BACKGROUND: Alterations in peripheral thyroid hormone metabolism play an eminent role in the development of the euthyroid sick syndrome. Altered solvation may also lead to changes in peripheral thyroid hormones. Data on thyroid hormones in critically ill children remain unclear. AIM: This study was aimed to evaluate thyroid hormone profile in children with sepsis as well as to assess the association between thyroid level and sepsis outcome. METHODS: An observational cohort study was conducted in 80 children with sepsis from October 2015 to January 2016 in Haji Adam Malik General Hospital. T3 and T4 level were measured on day 1 and after > 72 hours of sepsis diagnosed. RESULTS: We recorded length of stay in PICU, patient outcome and analysed the relationship with the chi-square test. Level of T3 and T4 were decreased on day 1 in pediatric sepsis. Of 80 subjects, 57 (71.2%) with low-level T3 and 41 (51.2%) with low T4 were found. The relationship between T3 and T4 level on day 1 with the length of stay were not found (P = 0.500; P = 0.987). There were a significant relationship between level of T3 and T4 with outcome (P = 0.0001; OR 24.706; P = 0.014; OR 3.086). Subject with normal T3 and T4 level had 24 and 3 times life chances compare to lower level. CONCLUSION: The Euthyroid Sick Syndrome in children with sepsis does exist. There was a significant relationship between T3 and T4 level on day 1 with patient outcome.

Background Red cell distribution width (RDW) is a hematological

The technique of providing basic and quick life support (BHD) and transportation to patients with cardiac and pulmonary arrest can save a patient's life. An ambulance driver as one of the ambulance personnel should be equipped with the two forms of skills above. The aim of community service is to increase the capacity of ambulance drivers in terms of providing basic life support skills and patient transportation to improve patient safety. This training was held in September 2019, at the H. Adam Malik General Hospital Training Center Installation Medan, with 24 participants. The training is carried out with 2 methods, namely exposure to BHD theory and BHD skills training. The knowledge and skills of participants before and after the training were assessed. Pre and post assessment results were analyzed using paired t-test with a significance level of p <0.05 Ambulance drivers in the Medan Tuntung and Medan Sunggal area are mostly over 30 years old, with most working as ambulance drivers for more than 5 years. The most recent level of education is high school graduation or equivalent. The results of statistical analysis using paired t-test, obtained a significant difference in the knowledge of ambulance drivers about basic life support theory before and after training (p = 0.000). Likewise, ambulance driver skills in providing basic life support for adult patients, infants and children were significantly different before and after training (p = 0.000). Training in basic life support skills and patient transportation can increase the capacity of ambulance drivers in providing basic life support..

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BACKGROUND: Previous studies showed that platelet profile may reflect the platelet function better than the platelet count itself, but the study on its use as a prognostic indicator in critically ill children is still limited. AIM: We analyzed the association between platelet profile such as platelet count, plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) and mortality, also its correlation with pediatric logistic organ dysfunction-2 (PELOD-2) score in critically ill children admitted to the pediatric intensive care unit (PICU). METHODS: A prospective cohort study was conducted in PICU Haji Adam Malik General Hospital, Medan. Assessment of platelet profile (platelet count, PCT, MPV, and PDW) and PELOD score on the 1st and 3rd day of PICU admission were performed. RESULTS: Eighty-three subjects were recruited in this study, 44 were boy with a median age of 6 (1–17) years old. The septic patient was 43 subjects (51.8%). Platelet count on the 1st day (p = 0.024) and PDW on the 3rd day (p = 0.018) of PICU admission was significantly associated with mortality. There was no correlation between platelet profile and PELOD-2 score on day 1 and 3. However, the difference between MPV on days 1 and 3 (ΔMPV) significantly correlated with the change of PELOD-2 score (r = 0,647, p < 0.0001). CONCLUSION: Platelet count on 1st day and PDW on the 3rd day had a significant association with mortality but no correlation between platelet profile and PELOD-2 score.