...A review of evidence supporting the use of Anti-Biotics in the treatment of Acute Otitis Media in children to prevent Mastoiditis. Word count: 1469 Module Leaders Jeshni Amblum & Stuart Rutland Contents Page 1. Front Sheet 2. Contents Page 3. A review of evidence supporting the use of Antibiotics in the treatment of Acute Otitis Media in children to prevent Mastoiditis. 4. Reference List 5. Appendices: i. SECAMB Clinical Management Plan/Patient Group Directive ii. FIGURE 3 - Thompson et al (2009) A review of evidence supporting the use of Antibiotics in the treatment of Acute Otitis Media in children to prevent Mastoiditis. Student no 18830 Rationale The Paramedic Practitioner (PP) role has recently adopted a number of Clinical Management plans and Patient Group Directives (PGD) increasing the scope of practice. One such PGD (Appendix i) allows for the utilisation of antibiotics, namely Amoxicillin and Clarithromycin, for the treatment of Otitis Media (OM). This essay will look at the evidence supporting the use of these antibiotics, their efficacy and if early use prevents OM from developing in to Mastoiditis. Its primary aim is to enhance a PP’s knowledge and support education working towards clinical autonomy. Description Otitis Media literally means inflammation of the middle ear (Merriam-Webster 2011) and is predominantly caused by an effusion with in the middle ear caused by Eustachian tube dysfunction (Dhillon and East, 1994...
Words: 2287 - Pages: 10
...whether to treat children’s ear infections with antibiotics or just do an initial observation. Therefore, the issue to be analyzed in this paper is: Should children’s ear infections be treated with antibiotics? Terms & Definitions The purpose of this paper is to evaluate primary research articles by using methods of critical thinking and asking the right questions. This paper will discuss the treatment options for acute otitis media (ear infection) in children with either initial observation/watchful waiting (observing the child first before deciding to prescribe medications) or antibiotic treatment (form of medication usually prescribed to rid the body of infection). There are ten questions that I will be using from the book “Asking the Right Questions (ARQ)” by Browne and Keeley (2010), in order to do a critical analyses of six articles. For each question I will first present views from authors who are against the use of antibiotic treatment for acute otitis media (AOM). Then I will present views from authors who would rather treat acute otitis media with antibiotics. The first and main ARQ question that will be brought up and answered throughout this paper is, “What are the issues and the conclusions?” (Brown & Keeley, 2010, p. 10). There are two types of issues, descriptive or prescriptive, that could describe an article. An issue is how an article will be discussed, what the article will be about, or the main point the author is wanting the reader to know. A descriptive...
Words: 3266 - Pages: 14
...Studies has identified that pacifier use associated with a reduced risk of sudden infant death syndrome ("Sudden Infant Death Syndrome"). De-Kun Li, a reproductive epidemiologist, conducted a study containing 185 mothers of SIDs babies and 312 mothers of control infants between 1997 and 2000. Li states that “a pacifier is a simple, easy to use and already widely used tool that can reduce SIDs (Biello),” simplifying it down to the fact that the bulky handle of the pacifier prevent the ability of the baby’s face to get bury in the bedding. However, Li and his colleagues at Kaiser Permanente Northern California emphasize that the results do not provide evidence that pacifiers prevent SIDS by themselves. Parents can simply reduce the risk of sudden infant death syndrome by placing the baby on their back while napping and provide support on either...
Words: 1514 - Pages: 7
...A. Type of each source/appropriateness/classification American Pediatrics and American Academy of Family Physicians. (2004). Clinical practice guideline: Diagnosis and management of acute otitis media. Retrieved from http://pediatrics.aappublications.org/content/113/5/1451.full This evidence based article is a filtered source and appropriate resource for nursing practice. It establishes comprehensive clinical guidelines to diagnose and manage acute otitis media (AOM), as well as when and how to treat signs and symptoms. It provides a review of multiple research studies and offers recommendations for practice. Its main finding is that watchful waiting is preferable to prescription of antibiotics in treatment of children with uncomplicated AOM. Block, S. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. Pediatric Infectious Disease Journal. 16(4)449-56. This is a unfiltered source. It is an appropriate source for nursing practice because it gives in depth overview of pathology on pathogens that are associated with AOM and the medications used in treatment. On the other hand, it does not address watchful waiting as a mode of treatment; instead it recommends other antibiotics to combat penicillin-resistant organisms. This article is an evidence summary. Kelley, P., Friedman, N., Johnson, C. (2007). Ear, nose and throat. In W. Hay, M. Levin, J. Sondheimer, & R. Deterding (Eds.), Current pediatric diafnosis and treatment...
