• Title/Summary/Keyword: 소아응급실

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Diagnostic Performance of Blood Culture Bottles for Abscess Culture in Patient with Abdominal Soft Tissue Abscess (복부 연조직 농양 환자에서 농양 배양을 혈액배양병으로 했을 때의 성과 1예)

  • Jo, Kyo Jin;Chang, Chulhun L.;Hwang, Jae-Yeon;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.118-123
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    • 2021
  • Culture tests are very important in choosing the appropriate antibiotics for bacterial infections. In some cases, bacteria that could not be identified in standard culture bottles could be detected using blood culture bottles. A previously healthy 13-year-old boy visited our emergency room. He experienced pain, redness, and hardness of periumbilical skin and a fever for five days. There was no history of abdominal surgery and penetrating trauma. Computed tomography showed abscess with cellulitis at the periumbilical soft tissue with no congenital anomaly. Ultrasonography-guided aspiration was performed, and about 8.5 mL of the purulent abscess was aspirated. The abscess was cultured using blood culture bottle. The pus grew Actinomyces radingae and Clostridium ramosum. When performing the pus culture, using blood culture bottles can be more effective and rapid than the standard culture method for the detection of bacterial pathogens.

Clinical Study of Childhood Accidents from a Hospital Over Ten Years with Regard to Foreign Body Aspiration (단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로)

  • Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1134-1140
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    • 2002
  • Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

Hand Hygiene Compliance of Healthcare Workers in a Children's Hospital (소아병원 종사자의 손 위생 수행)

  • Oh, Hyang Soon
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.186-193
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    • 2015
  • Purpose: The aim of study was to estimate the hand hygiene (HH) compliance of healthcare workers (HCWs) in a children's hospital. Methods: This study was conducted in a hospital which is a tertiary and educational children's hospital with 313 beds and 533 HCWs. Data were collected by direct observation methods from November 1, 2010 to December 31, 2010. Results: A total of 2,999 opportunities for HH were observed, and the overall HH rate was 95.3%. HH rate of the registered nurse, physicians and transferer was 97.7%, 89.2%, and 72.1%, respectively (P<0.001). Among physicians, HH rate of the fellows, professors, residents and interns was 97.5%, 93.9%, 89.7%, and 80.9%, respectively (P<0.001). HH rate in the emergency room, operation room, outpatient department (OPD), and the intensive care unit (ICU) was 97.2%, 97.2%, 95.4%, and 92.5%, respectively (P<0.001). Hand rubbing was the most frequently used (81.1%), and hand washing was frequently used in the case of 'after body fluids exposure risk' (37.7%) and 'after touching patient surroundings' (28.5%). HH methods were not statistically different from each departments (P =0.083), however, they were significantly different according to the World Health Organization (WHO) 5 Moments (P<0.001). Distributions in WHO 5 Moments by the job titles were significantly different (P<0.001). The odds ratio of physicians, ICU and OPD was 0.353 (95% CI, 0.241-0.519), 0.291 (95% CI, 0.174-0.487), and 0.484 (95% CI, 0.281-0.834), respectively. Conclusions: Compliance of HH was different by the job titles and departments. Effective custom-tailored HH programs for each job title and department need to be developed.

Acute Appendicitis: A Rare But Probable Manifestation of Kawasaki Disease

  • Wonshik Choi;Sin Weon Yun;Mineui Hong;Suk-Won Suh;Dae Yong Yi;Ji Young Park
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.97-103
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    • 2023
  • Kawasaki disease (KD) is an acute, systemic inflammatory disorder that often targets coronary arteries. Being the common cause of acquired heart disease in children, timely diagnosis and intravenous immunoglobulin treatment are crucial. However, it is challenging for physicians to diagnose KD if it presents with atypical manifestations. We report the case of a 5-year-old boy who initially presented with appendicitis; after an appendectomy, he had a prolonged fever. He was finally diagnosed with atypical KD and successfully recovered after intravenous immunoglobulin treatment. Through a literature review, we found 21 cases of appendicitis associated with KD. In most cases, the patients were male with a mean age of 5.3 years. Most had higher proportions of incomplete KD and coronary artery complications than expected for typical KD. In conclusion, appendicitis could be a rare complication of KD; therefore, multidisciplinary cooperation and early recognition of atypical KD are essential for timely diagnosis.

A Study on the Guardian's Experience about Tepid Massage of Children Who were Admitted to a Pediatric Emergency Room (소아응급실을 내원한 환아 보호자의 미온수 마사지 경험실태)

  • Kang, Hae-Sook;Yun, O-Bok
    • Perspectives in Nursing Science
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    • v.7 no.1
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    • pp.65-74
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    • 2010
  • Purpose: The purpose of this study was to investigate the guardian's experience about tepid massage of children who visited Pediatric Emergency Room (PER). Methods: Data for this study was collected from August 1 to September 30, 2009 using questionnaires of 300 guardians who visited a PER. All data analyses were done using the SPSS 17.0 program and statistical data on frequency and percentage were obtained. $x^2$ test was done as well. Results: The results of this study were as follows: 73.7% of the guardians were doing the tepid massage, and 40% of them were doing the tepid massage when guardians thought that their children had a fever. 8.6% of them were incorrectly doing the tepid massage on their children such as using ice or alcohol. 90.5% of the children's condition changed when they had the tepid massage applied. Only 48% of the guardians got information about tepid massage, and 52.8% of the guardians got this information from the medical team. There were significant differences according to the education background about tepid massage (p<.001) and past hospital admissions history. There were differences according to whether their child had experience with febrile seizure(p=.085) and having more than one child at home (p=.085). Conclusion: This study revealed that the guardians were incorrectly doing the tepid massage on their children. The results of this study suggest that it is necessary to develop certain emergency nursing processes on accurate information and management strategies about tepid massage, and further studies on the effects of this kind education intervention are necessary.

