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4 results

  • Chapter 15 - Pediatrics in a Field Hospital

  • 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 140-147

  • Summary

    It has been reported that 50% of the affected during natural or man-made disasters are children. They have unique vulnerabilities that require unique and specific management. It is therefore vital to understand the optimal management in pediatric emergencies, and to consider efforts regarding pediatric preparedness and response in humanitarian situations.

    This chapter reviews the necessary means of pediatric care that must be included in medical relief delegations, and proposes a structure for a dedicated medical team, as well as necessary logistic and administrative considerations.

    A triage algorithm is described, considering three key parameters: urgency, available resources, and the likelihood of saving a patient’s life. Ethical dilemmas posed by the above approach are discussed as well.

    Lastly, the authors discuss the necessary collaboration between the pediatric team and the traumatology and obstetrics/gynecology departments, and describe the structure and function of a pediatric ward in a field hospital, based on experience from medical relief delegations deployed by the Israel Defense Forces (IDF) after natural disasters in Haiti and Nepal.

  • Chapter 14 - Tracheotomy education for home care

  • Edited by Peggy A. Seidman, Stony Brook University, State University of New York, Elizabeth H. Sinz, Pennsylvania State University, David Goldenberg, Pennsylvania State University
  • Book:
    Tracheotomy Management
    Published online:
    25 October 2011
    Print publication:
    20 October 2011, pp 180-194

  • Summary

    The development of advanced neonatal care and anesthesia techniques enabled patients to be intubated for prolonged periods leading to a rise in incidence of acquired subglottic stenosis and the survival of patients with ventilator-dependent respiratory failure. The decision for tracheotomy tube placement should entail a detailed thought process and individualized plan for each patient. When evaluating children for tracheotomy tube placement, it is important to communicate openly with anesthesia staff. Correct size and positioning of the tracheotomy tube can be confirmed with a post-operative chest radiograph and/or passage of a small pediatric flexible endoscope. After tracheotomy, the patient should be closely monitored in the intensive care unit for 5-7 days. Careful dissection and ligature techniques are used for anterior jugular veins and the thyroid isthmus to avoid complications. Patients with tracheotomies have been shown to exhibit difficulties with speech and language development, even after decannulation.

  • The European Multiple Birth Study (EMBS)

  • R. Vlietinck, E. Papiernik, C. Derom, H. Grandjean, M. Thiery, R. Derom
  • Journal:
    Acta geneticae medicae et gemellologiae: twin research / Volume 37 / Issue 1 / January 1988
    Published online by Cambridge University Press:
    01 August 2014, pp. 27-30
    Print publication:
    January 1988
    • Article
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  • The more that twin and other multiple pregnancies are investigated, the more it becomes mandatory that collaborative studies are set up in order to attain the criticai number of cases needed to achieve meaningful and reliable results. The European Multiple Birth Study (EMBS) aims to study two aspects of twin and multiple pregnancy: 1) management of pregnancy and labour, with emphasis on the prevention of preterm delivery; 2) accurate determination of zygosity, a prerequisite for the proper use of the twin method in a variety of fields, eg, congenital malformations, genetics, clinical investigations, etc. The rationale, the methods and the organisation of the study are described and discussed.

  • Social Cost of Twin Births

  • Emile Papiernik
  • Journal:
    Acta geneticae medicae et gemellologiae: twin research / Volume 32 / Issue 2 / April 1983
    Published online by Cambridge University Press:
    01 August 2014, pp. 105-111
    Print publication:
    April 1983
    • Article
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  • This study analyzes costs for neonatal care and costs for care of handicapped children related to twin pregnancies and births. These costs are highly related to the unfavorable birthweight distribution for twins. Each twin pregnancy may cost 10 times more than a single pregnancy. This economic analysis favors all kinds of preventive policies and a calculation is proposed for measuring the probable effect in costs of even a slight decrease in the proportion of very low and low birthweight for twins.