地震灾区难民营12例脓疱疮患儿的护理

总结中国国际救援队在巴基斯坦地震灾区某难民营救治12例脓疱疮患儿的护理工作。主要是医疗队员按照消除传染源、切断传播途径、保护易感人群的思路进行了切实有效的治疗和护理工作:对于脓疱疮患儿采用局部生理盐水冲洗,外敷碘伏、红霉素软膏,口服头孢拉定的方法进行治疗;针对难民营存在的不利因素,开展卫生宣教、环境消毒、心理护理等。结果治疗5d后10例患儿治愈,剩余2例患儿皮损明显减轻,未在该难民营发现新发脓疱疮病例。体会到震后在难民营开展卫生宣教等护理工作对于脓疱疮患儿的治疗十分重要。     

甲硝唑混合液治疗新生儿脓疱疮30例疗效观察

目的观察甲硝唑混合液治疗新生儿脓疱疮的临床疗效及总结护理要点。方法将60例患儿随机分成治疗组及对照组,每组各30例,分别采用甲硝唑混合液和炉甘石、庆大霉素混合液外涂脓疱疮处,观察两组疗效、脓疱疮消退的时间以及有无不良反应的发生,并采取相应的护理措施。结果甲硝唑混合液用于治疗新生儿脓疱疮有效率为96.7%,对照组为60%,两组比较,差异有统计学意义(χ2=11.88,P0.05),治疗组的脓疱疮消退天数为2~5 d,对照组为4~8 d,两组比较,差异有统计学意义(t=-5.596,P0.01),两组均无不良反应的发生。结论甲硝唑混合液治疗新生儿脓疱疮能促进患部早日结痂,明显缩短病程,减轻患儿痛苦,是治疗新生儿脓疱疮的有效方法。     

印尼地震海啸灾区急危重伤员的多国联合转运

目的探讨地震海啸灾区多国陆空联合转运急危重伤病员的机制,以及对灾区医疗救援的作用。方法通过对中国国际救援队在印尼海啸灾区与多国救援队进行联合医疗救援实践的总结与分析。结果在印尼地震海啸灾区,中国国际救援队与其它国际救援队一起,对217名急危重伤员成功进行医疗转运。结论多国陆空联合进行医疗救援,有利于整合救援资源,提高救援效率；多国联合救援需内部进行详尽分工,优势互补；救援队员的自身防护是完成救援任务的基础。     

芦山地震灾区急救日记

2013年4月20日8时02分四川省雅安市芦山县龙门山沟发生7．0级地震。截至24日14时30分,地震共计造成196人死亡,失踪21人,11470人受伤。地震发生后,四川大学华西医院立即派遣医疗救援队赶赴灾区,本文为一名普通的医疗救援队成员在灾区救援工作中所记的日记,反映了地震现场救援的危险与困难,以及救援队员们的大无畏精神。     

远程护理会诊在雅安地震救援中的应用

目的：探讨远程护理会诊在雅安芦山地震救援中的作用。方法：总结解放军总医院远程医疗会诊系统在2013年“4·20”四川芦山地震伤员护理中发挥其远程医疗服务的经验。结果：在四川芦山地震发生后,解放军总医院第一时间组织开通面向灾区服务的远程医疗会诊系统,与位于地震灾区的多家医院及地震救援队救护车远程医疗系统联通,借助此系统。我们对部分地震重伤员进行了远程护理会诊。结论：远程医疗会诊系统在灾害救援中的应用提高了地震伤员的护理质量,有利于伤员的早日康复,为我国在灾难救援中实施远程护理指导提供了可借鉴的经验。     

从三次国外救援行动看中国国际救援队紧急医疗救援事业的发展

中国国际救援队是我国唯一一支可以参加世界各地紧急救援的专业队伍,能在接到命令后1个小时内迅速集结,数小时内赶往世界各地灾区救援.目前,中国国际救援队由二百余名医疗救护、搜索营救和地震方面的专家组成,其任务是协助灾区进行紧急医疗救援、疫病防治、搜救和地震灾后恢复重建工作.     

