Tele-dentistry in COVID-19 era: A conduit for dental care in uncertain times.

Tele-dentistry encompasses all sorts of digital technologies that involve the exchange of patient's clinical data from a distant site for the provision of dental health care. Tele-dentistry has emerged from the concept of telemedicine, which has been in practice since the 19th century. In recent times, an upsurge in the digital technologies was noted, which has made the possibility of remote access to dental care. The outbreak of COVID- 19 pandemic has restricted the normal routine ways of clinical practice. In these challenging times, tele-dentistry serves as effective platform for providing dental health care. Tele-dentistry has vast applications across various disciplines of dentistry, including preventive dentistry, paediatric dentistry, oral medicine, and oral pathology etc. In these pandemic times, tele-dentistry can be efficiently used for identification of dental emergencies, allowing effective triage and subsequent management. There are different communication platforms available for tele-dentistry. The most common technologies used are web-based video conferencing and smart phone-based applications. As the clinicians are not aware of these digital technologies utilised in tele-dentistry, there are certain challenges associated with its use. In conclusion, tele-dentistry serves as an effective tool in providing health care in challenging times, but it has been underutilised by the dental fraternity. The legislative authorities should establish proper standard protocols to ensure the safety and confidentiality of patient information while using these digital platforms.

Meeting Gaps in the Public Health Workforce During Emergencies: How a Nongovernmental Organization Supported Critical Staffing Needs in the COVID-19 Response.

The public health workforce continues to experience staff shortages, which hampered the ability of US state, tribal, local, and territorial health departments to respond to the COVID-19 pandemic. In April 2020, the US Centers for Disease Control and Prevention (CDC) awarded $45 million to the CDC Foundation to provide field assignees to support these health departments. To expand these efforts, the CDC provided an additional $20 million in May 2021 for vaccination efforts and $200 million in June 2021 to support COVID-19 response and general infrastructure support. The CDC Foundation worked with jurisdictions across the United States to develop job descriptions based on need and recruit nationally for positions. This expanded project, called the Workforce/Vaccine Initiative, hired 3,014 staff in 91 jurisdictions, with 2,310 (77%) hired by January 2022. Most assignments were fully remote (55%) or hybrid (28%). The largest number of staff (n=720) supported COVID-19 response work in schools. Other common functions included contact tracing/case investigation (n=456), program coordination (n=330), epidemiology (n=297), data and surveillance (n=283), and administrative support (n=220). To advance health equity and improve response efforts, 79 health equity staff were assigned to 30 jurisdictions. To support the needs of tribes, 76 field staff supported 22 tribal entities. This project demonstrated the important role of a flexible, centralized approach to rapid placement of staff in public health departments during an emergency response. While the goal of the Workforce/Vaccine Initiative was to meet short-term staffing needs, lessons learned could provide insights for building a sustainable and scalable public health workforce.

Bowel Emergencies in Patients With Cancer.

Cancer is the second most common cause of death worldwide. Bowel emergencies in patients with cancer are becoming increasingly more prevalent due to advances in cancer therapy and longer overall patient survival. When these patients present acutely, they are often frail and may have pre-existing co-morbidities. This article discusses the imaging features of bowel emergencies commonly encountered in oncological patients in clinical practice. These include chemotherapy related colitis, neutropenia enterocolitis and typhlitis, toxic megacolon, bowel perforation, malignant bowel obstruction and gastrointestinal haemorrhage. The radiologist plays a key role in identifying these oncological emergencies and guiding further management.

Enhancing Physicians' Autonomy through Practical Trainings.

