Pediatric emergency care
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Pediatric emergency care · Sep 2011
Comparative StudyEmergency department crowding is associated with decreased quality of care for children.
We sought to determine which of several simple indicators of emergency department crowding are most predictive of quality of care in 2 pediatric disease models: acute asthma and pain associated with long-bone fractures. ⋯ Two measures of ED crowding are consistently associated with lower-quality asthma- and fracture-specific care in the ED for pediatric patients.
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Pediatric emergency care · Sep 2011
Adolescent female with urinary symptoms: a diagnostic challenge for the pediatrician.
The objective of this study was to determine the accuracy with which physicians diagnose sexually transmitted infections (STIs) and urinary tract infections (UTIs) in adolescent females with urinary symptoms. Secondary aims were to determine the prevalence of STIs and UTIs in this subset of patients and to identify variables associated with a physician diagnosis of STI or UTI. ⋯ Pediatric emergency medicine physicians both underdiagnose and overdiagnose STIs and UTIs in patients with urinary symptoms. This diagnostic challenge necessitates that all adolescent patients presenting with urinary symptoms should be tested for STIs and UTIs and have adequate follow-up means established to ensure timely treatment.
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Pediatric emergency care · Sep 2011
Case ReportsOrnithine transcarbamylase deficiency presenting as recurrent abdominal pain in childhood.
Recurrent abdominal pain remains one of the most common symptoms in pediatrics. We present the case of a 3-year-old girl who had recurrent episodes of abdominal pain requiring more than 13 visits to the emergency department. ⋯ Urea cycle disorders often present beyond the neonatal period with frequent vomiting episodes; however, recurrent abdominal pain as a presenting symptom is unusual. Unnecessary invasive investigations of recurrent abdominal pain in childhood can be avoided by considering inborn errors of metabolism earlier in the differential diagnosis.
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Pediatric emergency care · Sep 2011
Physicians' perceptions of background noise in a pediatric emergency department.
The objectives of this study were to measure noise levels in a tertiary care pediatric emergency department (ED) and to identify attending staff physicians' and first-year residents' perceptions of background noise levels and its impact on communication and teaching. ⋯ The high background noise levels in a pediatric ED are perceived as stressful and interfering with communication and teaching. Noise levels in EDs should be measured, and noise reduction strategies should be implemented because physicians are not consistent in identifying excessive noise levels.
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Pediatric emergency care · Sep 2011
Multicenter Study Comparative StudyH1N1 hemagglutinin-inhibition seroprevalence in Emergency Department Health Care workers after the first wave of the 2009 influenza pandemic.
The 2009 H1N1 pandemic (H1N1pdm) virus has been associated with high rates of asymptomatic infections. Existing influenza infection control policies do not address potential transmission through exposure to asymptomatic infected individuals in health care settings. We conducted a seroprevalence study of H1N1pdm infection to determine whether health care workers (HCWs) in the emergency department showed increased evidence of infection during the first wave of the pandemic than that previously reported in adults in the community. ⋯ The higher serodetection rates in adults observed in the current study suggest potentially significantly more frequent infections in HCWs than in the general population. Further investigations are needed to ascertain the relative incidence of influenza infections in HCWs and non-HCWs, to study influenza transmission by asymptomatic infected subjects and ascertain the burden of such transmission in health care settings.