Pediatric emergency care
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Pediatric emergency care · Jun 1986
Current methods of training residents to manage pediatric cardiopulmonary arrests.
Pediatric residency training programs were surveyed to assess current methods of educating house staff to manage pediatric cardiopulmonary resuscitations. Of the 155 programs responding, 96% provide Basic Life Support training, while 79% offer Advanced Cardiac Life Support training, but only 30% provide ongoing education in the form of mock arrests. In general, the availability of the various forms of resuscitation management instruction was not related to either program size or institution needs. The system of training pediatric residents to manage pediatric cardiopulmonary resuscitations at The Johns Hopkins Hospital is outlined.
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Handgun injury is a major cause of morbidity and mortality in American society, particularly among young people. Large numbers of children are affected by handgun violence through the loss of fathers, brothers, and other relatives. Young children are injured, and occasionally killed, in handgun "accidents." Some young children and many adolescents are murdered with handguns. ⋯ Because of the great lethality of handguns and their very limited ability to provide personal protection, handgun injury can best be reduced by making handguns less available. Handgun control cannot reduce rates of crime or interpersonal assault, but it can reduce the frequency and severity of injury arising from these situations toward the much lower levels found in other countries. The involvement of children in the United States handgun injury epidemic warrants effective pediatrician involvement in efforts toward handgun control.
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Pediatric emergency care · Jun 1986
Can Medicaid format alter emergency department utilization patterns?
Emergency department utilization by recipients of Aid to Families with Dependent Children (AFDC) in a metropolitan children's hospital was monitored during a 36-month period (July 1982 to June 1985). There were 92,495 emergency department visits recorded in this interval. During 12 months of this period (July 1983 to June 1984) a pilot program (Citicare) for AFDC recipients requiring prior authorization by the primary care physician for emergency department utilization was in effect. ⋯ There was no corresponding decline in the number of patients admitted to the hospital through the emergency department during the monitoring period with 3,545, 3,555, and 3,922 annualized admissions respectively, for the targeted 12-month periods. These data suggest that the format of Medicaid programs can dramatically alter the utilization of emergency department services. Furthermore, the primary impact of this specific program was to decrease inappropriate emergency department use.