Pediatric emergency care
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Pediatric emergency care · Jun 2011
ReviewHospital-based pandemic influenza preparedness and response: strategies to increase surge capacity.
In the spring of 2009, the first patients infected with 2009 H1N1 virus were arriving for care in hospitals in the United States. Anticipating a second wave of infection, our hospital leaders initiated multidisciplinary planning activities to prepare to increase capacity by expansion of emergency department (ED) and inpatient functional space and redeployment of medical personnel. ⋯ Our health center successfully met the challenges posed by the 2009 H1N1 outbreak. The intent in sharing the details of our planning and experience is to allow others to determine which elements of this planning might be adapted for managing a surge of patients in their setting.
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Pediatric emergency care · Jun 2011
Case ReportsCholelithiasis in a toddler with sickle cell disease.
Cholelithiasis is rarely seen in toddlers and school-aged children, even in the setting of sickle cell anemia. In addition to more common etiologies, such as gastroenteritis, constipation, and urinary tract infection, the differential diagnoses of acute abdominal pain in young children with sickle cell disease include vaso-occlusive pain crisis and splenic sequestration. We describe a case of a toddler with sickle cell disease initially presenting with abdominal pain who was found to have symptomatic cholelithiasis.
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Pediatric emergency care · Jun 2011
Multicenter Study Comparative StudyIllicit drug exposure in patients evaluated for alleged child abuse and neglect.
Substantiation of drug exposure in cases with alleged maltreatment is important to provide proper treatment and services to these children and their families. A study performed at University of Iowa Hospitals and Clinics showed that 30% of pediatric patients with burn injuries, which were due to child maltreatment, were also exposed to illicit drugs. ⋯ The results of this study showed that an illicit drug screening protocol used in the assessment of children evaluated for child abuse identified almost 15% of the population of allegedly abused and neglected children who were tested according to a protocol being exposed to illicit drugs. Thus, routine drug testing of at least children assessed for neglect and nonaccidental burn and soft tissue injuries, children with a history of either parental drug use or domestic violence is recommended.
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Pediatric emergency care · Jun 2011
Multicenter Study Comparative Study"Inappropriate" pediatric emergency medical services utilization redefined.
Previous reports on emergency medical services (EMS) transportation of pediatric patients have demonstrated a high rate of overutilization. However, there is also a concern that pediatric patients may underutilize EMS for emergencies that might benefit from EMS. This article compares EMS utilization rate between adult and pediatric patients for high-acuity patients and for the most common reasons for transport. ⋯ As compared with adults, pediatric patients are less likely to utilize EMS for transport to the hospital for both routine and emergent complaints. The definition of inappropriate utilization of EMS for pediatric transport, which has largely focused on inappropriate overutilization, should also incorporate the potential of underutilization for critical patients.
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Pediatric emergency care · Jun 2011
Comparative StudyAssessing survey methods and firearm exposure among adolescent emergency department patients.
The objective of the study was to determine the nature of gun exposure in an adolescent population presenting to an urban emergency department (ED) and to ascertain attributes that correlate with the ability to buy a gun or to access a loaded gun within 3 hours. ⋯ The ability to buy a gun and access to a loaded gun within 3 hours are relatively common among ED adolescent patients. Having a gun in the home and witnessing a gun at school were independent predictors of the ability to access a loaded gun within 3 hours. Gang membership and drug use were associated with a self-reported ability to buy a gun.