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Biomedical subjects

L M Bernardo

Publications and source records attributed to L M Bernardo.

33 records · Page 2Linked to original sources
PubMedDate not supplied

Dog bites in children admitted to Pennsylvania trauma centers.

Dog bites are a major public health problem in the pediatric population, requiring emergency treatment for wound repair and possible hospitalization in a trauma center. Data from the Pennsylvania Trauma Outcome Study were analyzed, and the records of 183 pediatric dog bite patients from 1990 to 1995 were evaluated. Dog bites were found to constitute a very small proportion of the total pediatric admissions to Pennsylvania trauma centers; however, the findings were similar to other reported studies.

Animals↗
PubMedDate not supplied

Pediatric implications in bioterrorism part I: physiologic and psychosocial differences.

Children are physically and psychologically different from adults and require care modified to meet their needs. In the event of a bioterrorism attack, the child's stage of development can help or hinder his or her response to bioterrorist material. This Part 1 of a series of articles addresses the differences found in children and how health care providers can alter interventions to avoid causing further harm.

Adolescent↗
PubMedDate not supplied

Pediatric implications in bioterrorism part II: postexposure diagnosis and treatment.

Bioterrorism is an old tactic used in warfare. The use of fatal diseases or man-made poisons to subdue others has not been limited to wartime. Trauma personnel should be aware of commonly used agents, the signs and symptoms of their exposure, and recommended treatment. Children can be victims of terrorists' acts and need special attention because of their unique response to exposure, varying dosages of medications, and lack of active immunity.

Anthrax↗
PubMedDate not supplied

SCIWORA syndrome: nursing assessment.

Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) is a commonly misdiagnosed injury in children and adolescents. Failure to recognize SCIWORA can lead to additional injury. The critical care nurse recognizes the risk of SCIWORA, conducts a complete neurologic assessment on children experiencing cervical trauma, and provides immediate immobilization to prevent further neurologic complications. These pediatric neurosurgical and trauma nurse authors describe the nurse's role and include a SCIWORA case study in this article.

Adolescent↗
PubMedDate not supplied

Evidence-based practice for pin site care in injured children.

External fixation is an accepted treatment modality for pelvic and long-bone fractures in children following a traumatic injury. One aspect of nursing care in children receiving external fixation is pin site care to prevent pin tract infection. A review of the nursing and medical literature reveals common clinical guidelines for pin site care, such as observing for infection, cleaning the sites, removing crusts, and applying dressings. There is no evidence-based practice for the care of pin sites in children or adults receiving external fixation devices for pelvic or long bone fractures to prevent infection. While the nursing literature describes pin site care techniques, the surgical literature describes the prevalence of pin tract infection. Neither set of literature consistently addresses the protocols for and outcomes in pin site care. Experimental research is needed to create evidence-based practice guidelines for pin site care to prevent pin tract infection.

Child↗
PubMedDate not supplied

Analgesic prescription and administration to adolescents admitted to an adult versus pediatric trauma center.

OBJECTIVE: To compare the prescription and administration practices for narcotic and non-narcotic analgesics given to injured adolescents admitted to an adult versus pediatric trauma center. METHODS: A retrospective chart review of 45 medical records for documentation of prescribed and administered analgesics in the first 48 hours of hospitalization. RESULTS: Adolescents treated at the adult trauma center had significantly more narcotics ordered in the first 24 hours of admission compared to adolescents in the pediatric trauma center. However, when controlling for injury severity, there was no difference between the narcotic administration at the two trauma centers. There were no differences in the types or numbers of doses of non-narcotic analgesics prescribed or administered. CONCLUSION: There were no differences in the prescription or administration of narcotic and non-narcotic analgesics to injured adolescents in an adult versus a pediatric trauma center. Future research should focus on the prospective enrollment of injured adolescents at additional trauma centers and a larger sample size to validate or refute these findings.

Adolescent↗
PubMedDate not supplied

Pediatric sledding injuries in Pennsylvania.

OBJECTIVE: To describe the frequency, characteristics, and circumstances of pediatric sledding-associated injuries and to assess the validity of published risk factors and prevention measures for these injuries. METHODS: A retrospective, descriptive study of patients admitted to the 25 accredited trauma centers in Pennsylvania. RESULTS: Two hundred twenty-six patients were admitted for sledding-related injuries. Sixty-nine percent were male. The mean ICU LOS was 1.2 days (SD = 3), and the mean hospital LOS was 7 days (SD = 7.2). Ninety-eight percent were discharged alive. Forty-seven percent of the ISS scores were classified as moderate (ISS 7-15). There was almost no correlation between age and ISS (r = 0.06), but there was moderate correlation between ISS and length of ICU stay (r = 0.47). Hitting trees and stationary objects (n = 121) was the most common circumstance of injury. Patients struck by moving vehicles (n = 16) had the highest proportion of head (30%) and chest (15%) injuries, the highest mortality rate (33%), the highest median ISS score (20) and the highest mean ICU LOS (6.4 days) compared to patients who hit stationary objects or fell. CONCLUSIONS: Among children admitted to Pennsylvania trauma centers, most sledding injuries were of a mild and moderate severity and required an average of a week's hospitalization. Most children were injured from collision with stationary objects, supporting the precaution against sledding in areas with obstacles. The high mortality rate from motor vehicle/sled collisions justifies the prohibition against sledding in areas with moving vehicles.

Adolescent↗
PubMedDate not supplied

Dog bites in children treated in a pediatric emergency department.

ISSUES AND PURPOSE: Unintentional injury is the leading cause of death and disability among children. This study sought to describe the characteristics of dog bite injuries to aid in promoting healthy environments for children. DESIGN AND METHODS: This descriptive, retrospective study of one hospital's 1997 emergency department records detailed dog bite injuries to children and adolescents and resultant emergency treatment (N = 204). RESULTS: Children < or = 5 years of age accounted for 49% of the injuries. The biting dog's owner was generally a parent or neighbor. Only 2 children received rabies prophylaxis. PRACTICE IMPLICATIONS: Parents and children need information about safe interactions with dogs, including community leash laws and quarantine guidelines. Nurses should know the procedures for reporting dog bite injuries to local health authorities. Interested nurses can find many opportunities to assist with community safety campaigns.

Adolescent↗
PubMedDate not supplied

Playground injuries in children: a review and Pennsylvania Trauma Center experience.

ISSUES AND PURPOSE: To describe patient demographics, injury characteristics, and circumstances of playground injuries in children admitted to Pennsylvania trauma centers and to identify injury prevention strategies. DESIGN AND METHODS: Retrospective, descriptive study of 234 children ages 1 to 18 years sustaining playground-related injuries and whose hospital data were entered into the Pennsylvania Trauma Outcome Study. RESULTS: Most of the injuries occurred between April and September (77%), and noon to 6 P.M. (69%). Falls from playground equipment constituted the highest proportion of incidents (73%). Of 421 injuries (M = 1.8/patient), most were upper extremity (n = 117) and head (n = 110) injuries. PRACTICE IMPLICATIONS: Nurses can advocate for playground safety by teaching children to play safely and recommending age-appropriate equipment and protective surfacing.

Accidental Falls↗