Pediatric emergency care
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Pediatric emergency care · Jan 2004
ReviewSecondary triage of the injured pediatric patient within the trauma center: support for a selective resource-sparing two-stage system.
While it is generally agreed that pediatric trauma patients exposed to high-risk injury mechanisms should be sent to trauma centers, many patients seen with full trauma alerts are determined to have minimal injury. The purpose of this study was to develop and test a clinical tool to safely triage a group of pediatric trauma patients for initial evaluation by the emergency department (ED) within the trauma center. ⋯ This study serves as further support for the concept of multitiered triage systems within trauma centers. In such settings, initial evaluations of select pediatric patients can be safely performed by emergency medicine staff with deferral of full trauma team alerts.
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Pediatric emergency care · Jan 2004
ReviewPediatric observation status beds on an inpatient unit: an integrated care model.
Describe the usage of observation status (OS) beds on a pediatric inpatient unit and identify diagnoses likely to be successfully discharged compared to those requiring formal inpatient admission. ⋯ We describe the usage of OS beds in a community hospital that we believe can be a successful model for the care of pediatric patients. Future studies are needed to delineate the clinical characteristics of patients that would benefit from this care delivery model.
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Pediatric emergency care · Jan 2004
Difficulty in obtaining peak expiratory flow measurements in children with acute asthma.
To determine the frequency with which children >or=6 years with acute asthma can perform peak expiratory flow rate measurements (PEFR) in an emergency department (ED). ⋯ Adequate PEFR measurements are difficult to obtain in children with acute asthma. Treatment and research protocols cannot rely exclusively on PEFR for evaluation of severity.
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Pediatric emergency care · Jan 2004
Comparative StudyPatient-controlled analgesia for sickle cell pain crisis in a pediatric emergency department.
To determine whether a protocol to start patient-controlled analgesia (PCA) in the emergency department (ED-PCA) would shorten the length of time between narcotic bolus doses and PCA initiation as compared with standard inpatient initiation of PCA (IP-PCA). Also, to compare patient satisfaction and inpatient length of stay for the 2 groups. ⋯ A protocol to initiate PCA for sickle cell patients in a pediatric emergency department shortened the time of its initiation and was preferred by patients.
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Pediatric emergency care · Jan 2004
Case ReportsTraumatic dissection of the internal carotid artery.
We present the case of an 11-year-old male who had a dissection of his left internal carotid artery following a rather innocuous mechanism of injury. Although this phenomenon is documented in the medical literature, it remains a relatively rare event following blunt injury to the head and neck (0.3% occurrence rate in 1 study spanning 7 years). (Despite its rarity, it remains an important cause of cerebrovascular accidents in children. 2) Children presenting with gross neurologic abnormalities following blunt trauma to the head or neck should be considered to have sustained injury to the carotid arteries until proven otherwise.