0.5%甲硝唑与锌甘粉混合液治疗新生儿脓疱疮疗效观察及护理

目的探讨0.5%甲硝唑与锌甘粉混合液外涂治疗新生儿脓疱疮的疗效,并总结护理要点。方法将80例新生儿脓疱疮患儿随机分为治疗组与对照组各40例,治疗组采用0.5%甲硝唑与锌甘粉混合液局部外涂脓疱疮;对照组采用炉甘石洗剂局部外涂脓疱疮。比较两组患儿疗效及治愈时间。结果用药后第5d,治疗组患儿治疗总有效率明显高于对照组,两组比较,χ2=5.50,P<0.05,差异具有统计学意义;治疗组治愈时间明显短于对照组,两组比较,t=-6.35,P<0.01,差异具有统计学意义。结论 0.5%甲硝唑与锌甘粉混合液治疗新生儿脓疱疮疗效确切、疗程短,值得临床推广应用。     

穿刺抽液与灌洗术在新生儿脓疱疮护理中的应用

[目的]探讨使用针刺抽液及灌洗术护理新生儿脓疱疮的效果。[方法]将60例患儿随机分为治疗组与对照组各30例。将治疗组患儿置于辐射保暖床上，在抗感染及营养支持疗法基础上，首次处理脓疱使用穿刺抽液及灌洗术，之后每天局部用0．5％碘伏外涂脓疱疮3次至结痂。对照组除不使针刺抽液及灌洗术外，其余治疗及护理同治疗组。观察两组患儿脓疱疮治疗效果及脓疱疮消退时间。[结果]治疗组患儿脓疱疮治疗效果优于对照组、脓疱疮消退时间短于对照组，差异均有统计学意义（均P〈0．05）。[结论]穿刺抽液与灌洗术治疗脓疱疮疗效显著。     

比较两次地震救援谈救援物资管理体会

时隔云南彝良5.7级地震半年多的时间,4月20日8：02,雅安突发里氏7.0级地震。四川大学华西医院医疗救援队第一时间奔赴灾区开始了有效地地震医疗救援工作。作为两次均第一批奔赴重灾区医疗救援队的队员,笔者全过程参与了两次地震前线医疗救援急救阶段的工作,对现场救援工作深有体会,现特对比两次地震救援,对救援工作中的物资管理体会提出自己的一点看法,以供广大学者和医护工作人员参考。     

自制“黄水疮”膏治疗黄水疮

用自配的“黄水疮”膏治疗328例脓疱疮,用药3～7天,均痊愈。“黄水疮”膏药物组成:强的松5mg/片,氯霉素0.25 g/片,灰黄霉素0.1g/片,扑尔敏4mg/片,取上述四药各等片,研碎成粉。用适量凡士林调匀成膏。备用。方法:将病灶周围用0.1％新洁尔灭消毒。将疮面的分泌物及结痂清除,用盐水棉球拭净疮面,待干后将药膏均匀地薄层涂在疮面上,边缘超出2mm。范围小或易暴露的部位不包扎。反之,用敷料覆盖,每日或隔日换1次,如有局部淋巴结肿大和疼痛,发热等全身症状,加用口服抗生素,一般无需服药。效疗观察:换药第1日见疮面渗出明显减少。第2、3日见疮面红润、结痂,第3～7日结痂脱落愈合,治愈率100％。     

Israeli Defense Forces Medical Corps humanitarian mission for Kosovo's refugees

In April 1999, during the crisis in Kosovo, the Israeli government launched a medical, field hospital in order to provide humanitarian aid to the Albanian refugees that fled from their homes in Kosovo. This facility was set up by the Medical Corps of the Israeli Defense Forces, in a refugee camp located in Northern Macedonia. During the 16 days during which the hospital functioned, the medical staff treated 1,560 patients and hospitalized >100. The field hospital served as a referral center for all of the other primary clinics that were hastily erected in the camp and its surroundings. This communication elaborates on the various aspects of the humanitarian medical aid that were provided by this medical facility and the conclusions that learned from such a mission.     

