Articles: emergency-department.
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Pediatric emergency care · Feb 2014
Observational StudyPediatric Early Warning Score at Time of Emergency Department Disposition Is Associated With Level of Care.
The objective of this study was to determine the association between the Pediatric Early Warning Score (PEWS) at time of emergency department (ED) disposition and level of care. ⋯ Pediatric Early Warning Score is associated with the level of care at ED disposition but does not provide adequate sensitivity and specificity to be used in isolation. Performance characteristics are better for patients with respiratory complaints.
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Pediatric emergency care · Feb 2014
Case ReportsEmergency Point-of-Care Ultrasound Diagnosis of Hematocolpometra and Imperforate Hymen in the Pediatric Emergency Department.
A 12-year-old girl presented to the pediatric emergency department with a history of difficulty voiding and was found to have a firm, tender suprapubic mass on examination. Transabdominal emergency point-of-care ultrasound was used at the bedside to diagnose hematocolpometra due to an imperforate hymen. The diagnosis was confirmed by a comprehensive abdominal ultrasound and magnetic resonance imaging in the radiology suite. The patient was discharged on oral contraceptive medication and scheduled for an outpatient surgical hymenectomy following consultation with the gynecology service.
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ABSTRACTIntroduction:Determining which patients with ureterolithiasis are likely to require urologic intervention is a common challenge in the emergency department (ED). The objective was to determine if normal renal sonogram could identify low-risk renal colic patients, who were defined as not requiring urologic intervention within 90 days of their initial ED visit and can be managed conservatively. Methods:This was a prospective cohort study involving adult patients presenting to the EDs of a tertiary care centre with suspected renal colic over a 20-month period. ⋯ Seven (2.1%) US results were classified as findings unrelated to urolithiasis, and none of these patients required urologic intervention. The rate of urologic intervention was significantly lower in those with normal US results (p < 0.001) than in those with abnormal findings. Conclusion:A normal renal sonogram predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected renal colic.
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ABSTRACTIntroduction:Determining which patients with ureterolithiasis are likely to require urologic intervention is a common challenge in the emergency department (ED). The objective was to determine if normal renal sonogram could identify low-risk renal colic patients, who were defined as not requiring urologic intervention within 90 days of their initial ED visit and can be managed conservatively. ⋯ A normal renal sonogram predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected renal colic.
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Epilepsy & behavior : E&B · Feb 2014
Variables associated with emergency department and/or unplanned hospital utilization for children with epilepsy.
In the United States, approximately one million people are evaluated annually in an emergency department (ED) for the diagnosis of a seizure or epilepsy. The highest percentages of these patients are less than five years of age. No studies have been performed on assessing potential variables associated with recurrent ED visits and/or unplanned hospitalizations for children with epilepsy. ⋯ When controlling for other factors, patients who were given an incorrect or no emergency seizure dosing had a high probability of having multiple ED visits/unplanned hospitalizations compared with patients who were given correct dosing (odds ratio=11.28, 95% CI of odds ratio=(2.42, 52.63), p value<0.01 (p=0.0021)). Using a similar model, patients who experienced a higher number of no-shows to clinic visits had a higher probability of having multiple ED visits/unplanned hospitalizations (odds ratio=5.73 per 1 more number of no-show, 95% CI of odds ratio=(1.78, 18.44), p value<0.01 (p=0.0034)). Future studies are planned to target these risk factors with the goal of decreased ED and/or hospital utilization for children with epilepsy.