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6 results

  • Acute COVID-19, the Lived Experience, and Lessons to Learn for Future Pandemics

  • Rebecca Owen, Ruth EM Ashton, Francesco V Ferraro, Bethan E Phillips, Lindsay Skipper, Mark A Faghy
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
    Published online by Cambridge University Press:
    22 November 2023, e534
    • Article
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  • Objectives:

    The study aimed to increase the understanding of the lived experience of patients during the acute phase of a coronavirus disease 2019 (COVID-19) infection.

    Method:

    A Web-based survey was distributed through established patient and public engagement and involvement groups and networks, social media, and by means of word of mouth. The survey covered questions relating to patient demographics, COVID-19 diagnosis, symptom profile, and patient experience during acute COVID-19.

    Results:

    The findings demonstrate the varying symptom profiles experienced by people in the acute stage of COVID-19 infection, with participants sharing how they managed care at home, and/or accessed medical advice. Findings also highlight themes that people were concerned with being unable to receive care and believed they needed to rely heavily on family, with extreme thoughts of death.

    Conclusions:

    Although the urgent threat to public health has been negated by efficacious vaccines and enhanced treatment strategies, there are key lessons from the lived experience of COVID-19 that should be used to prepare for future pandemics and public health emergencies.

  • 10 - The acutely ill or injured child and adolescent: Nursing assessment and interventions

  • from Part C - Nursing children and young people
  • Edited by Jennifer Fraser, University of Sydney, Donna Waters, University of Sydney, Elizabeth Forster, Griffith University, Queensland, Nicola Brown
  • Book:
    Paediatric Nursing in Australia and New Zealand
    Published online:
    05 January 2022
    Print publication:
    05 January 2022, pp 255-292

  • Summary

    Children contract infections regularly during early childhood, so they can experience episodes of acute illness. They are also at greater risk of injury. For the most part, these episodes are of short duration and resolve with the care of parents at home, sometimes with support from community healthcare professionals such as a general practitioner. However, in some instances the illness can reach a level of severity that requires nursing care and medical treatment in a hospital setting. Infants and children are still developing, so they have physiological and anatomical differences from adults that require specialist skills and knowledge. Hospital environments can be challenging for both the young child and their family. In this chapter, some key nursing considerations and interventions for the acutely unwell and injured child and adolescent will be discussed. This is followed by an exploration of some of the illnesses and injuries children and adolescents can acquire that may require hospital care. You will be asked to reflect upon the nursing management of some of these conditions through review of case studies and reflective questions.

  • N-terminal pro-B-type natriuretic peptide levels in children: comparison in cardiac and non-cardiac diseases

  • Hyun Su Kim, Hee Joung Choi
  • Journal:
    Cardiology in the Young / Volume 30 / Issue 4 / April 2020
    Published online by Cambridge University Press:
    27 February 2020, pp. 500-504
  • Background:

    N-terminal pro-B-type natriuretic peptide (NT-proBNP), a well-known marker of cardiac disease, may be elevated in acute infections and other non-cardiac diseases. The aim of this study was to evaluate NT-proBNP levels in cardiac and non-cardiac diseases and found out the patient’s clinical status that affects the NT-proBNP levels.

    Methods:

    NT-proBNP levels were measured in three groups of children: a cardiac disease group, an infectious disease group, and a non-cardiac, non-infectious disease group.

    Result:

    In total, 348 children were enrolled, including 134 patients (38.5%) with cardiac disease, 170 patients (48.9%) with infectious disease, and 44 patients (12.6%) with non-cardiac, non-infectious disease. The NT-proBNP level of the cardiac disease group (median: 548 pg/mL; range: 5–35,000 pg/mL) was significantly higher than that of the infectious disease group (median: 193 pg/mL; range: 10–35,000 pg/mL) and the non-cardiac, non-infectious disease group (median: 280 pg/mL; range: 6–35,000 pg/mL). Regarding clinical status, the NT-proBNP levels were significantly higher in patients who needed mechanical ventilation support, oxygen therapy, or inotropic medication or had a change in mental status than in other patients. However, the systemic inflammatory response syndrome and mortality were not related to the NT-proBNP level.

    Conclusion:

    Among heterogeneous group of children, NT-proBNP level can be a useful marker of cardiac disease. Furthermore, the NT-proBNP levels were related to patients’ clinical deteriorations, such as shock rather than the inflammatory status of patients.

  • Chapter 26 - Primary and Ambulatory Care in a Field Hospital in Disaster Areas

  • from Section 4 - Clinical Considerations
  • Edited by Elhanan Bar-On, Kobi Peleg, Yitshak Kreiss
  • Book:
    Field Hospitals
    Published online:
    09 January 2020
    Print publication:
    09 January 2020, pp 256-261

  • Summary

    Acute injuries contribute to significant morbidity in the immediate time following high magnitude earthquake. Illnesses resulting from poor shelter and lack of access to electricity, clean water, and sanitation will appear later.

    The most common complaints are respiratory, gastrointestinal, genitourinary,malnutrition, and acute stress disorder.

    Ambulatory service can be delivered as a department within the field hospital or by outreach. The triage is a crucial part of the clinic and the medical team should identify patients who could most benefit. Other parts of the ambulatory service should contain consultation area, treatment area, pharmacy and laboratory.

    In the initial period the primary physicians will participate in triage of trauma patients, treating minor trauma and preparing patients for surgery. Therefore, they should be skilled in emergency medicine, ATLS and minor trauma.

    Later on, the primary physician may lead the postoperative management and the last efforts will be treatment of acute problems emerging due to poor sanitation and crowding and also management of chronic medical problems. For this purpose, they should be familiar with common infections in the disaster area and antibiotic resistance. And finally, communication with local health-care services as well as public and religious facilities is mandatory.

  • Energy intake and expenditure in elderly patients admitted to hospital with acute illness

  • K. Klipstein-Grobusch, J. J. Reilly, J. Potter, C. A. Edwards, M. A. Roberts
  • Journal:
    British Journal of Nutrition / Volume 73 / Issue 2 / February 1995
    Published online by Cambridge University Press:
    09 March 2007, pp. 323-334
    Print publication:
    February 1995
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  • Studies on hospitalized elderly subjects have demonstrated that negative energy balance is common during hospitalization, but have concentrated primarily on long-stay and psychogeriatric patients. There is little information on energy balance in elderly patients admitted with acute illness from the community, despite the importance of this patient group and the presence of a number of factors likely to predispose such patients to negative energy balance. In the present study energy balance was quantified in twenty patients (eight males, mean age 82 (SD 05) years; twelve females, mean age 84 (SD 6) years) admitted from the community with acute illness, and predicted basal metabolic rate (BMR) was compared with measured resting metabolic rate (RMR). Most patients were in negative energy balance during hospitalization, and median measured energy intake (El):measured RMR ratio was 1·0 (range 0·7–1·8). The mean difference between measured El and estimated total energy expenditure was −1·3 MJ/d (range -3·4 to +2·5 MJ/d). Estimated total energy expenditure exceeded measured El in fifteen of the patients and there was a significant decline in mid-arm muscle circumference (paired t, P < 0·05) during hospitalization. We conclude that moderate negative energy balance is common in this patient group, and that these patients are at risk of undernutrition during their hospital stay.