Outcomes of abdominal pain among children presenting to the Emergency Department of a tertiary hospital in the Republic of Ireland before and during the COVID-19 pandemic.

BACKGROUND: Acute abdominal pain in paediatric patients is a common presentation to the Emergency Department (ED). The COVID-19 pandemic had a significant impact on the health care sector leading to a decline in hospital attendance. AIMS: We compare the burden of paediatric abdominal pain 1 year before and after the start of the COVID-19 pandemic in an Irish ED. METHODS: A retrospective cohort study was conducted in a tertiary hospital. Ethical approval was obtained. Data was collected from January 1 to June 30, 2019, and 2021. Patients' charts were accessed using Therefore® software. Key variables were extracted and summarised in Microsoft Excel tables. Univariate and multivariate data analysis were conducted in SPSS® software. RESULTS: Six hundred sixty-one (2019) and 479 (2021) patient records were evaluated. There was a 28% reduction in case presentations during pandemic months. Age group, sex and attending discipline were similar for both years. Rates of imaging were significantly higher in 2021 (22.5% vs. 10.6%). Overall admission rate was higher in 2021 (37% vs. 25%, p < 0.001). Viral gastroenteritis decreased (13%) and non-specific diagnosis increased (46%) in 2021. Fewer children re-presented in 2021 (13%). CONCLUSIONS: The COVID-19 pandemic had an impact on the presentation, investigations and admission rates of abdominal pain in the ED. Our study highlights the need for increased awareness of severe abdominal pain signs and symptoms in paediatric patients and importance for diagnostic accuracy. Improving patient flow through the ED and having clear guidelines for staff and parents can optimise clinical practice and improve patient outcomes.

Acute Cardiorespiratory and Metabolic Effects of a Sandbag Resistance Exercise Protocol.

Ratamess, NA, Kang, J, Kuper, JD, O'Grady, EA, Ellis, NL, Vought, IT, Culleton, E, Bush, JA, and Faigenbaum, AD. Acute cardiorespiratory and metabolic effects of a sandbag resistance exercise protocol. J Strength Cond Res 32(6): 1491-1502, 2018-The purpose of this study was to examine the acute cardiorespiratory and metabolic effects of a sandbag (SB) resistance exercise protocol and compare the responses to time-matched treadmill running protocols. Eight healthy, resistance-trained men (21.1 ± 1.0 years; 86.1 ± 7.8 kg) completed 4 protocols of equal duration in random sequence: (a) SB, (b) treadmill running at 60% of V[Combining Dot Above]O2 reserve (60V[Combining Dot Above]O2R), (c) treadmill running at 80% of V[Combining Dot Above]O2 reserve (80V[Combining Dot Above]O2R), and (d) a control protocol. The SB protocol was 16 minutes in duration and consisted of 3 circuits of 8 multiple-joint exercises (with 11-, 20-, or 48-kg SBs) performed for as many repetitions as possible for 20 seconds followed by a 10-second rest interval before beginning the next exercise. Two minutes of rest was allowed between circuits. Breath-by-breath oxygen consumption (V[Combining Dot Above]O2) and heart rate (HR) were recorded throughout each protocol and for 30 minutes postexercise (PE) and blood lactate was determined before and immediately after each protocol. Blood lactate was significantly higher after SB compared with 60V[Combining Dot Above]O2R and 80V[Combining Dot Above]O2R. Mean and peak HR in SB was significantly higher than 60V[Combining Dot Above]O2R but not different from 80V[Combining Dot Above]O2R. Mean V[Combining Dot Above]O2 and energy expenditure (EE) in SB was significantly lower than 60V[Combining Dot Above]O2R and 80V[Combining Dot Above]O2R during each protocol but significantly higher after SB compared with 60V[Combining Dot Above]O2R and 80V[Combining Dot Above]O2R PE. Compared with 60V[Combining Dot Above]O2R and 80V[Combining Dot Above]O2R, respiratory exchange ratio was significantly higher during SB and through 5 minutes PE, but was significantly lower at 25-30 minutes PE after SB. Sandbag, as performed in this study, provides a superior metabolic stimulus to treadmill running during the PE period; however, the SB results demonstrate inferior EE compared with running at 60V[Combining Dot Above]O2R and 80V[Combining Dot Above]O2R.