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At least 19 recordsLinked to original sources
PubMed1991

[Measuring equipment for bedside diagnosis of respiratory function in spontaneously breathing newborn infants].

Equipment was developed for bedside lung function testing in the newborn using the simultaneous measurement of air flow rate, tidal volume, and esophageal pressure changes as a measure of transpulmonary pressure. The equipment has a number of advantages for the investigation of very low birthweight infants. A flow-through technique was used to eliminate the dead space of the face mask and a very thin micro-tipped catheter permits ready measurement of esophageal pressure. With this equipment, long-term measurements are also possible in oxygen-dependent newborns and the air-tightness of the mask can be monitored continuously. Long-time measurements in neonates are a prerequisite for standardizing the measuring conditions and adapting the duration of the measurement to the variability of the signals, especially in newborn with an irregular pattern of breathing.

Computer Systems↗
PubMed1979

New technique for servo-control of arterial oxygen tension in preterm infants.

Equipment has been developed for the servo-control of arterial oxygen tension in sick, newborn babies. Using an indwelling umbilical arterial oxygen electrode as sensor, the equipment successfully regulated the administration of oxygen to 12 newborn babies with respiratory distress syndrome, significantly improving the stability of arterial oxygen tension and lessening the duration of episodes of hypoxia and hyperoxia.

Arteries↗
PubMed1990

Immunization by inhalation of aerosolized measles vaccine.

The importance of effectively protecting infants against measles is substantial because of the number of lives that can be saved and the morbidity that can be prevented. (i) Infants contract measles before the recommended age of immunization. (ii) Circulating maternal antibodies render measles vaccination ineffective in many infants. These problems have led to clinical trials of immunizing infants using routes other than the usual subcutaneous one. One promising approach is the inhalation of aerosolized vaccine. This study was undertaken to try to immunize very young infants using easily accessible vaccine and ordinary equipment. Infants aged 4-6 months were selected for measles immunization by inhalation. They were clinically well, with no history of tuberculosis or asthma. From each child, 0.2 ml of blood was obtained by finger-prick. The blood was kept on ice, then centrifuged and the serum stored in a freezer at -20 degrees C. Each child was weighed and clinically assessed and his rectal temperature recorded. Using a plastic nebulizer to hold reconstituted vaccine by SCLAVO of Italy and an ordinary foot pump, the vaccine was aerosolized. One thousand TCID50 of the vaccine was administered to each child with a vinyl face mask for a period of at least 30 s, to allow him to retain 250 TCID50. The child was then clinically followed up three times a week for 4 weeks with particular reference to (i) fever, (ii) conjunctivitis, (iii) cough, and (iv) skin rash. None of the infants developed any of the above signs during the interval.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1992

Does the "Baby Cloche" heat shield keep low birth-weight infants warm?

To determine whether the "Baby Cloche" heat shield improves temperature control in low birth-weight infants we compared serial temperatures in 11 preterm infants nursed with or without the Cloche. Mean birth weights were 1490 and 1510 gm, mean weights at time of study 1680 and 1710 gm and mean postnatal age 20 and 27 days for study and control infants respectively. Serial measurements of rectal, abdominal skin, dorsum of the foot, Cloche wall and room temperature were recorded once or twice daily for 2 to 5 days. Mean rectal temperatures increased with increasing age from 35.3 in the first week of life to 37.0 degrees C by the third week (P less than 0.001). In infants nursed under the Cloche who were over 2 weeks of age mean rectal, abdominal and foot temperatures were 0.5, 0.6 and 1.6 degrees C higher (P less than 0.001); in younger infants there was no significant difference in any of the temperatures. Our findings suggest that the "Baby Cloche" improves temperature control in preterm infants over 1600 gm who are more than 2 weeks of age.

Age Factors↗
PubMed1996

Injury prevention counseling opportunities in pediatric otolaryngology.

OBJECTIVE: To determine the prevalence of injury prevention counseling opportunities in children referred to a pediatric otolaryngologist. DESIGN: A caregiver questionnaire was administered during office registration. SETTING: Hospital-based pediatric otolaryngology practice in a metropolitan area. PATIENTS: Random sample of 300 caregiver questionnaires stratified by the age of the child. MAIN OUTCOME MEASURES: Prevention counseling opportunities, defined as ignorance of hottest water temperature, child exposure to passive smoke, missing smoke detectors on one or more floors in the home, or failure to use a seat belt or bicycle helmet. RESULTS: The hottest water temperature was unknown by 72% of the caregivers, smokers were present in 25% of the households, bicycle helmets were not used by 22% of the children, car seats or seat belts were not used by 11% of the children, and 10% of the homes did not have a working smoke alarm on each floor. Older children were significantly less likely to use a seat belt than were younger children. Although 98% of the caregivers had a regular pediatrician, 91% of the families still offered one or more counseling opportunities (95% confidence interval, 87% to 94%). CONCLUSIONS: Substantial opportunities exist for injury prevention counseling in pediatric otolaryngology. At least one opportunity for counseling is present for about 90% of the families, most often concerning the maximum safe hot water temperature.

