Browsing by Subject "paediatrics"

Now showing 1 - 6 of 6
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    Care Through Family: a conceptual model of children’s nursing care
    (2021) North, Natasha; Leonard, Angela; Bonaconsa, Candice; Coetzee, Minette
    This project aimed to work with nurses to describe and document their practice. Nurse researchers from CNPDI worked with five teams of nurses in diverse paediatric settings in southern Africa to develop detailed descriptions of how nurses involve families in the care of their hospitalised child. We observed care and interviewed nurses and families to develop detailed descriptions of practice. We used visual research methods including graphic facilitation, sociograms and photographic elicitation to construct a detailed picture of routines, activities and environments. Holistic accounts of ‘real’ nursing practices were constructed through 1:1 and group interviews, exploring the underlying rationales and values. Comprehensive case study reports were produced for each setting and reviewed by key nurse participants. Together, researchers and nurses developed statements reflecting the model of care. After analysis of the data we constructed a description of nursing practice in the form of a model of nursing care which we call ‘Care Through Family’. The model is ordered around six themes. Each theme has a guiding principle, in the form of an illustrative statement reflecting the philosophies of care observed. Implementation of the model is supported by a self-assessment tool to guide nursing teams through a facilitated process of reflection and further practice development.
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    Effects of aminophylline therapy on urine output and renal function in children with acute kidney injury in an African setting
    (2022) Nyann, Beatrice Irene; Mc Culloch, Mignon
    Background Acute kidney injury (AKI) is a frequent complication of children admitted to the paediatric intensive care unit and is associated with significant short term and long -term consequences. The causes vary from conditions that decrease intravascular volume to the use of nephrotoxic medications. One key management modality of AKI is the use of diuretics to reduce fluid overload which is an important indication for initiation of renal replacement therapy (RRT) - dialysis and also an important indicator of morbidity and mortality. Aminophylline, a drug that is well known for its use in the treatment of bronchial asthma is also purported to have diuretic effects on the kidneys. A paucity of data to support the use of aminophylline as diuretic and especially in children has occurred until a recent renewal of interest in this drug as a diuretic. In the Paediatric intensive care unit (PICU) of the Red Cross War Memorial Children's Hospital (RCWMCH), the use of aminophylline to augment urine output started in the early 2000s.This retrospective case-cross over study assesses the effect aminophylline in critically ill children with AKI; specifically, the effect on urine output, improvements in serum creatinine levels or limitations of renal replacement therapy as well as any age-related differences in aminophylline effects. Methods Children admitted to the PICU of RCWMCH with AKI (from 2012 to June 2018) were identified through a search of the PICU database, folders of cases were obtained, and a folder review carried out. Cases that fulfilled the inclusion criteria (that is children admitted to PICU with AKI who received aminophylline) were subsequently recruited. Data captured and analyzed included demographics, underlying disease conditions, medications, vital signs, urine output, renal function, arterial blood gases, RRT and outcomes of AKI. Results Thirty-five children were analyzed. Urine output increased from a median of 0.4mls/kg/hr [IQR: 0.1, 1.1] at six hours prior to aminophylline administration to 0.6mls/kg/hr[IQR: 0.2, 1.9] at six hours post aminophylline therap,1.0mls/kg/hr(IQR:0.2, 2.7) after twelve hours and 1.6 mls/kg/hr(IQR:0.2, 4.2) after twenty-four hours and this was statistically significant based on the Friedman's analysis of variance test (p=0.001).The median change in postaminophylline urine output after six hours was 0.05mls/kg/hr (IQR:0.0, 0.6) and this change did not vary significantly across the age groups (p=0.530). There was no significant change in serum creatinine levels six hours pre and post- aminophylline administration [109(77,227), 125.5(82,200) micromole/l] respectively, p=0.135. Sixteen out of the thirty-five children (45.7%) required renal replacement therapy.
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    Medicine and the Arts Week 2 - My song for the living
    (2015-01-21) Hendricks, Marc
    In this video, paediatric oncologist Mark Hendricks discusses the intersections between music and healing in the context of caring for children with cancer in middle-income settings. He discusses the importance of listening to and understanding the individual needs of children, and he emphasizes the importance of family-centered care, with the need to consider the social and cultural context when caring for children with cancer. This is the second video in Week 2 of the Medicine and the Arts Massive Open Online Course.
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    Paediatric anaesthetics
    (2019) Purcell-Jones, Jessica
    This video is an introduction to the various differences that can be observed when administering anaesthetics to a child as compared to an adult.
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    Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status
    (2023) Dunn, Cornelle; Cloete, Philip; Saunders, Colleen; Evans, K
    Background Procedural sedation and analgesia (PSA) is considered a core competency in emergency medicine as patients present to the Emergency Centre (EC) on an unscheduled basis, often complex complaints that necessitate emergent management (1). Previous evidence has consistently shown that procedural sedation and analgesia(PSA) in the EC in the paediatric population, even the very young, is safe if appropriate monitoring is performed and appropriate medications are used (2–5). The aim of the study was to describe the indications for PSA in the paediatric EC population, the fasting status of paediatric patients undergoing PSA, and the complications observed during PSA in a single Western Cape emergency centre. Methods A retrospective, descriptive study was conducted at Mitchells Plain Hospital, a district-level hospital situated in Mitchells Plain, Cape Town. All paediatric patients younger than 13 years of age who presented to the EC and received PSA during the study period (December 2020 – April 2021) were included in the study. Data was extracted from a standardised PSA form and simple descriptive statistics were used. Results A total of 116 patients (70,7% male) were included: 13 infants (<1 year of age) 48 young children (1-5 years of age) and 55 older children (5-13 years of age). There were only 2 (1,7%) complications documented, both of which were vomiting and did not require admission. The most of patients received ketamine (93,1%). The standardised PSA form was completed in 49,1% of cases. Indications for PSA included burns debridement (11,2%), suturing (17,2%), fracture reduction (23,3%), lumbar punctures (31,9%) and others (27,6%). The indications for PSA varied between the different age groups. Conclusion The study findings are in accordance with previous international literature. Emergency Centre PSA in the paediatric populations did not show an increase in interventions or complications, despite the fasting status (6). Safe, timely PSA with minimal pain and unnecessary suffering can become the norm in Emergency Medicine practice in South Africa.
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    Paediatric triage in South Africa
    (Health and Medical Publishing Group, 2013) Cheema, B; Stephen, C; Westwood, A
    Reducing child mortality is a high priority in sub-Saharan Africa, and swift, appropriate triage can make an important contribution to this goal. There has been a lot of interest and work in the field of triage of sick children in South Africa over the past few years. Despite this, in many parts of South Africa no formal system for triage of children in acute and emergency settings is used. This article aims to explain some of the key paediatric triage tools being considered and developed in South Africa. The triage tools discussed are the World Health Organization Emergency Triage Assessment and Treatment (ETAT), the South African adaptation of this tool known as ETAT-SA, the South African Triage Scale (SATS), and the Revised Paediatric SATS (P-SATS). The article describes how they were developed and their relevance to the country.