There has been great debate and controversy in trying to determine the appropriate methods in attaining an accurate temperature in pediatric patients. In light of new technological advances to find innovative ways to attain exact temperatures in this population, there are hospitals and affiliated medical centers that still assess pediatric temperature through traditional means, which is rectal thermometer. Even more disturbing is the continued use of glass mercury-filled thermometers in the health care setting. These add additional risks of metal toxicity from the leakage of mercury and possible rectal perforation (Chiappini, Sollai, Longhi, Morandini, Laghi, Osio, Persiani, Lonati, Picchi, Bonsignori, Mannelli, Galli, & de Martino, 2010; Teran, Torrez-Llanos, Teran-Miranda, Balderrama, Shah, & Villarroel, 2011). Other means of assessing core temperature in terms of accuracy include obtaining a temperature through the pulmonary artery, tympanic membrane, esophagus, and urinary bladder (Braun, 2006). All of these are quite invasive techniques and are not well tolerated amongst the pediatric population. However, the most accurate noninvasive method can be quite confusing amongst the medical professional in the provisions of care and assessment.
Rectal thermometers are not well tolerated and can cause distress in the pediatric population. It can also have the risk of perforating the bowl if the practitioner does not perform the task as directed (Sund-Levander & Grodzinsky, 2013). If other means of temperature measurements were used, there could be a decrease in the specified risks but the accuracy of the measurement may be unreliable. There are few hospitals, like Children’s Hospital of Michigan, that use other means of taking a t...
... middle of paper ...
...r in children?. Journal of Clinical Nursing. 20. 1632-1639. Doi: 10.1111/j.1365-2702.2010.03568.x.
Reynolds, M., Bonham, L., Gueck, M., Hammond, K., Lowery, J., Redel, C., Rodriguez, C., Smith, S., Stanton, A., Sukosd, S., & Craft, M. (2014). Are Temporal Artery Temperatures Accurate Enough To Replace Rectal Temperature Measurement In Pediatric ED Patients?. Journal of Emergency Nursing. 40(1). 46-50. http://dx.doi.org/10.1016/j.jen.2012.07.007.
Sund-Levander, M. & Grodzinsky, E. (2013). Assessment of body temperature measurement options. British Journal of Nursing. 22(15). 880-884.
Teran, C.G., Torrez-Llanos, J., Teran-Miranda, T.E., Balderrama, C., Shah, N.S., & Villarroel, P. (2011). Clinical accuracy of a non-contact infrared skin thermometer in paediatric practice. Child: Care, health, and development. 38(4).471-476. Doi: 10.1111/j.1365-2214.2011.01264.x.
The various modes of heat loss during this phase include radiation, convection, conduction and evaporation. Radiation contributes to maximum heat loss (approximately 40%) and is determined by the fourth power of difference between ambient and core temperature. Convection is the next most important mode of heat loss (upto 30%), and is due to loss of heat to air immediately surrounding the body. It is proportional to the square root of the velocity of the air currents. Evaporation contributes to less than 10% of heat loss and occurs from cleaning fluids as well as skin, respiratory, bowel and wound surfaces. Conduction accounts for least heat loss (upto 5%) and is due to cold surfaces in contact with the body such as operating room table. After 3-4 hours, a plateau phase is realized when core heat production equals heat loss to the periphery and core temperature reaches a
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Following the proper guidelines for reducing the risk of transmission of TSEs in a clinical setting, the risk has been greatly reduced. As mentioned before no iatrogenic transmission from a medical instrument has been recorded since 1976 since following the standard guidelines. In an experiment by Amin et al., they examined the risk of transmission of vCJD via contact tonometry. They outlined that transmission could be further reduced by using larger volumes of washes for extended periods of time and also adding wiping between washes (16). This could help in the future to completely eradicate TSE transmission completely by increasing sterilisation methods. Proper training on all aspects of transmission of TSEs through medical equipment and proper sterilisation methods should be updated just to keep staff up to date to prevent the risks of TSEs transmission.
Gaither (2016) states that a pediatrician checks for mental or physical illnesses, and how to cure these illnesses. Gaither (2016) states that a pediatrician has many methods to successfully determine a child's health. Some examples stated by Gaither (2016) are that a pediatrician does physical exams, gives the child vaccinations, makes sure the child meets milestones in his or her development, a pediatrician also diagnoses illnesses, infections, or other injuries that the child may have, a pediatrician also gives advice for nutrition in foods, and answers questions that you may have about your child’s development. Gaither (2016) also states that pediatricians examine your baby after 48 to 72 hours to check up on your child, and then continue checking to make sure that make sure that the child is developing correctly. Another advantage that Gaither (2016) states of having a pediatrician are that the field only focuses on children, so pediatricians can easily spot abnormalities in a child and they can quickly cure
As a pediatric hospitalist, there are a wide range of duties that must be completed for the safety and well-being of one’s patients. A duty amongst all physicians is caring for a patient’s illnesses. As a pediatrician, one must be involved in the physical, mental, and emotional upbringing of adolescents throughout every stage of development in good health as well as in illness. A pediatrician takes care of a child from a few weeks after birth to the age of twenty-one when the patient transfers to a new physician. The duties designated to all pediatricians is to reduce infant and child mortality rates, control diseases, make sure patients lead well-maintained lifestyles, and make easier the lives of children and adolescents with chronic conditions. Becoming a pediatrician would improve the lives of many children.
