RESUMO
Pylorospasm can present with sonographic findings similar to hypertrophic pyloric stenosis. We present a rare case of methicillin-resistant Staphylococcus aureus subhepatic abscess causing pylorospasm in a neonate.
Assuntos
Abscesso Hepático/diagnóstico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Estenose Pilórica Hipertrófica/diagnóstico , Infecções Estafilocócicas/diagnóstico , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido , Laparotomia , Abscesso Hepático/microbiologia , Abscesso Hepático/terapia , Estenose Pilórica Hipertrófica/microbiologia , Estenose Pilórica Hipertrófica/terapia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapiaRESUMO
OBJECTIVES: To evaluate the impact of nurse integrated rounds (NIRs) on self-reported comprehension, attitudes, and practices of nurses and resident physicians (RPs) in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: A self-reported comprehension, attitude, and practice survey of RPs and nurses was done prior to (T0), 3 months (T3), and 15 months (T15) after initiation of NIRs in our PICU. Responses were graded on Likert-type scale from 1 to 5. The RPs, attending physicians, and nurses also ranked their overall perception of NIRs during these 3 survey time periods. RESULTS: All 3 components of the surveys showed statistically significant improvement (P < .05) from the T0 to T3 and T15 in RPs and nurses. A complete or almost complete reversal of attitude was noted for most questions in the attitude section in both RPs and nurses when T15 was compared to T0. The overall perception that NIRs was good for patient care also showed significant improvement in the survey of nurses and physicians. CONCLUSIONS: The NIRs are well accepted by nurses and physicians and are accompanied by self-reported improvements in comprehension, attitudes, and practices of nurses and RPs in the PICU.
Assuntos
Compreensão , Conhecimentos, Atitudes e Prática em Saúde , Unidades de Terapia Intensiva Pediátrica , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Autorrelato , Visitas de Preceptoria , Feminino , Humanos , Internato e Residência , Masculino , Inquéritos e Questionários , Recursos HumanosRESUMO
An 11-month-old male infant presented with history of bupropion ingestion (750 mg/kg). He developed seizures, respiratory failure, and severe hypotension with metabolic acidosis refractory to inotropic support. The patient received mechanical ventilation, intralipids, phenytoin, inotropic support (dopamine, norepinephrine, and epinephrine), and extracorporeal membrane oxygenation (ECMO). Inotropes were weaned upon initiation of ECMO and discontinued 66 hours after ingestion. Total ECMO duration was 71 hours. The patient was extubated on hospital day 8 and has not had any neurological sequelae upon 12-month follow-up examinations. We report for the first time successful use of ECMO after ingestion of a potentially fatal dose of bupropion.
