Pediatric emergency care
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Pediatric emergency care · May 2011
Comparative Study"Family plan"--multiple-patient visits from the same family to an inner-city pediatric emergency department.
The issue of multiple family members presenting to the emergency department (ED) for care during a single visit is unique to pediatric EDs (PEDs). The epidemiology of such multiple-patient visits (MPVs) has not been well characterized. The aims of this study were to describe patient characteristics, Emergency Severity Index (ESI) triage categories, length of stay, ED disposition, and payer characteristics of such MPV and to compare these characteristics to that of the overall ED visits (OEVs). ⋯ In our inner-city PED, most of the MPVs are for medical complaints, belong to a lower acuity, and have a low hospital admission rate.
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Pediatric emergency care · May 2011
Comparative StudyDetection of hypoventilation by capnography and its association with hypoxia in children undergoing sedation with ketamine.
Hypopneic hypoventilation, a decrease in tidal volume without a change in respiratory rate, is not easily detected by standard monitoring practices during sedation but can be detected by capnography. Our goal was to determine the frequency of hypopneic hypoventilation and its association with hypoxia in children undergoing sedation with ketamine. ⋯ Hypopneic hypoventilation as detected by capnography is common in children undergoing sedation with ketamine with or without midazolam. Hypoxia is frequently preceded by low ET(CO2) levels. Further studies are needed to determine if the addition of routine monitoring with capnography can reduce the frequency of hypoxia in children undergoing sedation.
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Pediatric emergency care · May 2011
Case ReportsTension chylothorax complicating acute malignant airway obstruction.
Acute upper airway obstruction represents one of the most challenging emergencies in pediatric practice. In particular, a tension chylothorax complicating a malignant airway obstruction is a rare and life-threatening complication. ⋯ To our knowledge, the extension of a cervical mass to the supraclavear region resulting in a compressive chylothorax represents an exceptional event in pediatrics. Early recognition and prompt treatment resulted to be essential to relieve the compression and to avoid end-stage hemodynamic and respiratory function derangement.
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Pediatric emergency care · May 2011
Comparative StudyClinical prevalence and correlates of substance use in adolescent psychiatric emergency patients.
This study used clinical and administrative data to describe the clinical prevalence and correlates of substance use disorders (SUDs) in 622 adolescents aged 12 to 17 years who were evaluated with 1 or more psychiatric diagnoses after presenting to an urban psychiatric emergency service. ⋯ Substance use disorders were prevalent in this population, and the rate of SUD treatment disposition was lower than anticipated. Substance use disorders were associated with lower functioning but not independently correlated with psychiatric diagnostic categories or symptom severity. This study supports the need for improved screening, intervention, and referral options for SUDs in this setting.
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Pediatric emergency care · May 2011
Comparative StudyPediatric minor injury outcomes: an initial report.
The objectives were (1) to present a preliminary evaluation of outcomes after pediatric emergency department (PED) minor injury care (not previously described) and (2) to test the feasibility of study methods and of a HRQOL tool in this acute care setting. ⋯ We found significant morbidity after PED treatment of minor injury. The study methods and PedsQL patient and proxy forms were feasible for emergency department use. The PedsQL had some initial indications of construct validity for this population.