Communication between parents and well‐siblings in the context of living with a child with a life‐threatening or life‐limiting condition

2020 ◽  
Vol 56 (10) ◽  
pp. 1521-1526
Author(s):  
Tiina Jaaniste ◽  
Sarah C Tan ◽  
Phillip Aouad ◽  
Susan Trethewie
Keyword(s):  
Life Threatening ◽  
Well Siblings ◽  
Limiting Condition

scholarly journals Acute Suppurative Thyroiditis in an Intravenous Drug User with a Preexisting Goiter

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Nikhil Yegya-Raman ◽  
Tabitha Copeland ◽  
Payal Parikh
Keyword(s):  
Drug User ◽  
Intravenous Drug User ◽  
Neck Mass ◽  
Subacute Thyroiditis ◽  
Suppurative Thyroiditis ◽  
First Case ◽  
Life Threatening ◽  
Acute Suppurative Thyroiditis ◽  
Limiting Condition ◽  
Iv Drug Use

Acute suppurative thyroiditis (AST) is an uncommon, potentially life-threatening cause of a rapidly enlarging neck mass. It may present similarly to subacute thyroiditis, a relatively benign and self-limiting condition. We report a case of AST in an adult intravenous (IV) drug user with a preexisting goiter who presented with a left forearm abscess that grew methicillin-sensitive Staphylococcus aureus. In this particular case, clinical suspicion for AST was high. As a result, early IV antibiotic therapy was initiated, and this led to rapid clinical improvement furthermore preventing airway compromise. To our knowledge, this is the first case of AST in the literature resulting from likely hematogenous spread in the setting of IV drug use and a preexisting goiter. Overall, this case highlights the importance of assessing risk factors for AST in patients whose presentations may seem more typical of subacute thyroiditis. Such an approach will lead to timely diagnosis and treatment to avoid potentially devastating consequences.

Impact on the family

2021 ◽  
pp. 111-125
Author(s):  
Veronica Dussel ◽  
Barbara Jones
Keyword(s):  
Social Care ◽  
Family Members ◽  
Well Being ◽  
Family Unit ◽  
Health And Social Care ◽  
The Family ◽  
Threatening Condition ◽  
Life Threatening ◽  
Limiting Condition ◽  
The Impact

In this chapter, we will focus on the importance of caring for the family of a child with a life-limiting condition (LLC) or life-threatening condition as a unit, each of the family members being integral to the well-being and care of the others. We recognize that the family unit itself is embedded within a wider context including the health and social care system, and more broadly within its society and culture. We discuss the concept of family, exploring the impact of having a child with an LLC, and how families adjust to this. We then expand on considerations about how to offer effective and timely support and help. We have included parents’ narratives with the aim of adding depth to the discussion, and in recognition of the truth of families’ own experiences.

scholarly journals Advances and Challenges in European Paediatric Palliative Care

2020 ◽  
Vol 8 (2) ◽  
pp. 20
Author(s):  
Lorna K Fraser ◽  
Myra Bluebond-Langner ◽  
Julie Ling
Keyword(s):  
Palliative Care ◽  
Epidemiological Data ◽  
Childhood Mortality ◽  
Quality Data ◽  
High Quality Data ◽  
Medical Interventions ◽  
Paediatric Palliative Care ◽  
Life Threatening ◽  
Definition Of ◽  
Limiting Condition

Advances in both public health and medical interventions have resulted in a reduction in childhood mortality worldwide over the last few decades; however, children still have life-threatening conditions that require palliative care. Children’s palliative care is a specialty that differs from palliative care for adults in many ways. This paper discusses some of the challenges, and some of the recent advances in paediatric palliative care. Developing responsive services requires good epidemiological data, as well as a clarity on services currently available and a robust definition of the group of children who would benefit from palliative care. Once a child is diagnosed with a life-limiting condition or life-limiting illness, parents face a number of complex and difficult decisions; not only about care and treatment, but also about the place of care and ultimately, place of death. The best way to address the needs of children requiring palliative care and their families is complex and requires further research and the routine collection of high-quality data. Although research in children’s palliative care has dramatically increased, there is still a dearth of evidence on key components of palliative care notably decision making, communication and pain and symptom management specifically as it relates to children. This evidence is required in order to ensure that the care that these children and their families require is delivered.

