced airway already in place, the patient should be turned to supine as quickly as possible and beginning CPR. It is probably safer. -
Виктория Антонова
Consider a broader recommendation than "There is an urgent need for comparative RCTs in the prehospital setting to determine which tourniquet designs produce beneficial outcomes in the pediatric population", such as an RCT of applying tourniquet designs and measuring time to pulselessness distal to the tourniquet. -
Виктория Антонова
I appreciate the intentionality of the researchers involved to address this glaring question that has largely been unaddressed. The research questions they seek answers to as well as the willingness to update their search four times in the process of analyzing while preparing the recommendations highlights there awareness of the newness and potential implications of these research questions. Based on the data provided, it appears that each of the recommendations is consistent with and directly tied to the outcomes as demonstrated. Thank you for your effort.