Pediatric emergency care
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Pediatric emergency care · Oct 2002
Multicenter StudyWho is responsible for pediatric triage decisions in Australian emergency departments: a description of the educational and experiential preparation of general and pediatric emergency nurses.
Pediatric presentations to the emergency department (ED) account for approximately one third of ED presentations. Triage is the process employed by the ED to prioritize presenting patients, including children, on the basis of clinical urgency. This role is undertaken by emergency nurses, and a range of recommendations are available regarding the level of experience and education required by the nurse responsible for pediatric triage decisions. However, little is known about the actual education and experience of nurses undertaking pediatric triage. ⋯ Educationalists and managers must make a commitment to pediatric triage preparation for nurses in EDs providing pediatric services. In particular, emphasis must be placed on providing pediatric continuing education for nurses practicing in mixed population EDs. However, it is also essential that the impact of education and experience on patient outcomes be investigated before an attempt is made to influence the preparation of nurses for triage.
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Pediatric emergency care · Oct 2002
Multicenter StudyFirst-time wheezing in infants during respiratory syncytial virus season: chest radiograph findings.
To evaluate the prevalence of pathologic chest radiographs in infants presenting with a first episode of wheezing during respiratory syncytial virus (RSV) seasons and to compare demographics and clinical variables between patients with benign and pathologic chest radiographs. ⋯ Seventeen percent of 140 previously healthy infants presenting with a first episode of wheezing during RSV seasons had a pathologic chest radiograph. However, only one patient (0.7%) had a cardiac anomaly, and all others had chest radiograph findings consistent with a respiratory tract infection.
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Pediatric emergency care · Dec 2001
Multicenter StudyApplicability of Ottawa knee rule for knee injury in children.
Previous studies have shown that the application of the Ottawa knee rule (OKR) reduces the need for radiographs in adults with acute knee injuries. Our objectives were to describe the epidemiology and incidence of knee injuries in children with acute knee trauma and to validate the OKR in a pediatric population. ⋯ In the pediatric population studied, the OKR did not identify all patients with knee fractures. Future studies may consider modifying the OKR to accommodate the differences between pediatric and adult patients to improve the sensitivity of the rule while maintaining its specificity, before it can be applied routinely in clinical practice.
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Pediatric emergency care · Feb 2000
Randomized Controlled Trial Multicenter Study Clinical TrialHistory and radiographic findings associated with clinically suspected radial head subluxations.
To determine: 1) physician practices regarding the use of radiographs for radial head subluxations (RHS), 2) the prevalence of missed fractures in children with a clinical diagnosis of RHS, 3) the relative risk of a fracture with a nonclassic history for mechanism of injury for RHS, and 4) radiographic findings associated with RHS that are difficult to reduce. ⋯ 1) Physicians tend to order radiographs for elbow injuries they initially perceive to be radial head subluxations when attempts at reduction fail. 2) In our study, fractures in children who presented with the classic flexed elbow/pronated wrist position were rare. 3) The relative risk of a fracture in children with a nonclassic history for mechanism of injury was not significant. 4) An isolated finding of a posterior fat pad in a child with RHS that is difficult to reduce was not associated with a fracture in our small sample of children with radiographic findings.