Pediatric emergency care
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Pediatric emergency care · Nov 2009
Case ReportsImported Dengue Fever: an important reemerging disease.
Fever in a returned traveler from the tropics often poses a diagnostic challenge to the emergency department physician because of the potential for serious morbidity and mortality associated with certain infections such as falciparum malaria and dengue. We report a case of imported dengue fever in a 15-year-old adolescent boy acquired during a recent travel to Guatemala. Dengue fever is a mosquito-transmitted viral infection of global importance. ⋯ The disease is underreported in the United States along the Mexican border. The epidemiology, clinical manifestations, diagnosis, control, and prevention of this important global reemerging infectious disease are reviewed. Clinicians should include dengue in the differential diagnosis of febrile illness in children who have recently returned from dengue endemic areas.
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Pediatric emergency care · Nov 2009
Multicenter Study Comparative StudyEpidemiology of psychiatric-related visits to emergency departments in a multicenter collaborative research pediatric network.
Describe the epidemiology of pediatric psychiatric-related visits to emergency departments participating in the Pediatric Emergency Care Applied Research Network. ⋯ Pediatric psychiatric-related visits require more prehospital and emergency department resources and have higher admission/transfer rates than non-psychiatric-related visits within a large national pediatric emergency network.
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Pediatric emergency care · Nov 2009
Comparative StudyPatients' and caregivers' beliefs about depression screening and referral in the emergency department.
To explore patients' and parents'/caregivers' beliefs about the acceptability of universal depression screening in the emergency department (ED) and their perceptions of the barriers and facilitators to a mental health referral following a positive screen. ⋯ Patients and caregivers generally support depression screening in the pediatric ED but identified several barriers to screening and referral for treatment. Recommendations include introduction of universal screening early in the ED visit, provision of specific information about the meaning of screening results, and support from family and health care providers to help reduce stigma and increase referral acceptability.
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Pediatric emergency care · Nov 2009
ReviewThe reimbursement gap: providing and paying for pediatric procedural sedation in the emergency department.
A number of medical, ethical, and legal obligations compel physicians to provide procedural sedation and analgesia (PSA) to pediatric patients requiring painful procedures in the emergency department (ED). Recognizing the additional demands that PSA places on ED physicians, the American Medical Association has approved Current Procedural Terminology codes for PSA in conjunction with ED procedures. However, some insurers have indicated reluctance or refusal to pay for PSA in the ED, despite these Current Procedural Terminology codes and the legal and ethical imperatives. ⋯ We found significant variability among private and public insurers in their willingness to pay for PSA. Emergency department PSA charges at one tertiary care pediatric center are reimbursed at less than half the rate of other ED services. Although existing state laws and federal regulations arguably require that insurers provide reimbursement for pediatric PSA, certain legislative and regulatory initiatives could clarify insurers' payment obligations.