Hypereosinophilia: a rare cause of stroke and multiorgan dysfunction

2021 ◽  
Vol 14 (10) ◽  
pp. e242619
Author(s):  
Kapil L Barbind ◽  
Revanth Boddu ◽  
KP Shijith ◽  
Kundan Mishra
Keyword(s):  
Ischaemic Stroke ◽  
Early Treatment ◽  
Eosinophil Count ◽  
Hypereosinophilic Syndrome ◽  
Renal Involvement ◽  
Rare Presentation ◽  
Laboratory Abnormality ◽  
Multiorgan Dysfunction ◽  
Life Threatening ◽  
Limiting Condition

Eosinophilia can occur due to a plethora of allergic, infective, neoplastic and idiopathic conditions. Hypereosinophilic syndrome (HES) is characterised by sustained eosinophilia and multiorgan dysfunction in the absence of an identifiable cause. It may range from a self-limiting condition to a rapidly progressive life-threatening disorder, of which ischaemic stroke is a rare presentation. Such episodes can rarely be the presenting manifestation, and may develop before any other laboratory abnormality or organ involvement. We report a case of HES presented with multiorgan (neurological and renal) involvement, managed successfully with steroids and cytoreductive therapy. High initial absolute eosinophil count can be a clue to the diagnosis and early treatment should be initiated in such patients, to prevent fatal outcomes.

Renal and urinary tract conditions

2018 ◽  
pp. 313-338
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Urinary Tract ◽  
Kidney Disease ◽  
Kidney Failure ◽  
Kidney Injury ◽  
Chronic Kidney Failure ◽  
Summary Table ◽  
Urinary Tract Disorders ◽  
Life Threatening ◽  
Specialist Nurses ◽  
Limiting Condition

Renal conditions can be an acute health problem or a debilitating life-limiting condition. Kidney failure can present as a slowly progressing chronic disease (chronic kidney disease) or as acute life-threatening medical emergencies known as acute kidney injury (AKI). People with chronic kidney failure will normally be cared for by specialist nurses and clinical teams working in hospital or community settings. General adult nurses will encounter people with kidney disease in all areas of clinical practice, either as a primary complaint or as a secondary complication of other disorders or treatments. This chapter outlines key facts about kidney disease which are likely to be useful to the general nurse. These include an overview of renal conditions and the principles of renal replacement therapy. Common urinary tract conditions and the management of urinary incontinence are also discussed, as are key nursing considerations when working with people with renal or urinary tract disorders. An overview of frequently prescribed medicines for renal and urinary tract conditions is presented in a summary table.

scholarly journals Estimating the current and future prevalence of life-limiting conditions in children in England

2020 ◽  
pp. 026921632097530 ◽  
Author(s):  
Lorna K Fraser ◽  
Deborah Gibson-Smith ◽  
Stuart Jarvis ◽  
Paul Norman ◽  
Roger C Parslow
Keyword(s):  
Population Based ◽  
Population Projections ◽  
Diagnostic Code ◽  
Hospital Data ◽  
Care Needs ◽  
Health And Social Care ◽  
Threatening Condition ◽  
Pakistani Origin ◽  
Life Threatening ◽  
Limiting Condition

Background: Previous studies showed increasing number of children with a life-limiting or life-threatening condition who may benefit from input from pediatric palliative care services. Aim: To estimate the current prevalence of children with a life-limiting condition and to model future prevalence of this population. Design: Observational study using national inpatient hospital data. A population-based approach utilizing ethnic specific population projections was used to estimate future prevalence. Setting/participants: All children aged 0–19 years with a life-limiting condition diagnostic code recorded in Hospital Episodes Statistics data in England from 2000/01 to 2017/18. Results: Data on 4,543,386 hospital episodes for 359,634 individuals were included. The prevalence of children with a life-limiting condition rose from 26.7 per 10,000 (95%CI 26.5–27.0) in 2001/02 to 66.4 per 10,000 (95% CI: 66.0–66.8) in 2017/18. Using a more restricted definition of a life-limiting condition reduced the prevalence from 66.4 to 61.1 per 10,000 (95%CI 60.7–61.5) in 2017/18. Highest prevalence was in the under 1-year age group at 226.5 per 10,000 and children with a congenital abnormality had the highest prevalence (27.2 per 10,000 (95%CI: 26.9–27.5)). The prevalence was highest among the most deprived group and in children of Pakistani origin. Predicted future prevalence of life-limiting conditions ranged from 67.0 (95%CI 67.7–66.3) to 84.22 (95%CI 78.66–90.17) per 10,000 by 2030. Conclusions: The prevalence of children with a life-limiting or life-threatening condition in England has risen over the last 17 years and is predicted to increase. Future data collections must include the data required to assess the complex health and social care needs of these children.

scholarly journals A Retrospective Review of Resuscitation Planning at a Children’s Hospital