Berkowitz, Carol. American Academy of Pediatrics: Dedicated to the Health of all Children. American Academy of Pediatrics. 8 Dec. 2004
This type of analysis is advantageous when used in conjunction with clinical trials, where it exhibits its most common application and is more familiar to clinical practitioners. The outcomes that are generated during this analysis may or may not be converted into monetary values . CEA will help to identify neglected opportunities by highlighting interventions that are relatively inexpensive, yet have the potential to reduce the disease burden substantially2. The examples that demonstrate the effectiveness of CEA can be evaluated using an example set forth using oral rehydration therapy (ORT) in young children. This example contests that ORT does not diminish the incidence of diarrhea, but dramatically reduces its severity and the associated mortality rate2. The data presented demonstrated that it could cost only US$2 to US$4 per life year saved helped make the case that this was something that public policy should promote, and many countries responded by promoting ORT, saving millions of lives2. The analysis set forth above demonstrates that CEA can in fact be utilized effectively when analyzing subjects having the same clinical units. The limitations of this analysis can be seen when performing such an analysis and the alternatives used in the comparison have different clinical units, thus making this analysis
This study is a clinical trial that aims to find out the effect of massage on behavioral state of neonates with respiratory distress syndrome. The participants were 45 neonates who hospitalized in neonatal intensive care unit of Afzalipour hospital in Kerman. Parental consent was obtained for research participation. The inclusion criteria included all infants born with respiratory distress syndrome, less than 36 weeks gestational age and without of any the following conditions: contraindication of touch, skin problems, hyperbilirubinemia, anemia, respirators, chest tube, addicted mother, congenital and central nervous system disease. Infants entered the massage protocol during the second day after starting enteral feeding, because the initiation of enteral feeding means that the infants in physiologically stable [12]. The researcher determined if infants met the study criteria. After initial assessment, the infants were entered to the group. The infants received 45 minute periods of massage intervention per day for 5 days. Each infant received tactile/kinesthetic stimulation, 15 minute periods at the beginning of three consecutive hours. Each massage always started at approximately 30 minutes after afternoon feeding and provided by one or two trained nurses. The 15 minute stimulation sessions consist of 3 standardized 5 minute phases. Tactile stimulation was given during the first and third phases, and kinesthetic stimulation was given during the middle phase. For the tactile stimulation, the neonate was placed in a prone position. After thorough hand scrubbing, the person providing stimulation placed the palms of her warmed hands on the infant’s body through the isolate portholes. Then She gently stroked with her hands for five ...
American Academy of Pediactrics. (2003). Family-Centered Care and the Pediatrician’s Role. Available: http://pediatrics.aappublications.org/content/112/3/691.full. Last accessed 23/01/14.
McMillan, Julia A., Ralph D. Feigin, Catherine DeAngelis, and M. Douglas Jones. Oski's Pediatrics, Principles & Practice. Williams & Wilkins, 2006.
Pediatricians mainly treat patients that are infants, and sometimes examine newborn babies to make sure the child is perfectly healthy and has no questionable health related issues after he or she has been delivered (Halm para. 13). Along with examining children, pediatricians treat patients with minor injuries, treatable illnesses, growth and development concerns, and many other health related issues(“Pediatrician” para. 1). Many skills are needed to complete the tasks tha...
Exploring the precision of assessing pain by using available tools in the hospitals chosen for the study by comparing them with the (COPT).
Sarah Dobinson is a patient at increased risk of infection she is an older patient in a hyper metabolic state secondary to trauma. To ensure Sarah’s safety a set of CVC guidelines have been developed using the most recent primary sources. These guidelines will focus on nursing interventions post insertion in an adult ICU setting they have been developed under four sections addressing the importance of hand hygiene and aseptic technique, changing of administra...
This reflection of vital signs will go into discussion about the strengths and weaknesses of each vital sign and the importance of each of them. Vital signs should be assessed many different times such as on admission to a health care facility, before and after something substantial has happened to the patient such as surgery and so forth (ref inter). I learned to assess blood pressure (BP), pulse (P), temperature (T) and respiration (R) and I will reflect and discuss which aspects were more difficult and ways to improve on them. While pulse, respiration and temperature were fairly easy to become skilled at, it was blood pressure which was a bit more difficult to understand.
Hypothermia, a doubtless fatal condition, happens once blood heat falls below 95°F (35°C). Although physiological condition is a ...