Emergency Department analgesia for children with acute appendicitis in Israeli government hospitals is markedly low. Patient-provider ethnic discordance may negatively influence the provision of analgesia. Significant efforts should be undertaken in order to increase analgesia provision rates and reduce social inequality.
Pediatric morbidity due to unintentional poison exposure is a significant burden on public health. We prospectively characterize patterns of unintentional poison exposure in a single pediatric emergency department, using a detailed computerized questionnaire for all unintentional injuries admitted during 2009 to 2017. Out of 71,765 visits due to unintentional injuries, 252 children were admitted due to unintentional poison exposure. Most (198/252, 79%) were between 1 and 3 years of age. The majority of events (209/252, 82.9%) occurred at the patient’s home and 81% (205/255) were classified as exploratory ingestion. In 41/252 (14%) cases, exposure to more than one substance was reported. Most events 231/293 (79%) involved medications and 21% were due to domestic products. Four medications account for 45% of the events (Paracetamol, Salbutamol, Antihypertensive, and Antidepressants). Opioids were responsible for only 1.7%. By, collaboration between government, public health, educational institutions and commercial companies, can the burden of pediatric unintentional poison exposure be reduced.
Introduction: Disaster Medicine (DM) requires skills, knowledge, and prior experience that are rarely put to test by health care providers. Pediatric DM presents unique challenges in terms of both knowledge and practice. Methods: An anonymous survey consisting of demographic and five-point Likert scale questions was administered to physicians, nurses, and other medical personnel from Israel’s major medical emergency teams who were deployed to respond to the refugee crisis in Ukraine. This included teams from the Hadassah and Tel Aviv Sourasky Medical Centers and the Israel Ministry of Health. Results: Of the 171 members of the medical teams deployed on the Ukraine border, a total of 105 responses were obtained (61.4%) from 61 physicians, 50 nurses, and 12 other health care providers. The teams were composed of pediatricians (31.6%), internal medicine physicians (21.6%), Emergency Medicine and intensive care physicians (18.0%), and 31.0% other specialties. For 60% of the participants, this was their first deployment, and 78% had received no training in DM. Members rated the need for DM training at 4/5 (IQR 3-5). Forty-nine (49) members (46.6%) were not briefed on situational awareness and 97 members (89.5%) were not trained in the recognition of acute stress reactions. The responders also rated their concerns about providing medical aid to children at 2/5 (IQR 1-3). A medical clown was part of the teams 42.8% of the time; the presence of clowns was rated at a median of 4/5 (IQR 4-5). The team members underscored the need for more targeted training in DM at 5/5 (IQR 3-5). Conclusion: The findings highlight the need for the formulation of a disaster education model that includes pediatric DM.
Abstract: Introduction: The impact of SARS‐CoV‐2 infections in children has generally been described as relatively benign. However, since April 2020, there have been reports of a new multisystem inflammatory illness affecting children and related to COVID‐19 termed Multisystem inflammatory syndrome in children (MIS-C). Aim: To describe three cases of children diagnosed with MIS-C and discuss the disease spectrum. Methods: We collected and reviewed data from three cases diagnosed with MIS-C admitted to our pediatric ward between October 2020 and January 2021. Discussion: MIS-C is a newly described disease that spans a spectrum of phenotypes and severity, and while it shares clinical similarities with Kawasaki disease, it has a unique set of epidemiological, laboratory and prognostic characteristics. In this review, we hope to add to the understanding of this new entity.
Background: The ongoing global refugee crises have raised concerns among medical communities worldwide. Methods: We compared data from refugee and Israeli children admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017. Results: 104,244 visits (0-18 years) to the pediatric emergency department (PED) were recorded. Admission rate to the PD for refugees was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli patients (P< 0.001). After matching for age groups (0-5 years), the hospital stay duration for the 0-2 years age was 3.22 (±4.80) days for the refugees and 2.78 (±3.17) for the local population (P<0.03). For 0-2 year old children, re-admission rates within 7 days, were 1.3% for refugees and 2.6% for Israelis, (p<0.05). Dermatological diseases (mainly impetigo and cellulitis) were more frequent in refugees (23.30% vs. 13.15%, p<0.01), however, acute gastroenteritis and respiratory diagnoses were more common in Israeli children (11.72% vs. 18.52%, p<0.05 and 6.26% vs. 14.84%, p<0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli patients (7.7% vs. 3%, P<0.05). Very significantly, 23% of refugees had no health care coverage, while only 0.2% of the Israeli patients had no medical coverage (P < 0.001). Conclusion: We found evidence for significant morbidity in refugees as compared to the local Israeli pediatric population, highlighting the need for tailoring different approaches to this fragile population.
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