Acute Salbutamol Exposures in ChildrenRetrospective five - year study

2020 ◽  
Vol 70 (12) ◽  
pp. 4299-4304
Keyword(s):  
Intensive Care ◽  
Bronchial Asthma ◽  
Pediatric Population ◽  
Descriptive Study ◽  
Emergency Hospital ◽  
Sympathomimetic Drug ◽  
Clinical Emergency

Salbutamol (Albuterol) is a sympathomimetic drug which is indicated as first therapeutic line in the treatment of bronchial asthma. In this study we’ve analyzed the cases with exposure to Salbutamol hospitalized and treated in the Department of Toxicology and Intensive Care of Clinical Emergency Hospital for Children Grigore Alexandrescu, from Bucharest. This is a retrospective and descriptive study, which lasted 5 years, from January 2012, until December 2016. The results showed that the administration of Salbutamol orally or inhalatory by nebulization in pediatric population is easy but frequently associated with accidental or iatrogenic overdoses. Keywords: Salbutamol, intoxication, children

scholarly journals Continuous intracranial pressure monitoring in severe traumatic brain injury in children

2019 ◽  
pp. 101-104
Author(s):  
St. M. Iencean ◽  
A. Tascu ◽  
C. A. Apetrei ◽  
C. Gheorghita ◽  
Tsz-Yan Milly Lo ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Severe Traumatic Brain Injury ◽  
Care Management ◽  
Pressure Monitoring ◽  
Intensive Care Management ◽  
Emergency Hospital ◽  
Clinical Emergency

We present the results of the Romanian team for the multi-center grant “Paediatric Brain Monitoring with Information Technology (KidsBrainIT). Using IT Innovations to Improve Childhood Traumatic Brain Injury Intensive Care Management, Outcome, and Patient Safety”, acronym KidsBrainIT. Children aged 2 to 16 years who require intensive care management after sustaining traumatic severe brain injury are included in this study in three neurosurgical hospital: "Prof. Dr. N. Oblu" Clinical Emergency Hospital Iasi, "Sf. Maria" Children Clinical Emergency Hospital Iasi and "Bagdasar-Arseni" Clinical Emergency Hospital Bucharest. Continuous real-time intracranial pressure monitoring became a "gold standard" in TBI intensive-care management and ICP-lowering therapy is recommended when ICP is elevated above 20 mmHg or more. Continuous ICP and mean arterial blood pressure (MAP) monitoring allow calculation of cerebral perfusion pressure (CPP) and to establish of an optimal CPP. This study aims to improve the treatments and the outcomes in severe traumatic brain injury in children.

One-year costs of intensive care in pediatric patients with traumatic brain injury

2021 ◽  
Vol 27 (1) ◽  
pp. 79-86
Author(s):  
Era D. Mikkonen ◽  
Markus B. Skrifvars ◽  
Matti Reinikainen ◽  
Stepani Bendel ◽  
Ruut Laitio ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Social Security ◽  
Functional Outcome ◽  
Injury Severity ◽  
Pediatric Population ◽  
Favorable Outcome ◽  
Index Hospitalization ◽  
Pediatric Tbi

OBJECTIVETraumatic brain injury (TBI) is a major cause of death and disability in the pediatric population. The authors assessed 1-year costs of intensive care in pediatric TBI patients.METHODSIn this retrospective multicenter cohort study of four academic ICUs in Finland, the authors used the Finnish Intensive Care Consortium database to identify children aged 0–17 years treated for TBI in ICUs between 2003 and 2013. The authors reviewed all patient health records and head CT scans for admission, treatment, and follow-up data. Patient outcomes included functional outcome (favorable outcome defined as a Glasgow Outcome Scale score of 4–5) and death within 6 months. Costs included those for the index hospitalization, rehabilitation, and social security up to 1 year after injury. To assess costs, the authors calculated the effective cost per favorable outcome (ECPFO).RESULTSIn total, 293 patients were included, of whom 61% had moderate to severe TBI (Glasgow Coma Scale [GCS] score 3–12) and 40% were ≥ 13 years of age. Of all patients, 82% had a favorable outcome and 9% died within 6 months of injury. The mean cost per patient was €48,719 ($54,557) (95% CI €41,326–€56,112). The index hospitalization accounted for 66%, rehabilitation costs for 27%, and social security costs for 7% of total healthcare costs. The ECPFO was €59,727 ($66,884) (95% CI €52,335–€67,120). A higher ECPFO was observed among patients with clinical and treatment-related variables indicative of parenchymal swelling and high intracranial pressure. Lower ECPFO was observed among patients with higher admission GCS scores and those who had epidural hematomas.CONCLUSIONSGreater injury severity increases ECPFO and is associated with higher postdischarge costs in pediatric TBI patients. In this pediatric cohort, over two-thirds of all resources were spent on patients with favorable functional outcome, indicating appropriate resource allocation.

scholarly journals Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study

2021 ◽  
pp. bmjmilitary-2021-001876
Author(s):  
Thibault Martinez ◽  
K Simon ◽  
L Lely ◽  
C Nguyen Dac ◽  
M Lefevre ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Selection Criteria ◽  
Distress Syndrome ◽  
Descriptive Study ◽  
Military Aircraft ◽  
Life Threatening ◽  
The Military

