Pediatric emergency care
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Pediatric emergency care · Oct 1992
Follow-up of patients with occult bacteremia in pediatric emergency departments.
Blood cultures are frequently obtained in pediatric emergency departments (EDs) from febrile young children at risk for bacteremia and subsequent development of serious bacterial infections. This study of 105 children with occult bacteremia treated in two large urban pediatric EDs describes the follow-up of these patients and the impact that positive blood culture results have on the detection of serious illness. Seventy-seven percent of patients had a follow-up visit in the ED, 8% had follow-up by telephone alone, and 15% were not contacted. ⋯ Ten children (9.6%), five of whom had been notified of the positive blood culture, returned with serious illnesses. Patients whose diagnosis of serious illness was facilitated by blood culture results had shorter delay in identifying cultures as positive than did patients notified of positive results who did not develop serious illness (16.2 vs 31.6 hours; P < 0.05). The delay in follow-up of children with occult bacteremia limits the usefulness of blood cultures in the early detection of serious illness.(ABSTRACT TRUNCATED AT 250 WORDS)
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Pediatric emergency care · Oct 1992
The usefulness of pulse oximetry in evaluating acutely ill asthmatics.
To examine the usefulness of pulse oximetry in determining the severity of acute asthma, the arterial oxygen saturation (SaO2) of 196 acutely ill asthmatic children was measured while the children were being treated in the emergency department (ED). The measure of severity used was the disposition from the ED--discharge or hospitalization--after receiving standard ED care. ⋯ The sensitivity of an SaO2 < or = 93% was 35%, and the specificity was 92%. We conclude that SaO2 lacks the sensitivity to differentiate the child who will respond to ED therapy from the child who will require further inpatient care.