Pediatric emergency care
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Pediatric emergency care · Jul 2019
Parent Intent and Willingness to Immunize Children Against Influenza in the Pediatric Emergency Department.
To determine rates of influenza immunization among children treated in a pediatric emergency department (ED) and to ascertain parent willingness for children to receive influenza vaccine (IV) in the ED. ⋯ Our data support an IV program in the pediatric ED as a means of increasing vaccination rates, particularly among high-risk patients. Parents are often concerned about adverse effects of IV, and providers should target education in this area.
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Pediatric emergency care · Jul 2019
Association Between Initial Emergency Department Lactate and Use of Vasoactive Medication in Children With Septic Shock.
Current guidelines emphasize early recognition of pediatric septic shock using clinical examination findings. Elevated serum lactate has been associated with increased mortality in adult patients with septic shock. Our objective was to determine the association between the initial serum lactate obtained in the pediatric emergency department (PED) from patients treated for septic shock and the use of vasoactive medication within 24 hours. ⋯ Increased initial lactate is associated with use of vasoactive medication within 24 hours in PED patients with septic shock.
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Pediatric emergency care · Jul 2019
A Collaborative Behavioral Model for Psychiatric Visits in a Pediatric Emergency Department.
Psychiatric pediatric emergency department (PED) visits are associated with extended length of stay (LOS) compared with nonpsychiatric visits. To address delays in definitive care, our PED incorporated a Collaborative Behavioral Model for patients with a psychiatric complaint. We evaluated LOS and 6-month readmission by comparing patients who received a psychiatric consultation through the model with a control group of nonpsychiatric patients. In addition, we assessed the utilization of laboratory tests and imaging and the impact of testing on final patient disposition. ⋯ Collaborative models, with specialized psychiatric components, can better coordinate the care of mental health visits by providing focused interventions that promote efficient disposition. In addition, laboratory and imaging studies resulted in few changes in management or final disposition.
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Pediatric emergency care · Jul 2019
Case ReportsSonographic Evaluation and Monitoring of Pneumoperitoneum After Air Enema Reduction for Intussusception.
Abdominal radiography and computed tomography scans are standard tests to diagnose pneumoperitoneum. With the growing availability of point-of-care ultrasound, pneumoperitoneum may be diagnosed in settings without easy access to radiography or computed tomography, such as in overcrowded emergency departments or resource-poor environments. The use of point-of-care ultrasound to diagnose or monitor pneumoperitoneum has been described in adult but not pediatric patients. We present a case of point-of-care ultrasound detection of pneumoperitoneum and monitoring for tension pneumoperitoneum, after failed air enema reduction for intussusception in an infant.
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Pediatric emergency care · Jul 2019
Case ReportsFitz-Hugh-Curtis Syndrome in Adolescent Females: A Diagnostic Dilemma.
Fitz-Hugh-Curtis syndrome is an extrapelvic manifestation of sexually transmitted infections. Partly because of the lack of specific clinical and laboratory features, this diagnosis is often missed or delayed. We describe a series of cases of patients with Fitz-Hugh-Curtis syndrome, where the diagnosis was initially not recognized and patients underwent extensive evaluations for their symptoms. Based on our experience, we also describe shared historical and physical features that may be useful in enhancing the recognition of patients with this disease.