Abstract
Purpose
To determine current perceptions of doctors, nurses and parents for the colour of a neonatal vomit which should prompt an urgent surgical review.
Methods
A voluntary scoping survey of parents/guardians of patients and non-surgical healthcare professionals was conducted with respondents asked to choose from 8 different selections in a colour swatch from pale yellow to dark green. A control group consisted of 13 paediatric surgeons. Data were analysed using the paired t test, Fishers exact test. A p value of < 0.05 was considered to be significant.
Results
365 participants responded: 36% (131/365) parents, 18% (64/365) nurses and 46% (166/365) doctors. 4/365 (1%) did not state their role. 343 participants completed all questions and responses were analysed using total responses for each question. 82% (121/148) of doctors and 78% (50/64) of nurses had more than 3 years of post-graduate experience. Overall, 63% (227/361) of participants (100% paediatric surgeons, 78% other doctors, 75% nurses/midwives & 30% parents) considered dark and light green vomits to be a sign of intestinal obstruction. 67% (242/361) of participants (100% paediatric surgeons, 72% other doctors, 56% nurses/midwives and 62% parents) believed dark and light green vomiting needed an urgent surgical referral. There were significant differences between the control group and other groups in terms of whether the neonate could wait until the next day for a review; nursing staff (p = 0.0002), postnatal/midwifery (p = < 0.0001), emergency medicine (p = 0.04), general practice (p = 0.002), neonatal (p = 0.0001) and paediatricians (p = 0.005). Only the neonatologists (p = 0.04), nursing staff (p = 0.001) and postnatal/midwifery (p = 0.004) believed that the neonate could have safe observation.
Conclusion
Although the perception that green vomiting is potentially serious is acknowledged by the majority of healthcare professionals surveyed, there is still a requirement for more targeted educational practices in nursing, midwifery and medical staff.
Similar content being viewed by others
References
Hajivassiliou CA (2003) Intestinal obstruction in neonatal/pediatric surgery. Semin Pediatr Surg 12:241–253. https://doi.org/10.1053/j.sempedsurg.2003.08.005
Burge DM (2016) The management of bilious vomiting in the neonate. Early Hum Dev 102:41–45. https://doi.org/10.1016/j.earlhumdev.2016.09.002
Cullis PS, Mullan E, Jackson A, Walker G (2018) An audit of bilious vomiting in term neonates referred for pediatric surgical assessment: can we reduce unnecessary transfers? J Pediatr Surg 53:2123–2127. https://doi.org/10.1016/j.jpedsurg.2018.07.007
Malhotra A, Lakkundi A, Carse E (2010) Bilious vomiting in the newborn: 6 years data from a Level III Centre: Bilous vomiting in the newborn. J Paediatr Child H 46:259–261. https://doi.org/10.1111/j.1440-1754.2009.01681.x
Ljuhar D, Gibbons AT, Ponsky TA, Nataraja RM (2020) Emerging technology and their application to paediatric surgical training. Semin Pediatr Surg. https://doi.org/10.1016/j.sempedsurg.2020.150909
Walker GM, Neilson A, Young D, Raine PAM (2006) Colour of bile vomiting in intestinal obstruction in the newborn: questionnaire study. BMJ Clin Res Ed 332:1363. https://doi.org/10.1136/bmj.38859.614352.55
Clark K, Thomas K, Herd F, Nanthakumaran S, Driver C (2011) Bile vomiting in paediatrics: what do we really know? Scot Med J 56:69–71. https://doi.org/10.1258/smj.2010.010015
Drewett M, Johal N, Keys C, Hall NJ, Burge D (2016) The burden of excluding malrotation in term neonates with bile stained vomiting. Pediatr Surg Int 32:483–486. https://doi.org/10.1007/s00383-016-3877-2
Scottoni F, Davenport M (2020) Biliary atresia: Potential for a new decade. Semin Pediatr Surg 29:150940. https://doi.org/10.1016/j.sempedsurg.2020.150940
Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI et al (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167:700–707. https://doi.org/10.1001/jamapediatrics.2013.311
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Chang, A., Sivasubramaniam, M., Souchon, A. et al. Current assessment of parental and health professional perception of the colour of neonatal vomiting: Results of a scoping survey. Pediatr Surg Int 37, 1243–1250 (2021). https://doi.org/10.1007/s00383-021-04908-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-021-04908-z