Articles: pediatrics.
-
Pediatr Crit Care Me · Sep 2018
Predictive Factors for Central Line-Associated Bloodstream Infections in Pediatric Cardiac Surgery Patients With Chylothorax.
To assess the prevalence of central line-associated bloodstream infections in pediatric patients with and without chylothorax after cardiac surgery and identify risk factors that predict those patients at highest risk for developing a central line-associated bloodstream infection. ⋯ The prevalence of central line-associated bloodstream infection is higher in pediatric patients with chylothorax after heart surgery. In patients with chylothorax, complexity of surgery, central venous catheter duration, and chest tube output are associated with increased risk for developing a central line-associated bloodstream infection. Using this knowledge will allow us to identify patients at increased risk for central line-associated bloodstream infections and to focus extra prevention efforts on them.
-
The purpose of this study is to determine if stable, well-appearing, drowning patients who have normal age-adjusted vital signs and pulse oximetry upon arrival to the emergency department may be safely discharged without a prolonged observation period. ⋯ The overall complication rate in initially stable, well-appearing drowning patients is low. An abnormal pulse oximetry reading at presentation may help predict subsequent complications. Those patients with normal age-adjusted vital signs and physical exam at presentation may not require a prolonged observation period.
-
Observational Study
Cephalic region war injuries in children: Experience in French NATO hospital in Kabul Afghanistan.
The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. ⋯ The cephalic lesions were the second most common region in children during our experience in Afghanistan. Lack of protection (helmet) in children may explain the frequency of cephalic wounds.
-
Previous studies have evaluated prehospital analgesia during combat operations in Iraq and Afghanistan, but were limited to the adult population. However, a significant portion of the casualties of those conflicts were children. We describe the prehospital analgesia administered to wartime pediatric trauma patients. ⋯ Overall, a low proportion of pediatric trauma subjects within this population received analgesia in the prehospital environment. The most common analgesic medication administered was morphine. Those receiving analgesic agents had more severe injuries and higher rates of concomitant interventions. These results highlight the potential need for Tactical Combat Casualty Care guidelines specifically providing recommendations for analgesia administration among pediatric patients.
-
Academic pediatrics · Sep 2018
Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience.
To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in an outpatient primary care practice with or without residents. ⋯ Pediatric resident LOE clinics had a greater average number of patient visits and revenue per faculty member but higher costs and lower operating margins than faculty clinics.