2017 ◽  
Author(s):  
Jean Kelly ◽  
Jo Ritchie ◽  
Leigh Donovan ◽  
Carol Graham ◽  
Anthony Herbert
Keyword(s):  
Retrospective Review ◽  
Medical Records ◽  
Time Interval ◽  
Professional Collaboration ◽  
Clinical Indicator ◽  
Paediatric Palliative Care ◽  
Centered Care ◽  
Life Threatening ◽  
Limiting Condition ◽  
Family Centered

Resuscitation plans (RP) are an important clinical indicator relating to care at the end of life in pediatrics. A retrospective review of the medical records of children who had been referred to the Royal Children’s Hospital, Brisbane, Australia who died in the calendar year 2011 was performed. Of 62 records available, 40 patients (65%) had a life limiting condition and 43 medical records (69%) contained a documented (RP). This study demonstrated that both the underlying condition (life-limiting or life-threatening) and the setting of care (PICU or home) influenced the development of resuscitation plans. Patients referred to the paediatric palliative care (PPC) service had a significantly longer time interval from documentation of a resuscitation plan to death and were more likely to die at home. All of the patients who died in the paediatric intensive care unit (PICU) had a RP which was documented within the last 48 hours of life. Most RPs were not easy to locate. Documentation of discussions related to resuscitation planning should accommodate patient and family centered care based on individual needs. With varied diagnoses and settings of care, it is important that there is inter-professional collaboration (particularly involving PICU and PPC services) in developing protocols of how to manage this difficult but inevitable clinical scenario.

scholarly journals Ultrasound as a problem solver to diagnose pneumomediastinum in an infant

2021 ◽  
Vol 10 (8) ◽  
pp. 205846012110306
Author(s):  
Polona Klavžar ◽  
Domen Plut
Keyword(s):  
Respiratory Failure ◽  
Chest Radiography ◽  
Acute Respiratory Infection ◽  
Imaging Modality ◽  
Problem Solver ◽  
Definite Diagnosis ◽  
Time Problem ◽  
Life Threatening ◽  
Limiting Condition

Pneumomediastinum is a relatively rare and usually a self-limiting condition in infants. However, it can lead to tension pneumomediastinum or pneumothorax, which may rapidly become life-threatening. Therefore, its timely and accurate detection is important and close follow-up to resolution is needed. Ultrasound can be used as a real-time problem solver to accurately diagnose pneumomediastinum in an infant and should be encouraged as a radiation-free adjunct imaging modality when radiography cannot provide a definite diagnosis. We present a case of a 13-month-old preterm girl with bronchopulmonary dysplasia and acute respiratory infection who presented with sudden respiratory failure due to spontaneous pneumomediastinum. Pneumomediastinum was eventually diagnosed with ultrasound, after chest radiography performed during the on-call hours was misinterpreted because not all typical radiographic signs of pneumomediastinum were present.

Living with a child who has a life limiting condition: The functioning of well‐siblings and parents

2021 ◽  
Author(s):  
Tiina Jaaniste ◽  
Anjali Cuganesan ◽  
Wei Ling ( Audrey) Chin ◽  
Sarah Caellainn Tan ◽  
Sandra Coombs ◽  
...  
Keyword(s):  
Well Siblings ◽  
Limiting Condition

Pathophysiology and management of altitude-related disorders

2016 ◽  
Author(s):  
Daniel S. Martin ◽  
Michael P. W. Grocott
Keyword(s):  
High Altitude ◽  
Acute Mountain Sickness ◽  
Specific Treatment ◽  
Symptomatic Treatment ◽  
Supplemental Oxygen ◽  
Poor Sleep ◽  
Effective Prophylaxis ◽  
Life Threatening ◽  
Medical Emergencies ◽  
Limiting Condition

Acute high-altitude related illnesses include acute mountain sickness (AMS), high altitude pulmonary oedema (HAPO) and high altitude cerebral oedema (HACO). AMS is characterized by headache, lack of appetite, poor sleep, lethargy, and fatigue. AMS is a common, generally benign, self-limiting condition if managed with rest, no ascent, and symptomatic treatment. Descent is indicated in severe cases. HACO and HAPO are rare, but serious conditions that should be considered life-threatening medical emergencies. HACO is characterized by the presence of neurological signs (including confusion) at altitude, commonly in the presence of headache. HAPO is characterized by breathlessness and signs of respiratory distress at altitude, particularly accompanying exercise. Management of HACO and HAPO involves urgent descent, supplemental oxygen (cylinder, concentrator, or portable hyperbaric chamber) if available, and specific treatment with dexamethasone (HACO) or nifedipine (HAPO). Slow controlled ascent (adequate acclimatization) is the best prophylaxis against the acute high-altitude-related illnesses. Acetazolamide is an effective prophylaxis against AMS.

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