Background: In medical emergencies adherence to standardized clinical protocols is crucial to ensure a better outcome for patients. Newly qualified physicians may play several roles in serving the National Health Service (substituting general practitioners, on-call duty, working in emergency rooms, etc.) in Italy. In these situations, the physician may have to manage critical patients autonomously. Moreover, newly qualified physicians may show a considerable deficiency in routine medical activities. In fact, many universities do not provide a practical simulation training programme, which is why a substantial number of students only face clinical emergencies when they start working after graduation. Study design: A cross-sectional study was performed by engaging medical doctors. Both experienced physicians and newly licensed physicians (graduated less than 24 months ago) were included in the study. Methods: A questionnaire was distributed to each participant during SIMED's Courses from June 2021 to December 2022. The questionnaire consisted of two sections. The first one analyzed participation in standardized practical courses on medical emer gencies (Basic Life Support, Advanced Cardiac Life Support, International Trauma Life Support and a course on Advanced Airway Management). The second section analyzed the perceived autonomy of health professionals in the management of five different work settings, using a 5-point likert scale. Results: 2,168 questionnaires were analyzed, of which 68.7% were from newly qualified doctors and 31.3% from more experienced doctors The highest rate of physicians who undertook training courses was achieved for the basic life support course (77.5%) and the lowest rate for the advanced trauma course (15.9%). Physicians perceive themselves the highest autonomy in Primary Care setting (63.1%), while in the Emergency Department they perceive themselves with less autonomy (24.0%). In the analyzed sample, experienced physicians show a higher percentage of autonomy than newly qualified doctors (31.4% vs 8.1%) in all scenarios. Conclusions: Our analysis shows a possible correlation between the self-perceived autonomy of physicians and attending practical simulation courses. Although the role of training through practical courses is relevant, the percentage of trained professionals is insufficient and therefore the implementation of practical training projects has to be encouraged.

San Raymundo: Focus Group About Comadronas' Response to Obstetrical Emergencies in Urban Guatemala.

INTRODUCTION: Comadronas attend most births in rural and urban Guatemala where the maternal mortality rate (MMR) is highest in Latin America. Information has been published regarding rural comadronas' response to obstetrical emergencies. Understanding urban comadronas' response to obstetrical emergencies is essential to addressing Guatemala's MMR. METHODS: A total of 17 urban comadronas participated in one, 34-min focus group to share their knowledge, practices, and attitudes regarding obstetrical emergencies. We used the long table to analyze the content to develop a matrix of themes. RESULTS: Five themes emerged. Urban comadronas receive consistent training, have hospital transportation, and feel confident in their knowledge, but they lack equipment and feel hospital providers disrespect them. Still, the joy of attending births outweighs the challenges they face. DISCUSSION: Urban comadronas described a different experience of responding to obstetrical emergencies than rural comadronas. Distinct approaches are needed to provide culturally congruent support for urban and rural comadronas when responding to obstetrical emergencies.

Sharing lessons learned from COVID-19 vaccine introductions: a global community forum for countries.

To optimize the efficient introduction and deployment of COVID-19 vaccines across the globe during the COVID-19 pandemic, in April 2021 WHO launched a new process and tools for countries to rapidly review the early phase of countries' COVID-19 vaccine introduction. This methodology is called the COVID-19 vaccination intra-action review, also known as mini COVID-19 vaccine post-introduction evaluation (mini-cPIE). As of November 2022, 46 mini-cPIEs had been conducted. In collaboration with Project ECHO, WHO convened and facilitated real-time experience sharing and peer-learning among countries following their mini-cPIEs through a virtual global real-time learning forum. This five-session clinic series was attended by 736 participants from 129 countries. Based on post-session feedback surveys, when asked about the utility of the sessions, half of the participants said that sessions led them to review national guidelines and protocols or make other changes to their health systems. The post-series survey sent following the end of the clinic series showed that at least eight countries subsequently conducted a mini-cPIE after participating in the clinics, and participants from at least nine countries indicated the experience shared by peer countries on the clinic largely benefited their COVID-19 vaccine introduction and deployment. In this article, we highlight the benefits and importance of creating a global experience-sharing forum for countries to connect and share pertinent learnings in real-time during an international public health emergency. Moving forward, it is critical to foster a culture of individual and collective learning within and between countries during public health emergencies, with WHO playing an important convening role.

"A Vulnerable Time To Be a Young Family in an Emergency": Qualitative Findings From an Exploration of an Emergency Perinatal and Infant Feeding Hotline in Louisiana.