Bicycling↗
PubMed1993

Taxicabs and child restraint.

For young urban families who may not own a car, taxicabs are a common mode of transportation. We surveyed the frequency of taxicab use involving children younger than age 4 years in a Baltimore, Md, clinic population and studied pediatric occupant safety issues, including taxicab child restraint law exemptions, taxicab occupant morbidity/mortality data, and taxicab child restraint device availability. In our inner-city clinic, 84 (78%) of 108 families reported that they did not own a car and 64 (76%) of those without cars rode with their small children in taxicabs at least monthly (n = 28), weekly (n = 27), or daily (n = 9), all without child restraints. Thirty-five of 50 states (70%) plus Washington, DC, exempt taxicabs from child restraint laws. Only 11 (27%) of 41 states with safety belt laws exempt taxicabs. There were 106 reported taxicab occupant fatalities from 1986 to 1990 in the United States, including 11 children and adolescents. National and state data on motor vehicle occupant morbidity do not separately examine taxicabs. Individual taxicab fleets we contacted would not release injury data. Of 50 urban taxicab fleets in four states (Delaware, Maryland, New Jersey, and Pennsylvania), only three (6%) offered child restraint devices by advance telephone request. There was no difference in availability based on state taxicab exemptions from child restraint laws. We conclude that taxicab use involving young children is common in this inner-city population. Data on taxicab occupant injuries are needed. Child restraint law exemptions for taxicabs should be eliminated. Education about, and enforcement of, child restraint laws for taxicabs is needed. Recent local legislation linking child restraint device availability to taxicab licensure should be encouraged.

Accidents, Traffic↗
PubMed1995

Epidemiology of shopping cart-related injuries to children. An analysis of national data for 1990 to 1992.

OBJECTIVE: To describe the epidemiologic characteristics of shopping cart-related injuries among children in the United States. DESIGN: A retrospective analysis of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for 1990 to 1992. RESULTS: An estimated 75,200 shopping cart-related injuries occurred in children younger than 15 years treated in US emergency departments during 1990 to 1992 (95% confidence interval, 57,500 to 92,900). Children younger than 5 years were at highest risk, accounting for 63,200 (84%) of the injuries. A 20% increase was observed in the number of injuries among 0- to 4-year-old children from 1990 to 1992. Fifty-three percent of injured children were male. The head and neck region was the most common anatomic site of injury, accounting for 74% of injuries among children younger than 15 years. An estimated 2000 children (2.7%) younger than 15 years required hospital admission (1.2% in 1990 compared with 3.5% in 1992). Children aged 0 to 4 years accounted for 93% of these hospital admissions. Among 0- to 14-year-old children, fractures accounted for 45% of hospital admissions, followed by internal injury (22%) and concussion (17%). CONCLUSIONS: Injuries related to shopping carts are an important cause of pediatric morbidity, especially among children younger than 5 years. These injuries can also result in death. Shopping carts should be redesigned to decrease the risk of injury to children, and transportation of children in shopping carts of current design should be prohibited.

Accidental Falls↗
PubMed1996

Child restraint device use in patients leaving a children's hospital.

OBJECTIVE: To determine the frequency of and factors associated with the use of child restraint devices (CRDs) in patients leaving an urban children's hospital. DESIGN: Verbally administered survey, followed by observation of CRD use. SETTING: Main parking area at an urban children's hospital with mandated use of parking attendants. PARTICIPANTS: A convenience sample of 295 parents or guardians who were leaving the hospital and were accompanied by at least 1 child younger than 48 months. RESULTS: Eighty percent of the respondents were female; 77% of the respondents were white and 22% were African American. Two hundred thirty-five (80%) used CRDs. Subjects who were at risk of CRD noncompliance included nonwhite individuals (adjusted odds ratio [OR], 6.6; 95% confidence interval [CI], 3.0-14.5), those whose primary source of medical care was from a public clinic (OR, 2.4; 95% CI, 1.1-5.3) or from a specialty clinic (OR, 2.4; 95% CI, 0.8-6.6), and those who were older than 24 months (OR, 8.7; 95% CI, 3.5-21.9). Parental education and income level were not important predictors of CRD compliance controlling for race, primary medical care source, and age. Study participants were observed for incorrect CRD use; 30% (30/ 99 of infants younger than 12 months were incorrectly placed in the forward-facing position, and 23% (54/ 235 of all CRD users did not use its harness. CONCLUSIONS: Patients who use public clinics or pediatric subspecialists as their primary source of medical care, especially those who are African Americans, are at risk of CRD noncompliance. Children's hospitals should take an active role in improving CRD use in these patients.

