Pediatric emergency care
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Pediatric emergency care · Feb 2015
APACHE Score, Severity Index of Paraquat Poisoning, and Serum Lactic Acid Concentration in the Prognosis of Paraquat Poisoning of Chinese Patients.
Many prognostic indictors have been studied to evaluate the prognosis of paraquat poisoning. However, the optimal indicator remains unclear. To determine the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the Severity Index of Paraquat Poisoning (SIPP), and serum lactate levels in the prognosis of paraquat poisoning, we performed a prospective study that enrolled 143 paraquat patients. ⋯ The APACHE II score, SIPP, and lactate level had different areas under the curve (0.847, 0.789, and 0.916, respectively) and accuracy (0.64, 0.84, and 0.89, respectively). Respiratory rate, serum creatinine level, Paco2, and mortality rate at 7 days after admission in patients with lactate levels greater than or equal to 2.95 mmol/L were markedly different compared with those of other patients (P < 0.05). The predictive value of lactic acid was superior to that of APACHE II score and SIPP for acute oral paraquat poisoning.
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Pediatric emergency care · Feb 2015
Meta AnalysisThe Efficacy of Isotonic and Hypotonic Intravenous Maintenance Fluid for Pediatric Patients: A Meta-analysis of Randomized Controlled Trials.
This study aimed to analyze the effect of isotonic versus hypotonic solution as intravenous maintenance fluid on level of plasma sodium in hospitalized children. ⋯ The meta-analysis revealed that there was potential risk of hyponatremia for routine infusion of hypotonic maintenance fluid. The use of isotonic solution was warranted in hospitalized pediatric patients.
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Pediatric emergency care · Feb 2015
Prevalence of 3 sexually transmitted infections in a pediatric emergency department.
This study aimed to determine the prevalence of Chlamydia trachomatis, Neisseria gonorrheae, and Trichomonas vaginalis and to describe factors associated with sexually transmitted infection (STI) in a pediatric emergency department (ED). ⋯ Approximately 1 in 10 sexually active adolescent ED patients without reproductive complaints had 1 or more STIs. This suggests the need for strategies to increase STI testing for this population.
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Pediatric emergency care · Feb 2015
Comparative StudyRelative productivity of nurse practitioner and resident physician care models in the pediatric emergency department.
Duty hour restrictions limit the use of resident physicians in pediatric emergency departments (PEDs). We sought to determine the relative clinical productivity of PED attending physicians working with residents compared with PED attending physicians working with nurse practitioners (NPs). ⋯ Pediatric emergency department attending physicians in an NP care model had greater clinical productivity, measured by RVUs, than PED attending physicians in a resident care model while treating similar patient populations.
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Pediatric emergency care · Feb 2015
Observational StudySOUND: A Structured Handoff Tool Improves Patient Handoffs in a Pediatric Emergency Department.
Handoff communication is an important contributor to safety and quality in the emergency department (ED). Breakdowns in this process may lead to unsafe conditions or adverse events. The purpose of this study was to test the hypothesis that the quality of patient handoffs in the pediatric ED would improve after implementation of a structured handoff method. ⋯ It is feasible to standardize patient handoffs in the pediatric ED. The implementation of SOUND improved completeness of handoffs with only a modest increase in the mean time spent discussing each patient. Future study is required to determine if SOUND will prove effective in other ED settings.