and financial data from 08/2020-04/2021 were tracked through the electronic health record, Palliative Care Quality Network registry, and McKesson Horizon Performance Manager.Results: Over 8.5 months, the ED-embedded PC service saw 565 consults. Of these, 46% had a code status change, 8% admitted to a lower level of care, 9% avoided hospitalization, and 13% newly referred to hospice. ED consult volume was consistent month-over-month. ED length-of-stay did not appreciably lengthen. None of these cases were related to COVID-19. Importantly, this additional consult team did not cannibalize inpatient consult volume from usual practice. Compared to inpatient PC consults, median hospital length-of-stay decreased from 10.8 days to 3.3 days (p<0.
Objective: The objective of this study was to compare the safety and efficacy of intranasal midazolam with intravenous lorazepam in acute seizures in children. Methods: Children aged 6 months–12 years with active tonic/clonic/tonic-clonic seizures coming to the pediatric emergency department were enrolled in the study after getting informed consent. Groups were randomly distributed (Group 1: Intranasal midazolam; Group 2: IV lorazepam) and the sample size was 80 (40 in each group). Under clinical and pulse oximetry monitoring, aqueous midazolam 0.2 mg/kg was administered intranasally through automated aqueous intranasal spray(Midacip 0.5mg per puff) in lying down or in 45° propped up position to Group 1, while injectable lorazepam 0.1 mg/kg was administered intravenously slow (to a maximum of 4 mg) to Group 2. Results: Both the groups were found to be comparable in baseline characteristics. Mean time to administer the drug after arrival to the doctor in intranasal midazolam and IV lorazepam was 3.65 (standard deviation [SD] 1.167) min and 7.93 (SD 3.23) min, respectively (p=0.0001). Intranasal midazolam group had significant control of seizures in <5 min of arrival (p=0.0006). The control of seizures within 1 min after drug administration was also found to be more effective in midazolam group (p=0.004). No adverse effects or respiratory depression were found in any of the groups. Conclusion: The ease to administer, effectiveness, and rapid onset of action of intranasal midazolam without causing any respiratory depression enable it to be considered as a first-line drug for acute seizures in all settings including homes/day-care centers.
Background: Screening for diseases is not very popular in Indian populace in general, and receive little attention from heath care policy makers, administrators or even health care providers, who concentrate on curative services. Health and nutritional screening of school children and adolescents, remains virtually a neglected field. So we conceived this study to look at the feasibility of large scale health screening of adolescents at school by a simple and inexpensive way by looking into the nutritional status (survey of anthropometry) and blood pressure readings among adolescents.Methods: Students from 5 rural school in South India from age group of 10 to 18 years (fifth to twelfth standard) were assessed for their height, weight, BMI and blood pressure. Data was entered in WHO EpidataTM (version 3.0) and transferred to SPSS 12.0 version for analytical studies.Results: In current study of 2201 students, wasting (35.5%), stunting (24.5%), high BMI (7.6%) were found. Prevalence of wasting is 1.63 times higher in males (p<0.001). There is significant relationship with high BMI and severe stunting (p<0.001, OR 2.54; 1.58%, 4.1%; 95% CI). Prevalence of pre-hypertension is 14.1% and hypertension is 9.5%. There is a linear trend in the prevalence of hypertension and BMI (p<0.001). As the BMI increases, blood pressure also increases.Conclusions: Even with all advances in health care, undernutrition is highly prevalent. Obesity is on a rise in rural population and high proportions of overweight children are stunted also. High BMI is a risk factor for hypertension.
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