Pediatric emergency care
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To determine the frequency of analgesic use in children (5 to 17 years inclusive) who present to a pediatric emergency department with acute abdominal pain. ⋯ Analgesic use in children who present to the emergency department with acute abdominal pain and require a surgical consultation was very low, although half required a laparotomy. Prospective studies are needed to determine the efficacy and safety of analgesic use in this setting.
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Pediatric emergency care · Nov 2004
Adherence of pediatric asthma patients with oral corticosteroid prescriptions following pediatric emergency department visit or hospitalization.
To determine caregiver adherence to oral corticosteroids prescribed in the emergency department for pediatric patients with an acute asthma exacerbation and to identify caregivers' perceived barriers to adherence with prescribed oral corticosteroids. ⋯ Efforts to increase corticosteroid adherence in children with acute asthma exacerbations should consider the causes for variation in caregiver adherence with length of therapy as well as caregiver perceptions regarding corticosteroid side effects.
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Pediatric emergency care · Nov 2004
Multicenter StudyEmergency mental health care for youth in Washington State: qualitative research addressing hospital emergency departments' identification and referral of youth facing mental health issues.
The purpose of this formative research was to gain a better understanding of how Washington State hospital emergency departments (EDs) identify and refer children and adolescents with mental health concerns. Increased understanding of emergency mental healthcare for youth will lead to the development and implementation of strategies and policies that enhance the system of providing mental health services to children and adolescents. ⋯ Specific interventions should be developed, implemented, and evaluated to increase coordination between the ED and the larger mental health system. This should include methods for increasing ED staff knowledge of available and accessible mental health services for youth, perhaps through an online system. In addition, the role of the ED in identifying youth facing mental health issues should be clarified, and a brief, nonintrusive screening tool for identifying emergency mental health concerns should be developed.
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Pediatric emergency care · Nov 2004
Case ReportsAn intentional opiate intoxication of an infant: when medical toxicology and child maltreatment services merge.
We present an instructive case of a 5-week-old infant seen in the emergency department with acute inspiratory stridor and depressed level of consciousness. His emergency department course identified an acute opiate intoxication. The child also developed chest wall rigidity, a rare complication of narcotic use. We discuss the emergency department management, as well as the toxicologic and child protection investigations.