BACKGROUND: Birthmark Doula Collective, a cooperative that provides doula and lactation services in the Greater New Orleans area, mounted an emergency response after two Category 4 storms: Hurricane Laura (2020) and Hurricane Ida (2021). The response included activating a no-cost emergency perinatal and infant feeding hotline. Both disasters coincided with a resurgence of COVID-19 infections in Louisiana. RESEARCH AIM: The aim of this study is to understand how an emergency perinatal and infant feeding hotline supported infant and young child feeding in emergencies during hurricanes in Louisiana. METHOD: This study used a cross-sectional, retrospective qualitative design in a population with low breastfeeding rates. We conducted a content analysis of 97 hotline call logs from Hurricanes Laura and Ida, focus groups with lactation support providers who staffed the hotline during either storm (n = 5), and interviews with mothers who called during Hurricane Ida (n = 2). Focus groups and interviews lasted 30 and 60 minutes, respectively. Transcripts were analyzed using thematic analysis techniques. RESULTS: Call logs revealed infant feeding needs (e.g., mastitis, low milk supply, relactation, and infant formula requests) and non-infant feeding needs (e.g., infant supplies, perinatal and infant care referrals, shelter information). Infant formula was the most requested supply during both hurricanes. Maternal participants discussed family vulnerabilities during Hurricane Ida. Staff described training and strategies to provide support while maintaining their own well-being. CONCLUSION: Providing a free emergency hotline service is one way to support pregnant and postpartum people and their families seeking infant feeding advice, supplies, and support in the immediate aftermath of a disaster.

The Interconnectedness of Euglycemic Diabetic Ketoacidosis With Concomitant Thyroid Storm: A Case Report.

Sodium-glucose transport protein 2 inhibitors (SGLT2i) are becoming commonplace in many chronic diseases: type 2 diabetes mellitus, heart failure, and chronic kidney disease. We present the case of a 65-year-old male with a history of type 2 diabetes who had been on an SGLT2i for over 12 months and was found to have euglycemic diabetic ketoacidosis (eDKA) occurring concurrently with a thyroid storm. This case report illustrates a unique scenario of two endocrine emergencies occurring simultaneously.

Application of empathy theory in the study of the effectiveness and timeliness of information dissemination in regional public health events.

Introduction: This study examines the role of empathy theory in enhancing the effectiveness and timeliness of information dissemination during regional public health events, with a focus on the SARS and COVID-19 pandemics as case studies. Utilizing an anthropological interview method, the research delves into the public's transformation from passive recipients to active participants in information dissemination, emphasizing the impact of empathy. Objective: The study aims to evaluate the application of empathy theory in the context of public health emergencies and to determine its influence on the quality of information dissemination and public engagement. Methods: The research involved two distinct surveys, each collecting 50 questionnaires from participants in different regions, to capture a diverse range of perspectives. The surveys assessed participants' views on information dissemination, their levels of empathy, and their behaviors in receiving and sharing health-related information. Results: The findings indicate that empathy plays a crucial role in facilitating the active involvement of the public in information dissemination. There is a notable difference in the public's emotional response and information sharing behaviors between regions with direct experience of the health events and those less affected. Conclusion: The study concludes that empathy theory, when applied to information dissemination during public health emergencies, can significantly improve the public's engagement and the overall effectiveness of communication strategies. The results underscore the need for empathetic communication to foster a sense of solidarity and collective action in response to public health crises.

Understanding health education needs of pregnant women in China during public health emergencies: a qualitative study amidst the COVID-19 pandemic.

Background: Public health emergencies impose unique challenges on pregnant women, affecting their physiological, psychological, and social wellbeing. This study, focusing on the context of the corona virus disease in 2019 (COVID-19) pandemic in China, aims to comprehensively explore the experiences of pregnant women amidst diverse public health crises. Herein, we investigate the health education needs of pregnant Chinese women in regard to public health emergencies to provide a scientific foundation for the development of targeted health education strategies. Objective: The study described in this article aims to explore the health education needs of pregnant Chinese women in the context of public health emergencies specifying the types of emergencies of pandemics and to provide a scientific basis for targeted health education interventions. Methods: Thirteen pregnant women were purposively selected, and the rationale for this sample size lies in the qualitative nature of the study, seeking in-depth insights rather than generalizability. Data collection involved semi-structured interviews, and the Colaizzi, which is a structured qualitative technique used to extract, interpret, and organize significant statements from participant descriptions into themes, providing a comprehensive understanding of their lived experiences. Results: The analysis yielded six prominent themes encompassing the following areas: I. Personal protection and vaccine safety; II. Knowledge of maternal health; III. Knowledge of fetal health; IV. Knowledge of childbirth; V. Knowledge of postpartum recovery; and VI. Knowledge sources of health education for pregnant women and their expectations of healthcare providers. Theme I was analyzed with two sub-themes (needs for personal protection knowledge, vaccine safety knowledge needs); Theme II was analyzed with three sub-themes (nutrition and diet, exercise and rest, sexual life); Theme III was analyzed with three sub-themes (medications and hazardous substances, pregnancy check-ups, and fetal movement monitoring); Theme IV was analyzed with three sub-themes (family accompaniment, analgesia in childbirth, and choice of mode of delivery); Theme V was analyzed with one sub-theme (knowledge of postnatal recovery); Theme VI was analyzed with one sub-theme (expectations of Healthcare providers). Sub-themes within each main theme were identified, offering a nuanced understanding of the multifaceted challenges faced by pregnant women during public health emergencies. The interrelation between sub-themes and main themes contributes to a holistic portrayal of their experiences. Conclusion: The study emphasizes the need for healthcare professionals to tailor health education for pregnant women during emergencies, highlighting the role of the Internet in improving information dissemination. It recommends actionable strategies for effective health communication, ensuring these women receive comprehensive support through digital platforms for better health outcomes during public health crises.

