Pediatric emergency care
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Emergency department (ED) overcrowding has been a serious issue on the national agenda for the past 2 decades and is rapidly becoming an increasingly significant problem for children. The goal of this report is to focus on the issues of overcrowding that directly impact children. Our findings reveal that although overcrowding seems to affect children in ways similar to those of adults, there are several important ways in which they differ. ⋯ Children may be at particularly increased risk for medical errors because of their inherent variability in size and the need for age-specific and weight-based dosing. We strongly recommend that pediatric issues be actively included in all future aspects of research and policy planning issues related to ED overcrowding. These include the development of triage protocols, clinical guidelines, research proposals, and computerized data monitoring systems.
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Pediatric emergency care · Jul 2007
ReviewPrevention and treatment of sleep deprivation among emergency physicians.
Emergency physicians commonly experience sleep deprivation because of the need to work shifts during evening and late night hours. The negative effects of this problem are compounded by job stress and traditional methods of scheduling work shifts. ⋯ Sleep-promoting agents may also help treat the problem by helping physicians to sleep during daytime hours. Minimizing sleep deprivation may help prevent job burnout and prolong the length of an emergency physician's career.
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Pediatric emergency care · Jul 2007
Review Case ReportsInfant botulism presenting with poor feeding and lethargy: a review of 4 cases.
Infant botulism is a rare cause of hypotonia in young infants. It may present with vague symptoms such as poor feeding and lethargy. We present 4 cases of infant botulism presenting to 2 community hospitals in central Maryland. ⋯ Three patients required endotracheal intubation. All were treated with botulism immune globulin, and all eventually made full recoveries. We discuss the differential diagnosis and provide an overview of infant botulism.
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Pediatric emergency care · Jul 2007
Randomized Controlled TrialA randomized trial to assess the efficacy of point-of-care testing in decreasing length of stay in a pediatric emergency department.
To compare the effect of point-of-care (POC) testing versus traditional laboratory methods on length of stay in a pediatric emergency department (ED). ⋯ Point-of-care testing can significantly decrease the length of stay in select pediatric patients in an ED setting. Point-of-care devices may prove to facilitate patient flow during busiest periods of service demand.
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Pediatric emergency care · Jul 2007
The predictive value and appropriate ranges of prehospital physiological parameters for high-risk injured children.
To assess: (1) the relative importance of prehospital physiological measures in identifying high-risk children; (2) whether different age-based criteria should be used for each prehospital physiological measure; and (3) outcome-based appropriate ranges of physiological measures in injured children. ⋯ Prehospital GCS and respiratory compromise were the most important physiological measures in identifying high-risk injured children. Age-specific criteria should be considered for RR, heart rate, and SBP.