Pediatric emergency care
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Pediatric emergency care · Jan 2013
Multicenter StudyPrevalence of abusive fractures of the hands, feet, spine, or pelvis on skeletal survey: perhaps "uncommon" is more common than suggested.
Recently, it has been suggested that views of the hands, feet, spine, and pelvis should be omitted from routine skeletal surveys (SSs) because these fractures are rarely identified by SS. Our objective was to describe the prevalence of fractures to the hands, feet, spine, or pelvis among SSs obtained for children in a large, multicenter population who underwent consultation for physical abuse. ⋯ A significant number of occult, abusive fractures would have been missed if SSs had omitted or deferred views of the hands, feet, spine, and pelvis. Given the risks associated with missed abuse, these views should be routinely included in the radiographic SS.
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Pediatric emergency care · Jan 2013
Multicenter StudyHospitalized children with influenza A H1N1 (2009) infection: a Spanish multicenter study.
Even though the majority of cases of influenza A H1N1 (2009) in children are mild, severe complications have been reported. Our objective was to describe the Influenza A H1N1 (2009) complications in pediatric population in Spain. ⋯ Respiratory manifestations were the main complication described. Although the majority of patients had a favorable evolution, a remarkable morbidity and mortality were observed. Patients with confirmed bacterial coinfection were at high risk of severe illness.
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Pediatric emergency care · Dec 2012
Multicenter StudyRole of computed tomography and clinical findings in pediatric blunt intestinal injury: a multicenter study.
Although computed tomographic (CT) scans are accurate in diagnosing solid-organ injuries, their ability to diagnose a blunt intestinal injury (BII) is limited, occasionally requiring repeated imaging. The purpose of this study was to evaluate the role of clinical findings as well as original and repeated CT imaging in the ultimate decision to operate for BII. ⋯ Although abdominal CT imaging may contribute to diagnosing intestinal injury after blunt trauma, most children undergo operation based on clinical findings. Repeated imaging should be limited to select patients with diagnostic uncertainty to avoid unneeded delay and radiation exposure.
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Pediatric emergency care · Oct 2012
Multicenter Study Comparative Study Controlled Clinical TrialCost analysis and provider satisfaction with pediatrician in triage.
The goals of this study were to (1) conduct a cost-benefit analysis, from a hospital's perspective, of using a pediatrician in triage (PIT) in the emergency department (ED) and (2) assess the impact of a physician in triage on provider satisfaction. ⋯ Placement of a PIT during periods of peak census resulted in shorter stay and notable provider satisfaction but at an incremental cost of $42,883 per year.
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Pediatric emergency care · Oct 2012
Multicenter Study Comparative StudyAdolescent synthetic cannabinoid exposures reported to Texas poison centers.
This study describes the pattern of adolescent synthetic cannabinoid exposures reported to a large statewide poison center system. ⋯ Adolescent synthetic cannabinoid exposures reported to Texas poison centers were more likely to involve inhalation. The adolescents were more likely to be male. The exposures more often occurred at the patient's own residence and managed at a health care facility with a serious outcome. This pattern of exposures was similar to that observed among adults.