Words: 1513 - Pages: 7
...Gaur et al. Tobacco Induced Diseases 2012, 10:4 http://www.tobaccoinduceddiseases.com/content/10/1/4 SHORT REPORT Open Access Association of smoking or tobacco use with ear diseases among men: a retrospective study Kiran Gaur1,3*, Neeraj Kasliwal2 and Rajeev Gupta2 Abstract Background: Health related behaviour specially smoking and tobacco in any form are major determinants of health and lead to health inequities. Tobacco leads to various health problems including ear, nose and throat diseases. Objective: To determine the influence of smoking or tobacco use on ear diseases we performed a retrospective study among men. Method: Of 11454 subjects of different age-groups there were 4143 men aged 20-60 years who were evaluated for demographic variables, smoking/tobacco use and middle and internal ear diseases. Descriptive statistics and age adjusted logistic regression analyses were performed. Results: Among the 4143 men, 1739 (42.0%) were smokers or used tobacco. In smokers/tobacco users compared to non-users the age adjusted odds ratios and 95% confidence intervals (CI) for chronic suppurative otitis media were 1.13 (CI 0.96-1.34), acute otitis media 1.16 (CI 0.82-1.64), suppurative otitis media 1.21 (CI 0.79-1.84), otosclerosis 0.97 (CI 0.52-1.33) (p > 0.05) and for overall middle ear diseases was 1.15 (CI 0.99-1.33, p = 0.05). For internal ear diseases the age adjusted odds ratios were for sensorineural hearing loss 1.12 (CI 0.92-1.58), 0.12 (CI 0.42-0.93) for vertigo...
Words: 3241 - Pages: 13
...interview is just a patients parents insight on AOM. This is not an appropriate resource because it is based on opinion rather than fact. None of the Above B1. Watchful Waiting It can be difficult to persuade the population that evidence based medicine is the best approach, especially with children. It is hard for parents to see their children in pain. When a child has an ear infection parents are typically calling within the first few hours after the initial compliant for an antibiotic. With that being said the use of antibiotics for every little sickness has caused a rise in the “super bug” (McCracken, 1998) or antibiotic resistant infection. In the article from The American Academy of Pediatrics (AAP) “Diagnosis and Management of Acute Otitis...
Words: 1128 - Pages: 5
...Pediatric Chiropractic Care: Scientifically Indefensible? Published by Sam Homola under Chiropractic,Science and Medicine Comments: 37 In a paper published in 2008, two academic chiropractors offered this observation: “The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions.”1 Despite lack of support by the medical and scientific community, chiropractic treatment of children is growing in popularity, and more chiropractors are specializing in “chiropractic pediatrics.” The International Chiropractic Association offers a post-graduate “Diplomate in Clinical Chiropractic Pediatrics” (DICCP) and publishes a “peer reviewed” Journal of Clinical Chiropractic Pediatrics. The diplomate syllabus is a 30-module, 360+ hours classroom course during weekends over a three-year period. There is no hospital training and no contact with diseased or injured children — only a “mandatory observational/training weekend at a chiropractic center for special needs children under multi-disciplinary care.”2 A post-graduate certification in chiropractic pediatrics (CICCP) can be earned after 180 hours of classroom instruction. In a June 2008 joint press release, the American Chiropractic Association’s (ACA) Council on Chiropractic Pediatrics and the Council...
Words: 2417 - Pages: 10
...Running Head: EBT TASK 2 1 Research Integration EBT Task 2 Western Governor’s University EBT TASK 2 2 Review and Classification of Evidence Source Type Appropriate Type of (American Academy of Pediatrics; American Academy of Family Physicians, 2004) or inappropriate Filtered Appropriate: This article establishes diagnosis and management guidelines for the treatment of AOM. Additionally, the authors make recommendations regarding treatment options for the symptoms of AOM and address the concept of watchful waiting as opposed to immediate antibiotic therapy. Recommendations are provided for clinical practice and were created using a systematic review of clinical research, making it an ...
