Articles: pediatrics.
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Comparative Study
Differences in the use of emergency room and hospitalization in relation to primary care pediatric services.
Two pediatric primary care services in Ofakim, Israel, were compared with respect to their use of hospital emergency room facilities and hospitalizations. The services compared were a community-based university pediatric clinic in which preventive and curative care were merged and a traditional service in which preventive and curative care were provided by different agencies. ⋯ The proportion of children who were admitted to hospital, among those referred to the emergency room, was much higher for the university clinic. Consistent differences were not found in the number of hospital admissions/1,000 children in the population, nor in the mean duration of stay of hospitalized children.
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Centralized treatment of critically ill pediatric patients and related problems are presented. Pediatric intensive care allows to overbridge deranged or interrupted organ functions while simultaneously treating the disease causing the disturbance. Its efficiency depends on continuity of medical care. ⋯ Some special aspects such as staffing, transportation of high-risk neonates, economy of operation and personal training programm are discussed. Results of pediatric intensive care at the University Children's Hospital Heidelberg are documented. Regionalisation of neonatal care is discussed based on the actuell situation in Baden-Württemberg.
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Out-patient surgery for infants and children offers the advantages of minimal emotional upset, less risk of infection, and fiscal economy. Many different operations can be done in the out-patient department and most children can be accepted for general anaesthesia for these operations. Preparation of the child is similar to that required for in-patient surgery. ⋯ Careful tracheal intubation should be utilized whenever indicated. Regional analgesia has many advantages over narcotic analgesics in the treatment of post-operative pain. A follow-up service should be provided.