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Background: Recognition and management of pediatric dysrhythmias is challenging for community emergency department (CED) providers, given their infrequent exposure to these cases. Method: A prospective, interventional study measured adherence of CEDs to pediatric supraventricular tachycardia (SVT) algorithm pre- and postimplementation of an in situ simulation-based collaborative program. CED teams' adherence was scored using a composite adherence score (CAS) based on the number of actions scored correctly on the performance checklist. Results: A total of 74 multiprofessional teams from nine CEDs participated in simulated sessions. Of 367 participants, 12.3% were physicians, 62.1% were RNs, and 25.6% were other providers. The mean CAS improved from 57% to 71%. The ability to identify an SVT rhythm, stable versus unstable SVT, and the correct performance of synchronized cardioversion significantly improved. Conclusion: This study demonstrated improvement in overall adherence of CEDs to pediatric SVT algorithm following a collaborative program in simulated setting. This approach could be adapted to improve the quality of care provided to children. This study demonstrated improvement in overall adherence of CEDs to pediatric SVT algorithm following a collaborative program in simulated setting. This approach could be adapted to improve the quality of care provided to children. [[J Contin Educ Nurs. 2019;50(9):404–410.] [ABSTRACT FROM AUTHOR]

We describe two pediatric patients with Duchenne muscular dystrophy that presented with acute neurologic deterioration and hypoxic respiratory failure requiring mechanical ventilation. These cases fulfill the clinical criteria for Fat Embolism Syndrome. Early recognition and aggressive supportive therapy with mechanical ventilation, right ventricular afterload reduction, and blood transfusion led to survival without any residual effects from the event. Fat Embolism Syndrome needs to be considered early in the course of patients with Duchenne muscular dystrophy who present with respiratory and neurological symptoms. [ABSTRACT FROM AUTHOR]

We report the case of a neonate born with a giant fibroma occupying the entirety of her left ventricle. Owing to the extensive resection, her postoperative course was complicated by severely diminished left ventricular function and complete heart block necessitating extracorporeal support. Ultimately, cardiac resynchronization therapy was used, after which the infant’s ventricular function gradually improved and she was successfully discharged to home. [ABSTRACT FROM AUTHOR]