Place des urgences medicales pediatriques dans un service medical a Pointe Noire

Les auteurs etudient les urgences medicales pediatriques chez les enfants ages de 0 a 15 ans dans un centre medico-social a Pointe Noire sur une periode de 5 ans (1988-1992). Ils constatent que les urgences medicales pediatriques representent 18;54 pour cent des admissions. Les principaux groupes etiologiques de ces detresses vitales sont par ordre de frequence les suivants: les urgences neurologiques (331 cas soit 52 pour cent); les urgences respiratoires (137 cas soit 21;5 pour cent); les urgences hematologiques (81 cas soit 12;70 cas) et les urgences gastro-enterologiques (73 cas soit 11;50 pour cent). Les autres urgences medicales pediatriques (etats infectieux severes: rougeoles; septicemies; urgences cardiologiques et les intoxications medicamenteuses severes) representent 2;30 pour cent des cas. La prevention des principales causes de ces detresses vitales; avant que les strategies preconisees par les soins de sante primaires et l'initiative de Bamako soient la cle de voute du systeme sanitaire dans notre region; passe par une education constante pour la sante

Un sistema de atencion de urgencias / A system for emergency attention

Se estudian los fenomenos que han producido un notorio aumento de las urgencias, y como un numero importante de los pacientes con trauma presentan lesiones de alto riesgo. Se revisan las causas de mortalidad en las diferentes edades. Se plantean estrategias para la atencion de pacientes que sufran accidentes de cualquier orden. Se estudian los niveles de atencion medica y se establecen normas relacionadas con las plantas fisicas de los hospitales, dotacion de los servicios de Urgencias, transporte de paciente y prevencion de accidentes

Emergency room admissions, meteorologic variables, and air pollutants: a path analysis.

Daily hospital emergency room admissions at hospitals located within 8 km of Los Angeles Basin monitoring stations at Long Beach, Lennox, Azusa, and Riverside, California, were examined for correlations with pollutant and meteorologic variables for 1974-1975. By conventional correlation and regression with lagged and temporospatial analysis, the authors could not distinguish effects of pollution by particulate sulfate from those due to meteorologic variables and oxidant. The authors use a variety of structural models and path analysis to estimate "direct" effects on emergency room admissions of maximum temperature, humidity, wind velocity, barometric pressure, carbon monoxide, sulfur dioxide, nitric oxide, high-volume suspended particulates, coefficient of haze, nitrogen dioxide, oxidant, and sulfate. Criteria for choice of models included plausibility of pairwise dependence relationships, magnitude of the correlations with emergency room admissions, and examination of the partial correlation matrix. Their results show that a variety of models gave similarly large path coefficients for a given location for the following variables: maximum temperature at each site; sulfate at Long Beach and Lennox but not at Riverside which nevertheless had the highest sulfate means; oxidant at Azusa which had the highest oxidant levels. At other locations, despite substantial and significantly elevated correlation coefficients, oxidant had a small or negative path coefficient. After considering other possible factors, the authors conclude that sulfate pollution at Lennox and Long Beach had an important and possibly causal association with demand for emergency room admissions. This demonstrates the usefulness of using a variety of structural models in the analysis of ecologic data.