Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Oct 2012
ReviewAcute otitis media in infants: the disease and the illness. Clinical distinctions for the new treatment paradigm.
Acute otitis media has changed conceptually from being a feared infection with severe complications to a modest disease that should be treated for symptomatic relief but often without immediate antimicrobials. This holds true for infants and children with nonsevere forms of the illness if the parents and the clinician agree to a strategy of watchful waiting with easy access for follow-up. ⋯ The appraisal of the symptoms that characterize the illness in a child, matched with the otoscopic intensity of the disease, provide a comprehensive estimation of overall severity that many experts have used for research. The perspectives examined in this article and the schematic construct that proposes considering disease and illness independently may help to bring the current paradigm of acute otitis media into everyday pediatric practice as a model for a more rational and personalized management of each patient.
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Otolaryngol Head Neck Surg · Oct 2012
Multidisciplinary team approach in the management of tracheostomy patients.
To examine whether the implementation of a multidisciplinary percutaneous tracheostomy team decreases complications, improves efficiency in patient care, and reduces length of stay and cost in patients undergoing percutaneous tracheostomy. ⋯ Airway bleeding, physiological disturbances, and efficiency of care improved after the institution of a multidisciplinary percutaneous tracheostomy team approach and may have a favorable impact on health care costs.
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Otolaryngol Head Neck Surg · Oct 2012
Reducing disposable equipment waste for tonsillectomy and adenotonsillectomy cases.
Large amounts of waste in hospitals are generated in the operating rooms from disposable surgical supplies. Tonsillectomy/adenotonsillectomy (T&A) cases use many disposable supplies that are not recyclable. ⋯ The aims were the following: (1) identify what disposable medical supplies were unnecessarily opened for each case, (2) eliminate all disposable medical waste that was not critical to the case in both settings, and (3) determine the cost reduction at both hospital and surgery center facilities by revising the current disposable instruments/supplies pulled for tonsillectomy cases. The authors report projected cost savings and reduction in waste for one children's hospital and nationally based on their waste reduction.