Child, Preschool↗
PubMed1997

Suspended rocking cradles, positional asphyxia, and sudden infant death.

OBJECTIVE: To describe the risk of unexpected death in infants who are placed in suspended rocking cardles. MAIN OUTCOME MEASURES: Ten cases of sudden infant death and 5 cases of infant asphyxia with successful resuscitation reported to the Consumer Product Safety Commission were analyzed. The death scene investigation reports and autopsy material were made available for evaluation. All 15 cases implicated a suspended head-to-toe rocking cradle. RESULTS: Infants were aged 3 months or younger and were found in the facedown prone position when discovered. The cradle was tilted at greater than 5 degrees, and the head was wedged at one end of the cradle. A locking pin was not used in 14 cases. Ten of the 15 infants died. The autopsy reports listed sudden infant death syndrome as the cause of death. CONCLUSIONS: Suspended rocking cradles represent a potentially lethal sleeping environment and should not be used without a locking pin in place. Infants should be placed in the supine position for sleep.

Asphyxia↗
PubMedDate not supplied

Head injuries in infants and children: measures to reduce mortality and morbidity in road accidents.

In the 6-year period from 1983 to 1988, 12 infants (less than 24 months of age) and 103 children (2 to 14 years of age) were killed in road crashes in South Australia. This represents an annual incidence of 6.4 deaths per 100,000 children at risk. At least 4 other children were killed in off-road vehicle-related accidents. Of these deaths, approximately half were car passengers, one third pedestrians, and one sixth pedal cyclists. Most of these infants and children died at the accident site or soon after, but 26 of them survived long enough to be admitted to hospitals with neurosurgical units and an audit of these patients suggests that there were at least 3 preventable deaths. However, autopsies of 78 patients show that the great majority of these deaths resulted from devastating brain and/or trunk visceral injuries. Better emergency care and the use of neurosurgical retrieval teams may save some lives. But more lives might be saved by the use of appropriate restraints for infants and children in cars, by reducing the exposure of child pedestrians and cyclists to road traffic, and by mandatory use of helmets by child cyclists. Off-road vehicular accidents are not as a rule included in road crash statistics; the practice of giving small motorcycles to young children has created a new category of vehicular accidents sometimes causing severe head injury.

Accidents, Traffic↗
PubMed1995

Promoting hospital discharge of infants in safety seats.

In 1990, the American Academy of Pediatrics (AAP) Committee on Injury and Poison Prevention issued a policy statement, "Safe Transportation of Newborns Discharged from the Hospital," recommending that hospitals adopt comprehensive policies, procedures and education programs for the discharge of newborns in child safety seats (CSSs). The purpose of this project was to determine if a statewide educational intervention based on the AAP statement would be effective in bringing about those recommendations in Nebraska hospitals. All hospitals providing newborn services in Nebraska were surveyed prior to and after the intervention to determine the nature and extent of their CSS discharge policies, patient education programs and loan programs. Post-intervention data indicate significant increases in the percentage of hospitals having formal infant CSS discharge policies (from 25.9% to 88%), providing CSS patient education (from 51% to 95%), and having safety seat loan/give-away programs (from 59% to 76%). It is concluded that a comprehensive, statewide educational program can influence hospitals to promote usage of, access to, and education with infant CSSs.

Accidents, Traffic↗
PubMed1990

Factors influencing the use of infant car restraints.

Over a six-week period 100 mothers in Dunedin, New Zealand obtained General Motors infant car seats from a rental scheme. In interviews conducted in the maternity hospital, before the seats had been used, the mother's perceptions of the comfort and ease of use of the seat were recorded. All mothers rated the seats as very safe. From details of 2,830 car trips undertaken by these mothers while their infants were 0-3 months old and from a further 687 journeys by 85 of those mothers when their infants were 4-6 months old we found that an infant car seat was used for only 72% of journeys with the younger infant compared to 91% of journeys with the older infant. Those mothers who had rated the seat--before ever using it--as appearing uncomfortable or difficult to use were less likely to make use of it. The seat was least likely to be used when the mother was going out for more than two hours in the evening for some purpose that involved only a short car journey.

Accidents, Traffic↗