CJEM Articles: Cheri Nijssen-Jordan

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  • November 2002 4 6
    Anna Karwowska, Cheri Nijssen-Jordan, David Johnson, H. Dele Davies

    Objectives: Fever is common in children and causes misconceptions among parents. Many investigators have called for improved parental education to dispel "fever phobia." Our objectives were to assess parental and health care provider understanding of fever, its treatment, and beliefs about its consequences, as well as to identify parental sources of information about fever.

    Methods: Self-administered surveys were distributed to 3 parent groups and 4 health care provider groups. Parent groups included parents of children with fever presenting to the emergency department (ED) (fever group, n = 209), parents of children with an injury presenting to ED (injury group, n = 160), and parents of healthy school children (school group, n = 141). Provider groups included pediatric ED physicians (n = 16), pediatric ED nurses (n = 39), general pediatricians (n = 26) and family physicians (n = 79).

    Results: Parent groups considered a temperature of 37.9°C to be a fever, 39.1°C to be a high fever, and 39.9°C to be a dangerous fever. Parents were most concerned about discomfort, seizures and dehydration, and parents in the "fever group" worried more about dehydration (p = 0.01) and brain damage (p = 0.03) than other parents. Most physicians were concerned about dehydration and seizures, but family physicians were most likely to express concerns about brain damage (40.5%) and death (34.1%).

    Conclusions: Fever phobia exists among parents and health care providers and is most likely in parents of febrile children and family physicians. Health care providers varied in their knowledge of fever and its treatment. Greater education of health care workers is required in order to provide families with appropriate information.

  • January 2000 2 1
    Cheri Nijssen-Jordan

    Objective: To determine the frequency of use and the success rates of intraosseous (IO) vascular access in the emergency department.

    Design: A retrospective chart review.

    Setting: A tertiary pediatric emergency department (ED) in a large urban centre.

    Methods: ED resuscitations (ICD-9 code 996) occurring between Oct. 1, 1989, and Sept. 30, 1995, were identified by searching the ED database, inpatient database, ICU admission log and provincial medical examiner's database. From these, all cases involving IO access were selected and comprised the study sample. Demographics, diagnosis, number of IO attempts, success or failure of IO placement, relevant times and patient outcomes were recorded on standard data forms. Frequency of use, success rates and performance times were reported.

    Results: IO access was successful in 36 of 42 (86%) patients. In total, there were 68 attempts, or 1.6 attempts per child. All but one child were less than 3 years of age. The median time to successful IO placement was 8 minutes. Two complications, both fractures, occurred in one patient, a 10-day-old neonate.

    Conclusions: IO success rates were high despite infrequent use.

  • January 2000 2 1
    Cheri Nijssen-Jordan