After the appearance of the COVID-19 pandemic in France, MEROPE system was created to transform the military tactical ATLAS A400M aircraft into a flying intensive care unit. Collective aeromedical evacuations (aero-MEDEVAC) of patients suffering from SARS-CoV-2-related acute respiratory distress syndrome was performed from June to December 2020. A total of 22 patients were transported during seven missions. All aero-MEDEVAC was performed in safe conditions for patients and crew. No life-threatening conditions occurred during flight. Biohazard controls were applied according to French guidelines and prevented crew contamination. Thanks to rigorous selection criteria and continuous in-flight medical care, the safe transportation of these patients was possible. To the best of our knowledge, this is the first description of collective aero-MEDEVAC of these kinds of patients using a tactical military aircraft. We here describe the patient’s characteristics and the flight’s challenges.

scholarly journals Nursing care time and quality indicators for adult intensive care: correlation analysis

2012 ◽  
Vol 20 (4) ◽  
pp. 651-658 ◽  
Author(s):  
Paulo Carlos Garcia ◽  
Fernanda Maria Togeiro Fugulin
Keyword(s):  
Intensive Care ◽  
Correlation Analysis ◽  
Intensive Care Units ◽  
Quality Indicators ◽  
Nursing Care ◽  
Nursing Staff ◽  
Care Delivery ◽  
Average Length ◽  
Quality Care ◽  
Descriptive Study

The objective of this quantitative, correlational and descriptive study was to analyze the time the nursing staff spends to assist patients in Adult Intensive Care Units, as well as to verify its correlation with quality care indicators. The average length of time spent on care and the quality care indicators were identified by consulting management instruments the nursing head of the Unit employs. The average hours of nursing care delivered to patients remained stable, but lower than official Brazilian agencies' indications. The correlation between time of nursing care and the incidence of accidental extubation indicator indicated that it decreases with increasing nursing care delivered by nurses. The results of this investigation showed the influence of nursing care time, provided by nurses, in the outcome of care delivery.

scholarly journals Mapping nursing goals of an Intensive Care Unit to the Nursing Outcomes Classification

2012 ◽  
Vol 20 (5) ◽  
pp. 854-862 ◽  
Author(s):  
Tânia Couto Machado Chianca ◽  
Patrícia de Oliveira Salgado ◽  
Juliana Peixoto Albuquerque ◽  
Camila Claudia Campos ◽  
Meire Chucre Tannure ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Records ◽  
Descriptive Analysis ◽  
Descriptive Study ◽  
Nursing Process ◽  
Nursing Outcomes ◽  
Nursing Outcomes Classification ◽  
Mapping Process ◽  
Nursing Diagnoses

AIM: to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD: a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS: nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION: these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.

scholarly journals ANALYSIS OF COMPLICATIONS OF ONCOLOGICAL PATIENTS DIED IN THE EMERGENCY HOSPITAL

2021 ◽  
Vol 21 (4) ◽  
pp. 30-35
Author(s):  
Yu. S. Korneva ◽  
Yа. А. Rudenko
Keyword(s):  
Emergency Medicine ◽  
Cancer Patients ◽  
Emergency Hospital ◽  
Clinical Hospital ◽  
Oncological Patients ◽  
Oncological Diseases ◽  
Clinical Emergency

The article analyzes the autopsy reports of cancer patients who died in the Clinical Emergency Medicine Clinical Hospital in Smolensk in order to study the complications? Related to oncologycal disease in these patients. The complications of oncological diseases that doctors have to deal with in emergency hospitals and their specific manifestations depending on the location of the tumor are also analyzed.

scholarly journals Quality assessment of medical care according to data of annual reports (as exemplified by Urology Department of Municipal Non-profit Enterprise "Lviv Clinical Emergency Hospital")

2021 ◽  
Vol 27 (1-2) ◽  
pp. 83-100
Author(s):  
A.B. Zimenkovsky ◽  
◽  
T.G. Gutor ◽  
O.M. Lesniak ◽  
◽  
...  
Keyword(s):  
Medical Care ◽  
Surgical Complications ◽  
Care Quality ◽  
Annual Reports ◽  
Absolute Increase ◽  
Non Profit ◽  
Emergency Hospital ◽  
Post Surgery ◽  
Positive Tendency ◽  
Clinical Emergency

Aim. The medical care quality remains one of the most pressing issues of the health care system, especially at the stage of reforming of the medical sector. Medical-statistical information comprising reporting forms is the basis for analyzing the status of medical care quality and incorporating management decisions to improve it. Material and Methods. The study was performed by the means of analysis of the annual reports of the Urology Department of Municipal Non-profit Enterprise "Lviv Clinical Emergency Hospital" over a ten-year period: from 2010 to 2019. Statistical analysis included the analysis of average and relative values, as well as the calculation of indicators of the dynamic range: growth rate and absolute increase. Results and Discussion. Analysis of the use of bed stock of the Urology Department of MNELCEH during 2010-2019 showed that the average quantity of inpatient days is 251.12-340.18 days per year. Inpatient turnover was in the range of 30.28-36.55 patients per year. The indicator of surgical activity increased by 5.4 percentage points (from 33.0% in 2010 to 38.4% in 2019). There was also a positive tendency of decrease of the duration of post-surgery stay of patients at the inpatient department of the Urology Department (from 9.25 in 2010 to 8.55 in 2019). During the study period of 2010-2019, the ratio of post-surgical complications remained relatively stable and did not exceed 5.1% (the indicator is in the range of 4.38% -5.09%). The analysis of the total mortality among all treated patients was in the range of 0.06%-0.65%. Conclusion. The indicators analyzed in the annual reports make it possible to identify the main problematic issues in the work of the department. In order to provide professional specialized care, quality and rational use of property and human resources, algorithms should be developed to increase treatment of patients with malignant tumors and urolithiasis at the department, as in recent years we could observe an outflow of patients with these diagnoses to other healthcare establishments. There is a need for individual analysis of the causes of post-surgical complications and mortality. These issues can be resolved by introducing clinical audit into the work of the department

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