'My happiness is the refugee camp, my future Palestine': optimism, life satisfaction and perceived happiness in a group of Palestinian children

Scand J Caring Sci; 2012; 26; 467–473 ‘My happiness is the refugee camp, my future Palestine’: optimism, life satisfaction and perceived happiness in a group of Palestinian children Background: This study aimed to explore optimism, perceived happiness and life satisfaction in a group of Palestinian children living in urban districts, rural areas and a refugee camp in the West Bank, as well as in a city in Israel. Method: Three self‐report instruments were administered to a convenience sample of school‐age children (n. 226; 8–12 years old): the Youth Life Orientation Test (YLOT), the Subjective Happiness Scale (SHS) and the Face Scale (FS). The scores were analyzed using anova s and correlation tests (Pearson’s r). Gender and age differences were explored. Results: Optimism, life satisfaction and perceived happiness characterize the entire group of Palestinian children in general. Very little difference was found as a function of gender. Conclusion: Palestinian children seem to enjoy a satisfactory quality of life with regard to optimism, satisfaction and perceived happiness. We hypothesize that these factors may reinforce resilience and positive adjustment to trauma in children. The implications for clinical psychology are discussed.     

Susceptibility of Staphylococcus aureus to Cefaclor and Cephalothin: Laboratory and Clinical Studies

In vitro susceptibility tests of 201 strains of Staphylococcus aureus by agar dilution revealed 90% to be susceptible to 8 μg or less of cefaclor per ml. Strains from hospitalized children and adults were more often resistant than those from patients with bullous impetigo. Cephalothin was more active than cefaclor against all strains tested. Results with disk tests, including those strains examined from the clinical investigation, revealed some discrepancies in identifying strains more resistant to cefaclor. In clinical studies, cefaclor proved quite effective for the treatment of bullous impetigo. Of 73 patients, 90% were cured and 7% improved after completing 5 or more days of treatment. Prompt improvement was noted among most patients seen 3 to 5 days after treatment was begun. One patient experienced mild diarrhea. There were no other adverse or toxic manifestations attributable to therapy.     

Delayed recognition of excess mortality in West Timor

Introduction: In September 1999, militia‐initiated violence in East Timor forced the displacement of approximately 290 000 persons to West Timor in Indonesia. Whereas the security and health status of the East Timorese in East Timor had been well‐monitored, by contrast, the health status of 150 000 refugees in approximately 200 camps in West Timor was essentially unknown. The death of a child during transfer from a refugee camp there to a United Nations transit camp prompted further investigation. Methods: The present study population was the largest West Timorese camp of 14 088 refugees. Despite security constraints, a rapid epidemiological assessment was undertaken. Retrospective analysis of camp mortality data, key informant interviews and environmental assessment were included. Results: A crude mortality rate of 2.3/10 000/day and an under 5 year mortality rate of 10.3/10 000/day were found. Environmental sanitation, personal hygiene, water quality and vector control were inadequate. International aid agencies provided medical care with variable case definitions, no treatment protocols, non‐standard treatment practices, inappropriate antibiotic use, variable referral practices and no secondary prevention. Syndromic diagnoses of causes of dealth guided recommendations for interventions. Follow‐up reports indicated that excess camp mortality was eliminated within a month. Conclusions: All conflict‐affected populations must have an ongoing examination of essential health data to identify urgent unmet needs, guide appropriate health interventions and monitor progress. Sentinel health events must be promptly reported and investigated. Syndromic diagnoses are useful in targeting life‐saving public health interventions. All humanitarian health assistance must have transparency, technical supervision and peer review to ensure compliance with minimum standards.     

Lightning, sudden cardiac death, simulation and an automated external defibrillator: the perfect storm

This is a report of an 11-year-old boy who had sudden cardiac death after a lightning strike while playing lacrosse at summer camp. The camp staff had performed weekly drills to prepare for various medical emergencies and quickly activated their "Emergency Activation System". The child received immediate cardiopulmonary resuscitation (CPR) and was defibrillated with an automated defibrillator (AED) within 3 min of becoming pulseless and was ultimately resuscitated after being defibrillated three times. A community ambulance with a defibrillator on board did not arrive until several minutes after the on-site team had achieved return of spontaneous circulation. In this report, we describe the clinical course of this patient; briefly review lightning injuries, other causes of sudden cardiac death in children and use of AEDs. Finally, we review how simulation has been used in this case and others as a mechanism to ensure preparedness for medical emergencies. This child is alive and well today because of these well-trained camp counselors. Their system of using simulation to maintain emergency readiness serves as an example for lay and professional medical providers alike.     

