In paediatrics, it is crucial to ensure that the child who is clinically deteriorating is rapidly recognised and treated. We implemented a Paediatric Early Warning Trigger (PEWT) in our unit to improve recognition of these patients. Our trigger was a series of physiological measurements with a PEWT call if any result was outside the accepted range. We retrospectively compared 12 months prior to the introduction of the trigger (January to December 2009) to the three years post the introduction of the trigger (January 2010 to December 2012). We compared the time from deterioration to involvement of senior staff during the two time periods. We also examined the rates of crash calls and PICU transfers in the two periods. We found that the time from deterioration to senior clinician involvement reduced from 312 minutes to 166 minutes and the rate of transfers to PICU among the triage category 1 & 2 patients reduced from 1:50 in 2009 to 1:129, 1:118 and 1:131 during the three years of the trial. The rate of cardiac arrest among this group reduced from 1:100 in 2009 to 1:129, 1:216 and 1:542 during the three years of the trial. This study demonstrates the effectiveness of a Paediatric Early Warning Trigger in an Irish setting. We have been able to maximise senior clinician input into our sickest children in a more timely fashion
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Pediatr Cardiol
January 2025
Cardiothoracic Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
Lead strangulation is a dangerous complication of epicardial pacemaker insertion. This complication has been increasingly highlighted lately. Our institution has recently identified four cases over the past five years.
View Article and Find Full Text PDFJ Craniofac Surg
January 2025
Department of Pediatric Plastic & Reconstructive Surgery, Children's Hospital Colorado.
Introduction: Pediatric craniofacial trauma, particularly from non-accidental trauma (NAT), is a significant cause of injury with enduring physical and psychological impacts. This study analyzes demographic patterns, injury characteristics, and trends in NAT-related craniofacial injuries to inform early identification, intervention, and prevention efforts.
Methods: Analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database was performed for the years 2009 to 2019.
Int J Gynecol Cancer
January 2025
Hacettepe University, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Ankara, Turkey.
Background: Vulvar squamous cell carcinoma incidence is increasing, especially among women under 60, largely attributed to human papillomavirus infections. Precursor pre-invasive vulvar lesions are frequently underdiagnosed. Routine vulvar inspection during cervical cancer screening could offer an opportunity for the detection of these lesions.
View Article and Find Full Text PDFInt J Surg
January 2025
Department of Liver Transplant Center, Organ Transplant Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, P.R, China.
Objective: T cell-mediated rejection (TCMR) is a major concern following liver transplantation (LT), and identifying its predictors could help improve post-transplant prognosis. This study aimed to develop a model to predict the risk of TCMR in children and adults after LT.
Method: Pre-transplant demographic characteristics, intraoperative parameters, and especially early post-transplant laboratory data for 1,221 LT recipients (1,096 adults and 125 children) were obtained from Hospital, University, between 1 January 2015, and 1 January 2022.
Acta Paediatr
January 2025
Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Gothenburg, Sweden.
Aim: Newborn infants with critical aortic arch obstruction are often undiagnosed at discharge, despite screening. This study investigated if adding the perfusion index improved early detection.
Methods: We retrospectively studied 38 newborn infants with critical aortic arch obstruction, who were routinely screened in 2014-2019 by 13 Swedish hospitals using pulse oximetry and the perfusion index.
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