scholarly journals The Utility of ABO Testing in Pediatric Patients Undergoing Elective Surgery

2019 ◽  
Vol 8 (9) ◽  
pp. 1372
Author(s):  
Kim ◽  
Ahn ◽  
Chung ◽  
Choi ◽  
Kim ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Screening Test ◽  
Pediatric Patients ◽  
Elective Surgery ◽  
Surgical Department ◽  
Elective Operation ◽  
Clinical Practice Pattern ◽  
Tailored Approach ◽  
Type Of Surgery

Background: Patients for elective operation often undergo routine ABO/Rh type and screening test for potential need of transfusion. Some institutions require double verification of ABO/Rh type. We evaluated the clinical practice pattern of performing ABO/Rh type and screening test in pediatric patients undergoing elective operation. Methods: Electronic medical records from pediatric patients who underwent elective surgery between June 2006 and June 2010 were retrieved. The frequency of ABO/Rh type and screening test and the incidence of packed red blood cell (pRBC) request and pRBC dispatch from the blood bank among those tested were analyzed by year and the surgical department. Results: Of the 23,631 patients, the incidence of ABO/Rh type and screening was 32.2%, and pRBC was dispatched in 37.9% of these patients. The incidence of ABO/Rh type and screening varied between 1.5% and 97.9% among surgical departments and also within the surgical departments depending on the type of surgery. The incidence of ABO/Rh type and screening showed a decreasing trend over the study period. Conclusions: There was significant variability among and within the surgical departments in the incidence of ABO/Rh type and screening in children undergoing elective surgery. A tailored approach may be beneficial to the patient in terms of comfort and cost.

Repurposing a Small Community Hospital Surgical Residency Program in an Epicenter of the COVID-19 Pandemic

2020 ◽  
pp. 000313482095635
Author(s):  
Melissa K. Meghpara ◽  
Amulya Alapati ◽  
Bhavana Devanabanda ◽  
Martine A. Louis ◽  
Neil Mandava
Keyword(s):  
Electronic Medical Records ◽  
General Surgery ◽  
Medical Records ◽  
Community Hospital ◽  
Small Community ◽  
Hemodialysis Catheter ◽  
Surgical Department ◽  
Surgical Residents ◽  
Lumen Catheter ◽  
Small Community Hospital

Background COVID-19 put a stop to the operative experience of surgical residents, leaving reassignment of the team, to the frontlines. Each program has adapted uniquely; we discuss how our surgical education changed in our hospital. Study Design A retrospective review of changes in general surgery cases, bedside procedures, and utilization of residents before and during the pandemic. Procedures were retrieved from electronic medical records. Operating room (OR) cases 1 month before and 5 weeks after the executive order were collected. Triple lumen catheter (TLC), temporary hemodialysis catheter (HDC), and pneumothorax catheter (PC) insertions by surgical residents were recorded for 5 weeks. Results Before the pandemic, an average of 27.9 cases were done in the OR, with an average of 10.1 general surgery cases. From March 23 to April 30, 2020, the average number of cases decreased to 5.1, and general surgery cases decreased to 2.2. Elective, urgent, and emergent cases represented 83%, 14.6%, and 2.4% prior to the order and 66.7%, 15.1%, and 18.2%, respectively, after the order. Bedside procedures over 5 weeks totaled to 153, 93 TLCs, 39 HDCs, and 21 PCs. Conclusion Repurposing the surgical department for the concerns of the pandemic has involved all surgical staff. We worked with other departments to allocate our team to areas of need and re-evaluated daily. The strengths of our team to deliver care and perform many bedside procedures allowed us to meet the demands posed by this disease while remaining as a cohesive unit.

Efficacy and duration of propranolol therapy for pediatric parotid hemangiomas

2018 ◽  
pp. 1-5
Keyword(s):  
Electronic Medical Records ◽  
Retrospective Review ◽  
Medical Records ◽  
Pediatric Patients ◽  
Vascular Anomalies ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Anatomic Locations ◽  
Propranolol Therapy