Words: 1745 - Pages: 7
...Why Breast is best! To breast feed or to formula fed? That question crosses every new mother’s mind. The choice you make to that question is one of the first and probably the most significant decisions you will make as a new parent. Breastfeeding takes some time to learn for both you and your infant but is definitely worth the effort and time. Your choice to breast feed your newborn infant will affect his or her whole life, from birth throughout his or her adult life. There is no question that a mother truly wants the best for her children from the time they learn they are expecting their new bundle of joy. Breast milk has the perfect combination of proteins, fats, vitamins, and carbohydrates your infant needs. Breast milk is far more than good food. It is a living fluid that protects your infant from disease and actively contributes to the development of your infant. As mentioned by Arsenault (2011) breast milk not only provides the nutrition your infant needs but it also provides protection by supplying your infant his or her first antibodies and immunities. Breast milk aids in protecting infants against infection and disease. According to the La Leche League International (LLL) (2004) Infant mortality rates are higher among artificially fed infants, even in places where everyone has access to safe water and good medical care. Morbidity rates- how often babies get sick- are also higher among artificially fed infants in both the developed and the developing world. Breastfeeding...
Words: 2539 - Pages: 11
...Discussion Post Week Eleven NURS6541, N-11 As an advanced practice nurse (APN), one will encounter children with both common and uncommon neurological and musculoskeletal disorders. Some of the disorders have serious consequences. Therefore, the APN must be diligent in diagnosing and treating any patient that presents with signs of either of these disease processes. For the purpose of this discussion, I will evaluate a case study and present differential diagnoses. I will identify unique characteristics for the primary diagnosis and explain a plan for the treatment and management for the disorder, including any medications and appropriate dosages. Lastly, I will discuss education strategies for the patient and families to aid in caring for their child. My case study is that of an 18-month-old male that presents with a three-day history of upper respiratory symptoms. The mother reports that the illness has gotten worse over the last eight hours. His fever was 103.2 degrees Fahrenheit at the highest. He is becoming fussier. The parent also states that he drank juice today and vomited and he is not drinking. His abdominal exam is...
Words: 930 - Pages: 4
...short stature due to shortening of limbs, affected individuals have characteristic facies with frontal bossing and mid-face hypoplasia, exaggerated lumbar lordosis, limitation of elbow extension, genu varum and trident-like hands. Incidence increases with paternal age. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3) (Di Rocco F et al 2014). FGFR3 is also important in craniofacial, vertebral and neurological development such that this mutation has multiple effects in an affected individual (Horton WA et al 2007). Clinical Presentation Gross motor development frequently is delayed. Motor milestones such as head control and independent sitting, standing, and ambulation may lag by 3-6 months. Speech and language problems may be caused by tongue thrust (due to abnormal maxillomandibular relationship) but often resolve spontaneously. Twenty percent of patients experience delayed speech acquisition. Cognitive skills are preserved, and the intelligence level is within normal limits. Cranial enlargement and poor head control place the infant at risk for extension injuries. An Australian study assessed the functional milestones of achondroplasia children aged 3-7 years. The data noted that while milestones were delayed across all ages studied, functioning improved between age 3 and 5 years, although not subsequently. Access to clinicians skilled in achondroplasia management may assist these children to become...
Words: 1507 - Pages: 7
...cells that connects the nerves to the brain. Four common taste are sweet, sour , bitter and salty . 9. Lips : Lips are the anterior boundary that makes the oral cavity. Upper lip contains maxillary teeth and lower lip contains mandibular teeth. Lip is comprised of four areas: hairy skin, vermillion, vermillion border , cupid’s bow. Vermillion referred as red part of the lips. Vermillion border is the exposed margins of the upper and lower lip. The two midline elevation of the upper lip forms cupid’s bow and the two column raised from these cupid’s bow known as philtral column or dimple. This philtral column extends from the cupid’s bow and meet with the columella. These two structures are more importantwhen re-constructing the lips in case of cleft lip. Tubercle is the midline outgrowth which is located in the human upper lip which is also important structure in re-construction of lip. 10. Face : The most important concern in the management of cleft patients is the anatomy and physiology of nasal and alar cartilages and the nasal septum. The shape of alar cartilages is U .One is lateral crus and second is medial crus. Lateral crus foms the ala and medial crus meets with columella. (dhingra ) In cleft patients nasal deformity occur due to incomplete muscular and skeletal support. When a uni-lateral cleft occurs, skeletal support and the muscular control on the cleft side is abnormally oriented which results in deviated nasal septum to the non- cleft side. Nasal deformity...
