Articles: critical-care.
-
Pediatric emergency care · Mar 1990
Children with abdominal pain: evaluation in the pediatric emergency department.
In a retrospective study of children with abdominal pain in a pediatric emergency department, 371 children were identified during four seasonally diverse months. Half of the children were two to six years old, 32% were seven to 11 years old, and 19% were 12 to 16 years old. Forty-eight different diagnoses were made, but 10 diagnoses were given to 83% of the patients. ⋯ Appendicitis was the only surgical problem that occurred in more than one percent of the children. The diagnoses were classified as medical (64.4%), surgical (6.5%), and nonspecific (29.1%). chi 2 and multinomial logit analysis revealed that guarding and abdominal tenderness were the two symptoms which were most strongly associated with a surgical diagnosis. The goal of this work is to assist the busy emergency clinician with the difficult task of making expeditious and accurate diagnoses for children with abdominal pain.
-
We undertook a prospective study of 125 intrahospital patient transports from the ICU in an attempt to identify any factors that could influence the occurrence of mishaps. One third of the transports sustained at least one mishap. Therapeutic intervention scoring system class IV transports had the highest rate of mishaps (35%). ⋯ Morbidity and mortality were not affected by mishaps. Although certain trends did emerge, no clearly defined predictive factor could be identified. Further study into transport mishaps is warranted.
-
Vestn. Khir. Im. I. I. Grek. · Mar 1990
[Organization of medical services for the victims of the earthquake in the city of Spitak, Armenian S.S.R].
Sanitary losses in the city of Spitak were about 47.8%, injures of the middle and critical degree being diagnosed in 9.5%. During the first period (from December 9 to 14, 1988) patients admitted to the hospitals predominantly had traumas of the head, chest, extremities, vertebral column (86.3%). ⋯ Success of treatment of the patients with this pathology was promoted by their having obtained qualified surgical and anesthesiological aid before evacuation to medical institutions of the Center in full value in combination with temporary admittance to the hospital at an average for 12-18 hours up to complete arrest of shock. During the first steps of evacuation the amputation of extremities was fulfilled in 3 cases.
-
Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Clinical TrialDouble-blind study of the reversal of midazolam-induced sedation in the intensive care unit with flumazenil (Ro 15-1788): effect on weaning from ventilation.
Midazolam (0.1-0.2 mg/kg/hr) and morphine (2 mg/hr) were given by carefully regulated continuous intravenous infusions to thirty patients who required sedation, analgesia and ventilation for between twelve and twenty-four hours in the Intensive Care Unit. The midazolam and morphine infusions were stopped at the end of the period of sedation required and the efficacy of placebo of flumazenil in reversing the sedative effects of midazolam was compared in this double-blind randomised parallel group study. Patients receiving flumazenil were less sedated (P less than 0.05), able to obey commands (P less than 0.05), weaned from ventilation (P less than 0.05) and extubated (P less than 0.05) significantly earlier than those receiving placebo.