Development and field testing of protocols for the management of pediatric telephone calls: protocols for pediatric telephone calls.

Although telephone calls comprise almost one fourth of all childhood patient-physician contacts, the content of telephone care is not emphasized in most educational and service programs. In response to the need to improve management of telephone calls to our pediatric emergency room, we developed 28 protocols to deal with the 25 most common complaints presented by phone. This paper describes the content of these protocols, the training of the health assistants who administered them, and the measures we took to assure their safety and general utility in pediatric practice settings. The study demonstrates the feasibility of an organized system for telephone care based on protocols which include: (1) basic data to be collected for each chief complaint category; (2) a range of appropriate dispositions; and (3) advice for home management when the patient does not require an immediate medical visit. Potential uses of these protocols for medical and nursing education and for clinical service needs are discussed.     

Down-regulation of the sodium pump following chronic exposure of HeLa cells and chick embryo heart cells to ouabain.

1 HeLa cells and primary cultures of embryonic chick heart cells were grown in medium containing low concentrations of ouabain for 24 h. 2 Compared with normal cells, cells grown in ouabain have fewer free sodium pump sites, an increased intracellular sodium concentration and a decreased intracellular potassium concentration. The cells are able to maintain their intracellular ion contents because the remaining pump sites have an increased turnover rate. 3 When cells that have been chronically exposed to ouabain are returned to normal growth medium, the sodium pump site numbers increase; the recovery process begins within 6 to 8 h and is complete within 24 h. Recovery of pump site numbers is primarily dependent upon de novo protein synthesis since the protein synthesis inhibitor, cycloheximide, prevents recovery.     

A simple circuit for filtering single unit action potentials from electrograms

A circuit is described which is able to select single motor unit action potentials from an interference pattern. The differentiator circuit produces its effect in 2 ways: by selecting only those action potentials of fast rise-time, it reduces the number of action potentials in the record; by producing an output of short-duration pulses, the probability of superposition is reduced.