[Short-stay observation in the Pediatric Emergency Room: a 2003-1993 comparison]. / L'osservazione temporanea in Pronto Soccorso pediatrico. Confronto 2003-1993.

AIM: To evaluate the effectiveness of Short-Stay Observation (SSO) in the paediatric Emergency Room (ER) according to changes over time of guidelines. METHODS: This retrospective study analyses the probability of discharge immediately from ER or after SSO and of hospital admission in Trieste during 2003 as compared with 1993. Subjects aged under 18 with respiratory, urinary tract, neurological and gastrointestinal pathologies, selected symptoms and injuries were studied. RESULTS: In 2003 the 86.2% of 6 350 patients enrolled in the study were discharged immediately, compared with the 81.7% of 5475 subjects in 1993 (RR 1.05, IC 95% 1.04-1.07), the 10.0% were discharged after SSO, compared with the 5.9% in 1993 (RR 1.71, IC 95% 1.50-1.95). The 3.8% of the subjects were admitted in 2003, compared to the 12.4% in 1993 (RR 0.30, IC 95% 0.26-0.35). The role of SSO was particularly significant in case of pneumonia, URI, urinary tract infections, seizures, gastroenteritis, abdominal pain, infant fever, injuries. CONCLUSIONS: The decrease of hospital admissions, pointed out in 2003, are related to a better choice of candidates for SSO and to changes in guidelines concerning the approach to urinary tract infections and seizures, the treatment of respiratory distress and gastroenteritis dehydration, and the early identification of predictors of injuries complications. The study confirms the effectiveness of SSO in both avoiding inappropriate admissions and reducing those with limited needs of hospital assistance, assuring the quality of care. The reduced hospital stay decreases child and his family discomfort and favours the care continuity due to the involvement of family paediatrician.

[Determination of orthophosphoric and orthophosphorous acids in the workplace air using ion chromatography]. / Opredelenie soderzhaniia ortofosforistoi i ortofosfornoi kislot v vozdukhe rabochei zony metodom ionnoi khromatografii.

The authors elaborated a method measuring air level of orthophosphorous and orthophosphoric acids by means of ion chromatography within the range of 0.1-25 mg/cu m. The samples are extracted through concentration on a filter. The analysis regime includes depression of the background levels. The separating column (4 x 200 mm) is filled with anion exchanger BT IAN, the suppressing column (6 x 150 mm) is filled with cation exchanger Dowex 50 x 8, the elutriating agent is 1.5 mM of sodium carbonate, the detector is conductometric. Minimal amounts of ions that could be detected in the analyzed solution are 7-10 ng (HPO32-), 10-15 ng (HPO 42-). The method is designed to analyze the air of workplace.

[Evaluation of temporary observation and short hospital stay in a pediatric emergency department]. / Valutazione dell'osservazione temporanea e del ricovero breve in un pronto soccorso pediatrico.

Temporary observation is a very short stay in Emergency Department, widely carried out in adult patients in our Country. No experience in childhood has been reported. In our emergency department children under 16 with acute diseases are admitted for 24-48 hours. From 1991 we carried out also temporary observation. Its effectiveness has been evaluated by studying our activity in 1992 (14.574 emergency room visits, with 664 admissions to our Department and 274 temporary observation) and 1993 (12820 emergency room visits, 573 admissions, 428 temporary observation). Compared to 1992, in 1993 there was a decrease of both emergency room visits (higher than expected from demographic lowering and in part due to payment for emergency room visits) and hospital admissions, and an increase of temporary observation. The stay in hospital was less than 6 hours in 94.2% of temporary observation patients. 18.2% of them were evaluated on clinical basis, 57% also by diagnostic examinations, 24.8% had some treatment. The 89% of the children were sent home following temporary observation, the others were admitted. Criteria for temporary observation were fairly similar to those for hospital admission, but not far as Central Nervous System and Renal Disease are concerned. Our study confirms the usefulness of temporary observation in childhood to reduce both the number of hospital admissions and the discomfort of the patient and his family. Nevertheless there is a need of criteria of appropriateness. Therefore we have elaborated guide lines for temporary observation and admission to our Department.