Pediatric emergency care
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Pediatric emergency care · Dec 1995
Comparative StudyCharacteristics of frequent pediatric emergency department users.
The purpose of this study was to examine the medical and demographic characteristics of patients who frequently seek emergency care at a pediatric emergency department (ED). Registration information of ED visits during the study period from 11/1/87 to 5/31/92 (4.6 years) was stored in a data base. Patients with 10 or more ED visits during this study period were considered to be "frequent" ED users. ⋯ We conclude that cultural differences appeared to be an important factor associated with frequent ED use by healthy persons. Medical care resources as measured by immunizations, insurance, and identification of a primary care physician did not appear to be deficient in this cohort of frequent ED users. Since recurrent wheezing is a dominant chronic condition among frequent ED users, pediatric emergency medicine training programs may consider the inclusion of the chronic management of wheezing in their curriculum.
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Pediatric emergency care · Dec 1995
Review Comparative StudyPediatric emergency medicine fellow clinical work requirements.
A wide range of clinical requirements exists among PEM fellowship programs. Programs are equally split concerning the question of whether fellows should work with supervision or independently in the first year; a significant number of fellowship programs require continued supervision of fellows in subsequent years. ⋯ Programs in which first-year fellows worked independently had fewer attendings and were less likely to provide 24-hour coverage. Fellows appear to work a similar or less demanding schedule than PEM attendings in most fellowship programs, and most fellowship directors feel that their fellows should continue with their current schedule.
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Pediatric emergency care · Dec 1995
Comparative StudyPreferences of parents for pediatric emergency physicians' attire.
While several studies have evaluated patient/parent's preference for physicians' attire in pediatric clinics, pediatric wards, and in adult emergency settings, none has been done in a pediatric emergency department (PED). Furthermore, factors that may influence these preferences such as severity of illness, time of visit, and type of emergency department (ED) visit (surgical vs medical) have not been considered. This study was designed to evaluate parents' attitudes toward pediatric emergency department physicians' professional appearance. ⋯ Our study demonstrated that: 1) pediatric emergency physician's attire does not matter to most parents. However, when asked to choose, clear preferences for likes and dislikes become evident. 2) Parents/guardians prefer pediatric emergency physicians who wear formal attire, including white laboratory coat, and do not like casual dress with tennis shoes. 3) Severity of illness, insurance type, and age, race, and gender of guardians do not affect preferences. 4) Parents of patients with surgical emergencies are more likely to prefer doctors wearing surgical scrubs. 5) Parents visiting the ED during night shift (11 PM to 7 AM) showed less interest in formal attire. Our findings may assist in parent/physician interaction in a PED setting.
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Pediatric emergency care · Dec 1995
Lumbar puncture in the clinical evaluation of children with seizures associated with fever.
This study was prospectively conducted to determine the frequency and yield of lumbar punctures performed in children with fever and seizures and to identify the criteria that were used by emergency physicians in selecting patients for this diagnostic procedure. During the five-year period from 1988 to 1992, 200 previously healthy children aged three months to five years were brought consecutively to the pediatric emergency department, after their seizure associated with fever. ⋯ An age less than 18 months, a febrile illness lasting over 48 hours, suspicious symptoms and signs of meningitis, and complex seizure features had significant influence on the decision of performing a lumbar puncture. Most children with meningitis had lethargy, irritability, and vomiting, and all had complex seizure features.