Pediatrics
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The objective of this study was to describe the epidemiology of gymnastics-related injuries among children in the United States. ⋯ Gymnastics has one of the highest injury rates of all girls' sports. Establishment of a national database for gymnastics-related injuries, including exposure data for direct calculation of injury rates, would permit better identification and monitoring of risk factors for gymnastics-related injuries and aid in the development, implementation, and evaluation of injury prevention strategies based on epidemiologic evidence.
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Comparative Study
Comparison of critically ill and injured children transferred from referring hospitals versus in-house admissions.
The purpose of this work was to compare the outcomes, severity of illness, and resource use of patients transferred to PICUs from outside hospitals to patients admitted from within the same hospital. ⋯ On average, children admitted to a cohort of US PICUs from referring hospitals were more ill and required more intensive care resources than patients admitted to the same PICUs from within the institution. Hospital-level differences in PICU efficiency and severity of illness were highly variable. These data highlight the need for standardized PICU admission criteria to maximize hospital efficiency and suggest opportunities for earlier intervention and consultation by hospitals with PICU-level services to improve quality of care for critically ill children.
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The purpose of this work was to determine the utility of total lower extremity radiographs versus dedicated tibia radiographs in the evaluation of the young child presenting with nonweight bearing without localizing signs. ⋯ Our study findings indicate that the diagnostic value of total lower extremity radiography is similar to dedicated tibia radiography in the workup of the nonweight-bearing young child without trauma history or localizing signs. Radiation and cost savings can be realized by reserving additional radiographs for patients with high clinical suspicion and normal findings on dedicated tibia radiography.
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Injury is the number 1 killer of children in the United States. In 2004, injury accounted for 59.5% of all deaths in children younger than 18 years. ⋯ Only the comprehensive cooperation of a broadly diverse group of people will have a significant effect on improving the care and outcome of injured children. This statement has been endorsed by the American Association of Critical-Care Nurses, American College of Emergency Physicians, American College of Surgeons, American Pediatric Surgical Association, National Association of Children's Hospitals and Related Institutions, National Association of State EMS Officials, and Society of Critical Care Medicine.
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Bronchiolitis is the leading cause of hospitalization for infants. Our objective was to identify factors associated with safe discharge to home from the emergency department. ⋯ This large multicenter study of children presenting to the emergency department with bronchiolitis identified several factors associated with safe discharge, including cut points for respiratory rate and oxygen saturation. Although the low-risk model requires further study, we believe that it will assist clinicians evaluating children with bronchiolitis and may help reduce some unnecessary hospitalizations.