Pediatric emergency care
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Pediatric emergency care · Oct 2013
ReviewRevised 4-Dose Vaccine Schedule as Part of Postexposure Prophylaxis to Prevent Human Rabies.
There is overwhelming evidence that the 4-dose vaccine schedule as part of postexposure prophylaxis to prevent human rabies for previously unvaccinated persons, as recommended by the Advisory Committee on Immunization Practices, United States in 2009, is safe and effective. When used appropriately with timely wound care and administration of human rabies immune globulin, the administration of 4 doses of vaccine on days 0, 3, 7, and 14 is likely to induce an adequate,long-lasting antibody response that is able to neutralize rabies virus and prevent disease in exposed patients. There has been no change in the recommended regimen for pre-exposure prophylaxis and for postexposure prophylaxis of previously vaccinated persons or for immunosuppressed patients.
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Pediatric emergency care · Oct 2013
Evaluation of a Novel Pediatric Appendicitis Pathway Using High- and Low-Risk Scoring Systems.
This study aimed to determine the test characteristics of a pathway for pediatric appendicitis and its effects on emergency department (ED) length of stay, imaging, and admissions. ⋯ The low-risk criteria had good sensitivity in ruling out appendicitis. The high-risk criteria could be used to guide referral or admission. Neither outperformed the a priori judgment of experienced providers.
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Pediatric emergency care · Oct 2013
Energy Drink and Other Substance Use Among Adolescent and Young Adult Emergency Department Patients.
This study aimed to understand current patterns of energy drink use and compare the extent of usage of energy drinks and other commonly used and misused substances between adolescent (13-17-years-old) and young adult (18-25-years-old) emergency department (ED) patients. ⋯ Energy drink use is common among ED patients. Given the high prevalence of energy drink use observed, emergency physicians should consider the involvement of energy drinks in the presentations of young people.
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Pediatric emergency care · Oct 2013
Association of Positive Responses to Suicide Screening Questions With Hospital Admission and Repeated Emergency Department Visits in Children and Adolescents.
Although validated suicide screening tools exist for use among children and adolescents presenting to emergency departments (EDs), the associations between screening positive for suicide risk and immediate psychiatric hospital admission or subsequent ED use, stratified by age, have not been examined. ⋯ Positive responses to suicide screening questions were associated with acute psychiatric hospitalization and repeated ED visits. Suicide screening in a pediatric ED may identify children and adolescents with increased need of psychiatric resources.
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Pediatric emergency care · Oct 2013
Observational StudyEmergency Department Conditions Associated With the Number of Patients Who Leave a Pediatric Emergency Department Before Physician Assessment.
As emergency department (ED) waiting times and volumes increase, substantial numbers of patients leave without being seen (LWBS) by a physician. The objective of this study was to identify ED conditions reflecting patient input, throughput, and output associated with the number of patients who LWBS in a pediatric setting. ⋯ In the study ED, throughput variables played a more important role than input or output variables on the number of patients who LWBS. This finding, which contrasts with a work done previously in an ED serving primarily adults, highlights the importance of pediatric specific research on the impacts of increasing ED waiting times and volumes.