scholarly journals Emergency management plan for paediatric patients with tracheostomies during the COVID-19 pandemic

2021 ◽  
Author(s):  
Beckie Petulla ◽  
Emma Ho ◽  
Emma Sov ◽  
Marlene Soma
Keyword(s):  
Emergency Management ◽  
Tracheostomy Tube ◽  
Management Plan ◽  
Air Leak ◽  
Airway Injury ◽  
Paediatric Patients ◽  
Airway Trauma ◽  
Long Term Ventilation ◽  
Age Range

Objectives: Paediatric patients living with tracheostomies are a medically vulnerable group. During the COVID-19 pandemic, there may be apprehension about their susceptibility to SARS-CoV-2 infection with unknown consequences. Healthcare workers managing this cohort can be anxious about viral transmission from respiratory secretions and aerosols emerging from the open airway. Our objective is to share a systematic approach to minimise incidental mismanagement, avoid iatrogenic airway injury, reduce aerosolisation and decrease staff exposure when treating these patients. Methods: A COVID-19 emergency management plan was created for paediatric patients with tracheostomies in the event of presentation with unknown, suspected or proven SARS-CoV-2 infection. Three documents were developed: a generic tracheostomy management plan detailing troubleshooting measures to reduce air leak from around the tube; a personalised management plan with customised recommendations; a guide for tracheostomy tube change with emphasis on minimising aerosol production. Results: Our plan was distributed to 31 patients (age range 11 months - 17 years) including 23 (74.2%) with uncuffed tubes and 9 (29%) on long term ventilation. There have been 10 occasions in which the plan was utilised and influenced care, including 4 situations where successful troubleshooting avoided tube manipulation and 6 situations where an uncuffed tube was safely replaced with a pre-selected cuffed tube to reduce air leak. Conclusions: A structured approach to emergency presentations during the COVID-19 pandemic may safeguard paediatric patients from unnecessary manipulation of their tracheostomy tube and airway trauma, as well as provide guidance to minimise viral exposure and allow provision of expeditious care.

CRISIS MANAGEMENT

1996 ◽  
Vol 36 (1) ◽  
pp. 716
Author(s):  
M. Sandman
Keyword(s):  
Emergency Management ◽  
Crisis Management ◽  
Management Plan ◽  
Public Affairs ◽  
Management Team ◽  
The One ◽  
Crisis Management Plan ◽  
The Impact ◽  
Objective Being

In essence, a crisis is a Public Affairs event and it is important to distinguish between a crisis on the one hand and an emergency on the other. An emergency may not necessarily become a crisis because the focus of an emergency is internal whereas the focus of a crisis is external.At West Australian Petroleum Pty Limited (WAPET) we have a crisis management plan which has been developed to facilitate the rapid notification and response to emergency incidents involving WAPET personnel and facilities.The plan requires the organisation of an Emergency Management Team to deal with the immediate impacts of the emergency, initiate a response and address the problem as quickly as possible.In addition, a separate Crisis Management Team is mobilised to address the external crisis situation by identifying the impact of the problem on the business, initiate a media response, liaise with outside agencies and support the Emergency Management Team.The overall goal of the emergency management system is to move from a reactive to a proactive mode of operation as quickly as possible.Different levels of emergency have been identified and procedures initiated to respond by individuals at different levels within the organisation.The process is tested periodically through the use of practice drills, the objective being to ensure that if a crisis occurs, the Company has in place procedures to respond at all levels to minimise impact upon the operations of the Company both short-term and long-term and to react to media interest in any crisis event.

Barriers to Physical Activity in Adolescents

2015 ◽  
Vol 23 (2) ◽  
pp. 47-59 ◽  
Author(s):  
Nadine Langguth ◽  
Tanja Könen ◽  
Simone Matulis ◽  
Regina Steil ◽  
Caterina Gawrilow ◽  
...  
Keyword(s):  
Physical Activity ◽  
Leisure Activities ◽  
Outcome Expectations ◽  
Multidimensional Approach ◽  
Factor Analyses ◽  
Physical And Mental Health ◽  
Tailored Interventions ◽  
Long Term Consequences ◽  
Age Range

During adolescence, physical activity (PA) decreases with potentially serious, long-term consequences for physical and mental health. Although barriers have been identified as an important PA correlate in adults, research on adolescents’ PA barriers is lacking. Thus reliable, valid scales to measure adolescents’ PA barriers are needed. We present two studies describing a broad range of PA barriers relevant to adolescents with a multidimensional approach. In Study 1, 124 adolescents (age range = 12 – 24 years) reported their most important PA barriers. Two independent coders categorized those barriers. The most frequent PA barriers were incorporated in a multidimensional questionnaire. In Study 2, 598 adolescents (age range = 13 – 21 years) completed this questionnaire and reported their current PA, intention, self-efficacy, and negative outcome expectations. Seven PA barrier dimensions (leisure activities, lack of motivation, screen-based sedentary behavior, depressed mood, physical health, school workload, and preconditions) were confirmed in factor analyses. A multidimensional approach to measuring PA barriers in adolescents is reliable and valid. The current studies provide the basis for developing individually tailored interventions to increase PA in adolescents.

