"Watch Me Grow- Electronic (WMG-E)" surveillance approach to identify and address child development, parental mental health, and psychosocial needs: study protocol.

BACKGROUND: The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) - developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents' mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the 'care-as-usual' group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and 'warm hand over' by a 'service navigator' to ensure their needs are met. METHODS: Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the 'care-as-usual' or 'intervention' group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. CONCLUSIONS: Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. TRIAL REGISTRATION: The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819 ) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.

Supraventricular tachycardia in an infant.

Treating this 1-month-old infant with SVT with adenosine was extremely effective and resulted in no observable side effects to the patient. More research needs to be performed and documented regarding the effectiveness and safety of this drug in pediatric patients. Emergency nurses should familiarize themselves with adenosine and should suggest its use in pediatric patients with SVT that does not respond to vagal maneuvers.

Subclavian and innominate artery trauma: a recent experience with nine patients.

This report summarizes a recent 24-month experience with 9 patients who were treated for injuries to the innominate or subclavian arteries at a large urban hospital. All patients were male, age range was 17 to 47 years, and mean age was 29 years. The mechanism of injury included major arterial avulsions sustained during cancer operations at the base of the neck (2), blunt injuries secondary to motor vehicle accidents (2), stab wounds (1), and gunshot wounds (4). The vessels injured included the right subclavian artery (2), the innominate artery (1), and the left subclavian artery (6). Associated major venous injuries were seen in 4 cases (44%) and major non-vascular injuries in 5 cases (55%). Arterial exposure involved a variety of incisions, including left thoracotomy, median sternotomy, clavicular resection, or a combination of these. Arterial continuity was restored in all cases using primary repair (2), autogenous saphenous vein graft (6), or prosthetic graft (1). Venous injuries were treated by ligation (2) or lateral venorraphy (2). One patient died unexpectedly on the tenth postoperative day for an overall mortality of 11 percent. Three of the 8 survivors sustained nonfatal complications (38%). All 8 survivors had patent arterial repairs at the time of hospital discharge, and 5 of 8 survivors were available for follow-up with intravenous digital subtraction angiography (DSA), revealing arterial repair patency in all.(ABSTRACT TRUNCATED AT 250 WORDS)