Pediatric emergency care
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Lunate and perilunate dislocations are uncommon, but devastating carpal injuries, which, if unrecognized in the emergency department and not treated promptly, lead to a high incidence chronic wrist pain and long-term functional disability. In this case report, we will review the wrist joint anatomy as pertaining to these injuries, mechanism of injury, signs and symptoms, radiological findings, and treatment of such injuries.
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Pediatric emergency care · Dec 2010
Multicenter StudyPhysician practice variation in the pediatric emergency department and its impact on resource use and quality of care.
To evaluate variation in case-mix adjusted resource use among pediatric emergency department (ED) physicians and its correlation with ED length of stay (LOS) and return rates. ⋯ Significant variation exists in physician use of common ED resources. Higher resource use was associated with increased LOS but did not reduce return to ED. Practice variation such as this may represent an opportunity to improve health care quality and decrease costs.
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Pediatric emergency care · Dec 2010
State trait anxiety in the emergency department: an analysis of anticipatory and life stressors.
To determine the relationship between stress indicators and state anxiety among pediatric emergency department (ED) patients, as a background to develop appropriate psychoeducational and behavioral interventions. ⋯ The ED experience produces fear/anxiety, particularly in younger patients with a chief complaint of pain and/or trauma. Findings may lead to the development of psychoeducational and behavioral interventions that focus on anxiety reduction.
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Pediatric emergency care · Dec 2010
Case ReportsInaccurate trauma history due to fear of health care personnel involving law enforcement in children of noncitizen immigrants.
Two cases illustrating intentional withholding of information by noncitizen parents of children with major trauma are described. The difficulties and the results of not obtaining an accurate history in the initial assessment of accidental trauma victims are discussed. The core problem in these cases seems to be a fear of health care providers and a false perception that emergency medical services and emergency department personnel are extensions of law enforcement. These cases illustrate potential issues in managing the children of noncitizen immigrants.