Objective: To assess the efficacy and duration of propranolol therapy in pediatric patients with parotid hemangiomas, and compare the results with the efficacy and duration of propranolol therapy in patients with infantile hemangiomas in other anatomic locations. Methods: In this retrospective review, we analyzed the electronic medical records of 21 patients with parotid hemangiomas seen at the Children’s Hospital of Orange County’s Vascular Anomalies Clinic between 2009 and 2015. We compared the duration of propranolol therapy and rate of re-growth after completion of therapy with established data for these parameters in the literature for patients with other infantile hemangiomas. Results: In our cohort, 13 of the 21 patients had completed therapy, with a mean duration of 26 months of propranolol therapy. Eighteen patients (85.7%) were treated with the goal dose of propranolol (2 mg/kg/day). Three patients required a higher dose in order to achieve significant improvement in the size of the hemangioma. All patients had some response to propranolol. Eight of the 13 patients (61.5%) who completed propranolol therapy saw regrowth once initial propranolol therapy was either weaned or stopped. Conclusion: Pediatric patients with parotid hemangiomas require longer duration of propranolol therapy than patients with other infantile hemangiomas, and a greater percentage may have regrowth after completion of therapy.

scholarly journals The Impact of a Clonidine Transition Protocol on Dexmedetomidine Withdrawal in Critically Ill Pediatric Patients

2020 ◽  
Vol 25 (4) ◽  
pp. 278-287 ◽  
Author(s):  
JiTong Liu ◽  
Jessica Miller ◽  
Michael Ferguson ◽  
Sandra Bagwell ◽  
Jonathan Bourque
Keyword(s):  
Critically Ill ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Pediatric Patients ◽  
Assessment Tool ◽  
Pediatric Intensive Care ◽  
Fluid Bolus ◽  
Optimal Dosing ◽  
Safety Endpoint ◽  
The Impact

OBJECTIVES This study describes our experience with a clonidine transition protocol to prevent dexmedetomidine (DEX) withdrawal in critically ill pediatric patients. METHODS Retrospective review of electronic medical records of patients in the pediatric intensive care unit of a single tertiary children's hospital. All patients up to 19 years of age, who received concomitant DEX infusion and enteral clonidine between June 1, 2016, and May 31, 2018, were included. RESULTS Two of 24 encounters had DEX restarted for withdrawal (8.3%). Five of 14 encounters who were transitioned to clonidine 2 mcg/kg every 6 hours required an increased dose, and 1 of 10 encounters transitioned to clonidine 4 mcg/kg every 6 hours required an increased dose (36% vs 10%, p = 0.21). For encounters with clonidine dose increases, 5 of 6 had improvements in Withdrawal Assessment Tool-1 (WAT-1) scores. Of these 5 encounters, 4 had decreasing or stable opioid and sedative requirements and 1 was transitioned to methadone. No encounters required discontinuation of clonidine owing to adverse events. Two of 24 encounters met our safety endpoint. One received a fluid bolus during the clonidine transition with no change in clonidine dosing, while the other had clonidine dose decreased for asymptomatic bradycardia. CONCLUSIONS The 24 encounters in our retrospective study add to the limited literature available to describe dosing, initiation time, and duration of clonidine to prevent withdrawal from DEX in critically ill pediatric patients. Further research is needed to clarify the optimal dosing and duration of clonidine to prevent DEX withdrawal in pediatric patients.

scholarly journals Comparison of ambulance usage characteristics in children between the pre-pandemic and pandemic periods in Turkey

2021 ◽  
Author(s):  
Eyüp Sarı ◽  
İshak Şan ◽  
Burak Bekgöz ◽  
HALİSE AKÇA
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Public Hospital ◽  
Traffic Accidents ◽  
Pediatric Patients ◽  
Male Gender ◽  
Medical Attention ◽  
Total Rate ◽  
The World ◽  
The Impact

Aim: A pandemic is an epidemic of an infectious disease that has spread across a large region of the world and affects many people. In this study, it was aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on ambulance use by pediatric patients in ……………., Turkey. Materials and Methods: This retrospective study was conducted in the spring-summer of 2019 and 2020. The electronic medical records of pediatric patients who were transported to the hospital by ambulance were analyzed. Results: It was determined that 49.6% of the 23,201 patients included in the study were transported during the pandemic period. Male gender was higher in both the pandemic and pre-pandemic periods, there was no difference in terms of average age. The rate of forensic cases and refugee patients increased, while that of emergency patients decreased. Both the arrival at the scene time and intervention time were prolonged. Medical cause was the most common cause of emergency calls in both years, however, it increased significantly in 2020. The decrease in cases of traffic accidents, suicides, and other accidents was statistically significant. In the pandemic period, total rate of COVID-19 infection and suspicion was 29.7%. Most of the patients had been referred to a public hospital. Conclusion: It was found that most of the ambulances were used for transporting patients with minor illnesses that did not require immediate medical attention.

