Pediatric emergency care
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Pediatric emergency care · Feb 2022
Low-Resource Emergency Department Visits for Children With Complex Chronic Conditions.
Reducing emergency department (ED) use in children with complex chronic conditions (CCC) is a national health system priority. Emergency department visits with minimal clinical intervention may be the most avoidable. We assessed characteristics associated with experiencing such a low-resource ED visit among children with a CCC. ⋯ Infant age, living close to the ED, and day/evening-time visits were associated with the greatest likelihood of experiencing a low-resource ED visit in children with CCCs. Further investigation is needed to assess key drivers for ED use in these children and identify opportunities for diversion of ED care to outpatient and community settings.
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Pediatric emergency care · Feb 2022
Pediatric Train Injuries: A 10-Year Review From the Pennsylvania Trauma Outcomes Study Database.
Trains can cause severe injuries in pediatric patients requiring significant resource utilization. We sought to review train injuries in Pennsylvania to determine the burden of these injuries on the pediatric trauma system. ⋯ Injuries caused by trains can be severe and are most commonly orthopedic or traumatic brain injuries. Targeted safety interventions may be possible given the common mechanisms and geographic clustering of these injuries.
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Pediatric emergency care · Feb 2022
The Use of PECARN and CATCH Rules in Children With Minor Head Trauma Presenting to Emergency Department 24 Hours After Injury.
Major studies (PECARN [Pediatric Emergency Care Applied Research Network], CATCH [Canadian Assessment of Childhood Head Injury]) that regulate the use of computed tomography (CT) algorithms in children with minor head trauma (MHT) have been conducted among children presenting in 24 hours after injury. In this study, we aimed to compare use and results of PECARN and CATCH rules in children presenting in and after 24 hours following injury. ⋯ Patients with MHT presenting after 24 hours following injury constitute a clinically important population. Regardless of the admission time, current guidelines predict traumatic CT abnormalities.
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Pediatric emergency care · Feb 2022
Observational StudyThe Impact of Diagnostic Decisions on Patient Experience in the Pediatric Emergency Department.
Patient experience serves as both a subjective measure of value-based health care delivery and a metric to inform operational decision making. The objective of this study was to determine if specific diagnostic and therapeutic interventions affect patient experience scores for children seen in the emergency department. ⋯ The positive association between more intensive diagnostic workups and patient experience could have implications on the utility of patient experience scores to evaluate pediatric care teams. Consideration should be taken to interpret patient experience scores in the context of compliance with approaches in evidence-based medicine.
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Pediatric emergency care · Feb 2022
Settling the Score: Injury Severity Score Fails to Capture Nuances in Pediatric Trauma.
Recent work has questioned the accuracy of the Injury Severity Score (ISS) and the Abbreviated Injury Scale (AIS) in the pediatric population. We sought to determine mortality rates in pediatric trauma patients at ISSs considered "severe" in adults and whether mortality would vary substantially between adults and children sustaining injuries with the same AIS. ⋯ Although the ISS predicts mortality well, children have lower mortality than do adults for the same ISS, and therefore, the accepted definition of severe injury is not equivalent between these 2 cohorts. Mortality risk is highly dependent on the specific nature of the injury, with large variability in outcomes despite identical AIS scores.