Code Blue evaluation in children's hospital.

BACKGROUND: True alarm rate of the Code Blue cases is at a low level in the Dr. Behçet Uz Children's Hospital in Izmir. This study aims to analyse the use of the Code Blue alarm cases in the children's hospital. METHODS: This retrospective clinical study evaluated the age and the gender of the cases, the arriving time of the Code Blue team, the date and time of the Code Blue Call, the reasons of the Code Blue Call, and the verification which were all obtained from the Code Blue forms of the hospital dated between January 2014 and January 2015. The data of 139 Code Blue cases' forms were investigated and was divided into two groups: before and after the education containing 88 and 51 cases, respectively. RESULTS: Conversive disorder (26% to 13%, P<0.01), syncope (21.5% to 19.6%, P<0.01), convulsion (17% to 13.7%, P<0.01), hypoglycemia (4.5% to 3.9%, P<0.01), anxiety (4.5% to 1.9%, P<0.01), head trauma due to syncope (4.5% to 0%), cardiac arrest (1.1% to 0%), respiratory difficulties (2.2% to 1.9%, P<0.01), suspicion of myocardial infarction (2.2% to 1.9%, P<0.01), fall from stairs (2.2% to 0%) and agitation cases (1.1% to 0%) were reduced, however, the hypertension cases were dramatically increased (3.4% to 29.4%, P<0.01) owing to the hospital staff's education. The Pearson's correlation coefficient before and after education was 0.837. About 97.8% of the Code Blue cases were false calls with female greater than male (P<0.01). CONCLUSION: The results of this study show that more education is required for the hospital's staff and a new color code that is to say pre-diagnosis team should be formed.

Code Blue evaluation in children's hospital / 世界急诊医学杂志（英文）

@#BACKGROUND: True alarm rate of the Code Blue cases is at a low level in the Dr. Beh?et Uz Children''s Hospital in ?zmir. This study aims to analyse the use of the Code Blue alarm cases in the children''s hospital.METHODS: This retrospective clinical study evaluated the age and the gender of the cases, the arriving time of the Code Blue team, the date and time of the Code Blue Call, the reasons of the Code Blue Call, and the verifi cation which were all obtained from the Code Blue forms of the hospital dated between January 2014 and January 2015. The data of 139 Code Blue cases'' forms were investigated and was divided into two groups: before and after the education containing 88 and 51 cases, respectively.RESULTS: Conversive disorder (26％ to 13％,P<0.01), syncope (21.5％ to 19.6％,P<0.01), convulsion (17％ to 13.7％,P<0.01), hypoglycemia (4.5％ to 3.9％,P<0.01), anxiety (4.5％ to 1.9％, P<0.01), head trauma due to syncope (4.5％ to 0％), cardiac arrest (1.1％ to 0％), respiratory difficulties (2.2％ to 1.9％,P<0.01), suspicion of myocardial infarction (2.2％ to 1.9％,P<0.01), fall from stairs (2.2％ to 0％) and agitation cases (1.1％ to 0％) were reduced, however, the hypertension cases were dramatically increased (3.4％ to 29.4％,P<0.01) owing to the hospital staff''s education. The Pearson''s correlation coeffi cient before and after education was 0.837. About 97.8％ of the Code Blue cases were false calls with female greater than male (P<0.01).CONCLUSION: The results of this study show that more education is required for the hospital''s staff and a new color code that is to say pre-diagnosis team should be formed.

Propofol infusion syndrome or adrenoleukodystrophy?

Following a propofol anesthetic, a 5-year-old girl with lower extremity spasticity seized and developed hypertriglyceridemia, hyperkalemia, and metabolic acidosis. A presumed diagnosis of propofol infusion syndrome (PRIS) was made, but further investigation revealed neonatal adrenoleukodystrophy. PRIS should be considered with this constellation of symptoms, but other neurometabolic disorders must always be ruled out.

Can antiemetics really relieve pain?

The analgesic properties of 2 antiemetic agents--metoclopramide and ondansetron--were investigated in studies which showed that metoclopramide may decrease postoperative opioid requirements, but the analgesic effect of ondansetron is controversial. The postoperative effects of metoclopramide and ondansetron on pain in patients undergoing laminectomy were evaluated. Forty six patients were randomized into 3 groups: group M, which consisted of 15 patients who received intravenous (IV) metoclopramide 0.5 mg 30 minutes before surgery; group O, which consisted of 16 patients who received ondansetron IV 0.1 mg 30 minutes before surgery; and group C, which consisted of 15 patients who received the same volume of saline IV 30 minutes before surgery. The efficacy and duration of analgesia were assessed using a visual analogue scale (VAS) at 0, 0.5, 1, 3, 6, and 24 hours after surgery. Hemodynamic parameters, additional analgesic requirements, and adverse effects were recorded for the study groups. Diclofenac 75 mg was administered intramuscularly as a rescue analgesic during the postoperative period. VAS scores were lower in the metoclopramide group than in the ondansetron and control groups (P<.05, each). The patients in the ondansetron and control groups required much more diclofenac than the patients in the metoclopramide group (P<.05). Metoclopramide administered preoperatively provided postoperative analgesia in patients undergoing elective laminectomy.