Incorporation of a "Coping with the Death of a Child" module into the pediatric advanced life support (PALS) curriculum.

OBJECTIVE: To develop an educational module for health professionals (HPs) addressing the clinical reality of death as an outcome of pediatric resuscitation efforts. Module goals were to: 1) reduce HPs' discomfort with situations involving patient death and survivor grief, 2) assist HPs coping with their own emotions surrounding a patient death, and 3) provide specific strategies useful in clinical management. The module was designed to be presented as part of the American Heart Association (AHA) and the American Academy of Pediatrics (AAP) Pediatric Advanced Life Support (PALS) provider course. METHODS: A multidisciplinary team created a module addressing both survivors' and HPs' needs regarding a PALS course "Coping with the Death of a Child" module. The module was presented to 964 PALS course participants. Content was revised after analysis of survey data collected from these participants. RESULTS: The revised module was presented to 601 PALS course participants; evaluations were obtained from 590 participants. On a 4-point Likert scale, ratings were: 79% "excellent," 18% "good," 2% "fair," and <1% "poor." CONCLUSION: The PALS course offers an opportunity to target HPs likely to encounter pediatric deaths for special education. While this is a challenging and potentially controversial topic to present to a diverse audience, incorporation of a "Coping with the Death of a Child" module into the PALS provider curriculum appears to be both feasible and useful.

Astemizole-induced cardiac conduction disturbances in a child.

The newly available antihistamine astemizole (Hismanal) has been previously associated with hemodynamically significant cardiac tachydysrhythmias. We describe a 3-year-old girl who developed multiple different cardiac dysrhythmias after an astemizole overdose. No hemodynamic compromise occurred, and the electrocardiogram returned to normal without use of antiarrhythmic agents within 7 hours.

Reliability, validity, and temporal stability of the geriatric depression scale in hospitalized elderly.

The reliability, validity, and temporal stability of the Geriatric Depression Scale (GDS) were studied in sixty-nine elderly patients who had their broken hips surgically repaired. The GDS demonstrated internal consistency reliability and concurrent validity with the Hamilton Depression Rating Scale. In addition, the GDS was stable across the hospital stay and thus appeared to be less influenced by the patients' acute health status.

The impact of coexisting depression and timing of psychiatric consultation on medical patients' length of stay.

Patients with a psychiatric disorder are known to make greater use of medical resources than patients without a psychiatric condition, but the impact of highly prevalent psychiatric illnesses, such as depression, on use of medical resources has not been fully explored. This study assessed the lengths of stay of 92 medical and surgical patients who met DSM-III criteria for depression and the relationship of their length of stay to the timing of psychiatric consultations. The 92 patients were hospitalized significantly longer (a mean of 2.52 days more) than they would have been had their length of stay been determined by their medical diagnosis-related group (DRG). A subgroup of 38 Medicare patients were hospitalized a mean of 5.22 days more than the mean stay allowed by their DRG. Consultations occurring earlier in the hospitalizations were linked to shorter stays.