Epidemiology, use, and practice of the intraosseous route in an out-of-hospital emergency department: a retrospective cross-sectional study.

Introduction: The Spanish Emergency Medical Services, according to the model we know today, were formed during the 80s and 90s of the 20th century. The Health Emergency Service (EMS), 061 La Rioja, began to assist the population of La Rioja in November 1999. An essential part of the mission of the SES is the provision of care and the transfer of critical patients using advanced life support unit (ALSU) techniques. In daily practice, out-of-hospital emergency services are faced with situations in which they must deal with the care of serious or critically ill patients, in which the possibility of being able to channel peripheral vascular access as part of ALSU quickly may be difficult or impossible. In these cases, cannulation of intraosseous (IO) vascular access may be the key to early and adequate care. Aim: This study aimed to determine the incidence and epidemiology use of IO vascular access in SES 061 La Rioja during the year 2022. Matherial and methods: We performed observational retrospective cross-sectional studies conducted in 2022. It included a population of 4.364 possible patients as a total of interventions in the community of La Rioja in that year. Results: A total of 0.66% of patients showed a clinical situation that required the establishment of IO vascular access to enable out-of-hospital stabilization; this objective was achieved in 41.3%. A total of 26.1% of patients who presented with cardiorespiratory arrest (CA) were stabilized, while 100% presented with shock and severe trauma. Discussion: IO vascular access provides a suitable route for out-of-hospital stabilization of critically ill patients when peripheral vascular access is difficult or impossible.

Reliability and Detectability of Emergency Management Systems in Smart Cities under Common Cause Failures.

Urban areas are undergoing significant changes with the rise of smart cities, with technology transforming how cities develop through enhanced connectivity and data-driven services. However, these advancements also bring new challenges, especially in dealing with urban emergencies that can disrupt city life and infrastructure. The emergency management systems have become crucial elements for enabling cities to better handle urban emergencies, although ensuring the reliability and detectability of such system remains critical. This article introduces a new method to perform reliability and detectability assessments. By using Fault Tree Markov chain models, this article evaluates their performance under extreme conditions, providing valuable insights for designing and operating urban emergency systems. These analyses fill a gap in the existing research, offering a comprehensive understanding of emergency management systems functionality in complex urban settings.

Composition and influencing factors of professionals' capacity in public health emergency rescues: a qualitative study.

Objective: To explore the composition and influencing factors of professionals' capacity in public health emergency rescues. Methods: A descriptive qualitative design was used in this study. Medical workers, managers, and members of an emergency rescue team in Hangzhou, Zhejiang, were recruited for participation through a purposive sampling method. The data were collected using semi-structured interviews and analyzed using a conventional content analysis method. Findings: A total of 2 themes and 13 sub-themes emerged from the analysis: ability composition (knowledge reserve, early warning assessment, information reporting, emergency response, self-protection, personal ability, coordination and cooperation, health education) and influencing factors (educational background, region, experience, hospital level, human resources, and financial investment). Conclusion: These findings offer a basis for the construction of a related indicator system and provide a reference for relevant departments to further optimize their emergency education and training, strengthen their emergency drills, and improve their emergency rescue abilities. The findings indicate that it is necessary to pay attention to the construction of an emergency rescue team, adjust the ratio of personnel, improve their remuneration, and promote work enthusiasm to improve the emergency rescue ability of an organization.

Approaches to Medical Emergencies on Commercial Flights.

