Inpatient Capacity Management during COVID-19 Pandemic: The Yale New Haven Hospital Capacity Expansion Experience

2021 ◽  
pp. 1-8
Author(s):  
Robert L. Fogerty ◽  
Michael Aniskiewicz ◽  
Todd Hedges ◽  
Sean Ryan ◽  
Piper Brien ◽  
...  
2016 ◽  
Vol 23 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Prakirthi Yerram ◽  
Shraddha Kansagra ◽  
Osama Abdelghany

Background Denosumab therapy is commonly used for the prevention of skeletal-related events in patients with bone metastasis. However, a common side effect of denosumab is hypocalcemia. Objective The aim of the study is to determine the incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis and evaluate risk factors for developing hypocalcemia. Methods This was a retrospective medication use evaluation reviewing the incidence of hypocalcemia in patients receiving outpatient denosumab for prevention of skeletal-related events at Yale–New Haven Hospital. Additionally, various risk factors were reviewed to determine their risk of developing hypocalcemia. Results As per Common Terminology Criteria for Adverse Events v4.03, of the 106 patients included in the study population, 37 (35%) patients had an incidence of hypocalcemia within 30 days of denosumab administration. Fourteen patients (13.2%) had an incidence of grade 1, 13 patients (12.3%) had an incidence of grade 2 hypocalcemia, and 7 patients (6.6%) had an incidence of grade 3 hypocalcemia. Grade 4 hypocalcemia occurred in three (2.8%) patients. Calcium supplementation did not decrease the risk of developing hypocalcemia. Patients who had one or more episodes of acute kidney insufficiency were at a higher risk of developing hypocalcemia (odds ratio = 7.5 (95% confidence interval = 1.8–36.3), p = 0.001). Conclusion This study found that the overall incidence of hypocalcemia and severe hypocalcemia was higher than reported in clinical trials. Additionally, calcium supplementation did not have an effect on incidence of hypocalcemia, while patients who experienced acute kidney insufficiency while on denosumab had a higher likelihood of developing hypocalcemia.


PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 961-963
Author(s):  
RICHARD B. MINK ◽  
MURRAY M. POLLACK

Although issues concerning withdrawal and limitation of life support are commonly discussed,1-6 actual practices in pediatrics are largely unknown and are limited to neonatal intensive care unit (ICU) studies. In the neonatal ICUs at Yale-New Haven Hospital and at Hammersmith Hospital, 14% and 30%, respectively, of all deaths followed withdrawal of care.7,8 In adult ICUs, limitation and/or withdrawal of therapy is common,9 and in one investigation, resuscitation was not attempted immediately before ICU death in nearly two-thirds of cases.10 Nonetheless, many physicians believe that most hospital deaths occur only after all resuscitative attempts have failed,6,11,12 and others believe that resuscitative efforts neither are indicated nor desirable in many cases.1,13


PEDIATRICS ◽  
1948 ◽  
Vol 2 (2) ◽  
pp. 200-206
Author(s):  
AUGUSTA STUART CLAY

THIS study was made in the belief that family living and growth can be healthier if parents understand how mother and baby develop and what they need. Eleven mothers were visited weekly for two months before and after the birth of their firstborn to discover what guidance they wanted, what was offered, and what additional guidance was needed. The writer secured their cooperation by agreeing to work with them as a consultant, to interpret their point of view to the doctor, to explain medical instructions when permitted, and to teach the normal growth processes of mother and baby. Ten mothers were registered in the prenatal clinics of the New Haven Hospital; the eleventh had a private physician. They had no recorded problems beyond the needs of healthy pregnancy and they wanted to participate. Eight husbands agreed to take part in the study. The other three were overseas, but their wives reported for them. Backgrounds varied; 20 of the 22 had had college or high school education; all were between 18 and 32. None dropped out, and after the four months all asked for continued guidance. Cases were too few and the study too brief for statistical evidence. But problems were uncovered which needed to be considered and which have largely been neglected in routine obstetric and pediatric care. These parents wanted to learn—not in classes, but in the privacy of home—how to care for mother and baby without disrupting their accustomed way of living. All wanted the care and interest of one doctor for mother and one for baby. However, six women and five men preferred to talk with a consultant who was not a doctor, but who was affiliated with their doctors. The doctors seemed too busy for "little things" and "family affairs," and they saw so many doctors that they all seemed strangers. Once they felt sure that the consultant's interest was in themselves rather than in teaching them, they set the pace and pattern in the conference. There was no questionnaire, no probing, no set procedure. If they had any immediate interests or problems: job, move, presents, trips, in-laws, illness—these were discussed before they talked of pregnancy and baby.


PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 900-906
Author(s):  
John M. Leventhal ◽  
Julia Hamilton ◽  
Susan Rekedal ◽  
Anna Tebano-Micci ◽  
Cynthia Eyster

To determine the value of using anatomically correct dolls in diagnostic interviews of young children suspected of being sexually abused, the records of 83 children who were less than 7 years of age and who were evaluated at Yale-New Haven Hospital because of a suspicion of sexual abuse were reviewed. The dolls were used in 60 cases (72%). When the dolls were used, children provided significantly more information than by interview alone about what had happened and about the identity of the suspected perpetrator. Children less than 3 years of age, however, were unable to provide details about the abuse despite the use of the dolls. The ratings of the likelihood that sexual abuse had occurred were based on all of the information in the case including that obtained through the diagnostic interview with the dolls. When these ratings were compared with the ratings based on evidence obtained solely from noninterview data, the likelihood of abuse was higher in 35% of the cases. It was concluded that substantially more information is provided by young children when anatomically correct dolls are used and that the likelihood of detection of abuse is increased when information from the child is included in the assessment.


1986 ◽  
Vol 23 (2) ◽  
pp. 262 ◽  
Author(s):  
J.T. Chambers ◽  
M. Merino ◽  
E.I. Kohorn ◽  
P.E. Peschel ◽  
P.E. Schwartz

2014 ◽  
Vol 7 (5) ◽  
pp. 262-268 ◽  
Author(s):  
Thomas Balcezak ◽  
Richard D’Aquila ◽  
Cristina DeVito Indiveri

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