Pediatric emergency care
-
Pediatric emergency care · Dec 1996
Comparative StudyThe need for pediatric-specific triage criteria: results from the Florida Trauma Triage Study.
The objective of the Florida Trauma Triage Study was to assess the performance of state-adopted field triage criteria. The study addressed three specific age groups: pediatric (age < 15 years), adult (age 15-54 years), and geriatric (age 55+ years). Since 1990, Florida has used a uniform set of eight triage criteria, known as the trauma scorecard, for triaging adult trauma patients to state-approved trauma centers. However, only five of the criteria are recommended for use with pediatric patients. This article presents the findings regarding the performance of the scorecard when applied to a pediatric population. ⋯ Although the state-adopted trauma scorecard, applied to a pediatric population, produced acceptable overtriage, it did not produce acceptable undertriage. However, our undertriage rate is comparable to the results of other published studies on pediatric trauma. As a result of the Florida Trauma Triage Study, a new pediatric triage instrument was developed. It is currently being field-tested.
-
Owing to recent emphasis upon the benefits of effective pain management, parents and health care providers expect infants and children to receive safe, effective sedation and analgesia for diagnostic and therapeutic procedures. The Committee on Drugs of the American Academy of Pediatrics has addressed the issue of safety in its recently revised guidelines for monitoring and management of patients undergoing sedation for procedures. Patients undergoing emergency procedures present additional problems because of the limited opportunity to optimally prepare patients and families. ⋯ New formulations of local and topical anesthetics have enhanced their efficacy and reduced pain associated with administration. Innovations in the administration of sedatives and analgesics, as well as antagonists, have enhanced both efficacy and safety. This article reviews recommended guidelines for monitoring and management of patients undergoing sedation for minor procedures and discusses various sedative, analgesic, and anesthetic alternatives available to clinicians.
-
Pediatric emergency care · Dec 1996
Pediatric injuries presenting to an emergency department in a developing country.
To describe the causes and outcomes of pediatric injuries using the emergency departments (ED) as a surveillance site. ⋯ Pediatric injuries are a significant cause of morbidity and mortality in this country, accounting for almost one third of injured patients. Because of the low frequency of pediatric injury deaths, ED surveillance may be a more effective means of identifying high risk groups and activities for injuries. Data from EDs may be useful in other developing countries to develop injury prevention programs.
-
Pediatric emergency care · Dec 1996
Comparative StudyPhysician parents and utilization of a pediatric emergency department.
Health care costs might be reduced if patients could be taught to avoid using an emergency department (ED) for nonurgent illness. This study sought to determine whether children with a physician parent, a group whose parents possess special expertise in judging the severity of acute illness, utilize a pediatric ED differently from children with non-physician parents. ⋯ Children with a physician parent were less likely to use a pediatric ED for nonurgent problems compared to other children. However, children with a nurse parent, a group whose parents have more medical education than we can expect the general public to ever attain, had a pattern of pediatric ED utilization that was similar to the control children. These data suggest that improved parental education alone may not decrease ED use for conditions that could be managed in a less costly setting.