scholarly journals Analysis of Preoperative Test Screening in Patients Undergoing Elective Surgery at the Gynecology Department of the “Rafael Ángel Calderón Guardia” Hospital during 2009

2011 ◽  
Vol 52 (3) ◽  
Author(s):  
Manrique Leal Mateos ◽  
Juan B Madrigal Solis
Keyword(s):  
Medical Records ◽  
Analytical Study ◽  
Elective Surgery ◽  
Cross Sectional ◽  
Preoperative Test ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Type Of Surgery ◽  
Abnormal Results

Aim: To evaluate the use of preoperative tests in patients undergoing an elective surgery at the Dr. Rafael Ángel Calderón Guardia Hospital during 2009. Methods: A cross-sectional observational analytical study was conducted. Two hundred and seventy two clinical histories, from patients who underwent surgery between 1 January 2009 and 3 June 2009, were analyzed. The analyzed variables were: age, coexisting morbidity prior to surgery, number and type of preoperative tests performed, missing and additional, and type of surgery performed. The number and type of preoperative tests required for each patient, depending on their morbidity, was decided according to the 2002 Guidelines of the American Society of Anesthesiologists (ASA). Results: The mean of preoperative tests performed for each patient was 4.3 (SD + 2.1). According to morbidity, the tests prescribed by ASA were fully conducted in only 44.9% (CI: 95% 38.8-51.0) of the patients. The mean of missed preoperative tests per patient was 1.7 (SD + 1.1). Ninety three percent (CI: 95% 89.3-95.7) of patients underwent a mean of 2.5 (SD+1.6) additional preoperative tests. Of the additional preoperative tests performed, 9.5% showed abnormal results. Only 7.6% (CI: 95% 2.5-16.8) of the medical records with abnormal results, recorded actions towards correcting these abnormalities and surgery was cancelled only for 3% (CI: 95% 0.4-10.5) of these patients. Conclusion: This study evidenced the inadequate use of preoperative tests, not only because they were not fully conducted in approximately 50% of patients, but also because a majority of them were requested a considerable amount of unjustified tests. 

scholarly journals Clinical, genetical and microbiological characterization of pediatric patients with Cystic Fibrosis in Ecuador

2019 ◽  
Author(s):  
Yazmina Lascano-Vaca ◽  
Esteban Ortiz-Prado ◽  
Lenin Gomez-Barreno ◽  
Katherine Simbaña-Rivera ◽  
Eduardo Vasconez ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Coagulase Negative Staphylococcus ◽  
Cross Sectional ◽  
Gram Positive Bacteria ◽  
Sectional Analysis

Abstract Summary Objective To characterize the epidemiology and the clinical, pathological, microbiological and genetical profile of children with cystic fibrosis treated in Ecuador. Methods We conducted a cross-sectional analysis of the pediatric population with a confirmed diagnosis of cystic fibrosis (CF) attending to one of the biggest III-level hospitals in Ecuador. All demographic, clinical and genetical variables were obtained from the electronic medical records (EMR) from 2017-2018. Results 47 patients with CF were observed and followed for more than a year. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after 9 months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetical mutation was F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13) and the G85E and the N1303K with 11.11% respectively (n = 3). Finally, there were 14.1% (n = 7) of patients with a mutation g.204099A> C, which has only been reported among Ecuadorians. Conclusions This is the first study carried out in Ecuador exploring the clinical, genetical and bacteriological analysis of patients with CF. Children with CF are often colonized by four species of gram-positive bacteria (S. aureus, Coagulase-Negative Staphylococcus, Streptococcus pneumoniae and M. catarrhalis) were the most predominant this condition atients were hospitalized for complications related to cystic fibrosis, with an average of 19 days of stay.

Adolescent Substance Use Screening Integrated With Electronic Medical Records

2014 ◽  
Author(s):  
C. McKenna ◽  
B. Gaines ◽  
C. Hatfield ◽  
S. Helman ◽  
L. Meyer ◽  
...  
Keyword(s):  
Substance Use ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Adolescent Substance Use ◽  
Adolescent Substance

908-P: Predictive Model for Glycemic Level of People with Diabetes Mellitus Using Data Extracted from Electronic Medical Records in Primary Care

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 908-P
Author(s):  
SOSTENES MISTRO ◽  
THALITA V.O. AGUIAR ◽  
VANESSA V. CERQUEIRA ◽  
KELLE O. SILVA ◽  
JOSÉ A. LOUZADO ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Predictive Model ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Glycemic Level ◽  
Using Data
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