Where should paediatric surgery be performed?   Commentary   Commentary   Commentary

Arul, G. Suren; Spicer, R. D.

doi:10.1136/adc.79.1.65

Cited by 74 publications

(18 citation statements)

References 58 publications

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“…Since there was no paediatric surgeon at the regional hospital, some of the patients with congenital malformations had to be stabilised and referred on to one of two teaching hospitals which are 445 and 303 km away from UWRH. Thus, protocols for stabilisation and direct transfers need to be explored to save time [49]. It is unfortunate that one of the children who presented with bleeding after circumcision died since the condition can be prevented by ensuring that all babies, especially those born in the community, receive vitamin K and are treated with blood transfusion if necessary, though other causes of bleeding in the newborn need to be excluded [18,50].…”

Section: Discussionmentioning

confidence: 99%

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

et al. 2020

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Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.

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Section: Discussionmentioning

confidence: 99%

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

et al. 2020

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“…70 It is generally accepted that pathologists seeing relatively few examples of certain specimen types will have a greater chance of producing an incorrect report. In medicine as a whole, there is an increasing recognition of the need for specialist experts to carry out specific tasks, [84][85][86] and this is also likely to be true for histopathology. Pathologists seeing insufficient numbers of rare or complex specimen types should probably not be reporting them.…”

Section: Using Audit To Minimize Errors In Reportsmentioning

confidence: 99%

Errors in histopathology reporting: detection and avoidance

Ramsay

1999

Histopathology

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The histopathological diagnosis is the bedrock of modern oncology, and plays a major role in the treatment of many other types of disease. Errors in these reports can critically affect patient care and may become the subject of media concern. This article considers how audit in histopathology can provide information about errors and inconsistencies in the diagnosis of surgical specimens. The use of audit to generate information about the background level of errors in pathology reports is reviewed, along with findings about the nature of these errors and the types of specimens more commonly affected. Generic audit strategies that can be used to minimize the risk of errors in reports are discussed, together with the use of audit to evaluate diagnostic criteria and pathological scoring or grading systems. The role of audit in determining the informational content of reports is included, and there is consideration of the relationship between sample size and error rates. The limited extent to which audit can be used to assess the performance of individual pathologists is also covered.

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“…There is better training for anaesthetists and assistants, including the rationalisation of paediatric surgical and anaesthetic services. [29] Increasingly, senior clinicians are directly involved in the care of children, with better individualisation of anaesthesia to suit the child and the avoidance of dogmatic regimens of care. Traditional RSI may still be the ‘gold standard’ for emergency surgery associated with bowel obstruction or bleeding post tonsillectomy in children.…”

Section: Introductionmentioning

confidence: 99%

Paediatric airway management: What is new?

2012

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Airway management plays a pivotal role in Paediatric Anaesthesia. Over the last two decades many improvements in this area have helped us to overcome this final frontier. From an era where intubation with a conventional laryngoscope or blind nasal intubation was the only tool for airway management, we have come a long way. Today supraglottic airway devices have pride of place in the Operating Room and are becoming important airway devices used in routine procedures. Direct and indirect fibreoptic laryngoscopes and transtracheal devices help us overcome difficult and previously impossible airway situations. These developments mean that we need to update our knowledge on these devices. Also much of our basic understanding of the physiology and anatomy of the paediatric airway has changed. This article attempts to shed light on some of the most important advances/opinions in paediatric airway management like, cuffed endotracheal tubes, supraglottic airway devices, video laryngoscopes, rapid sequence intubation, the newly proposed algorithm for difficult airway management and the role of Ex Utero Intrapartum Treatment (EXIT) procedure in the management of the neonatal airway.

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Where should paediatric surgery be performed? Commentary Commentary Commentary

Cited by 74 publications

References 58 publications

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

Errors in histopathology reporting: detection and avoidance

Paediatric airway management: What is new?

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