Pediatric emergency care
-
Pediatric emergency care · Sep 2012
Accuracy of plain radiographs to exclude the diagnosis of intussusception.
To prospectively determine the test characteristics of the 3-view abdominal radiograph to decrease the likelihood of ileocolic intussusception. ⋯ The presence of air in the ascending colon on the 3-view abdominal radiograph can decrease the likelihood of or exclude intussusception. When clinical suspicion is low, the presence of specific criterion on a 3-view abdominal radiograph series may obviate the need for further studies.
-
Pediatric emergency care · Sep 2012
Test characteristics of an automated age- and temperature-adjusted tachycardia alert in pediatric septic shock.
This study aimed to create and analyze the performance of an automated triage tool alerting triage nursing staff and physicians to an abnormal heart rate consistent with septic shock in a pediatric emergency department. ⋯ The BPA-automated sensitive triage tool, based solely on initial temperature and heart rate, led to the identification of most children with septic shock, even before clinical acumen and laboratory values were incorporated into the diagnostic algorithm.
-
Pediatric emergency care · Sep 2012
Comparative StudyA comparison of resource utilization between emergency physicians and pediatric emergency physicians.
Pediatric patients in the emergency department (ED) are typically seen either by general emergency physicians (EPs) or by pediatric emergency physicians (PEPs) who have completed either a fellowship in pediatric emergency medicine or both pediatric and emergency medicine residencies. This study evaluates admission rates, turnaround times, and test and medication utilization for EPs versus PEPs. ⋯ In our pediatric ED, which represents a natural experiment where the type of physician is the only variable, PEPs and EPs have similar rates of admission to floor beds and critical care. Pediatric EPs are slightly faster at throughput and order fewer tests and medication.
-
Bronchiolitis is a dynamic condition, and predicting clinical deterioration can be difficult. The objective of this study was to determine whether capnometry readings among bronchiolitic children admitted to the hospital are significantly different from those discharged from the emergency department. ⋯ Capnometry readings are not useful in predicting admission for children younger than 2 years with clinical bronchiolitis. There are no significant differences in capnometry readings among bronchiolitic children with low, medium, and high work of breathing scores.
-
Pediatric emergency care · Sep 2012
Physician management of pediatric mental health patients in the emergency department: assessment, charting, and disposition.
The focus of this study was to describe the clinical data that pediatric emergentologists recorded and how they were used in the mental health (MH) care of patients. ⋯ This study revealed that the pediatric emergentologists' charting of MH patients is inconsistent and incomplete. Although recorded clinical data predicted psychiatric consultation and disposition for these patients, missing data were evident in a significant number of records. The results of the study point to a need to develop a more uniform approach to the collection and recording of clinical data for MH patients.