Wound Care in Pediatric vs Adult Patients

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Questions and Answers

What is the prevalence ratio of pediatric to adult patients for simple repair wounds?

  • 1.59 (correct)
  • 4.4
  • 7.0
  • 0.29

Which type of wound location is most common for pediatric patients according to the data?

  • Dog bites (correct)
  • Intermediate repair wounds
  • Squirrel bites
  • Complex repair wounds

Which statement correctly reflects the findings about simple repair wounds for adult and pediatric patients?

  • Pediatric patients have a lower prevalence ratio.
  • Pediatric simple repair wounds are lesser than adults.
  • Adults show a higher prevalence of simple repair wounds.
  • Pediatric patients have a higher prevalence of simple repair wounds. (correct)

What is the percentage of dog wounds among adult patients?

<p>15.28% (B)</p> Signup and view all the answers

Which duration of wound size has a prevalence of 0 for both adult and pediatric patients?

<p>20.1-30 cm (B)</p> Signup and view all the answers

What was the primary objective of the study?

<p>To assess the epidemiology of RIG use in different age groups. (A)</p> Signup and view all the answers

During which years were the eligible participants for the study identified?

<p>2013 to 2019 (C)</p> Signup and view all the answers

How many adult patients met the inclusion criteria in the study?

<p>79,766 (C)</p> Signup and view all the answers

Which injury had the highest prevalence in paediatric patients compared to adults?

<p>Open wounds to the head, neck, and trunk (C)</p> Signup and view all the answers

What statistical method was used to differentiate paediatric from adult patients?

<p>Mutual information (D)</p> Signup and view all the answers

What is the significance of understanding wound characteristics in this study?

<p>To inform dosing and administration of RIG. (A)</p> Signup and view all the answers

Which gender had a higher percentage of paediatric patients in the study?

<p>Male (A)</p> Signup and view all the answers

What percentage of paediatric patients had complex repairs?

<p>0.7% (A)</p> Signup and view all the answers

What is the prevalence ratio for pediatric patients compared to adult patients for complex repair wounds overall?

<p>3.85 (A)</p> Signup and view all the answers

In which wound location do pediatric patients have a higher prevalence compared to adults?

<p>Head/Neck (A)</p> Signup and view all the answers

What is the main reason for the higher prevalence of dog bites in children?

<p>Curiosity and smaller size (C)</p> Signup and view all the answers

Which type of animal encounter has the highest number of incidents reported for adults?

<p>Dog (C)</p> Signup and view all the answers

What wound location has the lowest prevalence ratio for pediatric patients compared to adults?

<p>Arms (D)</p> Signup and view all the answers

Which of the following statements is true regarding rabies risk in children?

<p>Children have a greater risk of serious complications including rabies. (C)</p> Signup and view all the answers

What is a notable feature of complex repair wounds for adult patients?

<p>Are categorized by size and location (C)</p> Signup and view all the answers

Comparing adult and pediatric patients, which animal resulted in a higher number of encounters for pediatric patients?

<p>Dog (C)</p> Signup and view all the answers

What is the common age group for paediatric patients in the study?

<p>7-10 years (B)</p> Signup and view all the answers

Which diagnosis had the highest prevalence ratio for paediatric patients compared to adults?

<p>Laceration of eyelid/periocular area (D)</p> Signup and view all the answers

What statistical method was used to identify factors differentiating paediatric from adult populations?

<p>Mutual Information (B)</p> Signup and view all the answers

What was the predominant insurance type among patients in both groups?

<p>Commercial insurance (A)</p> Signup and view all the answers

How many total adult patients met the inclusion criteria for the study?

<p>79,766 (B)</p> Signup and view all the answers

Which of the following procedures is noted for having higher prevalence among paediatric patients?

<p>Removal of sutures (D)</p> Signup and view all the answers

What demographic variable associated with sex was found in the adult patient group?

<p>55.7% female (D)</p> Signup and view all the answers

What was the recorded prevalence of 'Dog bite' among adult patients?

<p>20.73% (A)</p> Signup and view all the answers

What is the prevalence ratio of 'Open wounds of head, neck, and trunk' for paediatric patients?

<p>5.92 (A)</p> Signup and view all the answers

Which of the following describes the overall outcome of the study?

<p>Significant differences in diagnoses and procedures between groups were found. (C)</p> Signup and view all the answers

What is the primary reason animal bites to the head and face are particularly risky?

<p>They can increase the risk of rabies progression. (A)</p> Signup and view all the answers

What is included in immediate post-exposure prophylaxis (PEP) for unvaccinated patients?

<p>Rabies immunoglobulin (RIG) and rabies vaccine. (A)</p> Signup and view all the answers

What can impair the immunogenicity of a rabies vaccine?

<p>Exceeding the RIG dose beyond 20 IU/kg. (D)</p> Signup and view all the answers

Why do children pose a higher risk for inadequate rabies immunoglobulin (RIG) treatment?

<p>Their weight limits the available RIG volume. (D)</p> Signup and view all the answers

What does the term 'incomplete infiltration' refer to in the context of rabies treatment?

<p>Insufficient volume of RIG used for infiltration. (A)</p> Signup and view all the answers

How has recent guideline improvement in some European countries addressed RIG dosing?

<p>They integrated volume-based and wound-based dosing. (A)</p> Signup and view all the answers

What kind of population bias may exist according to the limitations of the study?