Words: 2842 - Pages: 12
...Communicable Disease Outbreak (Measles) Community Health Task 2 Western Governors University Carissa J Dugan Student ID: 000468111 August 20, 2015 Measles was discovered in the 19th century by a Persian Doctor, but was not recognized until 1957 as an infectious agent in human blood by a Scottish physician. In 1912 measles became a notifiable disease and in the first decade that records were kept there was on average 6,000 deaths per year reported from the disease. (Center For Disease Control). There is no definite origination of measles but scientists believe that it dates back to the Roman Empire about the 11th and 12th century (NCBI, 2010). The first outbreak known in America was in 1657 in Boston, Massachusetts. The disease spread quickly through the town and eventually believed to be the source of further infections nationwide. (The History Of Vaccines). A decade prior to a vaccine being developed it was estimated that all children would get the disease by the age of 15 (Center For Disease Control). It was not until 1964 a vaccine was developed to help eradicate the disease. John F. Enders and Dr. Thomas C. Peebles is credited with creating the vaccine, he was able to collect blood samples from the infected in Boston and was successful in isolating the measles virus in an infected 13 year old boy named David Edmundson. (Center For Disease Control). However it was not until 1968 that the vaccine was ready for use and distributed (Center...
Words: 1143 - Pages: 5
...can only tell if a baby is at risk of Down's Syndrome. Scientists from Cyprus, Greece and Britain said the new technique correctly identified 14 Down syndrome cases and 26 normal foetuses in a blind test. They believe it will also be possible to diagnose the condition earlier on. Study author Philippos Patsalis, of the Cyprus Institute of Neurology and Genetics, said: 'The method is simple and fast and easy to perform in every genetic diagnostic lab worldwide because it does not require expensive equipment, software or special infrastructure. 'The test is the first worldwide to demonstrate 100 per cent sensitivity and 100 per cent specificity in all normal and Down's syndrome pregnancies examined.' Down's syndrome is a genetic disorder that causes physical and learning disabilities and raises the risk of heart disease. Infants with the condition have three copies of the Chromosome 21 instead of the normal two. It affects about one in every 700 live births but women of 40 are 16 times more likely to have a Down's child than a 25-year-old. At present all pregnant women are offered screening to see if their baby is at risk of Down's syndrome. For a firm diagnosis, doctors must take a sample of amniotic fluid or the placenta, which involves a 1 in 100 risk of miscarriage. Several research teams have published studies suggesting that analysing the mother's blood can detect Down syndrome in a foetus. There is no...
Words: 1425 - Pages: 6
...CHAPTER II REVIEW OF RELATED LITERATURE Infectious diseases represent a serious health problem today and account for one third of all deaths worldwide (Perumal et al., 2012), and herbal medicine has been used in many parts of the world as a rich tradition for the treatment of these infectious diseases (Titilope et al., 2012), both infectious and non-infectious. Attah et al. (2012) makes similar claims with the evaluation and development of compounds from similar claims with the evaluation and development of compounds from medicinal plants for the treatment of diseases which is one of the areas that is gaining grounds and acceptability world-wide (p.1). According to the World Health Organization, medicinal plants would be the best source to acquire different effective drugs and, therefore, those plants should undergo investigation to have a better understanding of their properties, safety and efficacy (Rajeh et al., 2010; Nascimiento et al., 2000). There are some published reports describing the antimicrobial activity of various crude plant extracts (Igoli et al., 2005; Alzoreky et al., 2003). It is estimated that there are about 2.5 million species of higher plants and the majority of these have not yet been examined for their pharmacological activities (Ram et al., 2003). In relation with the applications of herbal plants, weed, which is a plant that grows out of place and is competitive, persistent and pernicious (James et al., 1991), have been a part of civilization and...
Words: 3671 - Pages: 15
