Specialist GP Nikki Vadgama provides some tips to make your next paediatric eczema consult easier. She includes a review of new guidelines, resources, websites and medications for paediatric eczema management
Cutting-edge endoscopic technology is dramatically improving patient outcomes at North Shore Hospital
Cutting-edge endoscopic technology is dramatically improving patient outcomes at North Shore Hospital
Revolutionary new technology is reducing the need for pancreatic surgery, saving lives and dramatically reducing recovery times at North Shore Hospital (NSH).
Acute inflammation of the pancreas, which can be caused by gallstones or heavy alcohol use, is a life-threatening condition that affects around 350 people living in the Waitemata DHB catchment every year.
Until recently, patients with a build-up of infected fluid around the pancreas have required major surgical intervention to drain the fluid. The procedure was invasive, carried a 25 per cent post-operative mortality rate and those who survived face months of recovery time in an intensive care setting.
But the introduction of a single new procedure at NSH has had stunning results.
Waitemata DHB clinicians have begun using new technology that sees them inserting a flexible endoscope through the patient’s mouth into the stomach. Using ultrasound technology, a stent is then inserted into the affected area.
The result is less-invasive treatment, faster recovery for the patient and – based on early evidence – a significant improvement in the rate of survival.
“We have had a 100% success rate for our first 11 patients, saving over two months of ICU beds and two people are alive who may otherwise have died,” says Waitemata DHB gastroenterologist Dr Marius van Rijnsoever said.
“Besides the improved patient outcomes, it has also resulted in a saving of more than $400,000 in ICU costs alone. These precious resources are now able to be directed to the care of other patients.”
“Some patients have gone home a few days after the procedure, converting what had previously been a life-threatening condition into something which can be managed as an outpatient in the community.”
Waitemata DHB doctors are now also using this technique to treat people who have infected gallbladders but are too sick for an operation, which requires long hospital stays and does not fix the problem permanently.
This new technology will reduce the number of procedures per patient from three down to just one. It offers a permanent fix and reduced length of hospital stays from seven days to only three. Complication rates are also cut from 70% to 15%.
“It has been amazing to see patients make dramatic improvements and we are very proud to be the hospital with the biggest expertise on this topic in the Auckland area,” says Dr van Rijnsoever.
Waitemata DHB Chief Executive Dr Dale Bramley said the use of new endoscopic technology was part of the DHB’s ongoing commitment to improving patient experience and health outcomes.
“This is a good example of our highly skilled workforce utilising the very best of modern medical technology to achieve outcomes for patients that were previously impossible,” Dr Bramley said.
“The early results are more than just encouraging; the use of this new technology is preserving quality-of-life and saving patients from preventable death, so this is a major breakthrough for the DHB in the care we provide to our community.
“Waitemata DHB hospitals already have some of the lowest hospital mortality rates of any hospitals in the country. Initiatives like this will reduce it even further.”