ABSTRACT
For a large number of ischaemic, infective, inflammatory or traumatic conditions, hyperbaric oxygen therapy is either the only treatment or an adjunct that significantly reduces morbidity and mortality. The primary aim of this review is to identify clinical conditions treated in a paediatric population referred to Australian hyperbaric units. Secondary aims are to describe outcomes of treatment and detail any complications occurring during treatment or during transfer between units. This was a retrospective cohort study (January 1998-December 2011) of children treated at four Australian hyperbaric medical units. A total of 112 children underwent 1099 hyperbaric treatments for 14 indications. Ages were not normally distributed with a median age of 14 years (interquartile range 11-16; range 0.25-16 years). Treatments were completed as planned in 81.5% of cases with 25 patients' treatment terminated at the request of physicians, parents or patients. Complications relating to hyperbaric oxygen therapy occurred in 58 treatments (5.3%). Central nervous system oxygen toxicity occurred in 1:366 treatments. Our findings indicate that provision of hyperbaric oxygen therapy to children is feasible in major regional hyperbaric units and is associated with low complication rates. Management of children in an adult hyperbaric facility, however, requires significant cooperation between paediatric, intensive care and hyperbaric consultants, as the need for transfer to another hospital and prolonged transports often impacts on optimal ongoing surgical and intensive care management.
Subject(s)
Hyperbaric Oxygenation/methods , Patient Transfer/methods , Adolescent , Australia , Child , Child, Preschool , Cohort Studies , Feasibility Studies , Female , Humans , Hyperbaric Oxygenation/adverse effects , Infant , Male , Retrospective Studies , Treatment OutcomeSubject(s)
Antivenins/therapeutic use , Spider Bites/therapy , Adult , Disabled Persons , Female , Humans , Male , Middle Aged , Spider Bites/complications , Spider Bites/physiopathology , Spider Venoms , Time FactorsABSTRACT
Plain abdominal radiographs are ordered frequently in emergency departments. Previous studies have shown that these radiographs are often requested inappropriately with little likelihood of producing useful information. This study shows that the overall number can be reduced significantly, with little risk to patients, when clear guide-lines are applied.
Subject(s)
Emergency Service, Hospital/organization & administration , Radiography, Abdominal , Abdomen/diagnostic imaging , Humans , UltrasonographyABSTRACT
The published literature in Australia on red-back spider-bites allows no means of determination of the incidence of this envenomation. This retrospective study describes the experience at Fremantle Hospital with red-back spider-bites over a six-year period from 1982-1987 inclusive. One hundred and fifty patients were admitted to hospital with a definite red-back spider-bite, of whom 32 (21%) patients received antivenom; 11 (34%) of these patients received more than one ampoule. In earlier series, only 3% of patients have received more than one ampoule. These results suggest that the WA red-back spider is particularly venomous, and that the annual number of definite red-back spider-bites in Australia lies between approximately 830 and 1950 cases.
