Articles: emergency-services.
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Pediatric emergency care · Sep 2024
Randomized Controlled TrialMolecular Point-of-Care Testing in the Emergency Department for Group A Streptococcus Pharyngitis: A Randomized Trial.
To compare clinical and health systems outcomes of rapid molecular testing versus throat culture recovery for the management of group A Streptococcus (GAS) pharyngitis in a pediatric emergency department (PED). ⋯ Establishing a POC nucleic acid amplification testing program for GAS in a PED facilitates earlier treatment and fewer antibiotic prescriptions. Although this did not translate to improved clinical and health systems outcomes in our study, it may serve as an important tool amid evolving pediatric febrile illnesses and growing antimicrobial resistance patterns.
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Pediatric emergency care · Sep 2024
Multicenter Study Observational StudySerial Trauma Abdominal Ultrasound in Children (STAUNCH): A Pilot Study.
Ultrasound has established utility within pediatric emergency medicine and has an added benefit of avoiding excessive radiation exposure. The serial focused assessment with sonography in trauma (sFAST) examination is a potential alternative to improve pediatric trauma evaluation. We sought to evaluate the accuracy of sFAST in pediatric patients with blunt abdominal trauma. ⋯ This pilot study found that sFAST can enhance blunt trauma evaluation and improve sensitivity and diagnostic accuracy. More data are needed to determine how sFAST can be utilized in pediatric patients with blunt abdominal trauma.
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Multicenter Study Observational Study
Afebrile status at the time of emergency department visit is associated with delayed antibiotic therapy in patients with sepsis (revised).
To determine whether there is a difference in antibiotic administration time and prognosis in afebrile sepsis patients compared to febrile sepsis patients. ⋯ Afebrile sepsis patients were associated with higher 28-day mortality compared to their febrile counterparts and were delayed in receiving antibiotics. This underscores the need for improved early detection and treatment strategies for the afebrile sepsis patients.
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We implemented a virtual observation unit in which emergency department (ED) patients receive observation-level care at home. Our primary aim was to compare this new care model to in-person observation care in terms of brick-and-mortar ED length of stay (inclusive of ED observation unit time) as well as secondarily on inpatient admission and 72-hour return visits (overall and with admission). ⋯ Virtual observation unit patients used fewer hours in ED and ED observation relative to on-site observation patients. This new care delivery model warrants further study because it has the potential to positively impact ED capacity.