Surgical Outcome in Paediatric Patients with Ebstein's Anomaly: A Multicenter, Long-Term Study

2016 ◽  
Vol 64 (S 02) ◽  
Author(s):  
L. Geerdink ◽  
G. du Marchie Sarvaas ◽  
I. Kuipers ◽  
W. Helbing ◽  
T. Delhaas ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Ebstein’S Anomaly ◽  
Term Study ◽  
Ebstein's Anomaly ◽  
Long Term Study ◽  
Paediatric Patients

Thrombin generation in paediatric patients with congenital heart disease

2008 ◽  
Vol 28 (S 01) ◽  
pp. S61-S66 ◽  
Author(s):  
G. Cvirn ◽  
A. Rosenkranz ◽  
B. Leschnik ◽  
W. Raith ◽  
W. Muntean ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Negative Correlation ◽  
Congenital Heart ◽  
Thrombin Generation ◽  
Significant Negative Correlation ◽  
Peak Height ◽  
Global Test ◽  
Paediatric Patients ◽  
Age Range

SummaryThrombin generation was studied in paediatric patients with congenital heart disease (CHD) undergoing cardiac surgery using the calibrated automated thrombography (CAT) in terms of the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. The suitability to determine the coagulation status of these patients was investigated. Patients, material, methods: CAT data of 40 patients with CHD (age range from newborn to 18 years) were compared to data using standard coagulation parameters such as prothrombin (FII), antithrombin (AT), tissue factor pathway inhibitor (TFPI), prothrombin fragment 1.2 (F 1.2), thrombin-antithrombin (TAT), activated partial thromboplastin time (aPTT), and prothrombin time (PT). Results: A significant positive correlation was seen between ETP and FII (p < 0.01; r = 0.369), as well as between peak height and F II (p < 0.01; r = 0.483). A significant negative correlation was seen between ETP and TFPI values (p < 0.05; r = –0.225) while no significant correlation was seen between peak height and TFPI. A significant negative correlation was seen between F 1.2 generation and ETP (p < 0.05; r = –0.254) and between F 1.2 generation and peak height (p < 0.05; r = –0.236). No correlation was seen between AT and ETP or peak. Conclusions: CAT is a good global test reflecting procoagulatory and inhibitory factors of the haemostatic system in paediatric patients with CHD.

Primary Calvarial Ewing Sarcoma: A Case Series

2021 ◽  
Author(s):  
Sandeep Mohindra ◽  
Manjul Tripathi ◽  
Aman Batish ◽  
Ankur Kapoor ◽  
Ninad Ramesh Patil ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Excision ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intradural Tumor ◽  
Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

Evaluation attempt of own body sensing amongst persons with and without scoliosis

2021 ◽  
pp. 1-6
Author(s):  
Elżbieta Szczygieł ◽  
Agata Gigoń ◽  
Izabela Cebula Chudyba ◽  
Golec Joanna ◽  
Golec Edward
Keyword(s):  
Idiopathic Scoliosis ◽  
Sensory Integration ◽  
Head Position ◽  
Clinical Test ◽  
Spine Deformity ◽  
Functional Tests ◽  
Body Proportion ◽  
Average Value ◽  
Age Range

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a common structural spine deformity affecting 2%–4% of adolescents. Due to the unknown cause of idiopathic scoliosis, its therapy is a long-term and often unsatisfactory process. In the literature, it is often suggested that problems related to the feeling of one’s own body are caused by AIS. OBJECTIVE: The aim of this study was to assess the feeling of one’s own body among children with and without scoliosis on the example of feeling the head position, pelvis shape and balance. METHOD: The research included 62 children: 30 with scoliosis and 25 without diagnosed scoliosis with an age range between 11 to 19 years. The minimum scoliosis value was 7∘ and the maximum was 53∘. The average value was 25∘. During the study, three functional tests were used: Cervical Joint Position Error Test (CJPET), Clinical Test of Sensory Integration on Balance (CTSIB) and Body proportion demonstration test (BPDT). RESULTS: The results of the tests showed statistically significant differences (CJPET p= 3.54* 10-14, CTSIB p= 0.0376, BPDT p= 0.0127). However, none of the studies showed a correlation between the results of people with scoliosis and the value of their Cobb angles.

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