In-flight medical incidents are becoming increasingly critical as passengers with diverse health profiles increase in the skies. In this paper, we reviewed how airlines, aviation authorities, and healthcare professionals respond to such emergencies. The analysis was focused on the strategies developed by the top ten airlines in the world by examining training in basic first aid, collaboration with ground-based medical support, and use of onboard medical equipment. Appropriate training of crew members, availability of adequate medical resources on board airplanes, and improved capabilities of dialogue between a flying plane and medical doctors on the ground will contribute to a positive outcome of the majority of medical issues on board airlines. In this respect, the adoption of advanced telemedicine solutions and the improvement of real-time teleconsultations between aircraft and ground-based professionals can represent the future of aviation medicine, offering more safety and peace of mind to passengers in case of medical problems during a flight.

Effectiveness of Simulation-Based Training of Undergraduate Medical Students Regarding the Management of Eclampsia: A Randomized Controlled Educational Trial.

Introduction Obstetric emergencies, like eclampsia, need a quick and accurate response from the treating physician coming into first contact with the patient. Therefore, all doctors, even primary care physicians, interns, and resident doctors, need training to handle such cases proficiently, leaving minimal chances of error. Providing training for the management of these critical conditions on actual patients is not practically feasible. Clinical simulation in obstetrics can be used for the improvement of these skills for undergraduate and postgraduate students. We conducted a non-blinded randomized controlled trial with the primary aim of developing and implementing a module for training undergraduate medical students on the assessment and management of eclampsia and to evaluate and compare it with traditional didactic lectures or case-based learning. Methods The present randomized controlled educational trial was conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India. The undergraduate medical students (Phase 3, Part 1) posted in the department during their clinical postings or tutorials were randomized into two groups. A total of 62 students were randomly divided into two groups, Group A and Group B, each consisting of 31 students. However, only 24/31 (77.42%) in Group A and 19/31 (61.3%) in Group B finally agreed to participate in the study. One group (Group A, with 24 participants) was taught the diagnosis and management of antepartum eclampsia through simulation-based training, and the other group (Group B, with 19 participants) was taught the same topic through conventional teaching, which consisted of didactic lectures through PowerPoint presentations and case-based discussion. Learning objectives were kept identical for both groups. Pre- and post-test scores were compared for both groups. Results The mean pre-test score of the simulation group was 6.13 ± 1.39, and that of the conventional teaching group was 6.05 ± 1.54. The post-test score of the simulation group was 9.17 ± 1.34, and that of the conventional teaching group was 7.37 ± 1.70. The simulation group showed an extremely significant (two-tailed p < 0.0001) improvement in their post-test scores when compared to their scores before the module was taught. The difference in the scores of simulated teaching (Group A) and conventional teaching (Group B) was also statistically significant (p = 0.005). Simulation-based learning was found to be more interactive, helpful in providing real-life-like experiences, led to better retention and understanding, and motivated the students for self-directed learning. Conclusion Although both conventional and simulation-based teaching were useful, simulation-based training was more effective in teaching undergraduate medical students regarding the diagnosis and management of eclampsia. Simulation-based learning is more interactive, provides real-life-like experiences, leads to better retention and understanding, and motivates the students for self-directed learning.

Clinical and sociodemographic characteristics of patients with epilepsy attended at a regional reference psychiatric emergency unit.

OBJECTIVE: Epilepsy is one of the most prevalent chronic neurological diseases, presenting a high frequency of psychiatric disorders (PD). This study sought to evaluate the clinical and sociodemographic profile of patients with epilepsy (PWE) attended at a regional reference psychiatric emergency unit. METHODS: A retrospective, cross-sectional, and descriptive observational study was conducted utilizing a patient record database of individuals with epilepsy who were attended in a regional reference psychiatric emergency unit between January 2018 and August 2022. RESULTS: Out of the 31,800 psychiatric emergency visits, 260 (0.8 %) were of patients with epilepsy (ICD-10: G40). The majority were males (63.5 %) with a mean age of 42.11±15.39 years, single marital status (154; 59.25 %) and elementary education (75; 28.9 %). Most of them (203; 78.1 %) presented at least one psychiatric comorbidity at the emergency visit, but 109 (41.9 %) were not receiving any psychiatric follow-up. A total of 106 patients (40.8 %) had experienced at least one past psychiatric hospitalization. CONCLUSIONS: The occurrence of PD is highly prevalent in PWE, and probably with a high frequency of psychiatric emergencies occurring among them. Further studies are needed to assess such patient profile, particularly involving data from psychiatric emergency units.

Efficacy of the Gulu University Reproductive Health Simulation Training for final year medical students and interns: a before-and-after study.

