Biomedical subjects

L J Ropp

Publications and source records attributed to L J Ropp.

3 recordsLinked to original sources

PubMed1993

A randomized, controlled trial of radiograph ordering for extremity trauma in a pediatric emergency department.

STUDY OBJECTIVES: The objectives of this study were to determine whether triage nurses using the Brand protocol would order fewer radiographs than would physicians carrying out standard practice procedures, without missing an increased number of joint or bone injuries; the test characteristics and the interobserver reliability of the Brand protocol; and whether having triage nurses order radiographs could reduce total patient waiting time in the emergency department. DESIGN: Randomized, controlled trial. SETTING: The ED of a free-standing children's hospital with approximately 55,000 visits annually. TYPE OF PARTICIPANTS: Children less than 18 years of age who had a history of extremity trauma in the preceding seven days. INTERVENTIONS: Triage nurses applied the Brand protocol to determine the need for a radiograph. MEASUREMENTS AND RESULTS: Of the Brand protocol group, 81.9% had radiographs ordered compared with 87.1% of the control group (P = .03). The percent of positive radiographs was 40.8% in the Brand protocol group compared with 42.6% in the control group (P = .21). There were 3.2% (16) missed radiographic findings in the Brand protocol group compared with none in the control group (P < .001). Patients randomized to the Brand protocol group spent 3.3 hours in the ED compared with 3.6 hours for the control group (P < .001). CONCLUSION: Having triage nurses use the Brand protocol reduced the number of radiographs ordered but at the same time increased the number of missed radiographic findings. However, having triage nurses order radiographs also significantly shortened waiting time in the ED.

Adolescent↗

PubMed1991

Randomized trial of salbutamol in acute bronchiolitis.

To test whether nebulized salbutamol (albuterol) is safe and efficacious for the treatment of young children with acute bronchiolitis, we enrolled 83 children (median age 6 months, range 1 to 21 months) in a randomized, double-blind clinical trial. Participants received two treatments at 30-minute intervals of either nebulized salbutamol (0.10 mg/kg in 2 ml 0.9% saline solution) or a similar volume of 0.9% saline solution placebo. Outcome measures were the respiratory rate, pulse oximetry, and a clinical score based on the degree of wheezing and retractions. Patients in the salbutamol arm had significantly greater improvement in clinical scores after the initial treatment (p = 0.04). There was no difference between the groups in oxygen saturation (p = 0.74); patients treated with salbutamol had a small increase in heart rate after two treatments (159 +/- 16 vs 151 +/- 16; p = 0.03). We conclude that salbutamol is safe and effective for the initial treatment of young children with acute bronchiolitis.

Acute Disease↗

PubMed1989

Pediatric emergency medicine: a developing subspecialty.

Questionnaires were sent to 245 North American institutions with pediatric residency programs. There was a 69% response rate. Pediatric emergency care is provided in three types of facilities: emergency departments in pediatric hospitals, separate pediatric emergency departments or combined pediatric and adult emergency departments, in multidisciplinary hospitals. There are at least 262 pediatricians practicing full-time pediatric emergency medicine. The majority work in pediatric emergency departments, an average of 30.7 clinical hours per week. There are 27 pediatric emergency medicine programs with 46 fellows in training and 117 full-time positions available for emergency pediatricians throughout North America. Varying qualifications for these positions include board eligibility in pediatrics, certification in Basic Life Support or Advanced Trauma Life Support, and a fellowship in pediatric emergency medicine. The demonstrated need for pediatricians, preferably trained in emergency care, clearly indicates that pediatric emergency medicine is a rapidly developing subspecialty of Pediatrics that will be an attractive career choice for future pediatricians.

Adult↗