Diagnosis and treatment of impetigo

Impetigo is a highly contagious, superficial skin infection that most commonly affects children two to five years of age. The two types of impetigo are nonbullous impetigo (i.e., impetigo contagiosa) and bullous impetigo. The diagnosis usually is made clinically, but rarely a culture may be useful. Although impetigo usually heals spontaneously within two weeks without scarring, treatment helps relieve the discomfort, improve cosmetic appearance, and prevent the spread of an organism that may cause other illnesses (e.g., glomerulonephritis). There is no standard treatment for impetigo, and many options are available. The topical antibiotics mupirocin and fusidic acid are effective and may be superior to oral antibiotics. Oral antibiotics should be considered for patients with extensive disease. Oral penicillin V is seldom effective; otherwise there is no clear preference among antistaphylococcal penicillins, amoxicillin/clavulanate, cephalosporins, and macrolides, although resistance rates to erythromycin are rising. Topical disinfectants are not useful in the treatment of impetigo.     

Randomized clinical trial of topical mupirocin versus oral erythromycin for impetigo.

The safety and efficacy of a new topical antiinfective agent, mupirocin, was compared with that of oral erythromycin ethylsuccinate in the treatment of impetigo in children. Sixty-two children aged 5 months to 13 years with impetigo were assigned to be treated with either mupirocin in three daily applications or erythromycin ethylsuccinate (40 mg/kg of body weight per day divided into four doses) according to a randomized treatment schedule. On the initial visit, exudate or cleansed infected sites or both were cultured and therapy was begun. All patients were treated for 8 days. Patients were seen again on days 4 to 5 of therapy, at the end of therapy, and 7 days after the end of therapy. Sites of infection were comparable between the groups, as were bacteriologic responses. At the first visit, 24 of 30 children in the mupirocin group and 14 of 32 children in the erythromycin group were cured or had at least a 75% reduction in size of the lesions. At the end of the study, all 29 of the children in the mupirocin group who came to follow-up, compared with 27 of 29 in the erythromycin group, were cured. Side effects were few. Five children in the erythromycin group developed mild diarrhea. Thus, mupirocin appears to be safe and effective in treating impetigo in children. Our data show a trend toward more rapid clinical response with mupirocin than with erythromycin.     

Safety of summer camp for children with chronic and/or life threatening illness.

The purpose of this work was to retrospectively evaluate the medical needs of children with chronic and/or life-threatening illness attending summer camp at Barretstown Gang Camp (Ireland). Data on medical facility visits collected over 28 sessions (2120 children) between 1998 and 2001 were reviewed. Children originated from 20 different European countries. The most common diagnoses were leukaemia, lymphoma, sarcoma and brain tumour. Forty-eight percent of the children required medical care during their stay and 3386 total visits were recorded. The most common cause of medical facility visit was pain, followed by injury (trauma, bruises, burn) and flu/cold symptoms. Only 8 brief hospital transfers were necessary for the 2120 children. This large-scale study confirms the safety of a well-organized medically supervised summer therapeutic recreational program for children with chronic conditions, including children undergoing chemotherapy treatment and factor replacement.     

Narrative inquiry into life experiences of refugee women and men

BACKGROUND: Africa is the site of many refugee camps, and non-governmental agencies are often responsible for providing programmes and services to improve refugees' quality of life and health in temporary encampments. Rwanda hosts three refugee camps as a result of the 1994 genocide. AIM: This research examines meaningful life experiences as narrated by women and men Congolese refugees residing in a refugee camp in Rwanda. METHODS: Two in-depth interviews were conducted with 15 refugee men and 14 refugee women. Content in the research text was analysed separately by gender. FINDINGS: Women's experiences revealed themes of leaving the good life behind, worrying about their daughters, feeling ambivalent about marriage and lacking hope. Men's experiences revealed themes of leaving the good life behind, having no peace in the heart and fearing the future. CONCLUSIONS: Listening to refugee voices in narrated life experiences provides an opportunity for non-governmental organizations to create programmes and services that pertain closely to refugees' life experiences.     

Camp nursing: rewards and challenges

Every summer, millions of children attend summer camp, bringing with them flashlights, sleeping bags, bug spray, and a wide array of acute and chronic medical conditions. Registered nurses provide care to these children in an environment that is fun-filled, rewarding, and challenging. Familiarity with camp settings, as well as with expectations of the nurse at camp, are important because the demands are quite different from traditional nursing practice. Due to the challenges that are inherent in the camp nursing role, nurses considering this area of practice must be knowledgeable about the various camp settings, camp nurse responsibilities, practice issues for camp nursing, implications for education and research, and resources for the nurse contemplating a camp nursing position.