Rarely, there is anxiety or distress on awakening from ketamine sedation, which settles spontaneously. A pleasant emergence phenomenon is common, but is not distressing for the child, and has no long-term (up to 30 days) negative sequelae. The belief that ketamine, in the doses used for ED PPS, causes frequent emergence delirium is flawed. There was no evidence of an increased rate of nightmares on telephone follow up in the weeks post procedure. None required any active treatment and all except one settled within 20 min. Of all, 93 (12.5%) children cried on awakening when recovering from PPS, 291 (39%) experienced pleasant altered perceptions and 16 (2.1%) experienced what was called 'emergence delirium'. Standard inclusion and exclusion criteria for the use of ketamine were followed.Ī total of 745 prospective data collection records were available for analysis over the 5 year period. Prospective data relating to any emergence agitation, crying, hallucinations, dreams, altered perceptions, delirium and necessary interventions were recorded in consecutive cases of ketamine PPS from March 2002 to June 2007, and analysed. The present study set out to determine the true incidence and nature of this phenomenon. Some emergency physicians do not use ketamine for paediatric procedural sedation (PPS) because of concern about emergence delirium on recovery.
and a great selection of similar New, Used and Collectible Books available now at great prices. The net results are a new perspective on what is really important in organizational life, original insights on familiar experiences, and some clear signposts for the next generation of nonlinear social scientists.Ketamine has become the drug most favoured by emergency physicians for sedation of children in the ED. Up to 55 of patients who are administered ketamine experience an emergence phenomena (EP) that closely mimics schizophrenia and increases their risk of injury however, to date, no studies have investigated genetic association of ketamine-induced EP in healthy patients. : Managing Emergent Phenomena: Nonlinear Dynamics in Work Organizations (9780805831634) by Guastello, Stephen J.
Unusual concepts are also encountered, such as the organizational unconscious, collective intelligence, and the revolt of the slaved variables. Applications include: work motivation, personnel selection and turnover, creative thinking by individuals and groups, the development of social networks, coordination in work groups, the emergence of leaders, work performance in organizational hierarchies, economic problems that are relevant to organizations, techniques for predicting the future, and emergency management.Įach application begins with a tight summary of standard thinking on a subject, followed by the new insights that are afforded by nonlinear dynamics and the empirical data supporting those ideas. The dynamics concepts are then explained along with the most recent research methods for analyzing real data. Managing Emergent Phenomena begins by describing how the concept of an organization has changed from a bureaucracy, to a humanistic and organic system, to a complex adaptive system. Chaos, catastrophe, self-organization, and complexity theories (nonlinear dynamics) now have practical and measurable roles in the functioning of work organizations.
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