Tuesday, June 25, 2019

오늘은 일찍 깼다...

기도를 했다. 교회를 위해서 그리고 나를 위해서...


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500007/

-Current research indicates that care processes...are perhaps better measures of the overall quality of care for the injured child. 
-Survival...may no longer be a sufficient indicator of quality care... mortality is relatively low in injured children (about 4% in the recent literature)
-half of all U.S. emergency departments see fewer than 10 pediatric patients per day
-Surgeons experienced in pediatric trauma...development of non-operative management of solid organ injuries 
-unnecessary laparotomies. 
-large variations in splenectomy rates across the country, unexplained by severity of injury
-Developing and maintaining a pediatric intensive care unit (PICU)...the closed-ICU model 
-(I can do referred?) Whereas organized trauma systems clearly reduce deaths in adults, similar evidence to support regional pediatric trauma care remains limited.[,] Seminal work by Pollack and others provided the initial evidence that critically ill and injured children treated in tertiary care facilities had a reduced risk of death compared to nontertiary care centers
-trauma designation and pediatric expertise 
-Despite this regionalization effort, most injured children in the US are not treated at specialized pediatric centers.[,] Segui-Gomez and colleagues reported that 77% of injured children receive care at centers without pediatric designation
-(Is this necessary?)improved coordination among acute care facilities 
-Although specific data about inclusive pediatric trauma systems are currently lacking, 

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Big variances in the mortality...

-First of all, if the rate (mortality) is simply obtained based on the binomial distribution, the variance of the mortality cannot be large ...