Pediatric emergency care
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This article uses a case report and discussion to demonstrate the removal of magnets which have become lodged in the nasal cavity as a result of using magnet-backed earrings to decorate the alae. If bi-alar decoration is used, removal of nasal magnets can present more of a challenge than other nasal foreign bodies. This is because of their attraction to each other through the septum and because of the edema that can form around the magnets. This case discusses that removal of magnets lodged in the nares can be easily achieved with minimal trauma, by the use of a household pocket magnet.
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Pediatric emergency care · Sep 2005
A reexamination of the feasibility of the administration of routine childhood vaccines in emergency departments in the era of electronic vaccine registries.
To determine if electronic vaccine records facilitate successful routine childhood vaccination in the emergency department (ED). ⋯ Assuming that the electronic vaccination record performed such as an online vaccine registry, the effort to access the registry might find a substantial number of children late for a routine childhood vaccination. In this setting, we found that approximately one sixth of the children with electronic vaccine records would be found late for vaccination, and based on physician assessment and parental survey, one half of those children would receive that vaccination if available in the ED. These rates offer health care planners a sense of the magnitude of the vaccination rates in the ED as we move toward regional vaccination registries with online capabilities to be accessed by EDs.
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Pediatric emergency care · Sep 2005
Case ReportsIs it acute omphalitis or necrotizing fasciitis? Report of three fatal cases.
We describe 3 Costa Rican newborns that developed acute omphalitis, complicated with fulminant abdominal wall and genital necrotizing fasciitis. The emergency practitioner should be capable of distinguishing promptly between acute omphalitis and early necrotizing fasciitis. Prompt medical treatment and surgical debridement should be encouraged to decrease the high associated morbidity and mortality rates.
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Pediatric emergency care · Sep 2005
Case ReportsNeurological manifestations of an acute abdomen in children.
The acute abdomen in the pediatric age group is not infrequently fraught with diagnostic pitfalls. The younger the patient, the more problematic the presentation can be. Among the more unusual manifestations of an acute abdomen is an apparent encephalopathic picture. We present 2 cases which serve to illustrate the diagnostic difficulties encountered.
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Pediatric emergency care · Sep 2005
Comparative StudySurvey of academic pediatric emergency departments regarding use of evaluation and management codes.
The aims of the study were to determine the frequency at which each emergency medicine evaluation and management (E/M) code is used, to identify factors associated with their use by academic pediatric emergency departments (PEDs), and to compare PED E/M code utilization rates with rates reported by Centers for Medicare and Medicaid Services for general emergency departments (EDs). ⋯ Although the response rate was low, and thus the validity of the results was limited, the findings may serve as a benchmark for E/M code utilization in PEDs. The large variation in use of the E/M codes among the PED in our study and the lower rate of using the highest E/M codes by the PEDs compared with the general EDs suggest potential opportunities for academic PEDs to improve billing practices.