Pediatric emergency care
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Pediatric emergency care · Apr 1993
Comparative StudyReferral, admission, and discharge patterns in a pediatric emergency department in Israel.
The pediatric emergency department (PED) is an important component of the medical services provided by a hospital. The purpose of the study was to describe the patterns of referrals, admissions, and discharges in a PED to determine to what extent the PED is used solely as an emergency unit, as opposed to being used as a part of a set of primary care facilities. Data were recorded from 1200 patient charts, out of 19,000 visits to a PED in Israel in 1988. ⋯ The rate of admissions was low (11%). This study shows that a large part of the PED work is actually primary care. Some of the demographic, cultural, and ethnic reasons for these patterns are reviewed.
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Pediatric emergency care · Apr 1993
Comparative StudyCorrelating infectious outcome with clinical parameters of 1130 consecutive febrile infants aged zero to eight weeks.
The study objectives were to characterize the infectious outcomes and associated clinical parameters of a large group of febrile young infants who received outpatient sepsis evaluation. This retrospective review of consecutive cases during a seven-year period was set in an urban pediatric emergency department. Febrile infants, aged zero to eight weeks, were the participants. ⋯ The rate of positive cultures per patient age was doubled in those aged zero to four weeks (12%) compared with those aged four to eight weeks (6%). The 49 cases of invasive bacterial infections (bacterial meningitis/bacteremia) were most commonly associated with lower degrees of fever, as slightly over one half (25/49) had temperature < 39 degrees C. The most common pathogens of invasive bacterial infection were group B streptococcus and Escherichia coli, accounting for 33 of 49 cases (67%); the most common pathogens of invasive bacterial infection in older children (Haemophilus influenzae type b and Streptococcus pneumoniae) were relatively underrepresented, accounting for only five of these 49 (10%) cases.
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Pediatric emergency care · Apr 1993
Review Case ReportsPenile zipper entrapment: a simple and less threatening approach using mineral oil.
Penile zipper entrapment, when it presents to the office or emergency department, can prove to be a challenging management problem. An easily implemented alternative approach is presented, along with a review of previously reported experience with this problem.
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Pediatric emergency care · Apr 1993
Review Practice Guideline GuidelinePediatric cardiopulmonary resuscitation: an update based on the new American Heart Association guidelines.
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Pediatric emergency care · Apr 1993
Comparative StudyAn evaluation of the physical and functional characteristics of infant resuscitators.
Self-inflating resuscitators (SIRs) are commonly used to assist ventilation in the newborn. Despite their widespread use, there is limited information available on the functional and physical characteristics of SIRs. We studied five new infant bag-valve units to compare their physical characteristics, including reservoir, accumulator, and dead space volumes (VD), pressure relief mechanism (PRM), inspiratory resistance (RI), and functional mechanics including stroke volume (SV), fraction of delivered oxygen (FDO2), and cycle frequency at -5 degrees C, 20 degrees C, and 49 degrees C, using a test lung apparatus and experienced respiratory therapists. ⋯ However, the following deficiencies were noted: 1) MPR and Pulmanex had no PRM (ASTM requirement); 2) MPR could not cycle at -5 degrees C; 3) the VDs for Pulmanex (10 ml) and MPR (15 ml) were high; 4) the CPR connector broke during normal use, and the MPR connector frequently disconnected; 5) the Laerdal expiratory valve was incompetent; and 6) the Laerdal and CPR could be misassembled for use. Our study shows that some commercially available SIRs do not meet all CSA and ASTM standards and may not be ideal in specific clinical situations. The choice of a SIR may be dictated by the clinical situation in which its use is intended.