Physicians’perspectives on adverse drug reactions in pediatric routine care:a survey

Background Children and adolescents are at particular risk for adverse drug reactions(ADRs).We investigated physicians’perceptions on ADRs in pediatric routine care.Methods In this exploratory study from April to November 2020,we invited physicians treating pediatric patients across Germany to complete an online questionnaire consisting mainly of closed questions.Results Completion rate was 98%(127/129).Of all participants,23%(29/127)stated they were not able to estimate how many of their pediatric patients experienced ADRs during drug therapy.The remaining physicians estimated that 7.5%(median;Q25/Q753%/20%)of their pediatric patients were afected by ADRs.Regarding counseling on ADRs,61%(77/127)stated they do not ask regularly the extent to which parents want to be informed.In total,26%(33/127)stated they avoid counseling on ADRs concerning commonly used approved therapies,whereas only 4%(5/127)did so concerning of-label use(P<0.001).Altogether,16%(20/127)stated they rather prescribe new medicines as they hope for better efectiveness;72%(91/127)said they are cautious about doing so owing to yet unknown ADRs.Of all respondents,46%(58/127)stated they do not report ADRs to the authorities.Concerning the black triangle symbol,a European pharmacovigilance measure,11%(14/127)stated they knew it and 6%(7/127)stated they reported any suspected ADR for drugs with that symbol.Conclusions Physicians’perspectives on ADRs were ambivalent:ADRs infuenced their parent counseling and drug prescribing;yet,they struggled to estimate the impact of ADRs on their patients and were not aware of specifc pharmacovigilance measures.

Application effect of optimized emergency nursing process in the rescue of patients with acute myocardial infarction

Background Acute myocardial infarction is a common and prevalent cardiovascular disease that can lead to serious consequences such as shock,arrhythmia,and heart failure.In dealing with acute myocardial infarction,the optimization of emergency nursing process can ensure the effectiveness and safety of rescue work,and help improve the prognosis and rehabilitation of patients.Methods 68 cases of patients with acute myocardial infarction admitted to our hospital from August 2021 to March 2023 were selected as the subjects of this study.They were randomly divided into an observation group and a control group,with 34 cases in each group.The control group received routine nursing care,while the observation group received optimized emergency nursing process based on it.the success rates of rescue,emergency efficiency,complications,and hemodynamics were compared between the two groups.ResultsThe success rate of rescue in the observation group was 100.00%,while in the control group it was 88.24%,the success rate of rescue was statistically different between the two groups(P<0.05).The observation group had shorter time intervals from onset to hospital admission,shorter door-to-activation time,shorter door-toballoon time,and reduced length of hospital stay compared to the control group(P<0.05).The total proportion of patients with complications such as arrhythmias in the observation group was 0.00%,while in the control group it was 11.76%,the difference between the two groups was statistically significant(P<0.05).The Cardi-ac output(CO)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is higher than the control group.The Mean arterial pressure(MAP)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is lower than the control group(P<0.05).Conclusions Optimized the emergency nursing process can improve the success rate of rescue and emergency efficiency in patients with acute myocardial infarction,reduce the occurrence of adverse complications,and improve negative emotions such as anxiety.It is worth promoting and applying.