Academic pediatrics
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Academic pediatrics · Apr 2020
Comparative StudyLanguage Barriers and the Management of Bronchiolitis in a Pediatric Emergency Department.
Language barriers may influence the management of pediatric emergency department (PED) patients who may not align with evidence-based guidelines from the American Academy of Pediatrics. Our objective was to determine if a family's preferred language of Spanish versus English was associated with differences in management of bronchiolitis in the PED. ⋯ Among children diagnosed with bronchiolitis, Spanish-speaking families were more likely to have chest x-rays, complete blood counts, and blood cultures ordered compared to English-speaking families. Further research on how clinical practice guidelines and equity-focused guidelines can impact disparities in diagnostic testing within the PED is warranted.
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Academic pediatrics · Apr 2020
Medical Decision-Making in Foster Care: Considerations for the Care of Children With Medical Complexity.
To explore how medical decision-making for children with medical complexity (CMC) occurs in the context of foster care (FC). ⋯ Medical decisions for CMC can have uncertain risk/benefit ratios. For CMC in FC, many individuals have roles in these nuanced decisions; those with ultimate decision-making authority may have minimal interaction with the child. Pediatricians can assist by clarifying who has legal decision-making authority, facilitating team communication to promote truly informed consent, and serving as a resource to decision-makers. Further research should explore how to adapt the traditional model of shared decision-making to meet the needs of this population.