RESUMO
The use of interpreters is essential in our multicultural society. The families and patients we treat come from differing backgrounds, cultures and spoken language. Many are not proficient in, or may even entirely lack, the ability to communicate effectively in English. As health professionals, we must meet their needs and manage the risks to provision of good quality care that language barriers may introduce. Use of an interpreter or interpreting service is an important skill, which is rarely formally taught in undergraduate or postgraduate curricula. Here, we present some of the pitfalls of using an interpreter, and offer some tips on getting the best out of their use.
Assuntos
Barreiras de Comunicação , Pediatria , Encaminhamento e Consulta , Tradução , HumanosRESUMO
People are full of useful advice, especially when you make the transition to the senior doctor grade. We present a very helpful model we have used over some time to aid us when we have issues.
Assuntos
Relações Interprofissionais , Resolução de Problemas , Humanos , Pediatria , Grupo AssociadoRESUMO
We present a case that illustrates the challenges in making a unifying diagnosis and bringing together symptoms which, at first, seem unrelated. We aim to illustrate the process of decision-making and the practice of working along several parallel processes to reach a single explanation for a child to present unwell.
Assuntos
Menorragia/etiologia , Pseudotumor Cerebral/diagnóstico , Doenças do Nervo Abducente/etiologia , Acetazolamida/uso terapêutico , Adolescente , Anemia/complicações , Anemia/etiologia , Teste de Coombs , Diuréticos/uso terapêutico , Fadiga , Feminino , Cefaleia/etiologia , Hemoglobinas/análise , Humanos , Pseudotumor Cerebral/terapia , Hemorragia Retiniana/etiologia , Punção Espinal , Trombocitopenia/complicações , Acuidade Visual , VômitoRESUMO
OBJECTIVE: Examine admissions for bronchiolitis, comparing centres with oxygen saturation thresholds for admission of 90% versus 92%. DESIGN: Prospective multi-centre service evaluation, all admissions for bronchiolitis during 4-week period, November 2018. SETTING: Paediatric departments across 12 hospitals in the West Midlands, UK. PATIENTS: 320 patients aged 6 weeks-1 year, diagnosis of bronchiolitis, exclusions: chronic illness or high dependency/intensive care admission. MAIN OUTCOME MEASURES: Reason for admission, admission saturations and length of stay. RESULTS: Inadequate feeding was the the most common reason for admission (80%). Only 20 patients were admitted solely because of low saturations. Median peripheral oxygen saturation in this group was 88%. Median length of stay in 90% centres was 41 hours, against 59 hours for 92% centres (p=0.0074). CONCLUSIONS: Few patients were admitted solely due to low oxygen saturations, only one had a potentially avoidable admission if thresholds were 90%. Length of stay was significantly reduced in the 90% threshold centres.