Background: Reproductive health emergencies, such as postpartum hemorrhage, contribute significantly to maternal and neonatal morbidity and mortality in Uganda due to knowledge and skills gaps. Medical interns, intern midwives, and nurses are crucial as frontline healthcare workers in responding to these emergencies. Our proposed hands-on strategy involves comprehensive simulation-based training (SBT) to equip these healthcare workers with the essential knowledge to manage common reproductive health emergencies and procedures in the country. Objectives: The study aimed to assess the effectiveness of comprehensive SBT in improving the knowledge of interns and fifth-year medical students on reproductive health emergencies and procedures at Gulu University and its Teaching Hospitals in Uganda. Design: A before-and-after study. Methods: A 4-day SBT was conducted for fifth-year medical students and interns (nurses, midwives, and doctors) at Gulu University Teaching Hospitals, focusing on reproductive health emergencies. Pre- and post-tests with 40 multiple-choice questions were used to evaluate knowledge enhancement, the scores were summarized as medians and interquartile ranges. Paired sample t-tests was used to test the difference in pre- and post-test scores. Independent sample t-tests compared median post-test results between interns and students, with a p-value <0.05 considered significant. Results: A total of 153 participants were enrolled, the majority being males (78.4%, n = 120) and medical students (73.9%, n = 113). Among the 40 interns, 55% (n = 22) were doctors, 30% (n = 12) were midwives, and 15% (n = 6) were nurses. The study participants showed an increase in knowledge, with median post-test scores higher than pre-test scores for all participants [63% (interquartile ranges, IQR: 57-71%) versus 49% (42-54%), with a median difference of 14% (8-23%), p < 0.001]. Conclusion: The SBT effectively imparts key knowledge competencies to the interns and fifth-year medical students. We recommend that SBT be included as part of the course units that students should take and for continuous medical education for qualified healthcare workers in resource-limited settings.

Ultrasonography of acute retroperitoneum.

The retroperitoneum is an important space in the human body that is often implicated in a range Epub ahead of print of acute medical conditions, some of which can be life-threatening. Ultrasonography may serve as a pivotal first-line imaging technique when assessing patients with suspected retroperitoneal abnormalities. Effective ultrasonography of the retroperitoneum requires a comprehensive grasp of its anatomy, adjacent structures, and potential pathologies. Being well-acquainted with the imaging characteristics of acute conditions can meaningfully assist in an accurate diagnosis and guide subsequent management. This review article summarizes and illustrates the acute conditions involving the retroperitoneum through the lens of ultrasound imaging.

Intrapulmonary administration of recombinant activated factor VII in pediatric, adolescent, and young adult oncology and hematopoietic cell transplant patients with pulmonary hemorrhage.

Introduction: Diffuse alveolar hemorrhage (DAH) is a devastating disease process with 50-100% mortality in oncology and hematopoietic cell transplant (HCT) recipients. High concentrations of tissue factors have been demonstrated in the alveolar wall in acute respiratory distress syndrome and DAH, along with elevated levels of tissue factor pathway inhibitors. Activated recombinant factor VII (rFVIIa) activates the tissue factor pathway, successfully overcoming the tissue factor pathway inhibitor (TFPI) inhibition of activation of Factor X. Intrapulmonary administration (IP) of rFVIIa in DAH is described in small case series with successful hemostasis and minimal complications. Methods: We completed a single center retrospective descriptive study of treatment with rFVIIa and outcomes in pediatric oncology and HCT patients with pulmonary hemorrhage at a quaternary hematology/oncology hospital between 2011 and 2019. We aimed to assess the safety and survival of patients with pulmonary hemorrhage who received of IP rFVIIa. Results: We identified 31 patients with pulmonary hemorrhage requiring ICU care. Thirteen patients received intrapulmonary rFVIIa, while eighteen patients did not. Overall, 13 of 31 patients (41.9%) survived ICU discharge. ICU survival (n=6) amongst those in the IP rFVIIa group was 46.2% compared to 38.9% (n=7) in those who did not receive IP therapy (p=0.69). Hospital survival was 46.2% in the IP group and 27.8% in the non-IP group (p=0.45). There were no adverse events noted from use of IP FVIIa. Conclusions: Intrapulmonary rFVIIa can be safely administered in pediatric oncology patients with pulmonary hemorrhage and should be considered a viable treatment option for these patients.