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Pediatric Dehydration Assessment at Triage: Prospective Study on Refilling Time
Samuele Caruggi,Martina Rossi,Costantino De Giacomo,Chiara Luini,Nicola Ruggiero,Alessandro Salvatoni,Silvia Salvatore 대한소아소화기영양학회 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.4
Purpose: Dehydration is a paediatric medical emergency but there is no single standard parameter to evaluate it at the emergency department. Our aim was to evaluate the reliability and validity of capillary refilling time as a triage parameter to assess dehydration in children.Methods: This was a prospective pilot cohort study of children who presented to two paediatric emergency departments in Italy, with symptoms of dehydration. Reliability was assessed by comparing the triage nurse’s measurements with those obtained by the physician. Validity was demonstrated by using 6 parameters suggestive of dehydration. Comparison between refilling time (RT) and a validated Clinical Dehydration Score (CDS) was also considered. The scale’s discriminative ability was evaluated for the outcome of starting intravenous rehydration therapy by using a receiver operating characteristic (ROC) curve. Results: Participants were 242 children. All nurses found easy to elicit the RT after being trained. Interobserver reliability was fair, with a Cohen’s kappa of 0.56 (95% confidence interval [CI], 0.41 to 0.70). There was a significant correlation between RT and weight loss percentage (r-squared=−0.27; 95% CI, −0.47 to −0.04). The scale’s discriminative ability yielded an area under the ROC curve (AUC) of 0.65 (95% CI, 0.57 to 0.73). We found a similarity between RT AUC and CDS-scale AUC matching the two ROC curves.Conclusion: The study showed that RT represents a fast and handy tool to recognize dehydrated children who need a prompt rehydration and may be introduced in the triage line-up.
Pediatric Dehydration Assessment at Triage: Prospective Study on Refilling Time
Caruggi, Samuele,Rossi, Martina,De Giacomo, Costantino,Luini, Chiara,Ruggiero, Nicola,Salvatoni, Alessandro,Salvatore, Silvia The Korean Society of Pediatric Gastroenterology 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.4
Purpose: Dehydration is a paediatric medical emergency but there is no single standard parameter to evaluate it at the emergency department. Our aim was to evaluate the reliability and validity of capillary refilling time as a triage parameter to assess dehydration in children. Methods: This was a prospective pilot cohort study of children who presented to two paediatric emergency departments in Italy, with symptoms of dehydration. Reliability was assessed by comparing the triage nurse's measurements with those obtained by the physician. Validity was demonstrated by using 6 parameters suggestive of dehydration. Comparison between refilling time (RT) and a validated Clinical Dehydration Score (CDS) was also considered. The scale's discriminative ability was evaluated for the outcome of starting intravenous rehydration therapy by using a receiver operating characteristic (ROC) curve. Results: Participants were 242 children. All nurses found easy to elicit the RT after being trained. Interobserver reliability was fair, with a Cohen's kappa of 0.56 (95% confidence interval [CI], 0.41 to 0.70). There was a significant correlation between RT and weight loss percentage (r-squared=-0.27; 95% CI, -0.47 to -0.04). The scale's discriminative ability yielded an area under the ROC curve (AUC) of 0.65 (95% CI, 0.57 to 0.73). We found a similarity between RT AUC and CDS-scale AUC matching the two ROC curves. Conclusion: The study showed that RT represents a fast and handy tool to recognize dehydrated children who need a prompt rehydration and may be introduced in the triage line-up.
Sub-100-fs Cr:YAG laser mode-locked by monolayer graphene saturable absorber.
Davide Di Dio Cafiso, Samuele,Ugolotti, Elena,Schmidt, Andreas,Petrov, Valentin,Griebner, Uwe,Agnesi, Antonio,Cho, Won Bae,Jung, Bo Hee,Rotermund, Fabian,Bae, Sukang,Hong, Byung Hee,Reali, Giancarlo,P Optical Society of America 2013 Optics letters Vol.38 No.10
<P>We report on mode-locking of a Cr:YAG laser at 1516 nm using a monolayer graphene-based saturable absorber of transmission type generating 91 fs pulses with a Fourier product of 0.38 at an average output power exceeding 100 mW. Stable single-pulse mode-locked operation without any sign of Q-switching instabilities or multiple pulses is achieved.</P>