Pediatric emergency care
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Pediatric emergency care · Aug 2009
Case ReportsMonkey bites in travelers: should we think of herpes B virus?
Monkey bites are frequently reported among children traveling to tropical countries and can be associated with the transmission of zoonoses. Potentially fatal transmission of herpes B virus from macaque bites is rare but well documented in biomedical research facilities. The risk in travelers remains unknown. We report a case of a 7-year-old girl bitten by a macaque on her forehead and discuss her postexposure management.
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Pediatric emergency care · Aug 2009
Comparative StudyThe Emergency Severity Index Version 4: reliability in pediatric patients.
The Emergency Severity Index version 4 (ESI v.4) is a triage system, which demonstrates reliability in adult populations, however, it has not been extensively studied in pediatrics. The goal of this study was to measure interrater reliability and agreement rates within and between a group of pediatric emergency medicine physicians and pediatric triage (PT) nurses using ESI v.4 in a pediatric population. ⋯ ESI v.4 is a reliable tool for triage assessments in pediatric patients when used by experienced pediatric emergency medicine physicians and PT nurses. It is a triage system with high agreement between physicians and nurses.
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Pediatric emergency care · Aug 2009
Pain Management Practices in a Pediatric Emergency Room (PAMPER) Study: interventions with nurses.
Children's pain in emergency departments (EDs) is poorly managed by nurses, despite evidence that pain is one of the most commonly presenting complaints of children attending the ED. Our objectives were 2-fold: to verify if tailored educational interventions with emergency pediatric nurses would improve nurses' knowledge of pain management and nurses' pain management practices (documentation of pain, administration of analgesics, nonpharmacological interventions). ⋯ The interventions contributed to the improvement of the nurses' knowledge of pain management and some of the practices over time. We believe that an intervention tailored to nurses' needs and schedule has more impact than just passive diffusion of educational content.
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Pediatric emergency care · Aug 2009
The efficacy of pediatric advanced life support training in emergency medical service providers.
Pediatric advanced life support (PALS) teaches skills unique to pediatric resuscitation. The purpose of this study was to assess the effect of PALS training among emergency medical service (EMS) providers in out-of-hospital trauma and medical resuscitations. A physician panel evaluated all EMS run sheets of pediatric traumas and medical resuscitations brought to a tertiary children's hospital/regional trauma center over a 3-year period. ⋯ Similarly, PALS-trained squads were more successful in intraosseous line placement than non-PALS-trained squads (100% vs 55%; P < 0.01). However, despite better procedural skills, there was no difference in mortality rates between the groups (37% PALS vs 32% non-PALS). We conclude that PALS training improves procedural skills among EMS personnel and should be strongly considered as part of EMS training.
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Pediatric emergency care · Aug 2009
Ten-year retrospective study of delayed diagnosis of injury in pediatric trauma patients at a level II trauma center.
Published rates of delayed diagnosis of injury (DDI) in pediatric trauma vary from 1.0% to 18%. The purpose of this study was to determine the long-term trend of DDI over 10 years, to identify risk factors associated with DDI, and to elucidate patterns of DDI. ⋯ The rate of missed injuries remained relatively constant over the past 10 years at our institution. More severely injured patients are more likely to have missed injuries. Special attention to the lower extremities of the younger trauma patient may be warranted.