Articles: emergency-department.
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Pediatric emergency care · Aug 2014
Comparative StudyShould Pediatric Emergency Physicians Be Decentralized in the Medical Community?
Pediatric emergency physicians (PEPs) are well established as primary emergency department (ED) providers in dedicated pediatric centers and university settings. However, the optimum role of these subspecialists is less well defined in the community hospital environment. This study examined the impact on the ED care of children after the introduction of 10 PEPs into a simulated medical community. ⋯ The greatest impact of PEPs on an ED population of children is produced when the PEPs distribute themselves throughout a medical community rather than create individual pediatric EDs in a small number of hospitals.
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We aimed to determine the association between scalp hematoma characteristics and traumatic brain injuries in young children with blunt head trauma who have no other symptoms or signs suggestive of traumatic brain injuries (defined as "isolated scalp hematomas"). ⋯ In patients younger than 24 months with isolated scalp hematomas, a minority received CTs. Despite the occasional presence of traumatic brain injuries on CT, the prevalence of clinically important traumatic brain injuries was very low, with no patient requiring neurosurgery. Clinicians should use patient age, scalp hematoma location and size, and injury mechanism to help determine which otherwise asymptomatic children should undergo neuroimaging after minor head trauma.
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Randomized Controlled Trial Comparative Study
Efficacy of AccuVein to Facilitate Peripheral Intravenous Placement in Adults Presenting to an Emergency Department: A Randomized Clinical Trial.
In the emergency department (ED), intravenous (IV) catheter placement is one of the most frequent interventions and may be a real challenge in some conditions. Improvement of the success rate with new technology represents a great opportunity. This randomized controlled trial aimed to show the superiority of AccuVein to cannulate veins in adults compared to routine care. ⋯ Use of the AccuVein did not improve IV cannulation in nonselected ED patients.
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Bilateral chemical eye injuries are a common and important problem in the Emergency Department. Irrigation of both eyes can be time-consuming, so we present a novel, simple and cost-effective technique for hands-free bilateral eye irrigation. Modifications of a generic dual-lumen cannula adapter and fixation about the glabella allow sterile irrigation fluid to be delivered directly to the medial canthi of the contaminated eyes in a hands-free fashion. ⋯ Patients regain autonomy of movement to reposition themselves for comfort or to manipulate the eyelids for more effective irrigation. Clinicians are freed to tend to other tasks. By sharing this technique we hope to stimulate discussion on the safest and most effective method of irrigating chemically injured eyes and prompt the generation of comparable outcome data for the benefit of patients.