Pediatric emergency care
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Pediatric emergency care · May 2005
Self-reported pain intensity and associated distress in children aged 4-18 years on admission, discharge, and one-week follow up to emergency department.
Pain is the most common complaint among children presenting to the Emergency Department (ED), yet it is poorly managed. Although the poor management of pain has been documented, no studies have simultaneously determined the distress caused by the presenting pain nor have children been followed after the ED visit to determine whether the pain and distress have resolved. The purpose of this study was to describe pain intensity, distress from pain, and treatment of pain in children presenting to the ED and to follow them 1 week later to describe resolution of their pain. ⋯ A greater proportion of children report high intensity of distress from pain than of pain intensity itself when in the ED. Only a small proportion of children received analgesics during the visit to the ED and only slightly more on discharge. Although pain seems to resolve by 1 week, distress is less likely to have resolved. More attention needs to be paid both to pain children are experiencing in the ED and equally to the accompanying distress.
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Pediatric emergency care · May 2005
Do major televised events affect pediatric emergency department attendances or delay presentation of surgical conditions?
To investigate whether major televised sporting events influence the level of attendance at a pediatric emergency department or reduce subsequent surgical admissions. ⋯ We have demonstrated that the live broadcast of soccer games from a major sporting tournament does not significantly decrease emergency department workload. In addition, it does not reduce the number of children who require admission to a pediatric surgical department. This suggests that the staffing organization of a pediatric emergency department cannot be altered on the basis that a major sporting tournament is being televised.
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To determine the prevalence of serious bacterial infection in infants younger than 3 months with fever > or =40 degrees C. ⋯ Hyperpyrexia is rare among febrile infants younger than 3 months. One-third of infants with temperature > or =40.0 degrees C had SBI. Future management algorithms might include hyperpyrexia as a risk factor for serious infection.
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Pediatric emergency care · May 2005
Factors affecting emergency department assessment and management of pain in children.
To evaluate statewide emergency department assessment and management of pain in pediatric patients as a quality improvement initiative. ⋯ Disparity exists between perceived and documented emergency department pain management practices for children. Quality improvement initiatives should focus on improving pain assessment in infants, treating moderate to severe pain in children of all age groups, and education of health care providers in pain management strategies. Resources should target health care processes effective in decreasing pediatric pain.
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Pediatric emergency care · May 2005
Case ReportsThe lost endotracheal tube: an unreported complication of prehospital intubation.
This case describes a previously unreported rare, but potentially disastrous, complication of endotracheal tube intubation initiated by prehospital emergency medical services personnel. This report details an inadvertent prehospital esophageal intubation and a critical error in communication between the prehospital and hospital service that resulted in failure to identify or remove the tube until after admission. ⋯ Refraining from the use of slang terms may help prevent miscommunication between personnel upon transfer of patient care. This case shows the need be critical, observant, and wary at all times for even the most implausible findings in medicine.