Biomedical subjects
Publications and source records attributed to J I Gilman.
This chapter has attempted to provide a broad overview of the considerations necessary to assemble the vehicles for a transport system, some aspects of the safety requirements, and a general guideline for formulating carrier contracts. The staff of new programs or programs that are having operational difficulties would be well advised to consult and visit with the staff of other successful programs to learn the pitfalls inherent in this kind of operation.
This study attempts to define the effect of early repair and breast-feeding on the outcome of cleft lip surgery. The first part deals with 100 consecutive cleft lip repairs categorized retrospectively by age at operation. Forty-nine patients were operated on during the first 3 weeks of life; 51 at an older age. There were no statistically significant differences in complication rate between the groups (14 and 18 percent, respectively). A subgroup of 26 infants was operated on at a week or less of age; these sustained significantly fewer complications (8 percent). There was no apparent difference in the operative results as defined by whether or not the child needed a subsequent revision. A second group of 60 mothers was offered the choice of breast-feeding their babies immediately following operation. Sixteen breast-fed for a minimum of 6 weeks, 22 were fed by means of a cup or syringe, and 22 started breast-feeding but converted to a bottle within 6 weeks. No complications attributable to breastfeeding were observed, and the rate of weight gain was definitely enhanced in the breast-feeding group. Hospital stay was shortened by an average of over a day (33 percent) as compared with those fed by cup. This effect was related to the easier transition from IV administration to oral intake when breast-fed. We are currently encouraging early repair and breast-feeding in the full-term baby as the optimum method of management of newborns with cleft lip.
This article discusses the role of the pediatric emergency transport system as an outreach modality of the pediatric intensive care unit. Most of the discussion focuses on the Denver model.
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