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Child Health RESEARCH STUDY: Acute Otitis Media

Michael-Jon Rosslee

Child Health Collection Case

General Information

Report: Newborn between 1-6 calendar months of age

Sex: Female

Age: 4 months

CDC: Grassy Park

Disease Narrative

A 4-month-old lady, was helped bring into Grassy Playground Community Day Medical center (CDC) by her mom, who was worried that she was "pulling and touching her ears more than common" for days gone by two days. Mrs X got taken her to go to an exclusive doctor fourteen days prior anticipated to a "runny nasal but she's in any other case been well since". The child now, in addition to presenting with ear canal problems, is "more irritable and restless" than normal which is "waking during the night" from ear pain leading to Mrs X to get health care on her behalf daughter. She doesn't have any discharge from her ear or associated fever and Mrs X hasn't attempted any form of treatment of the hearing contamination with home or higher the counter-top remedies.

Mrs X, who works as a caterer in Kingsbury hospital, feared for her daughter's health after having "seen other children with ear canal infections display similar signs" and wished to ensure that the problem was seen to by a medical health professional as soon as possible. This is actually the first time this set of symptoms has occurred, and, other than the trip to the private doctor, the road to health credit card and mother both indicate the child keeps growing well and is "is a happy healthy child. " As both the child's parents work during the day time, she actually is looked after by a pal of Mrs X, who, in affectionate conditions, is termed a "day mother" by the family.

Health System Experience

Mrs X fortunately has experienced health care from both the general public and private healthcare system, with the decision of health care service dictated by many factors such as illness, time available and money. On reflection she notes she actually is happy with medical good care service provided by both the private and public system, but further continues on to state that within the private healthcare system it seems that the doctors and nurses "go further" in providing all round healthcare, whereas in the public system it appears they just "do the minimum amount in treatment in order to go patients along". As a result, she "enjoys the experience more" within the private health care system than that of the public healthcare system.

Mrs X does go on to notice that at Grassy Recreation area CDC appointment times and quick queues have made the experience better and under normal circumstances, Mrs X would have been able to reach at the given time for the appointment without having to wait too much time to be seen. In contrast, today, Mrs X attained the medical clinic at 9H00 without an appointment and could have usually waited for an extended time frame hadn't the medical students seen to her and her child. Mrs X notes this as an isolated incidence in not having a scheduled appointment. The students performed an over-all examination including weight, size, MUAC and a specific systemic study of the ENT to be able to research the complaint of any ear disease.

Generally, Mrs X also further continues on to note, the positive behaviour of the health care employees who; "always provide you with the full information", ensure that she is kept up to date with all the innovations in regards to her daughter's health insurance and enquire after her health insurance and the framework of the family. This has led to Mrs X perceiving a high quality of health care received from the CDC. Finally, she made a demand "more sisters, nurses and doctors", as, although there's a high quality of good care, she feels that consequently "more patients could be helped and looked after" at the CDC.

Family and Financial Cost

Both Mr and Mrs X both work full time, thus having to take the kid to the CDC or private doctor for a ailment is an encumbrance on their capacity to earn and support their family. Nonetheless, Mrs X seems that it is worth the cost in her time as she would like to be "in the discussion with her child, as then she recognizes what is wrong with her and exactly how best to address it". Financially, participating in an exclusive doctor is only done when necessary, which is as opposed to the public health care system where the health care is cheaper/free but will often spend longer holding out and so not earning money because of the time taken off work. Thereby, it seems it is just a cost-benefit problem for the family as both Mr and Mrs X "get paid monthly, they cannot absorb surprising costs". The family is normally under no heavy financial burden and obtain no offer. Mrs X notes a "good value of service" received from the CDC and it is always in a position to make time and money available for the small bills required in the looking after of her daughter.

Preventable-Promotional Aspects

The child was established to have an acute ear disease and preventable and promotional aspects of her health care thereafter can be seen in three proportions, mainly; downstream, midstream and upstream actions. Upstream and midstream options would simply contain standard education and health campaign targeted towards carers of infants in order to allow them to care for/prevent ear infections in babies themselves and what danger signs or symptoms warrant the seeking of medical attention.

Downstream would contain treating the acute ear illness. Amoxicillin and Paracetamol syrup were prescribed and the mother health promoted on administration of medication, bottle hygiene, the Vitamin supplements A and deworming timetable, and to give back if danger signs or symptoms noted.

Mrs X is aware of general ear health care in regards to to; not using ear canal buds to clean her daughter's ears, not putting foreign things within the ear canal, but is often not aware or any ameliorating factors that may have averted the ear infection to begin with. Upon further discussion, it is known that when washing her daughter's brain, the ear does indeed become submerged in the shower water and water does enter into the ear canal canal which does be concerned Mrs X. Health education to ease the fret was conducted.

Pathophysiology

Acute otitis mass media is a common ear canal infection among newborns where elements of the middle ear canal become afflicted and swollen with liquid build-up and entrapment behind the tympanic membrane. Signs or symptoms of serious otitis media can vary but usually consist of ear canal pain/tugging or pulling at the ears, trouble sleeping, ear release, restlessness. It aetiology is usually bacterial in dynamics and is also often preceded by/associated with a sore throat or upper respiratory system infections. Children and infants tend to be more predisposed to severe otitis media because of the fact that the Eustachian tubes are smaller and more horizontal than in individuals. This facilitates traffic monitoring up of bacterias and reduced drainage of smooth from the ear canal even in normal circumstances.

Local swelling of the Eustachian pipe and inner hearing can cause blockage and in that way further encourage substance build-up within the center ear. Diagnosis is manufactured by record and conclusions on basic and ENT exam. Treatment includes; an antibiotic (usually Amoxicillin), an analgaesic such as paracetamol or ibuprofen, a follow-up visit 5 days later and health campaign on general areas of toddler/child health such as immunisations and Vitamin A supervision.

Research Articles

  1. Kilpi T, Ahman H, Jokinen J, Lankinen K, Palmu A, Savolainen H et al. Protective efficacy of a second pneumococcal conjugate vaccine against pneumococcal severe otitis media in infants and children: randomized, controlled trial of an 7-valent pneumococcal polysaccharide-meningococcal outer membrane protein complex conjugate vaccine in 1666 children. Clin Infec Dis. 2003;37(9):1155-1164.
  2. Del Mar C, Glasziou P, Hayem M. Are antibiotics indicated as primary treatment for children with severe otitis multimedia? A meta-analysis. BMJ. 1997;314(7093):1526-1526.
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