Pediatric emergency care
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Pediatric emergency care · Nov 2011
Review Case ReportsLemierre syndrome in a 22-month-old due to Streptococcus pyogenes: a case report.
We report a case of Lemierre syndrome secondary to Streptococcus pyogenes in a 22-month-old girl. This case report and literature review took place at a pediatric intensive care unit at a freestanding tertiary children's hospital. ⋯ Lemierre syndrome can occur in young children secondary to S. pyogenes, and a classic presentation may not occur. A high index of suspicion is crucial to the diagnosis.
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Pediatric emergency care · Nov 2011
Optimizing patient/caregiver satisfaction through quality of communication in the pediatric emergency department.
Optimizing patient/family caregiver satisfaction with emergency department (ED) encounters has advantages for improving patient health outcomes, adherence with medical plans, patient rights, and shared participation in care, provider satisfaction, improved health economics, institutional market share, and liability reduction. The variables that contribute to an optimal outcome in the pediatric ED setting have been less well investigated. The specific hypothesis tested was that patient/family caregiver-provider communication and 24-hour postdischarge phone contact would be associated with an increased frequency of highest possible satisfaction scores. ⋯ Achieving optimal patient/caregiver satisfaction scores in the pediatric ED is highly dependent on the quality of the interpersonal interaction and communication of ED activities. Wait time and other throughput variables are less important than perceived quality of the health interaction and interpersonal communication. Patient satisfaction has advantages greater than market share and should be considered a component of the care-delivery paradigm.
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Pediatric emergency care · Nov 2011
Community pediatric hospitalists providing care in the emergency department: an analysis of physician productivity and financial performance.
Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. ⋯ Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.
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Pediatric emergency care · Nov 2011
Evaluation and management of sexually transmitted infections in adolescent males presenting to a pediatric emergency department: is the chief complaint diagnostic?
The objectives of the study were to (1) describe evaluation and treatment patterns for adolescent males presenting with a concern for sexually transmitted infection (STI) in a pediatric emergency department, (2) assess the rates of STIs in symptomatic males, and (3) determine the utility of urinalysis alone in predicting STIs in adolescent males. ⋯ Sixty-four percent of patients were diagnosed with either GC or CT. Although UA is helpful in predicting STI, limited use is warranted, given the high prevalence of disease in this selected population. The urine culture does not appear to be a necessary adjunct in the management of these patients.
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Pediatric emergency care · Nov 2011
Case ReportsA life-threatening presentation of child physical abuse: jejunal perforation.
Intra-abdominal injuries from impacts are the second most common cause of death in battered children. However, it may be difficult to distinguish between accidental abdominal injury and abuse, especially in the absence of other clinical findings. ⋯ An exploratory laparotomy revealed perforation of the jejunum, and an end-to-end anastomosis was performed. The patient was evaluated by the hospital's child protective team to implement appropriate diagnostic and child-protective interventions, and the child was discharged home in 10 days.