<p>Selection bias of adults and children suspected of rabies. (B)</p> Signup and view all the answers

What is a common misconception about the dosage of RIG for paediatric patients?

<p>Children need the same RIG volume as adults. (B)</p> Signup and view all the answers

Flashcards

Rabies Immune Globulin (RIG)

A treatment used for rabies exposure to boost immunity.

Paediatric Patients

Children receiving medical treatment, typically under 18 years old.

Adult Patients

Individuals aged 18 years or older seeking medical care.

Diagnosis

The identification of a disease or condition based on symptoms.

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ICD Codes

International codes for diseases used in healthcare for diagnosis.

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CPT Codes

Codes used to describe medical, surgical, and diagnostic services.

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Prevalence Ratio

A measure that compares the prevalence of a condition in two groups.

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Top Diagnoses in RIG Study

Most common conditions prompting RIG use among patients.

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Statistical Analysis in Study

Methods used to differentiate treatments and outcomes between groups.

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Procedure Codes

Codes identifying specific medical procedures performed on patients.

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Simple Repair Wounds

Basic wound treatments categorized by size, focusing on prevalence in adults vs children.

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Intermediate Repair Wounds

Moderate complexity wound treatments, more involved than simple repairs.

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Complex Repair Wounds

Wounds requiring advanced treatment based on location and size.

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Complex Repair Wounds

Advanced wound treatments that require more skill and resources, often for severe injuries.

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Wound Location by Patient Type

Data summarizing where on the body different age groups receive wounds.

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Pediatric Wound Location

Areas on the body where children commonly sustain injuries.

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Dog Bites

Injuries inflicted by dogs, often affecting children more due to size and behavior.

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Animal Encounter Types

Categories of interactions between humans and animals leading to injuries.

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Rabies Exposure

Contact with potentially rabid animals requiring urgent medical attention.

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Risk Factors for Animal Bites

Conditions that increase the likelihood of getting bitten, especially in children.

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Facial Injuries

Wounds to the head and face, critical due to proximity to the brain.

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Animal bites risk

Bites to the head and face are riskier for rabies due to rapid progression.

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Post-exposure prophylaxis (PEP)

Immediate treatment for unvaccinated individuals to prevent rabies after exposure.

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RIG dosing in children

Children require careful RIG volume dosing due to smaller body sizes and complex wounds.

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RIG administration failure

Failures can occur due to incomplete infiltration or improper wound care.

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RIG guidelines revision

CDC revised RIG administration guidelines in 1999 for better treatment outcomes.

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WW on RIG efficacy

Weight-based dosing for RIG may not reflect safety and efficacy in children.

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Complex wounds in children

Children's larger and more complex wounds increase RIG volume requirements.

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Epidemiology of RIG Use

The study of how common RIG use is among different age groups in the USA.

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Paediatric Prevalence

Higher rates of certain conditions and RIG use in children compared to adults.

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Open Wounds

Injuries where the skin is torn or cut, especially to the head and neck.

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Prevalence of Complex Repairs

Children show a 3.83-fold higher rate of complex wound repairs than adults.

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RIG Administration Factors

Dosing and administration for RIG depend on wound characteristics and patient age.

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Statistical Findings

Study found 79,766 adults and 20,381 pediatric patients received RIG from 2013-2019.

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RIG Patient Outcomes

Analysis of medical procedures and diagnoses associated with RIG use.

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Study Design

The study is a cross-sectional prevalence study conducted over several years.

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Study Notes

Epidemiology of Rabies Immune Globulin Use in Pediatric and Adult Patients in the USA

  • Study compared epidemiology of pediatric and adult patients receiving rabies immune globulin (RIG)
  • Cross-sectional prevalence study
  • Data from the Symphony and Integrated Dataverse from 2013 to 2019
  • Participants presented between 2013 and 2019
  • Integrated claims and demographic data

Primary and Secondary Outcome Measures

  • Prevalence of diagnosis and procedures associated with pediatric and adult patients based on frequency of medical procedures used
  • International Classification of Diseases (ICD-9-10) codes, respectively
  • Used medical terminology codes to identify features that differentiate the populations
  • Calculated prevalence ratios from adult to compare adult and pediatric patients

Results

  • 79,766 adult and 20,381 pediatric patients were in the study
  • Prevalence of open wounds higher in adults
  • 3.10-fold higher prevalence of open wounds to the head, neck and trunk in pediatric patients
  • Higher prevalence of facial lacerations and eyelid lacerations in pediatric patients compared to adult patients

Top Diagnoses Differentiating Pediatric versus Adult Patients

  • Open wounds of the head, neck and trunk were more prevalent in pediatric patients.
  • Dog bites were more prevalent in pediatric versus adult patients (18.19% vs. 20.73%).
  • Encounters for removal of sutures were more prevalent in pediatric patients compared to adults
  • Open wounds on the hand except fingers/alone were more prevalent in adults versus pediatric patients
  • Open wounds on hands, feet, wrists, and arms were more prevalent in adult patients
  • Lacerations of the eyelid and periorbital area were more prevalent in pediatric patients

Top Procedures Differentiating Pediatric versus Adult Patients

  • Injection of Ketorolac tromethamine(15mg) for procedural pain was more prevalent in adults.
  • Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes were present in a higher frequency in pediatric patients.
  • Subsequent hospital care for evaluation and management of a patient was more prevalent in pediatric patients compared to adults.
  • Level 3 hospital emergency department was more prevalent in pediatric patients than adults.

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