Pediatric emergency care
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Pediatric emergency care · Oct 2014
Comparative StudyChanges in practice patterns with the opening of a dedicated pediatric emergency department.
Dedicated pediatric emergency departments (ED) staffed by pediatric emergency medicine physicians are becoming more common. We compared processes of care and outcomes before and after opening a dedicated pediatric ED. ⋯ Opening of a pediatric ED with pediatric emergency physicians was associated with decreases in ED LOS, rates of LWBS, general radiographic, and computed tomography imaging as well as laboratory testing, and increases in patient satisfaction scores. The clinical significance of these changes is unclear.
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Pediatric emergency care · Oct 2014
Clinical signs and symptoms associated with intussusception in young children undergoing ultrasound in the emergency room.
The purpose of this study was to evaluate all patients suspected of having intussusception and identify which signs and symptoms were associated with the disease. ⋯ The presence of crying, abdominal mass, pallor, and vomiting were clinical indicators of intussusception. Individually, none of these variables were helpful in confirming the diagnosis but in the presence of all 4, there is a 95% probability of having the disease. The absence of all 4 of these made the likelihood of having the disease very low.
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Pediatric emergency care · Oct 2014
Observational StudyFrequent pediatric emergency department use in infancy and early childhood.
To define the threshold and population factors associated with pediatric emergency department (PED) use above the norm during the first 36 months of life. ⋯ The threshold for frequent PED use was more than 5 visits per patient within the first 36 months of life. Further study is needed to better define this population and develop targeted interventions to ensure care provision occurs in the ideal setting.
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Pediatric emergency care · Oct 2014
Observational StudyPediatric emergencies admitted in the resuscitation room of a swiss university hospital.
Pediatric resuscitation is an intense, stressful, and challenging process. The aim of this study was to review the life-threatening pediatric (LTP) emergencies admitted in a Swiss university hospital with regards to patients' demographics, reason for admission, diagnosis, treatment, significant events, critical incidents, and outcomes. ⋯ The LTP emergencies accounted for a small proportion of all pediatric emergencies. They were more medical than surgical cases and resuscitation measures because of hemodynamic instability were the most frequent treatment.
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Computed tomography (CT) is the standard for immediate imaging of head-injured children, but it uses radiation that predisposes to malignancy. The study goals were to describe imaging practices in this population and to identify barriers to rapid magnetic resonance imaging (MRI) use. ⋯ Concerns about radiation exposure motivate change of practice in the management of head-injured children and adolescents. Head CT use is greater at hospitals with lower pediatric volumes, community hospitals, and by providers without pediatric residency training. Obstacles to increased use of MRI or head-injured children include availability, patient intolerance, and long scan acquisition times.