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CASE REPORT OF PREMATURE CONTACT BY UNPROPER REDUCTION OF AVULSED TOOTH (탈구된 치아의 부적절한 재식으로 인한 조기접촉의 치험례)

  • Ra, Ji-Young;Kim, Dae-Eop;Yang, Yong-Sook;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.1-6
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    • 2005
  • Injury of permanent teeth by trauma usually occurs to $8{\sim}10\;years$ old children, in mixed dentition. Fracture, dislocation, intrusion, extrusion, avulsion are the common types of trauma in teeth. The injuries which teeth are dislocated from the alveolar sockets can be treated by reduction and fixation. In this case report two children visited Wonkwang University Dental Hospital after the emergency treatment of tooth injury by other medical institutes. In these cases the injured teeth were not reducted properly and showed premature contact. So the teeth were dislocated from the alveolar sockets intentionally and fixed again in the proper position. Unproper reduction can cause premature contact, delay of healing, difficulty of mastication, and malocclusion. For this reason emergency rooms or local dental clinics where patients with dental trauma can be examined first, must know well about the treatment procedure of the injured teeth and should be consulted to the profession when necessary.

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A Case of Primary Epiploic Appendagitis (원발성 복막수염 1례)

  • Ha, Tae Young;Kim, Chi Kwan;Jeong, Jin Young;Lee, Jong Hwa
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1024-1027
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    • 2002
  • Epiploic appendages are small, 0.5-5 cm long, peritoneal pouches containing small vessels and fat, located on the serous surface of the colon, from the cecum to the rectosigmoid junction. Pathologic states are rare in these appendages, the most frequent being is infarction either due to torsion or spontaneous. As a result of subsequent inflammatory reaction, the condition has been termed primary epiploic appendagitis. The condition is manifested by localized abdominal pain, which is often mistaken for appendicitis or diverticulitis and is usually diagnosed at surgery. With the aid of comtemporary imaging modalities, however, the diagnosis of epiploic appendagitis need no longer hinge on the pathologic specimen but may be established by the clinician. As this disorder recently has been demonstrated to be predominantly self-limited, laparotomy is no longer considered necessary. Conservative management has been shown to be safe. We report a 5-year-old male patient with epiploic appendagitis who presented with acute abdominal pain.

A Case of Grayanotoxin Intoxication Presenting with Mental Changes and Vomiting (의식 변화와 구토를 주소로 내원한 Grayanotoxin Intoxication 1예)

  • Kim, Cu-Rie;Kim, Dong-Soon;Lee, Hee-Woo;Ahn, Young-Min;Uhm, Ji-Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.223-225
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    • 2008
  • Rhododendron species is one of the largest and most diverse genera in the plant kingdom, comprising over 800 species and existing all over the globe. Grayanotoxin intoxication is caused by ingestion of honey and flowers. Grayanotoxin exists in honey, flowers, pollen, and nectar of the Rhododendron species. Grayanotoxin-intoxicated patients may present with nausea, vomiting, dizziness, weakness, hypotension, bradycardia, and syncope for several hours. We report a case of grayanotoxin intoxication associated with mental changes. A 9-year-old male presented with impaired consciousness and delirium 26 hours after eating about 10 rhododendron sclippenbachii flowers. A brain MRI and EEG were normal. Parenteral fluids were administered and these symptoms resolved completely in 17 hours.

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Methemoglobinemia development after ingestion of a chinese herbal medicine: A case report (한약 복용 후 발생한 메트헤모글로빈혈증 1예)

  • Hyun, Se Eun;Hwang, Pil Joo;Nam, Kyung Pil;Yoo, Eun Gyong;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.385-388
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    • 2009
  • An 8-year-old girl visited the emergency room with perioral cyanosis and dyspnea, which had developed 20 hrs prior to the hospital visit. She had taken a Chinese herbal medication for 3 days prior to the onset of the symptoms. A co-oximeter examination revealed a methemoglobin level of 23.7%. An intravenous infusion of methylene blue was administered. Chemical analysis of the herbal medication revealed an ammonia (NH$_{3}$) level of 239.41 mg/L. More studies are needed on the correlation between methemoglobinemia and the components of Chinese herbal medicines.

An Analysis of Pediatric Emergency Nursing Practice and Nursing Competence among Emergency Department Nurses (응급실 간호사의 소아응급간호 업무 및 간호수행자신감 분석)

  • Jeon, Heekyung;Im, YeoJin
    • Child Health Nursing Research
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    • v.25 no.2
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    • pp.143-153
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    • 2019
  • Purpose: The purpose of this study was to examine the frequency, perceived importance and competence of pediatric emergency nursing practice (PENP) in nurses who cared for pediatric patients in the emergency department. Methods: This cross-sectional descriptive study analyzed 175 emergency department nurses caring for pediatric patients at 7 university hospitals with more than 500 beds, located in Seoul and Gyeonggi Province. The measurement tool was modified from the Classification of Standard Nursing Activities to measure the frequency, importance of PENP, and nursing competence. It comprised 143 items in 16 domains of PENP. Results: The most frequent nursing practice was the domain of 'nursing records and environmental management' and the least frequent practice was the 'research and consulting' domain. The nursing care domain perceived to be most important by nurses was 'specialized intensive nursing care'. The nursing care domain with the highest level of nursing competence was 'hygiene care', and the domain with the least level of nursing competence was the 'research and consulting'. Conclusion: These results will be utilized as basic data for future pediatric emergency nursing education initiatives and for establishing priorities of nursing policy to improve health care for children admitted to the emergency department.