Pediatric emergency care
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Pediatric emergency care · Jun 2010
Randomized Controlled Trial Comparative StudyAlcohol use history differentiates adolescents treated in the emergency department after an alcohol-related incident.
The current study compared 3 groups of adolescents identified in an emergency department (ED) following an alcohol-related event: (1) alcohol-positive adolescents scoring at or above the clinical cutoff on a measure of problematic drinking, the Adolescent Drinking Inventory (ADI) (n = 45); (2) alcohol-positive adolescents scoring below the clinical cutoff on the ADI (n = 68), and (3) alcohol-negative adolescents (n = 64). We examined whether these 3 groups of adolescents differed on measures of substance use as well as psychosocial factors. ⋯ These findings underscore that alcohol-positive adolescents being treated in an ED are a heterogeneous group with respect to substance use as well as parent and peer risk factors. Physicians need to consider relevant background factors when making individualized discharge recommendations.
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Pediatric emergency care · Jun 2010
A pilot study to assess candidacy for emergency contraception and interest in sexual health education in a pediatric emergency department population.
The objective of the study was to assess potential candidacy for hormonal emergency contraception (EC) and desire for sexual health education among female adolescents presenting for care to a pediatric emergency department (ED). ⋯ Among sexually active adolescents seeking care in an urban, children's hospital ED, a significant proportion could potentially utilize EC if they so chose. Furthermore, adolescents with and without a history of sexual activity expressed interest in learning about sexual health issues in the ED setting.
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Pediatric emergency care · Jun 2010
Nurse practitioner roles in pediatric emergency departments: a national survey.
Emergency department (ED) visits continue to climb in the United States despite numerous primary care initiatives. A variety of staffing models including the utilization of nurse practitioners (NPs) and physician assistants (PAs) and the use of fast-track or express care are alternative methods of caring for the ED patients with less acute illness. Our objectives were to determine the prevalence of NPs in pediatric EDs (PEDs) and fast-track areas and to identify common procedures performed by NPs in PEDs. ⋯ The use of NPs in the PED is common. Nurse practitioners in the PED perform a number of different procedures. Future studies analyzing practice patterns and effectiveness of the NP role in the PED are needed.
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Pediatric emergency care · Jun 2010
Case ReportsA febrile young infant with splenomegaly and ecchymoses.
We discuss a young infant who presented to the emergency department with fever, ecchymoses, and splenomegaly with subsequent diagnosis of infant acute lymphoblastic leukemia. We review the infant's presentation, diagnostic, and therapeutic interventions, as well as the rare diagnosis of infant acute lymphoblastic leukemia and its poor prognosis. We pay particular attention to the hyperleukocytosis seen in this patient, a true oncologic emergency, and its treatment in the emergency department setting.
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Pediatric emergency care · Jun 2010
Case ReportsRetropharyngeal abscess in a young child due to ingestion of eel vertebrae.
Foreign body ingestion was immediately suspected at the emergency department when a 14-month-old boy presented with fever, refusal to eat, and history of choking after consumption of congee with minced fish meat the day before. Two eel vertebrae were subsequently retrieved from the piriform fossa. This case is reported to discuss the importance of obtaining the relevant history of foreign body ingestion and high index of suspicion in very young children. Parents must be educated about the risk of feeding infant and young children with bone-containing foods.