Pediatric emergency care
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Pediatric emergency care · Jun 2011
Randomized Controlled Trial Comparative StudyParental health literacy and asthma education delivery during a visit to a community-based pediatric emergency department: a pilot study.
The objective of the study was to compare change in asthma knowledge among parents with low or adequate health literacy after video or written asthma education delivered during their child's asthma-related emergency department (ED) visit. ⋯ Asthma education materials distributed at the time of an ED visit increase parental knowledge about the disease. Video-based asthma education appears promising as a tool for increasing asthma knowledge in both low- and adequate-health-literacy parents.
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Pediatric emergency care · Jun 2011
ReviewHospital-based pandemic influenza preparedness and response: strategies to increase surge capacity.
In the spring of 2009, the first patients infected with 2009 H1N1 virus were arriving for care in hospitals in the United States. Anticipating a second wave of infection, our hospital leaders initiated multidisciplinary planning activities to prepare to increase capacity by expansion of emergency department (ED) and inpatient functional space and redeployment of medical personnel. ⋯ Our health center successfully met the challenges posed by the 2009 H1N1 outbreak. The intent in sharing the details of our planning and experience is to allow others to determine which elements of this planning might be adapted for managing a surge of patients in their setting.
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Pediatric emergency care · Jun 2011
Comparative StudyAssessing survey methods and firearm exposure among adolescent emergency department patients.
The objective of the study was to determine the nature of gun exposure in an adolescent population presenting to an urban emergency department (ED) and to ascertain attributes that correlate with the ability to buy a gun or to access a loaded gun within 3 hours. ⋯ The ability to buy a gun and access to a loaded gun within 3 hours are relatively common among ED adolescent patients. Having a gun in the home and witnessing a gun at school were independent predictors of the ability to access a loaded gun within 3 hours. Gang membership and drug use were associated with a self-reported ability to buy a gun.
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Pediatric emergency care · Jun 2011
Comparative StudyPredictors of psychiatric boarding in the pediatric emergency department: implications for emergency care.
Patients who present to the emergency department (ED) and require psychiatric hospitalization may wait in the ED or be admitted to a medical service because there are no available inpatient psychiatric beds. These patients are psychiatric "boarders." This study describes the extent of the boarder problem in a large, urban pediatric ED, compares characteristics of psychiatrically hospitalized patients with boarders, and compares predictors of boarding in 2 ED patient cohorts. ⋯ Suicidal patients continue to board. Limits within the system, including timing of ED presentation and a dearth of specialized services, still exist, elevating the risk of boarding for some populations. Implications for pediatric ED psychiatric care delivery are discussed.
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Pediatric emergency care · Jun 2011
Case ReportsSuccessful intravenous thrombolysis in a 14-year-old boy with ischemic stroke.
We report a healthy 14-year-old boy with an acute left middle cerebral artery stroke, treated 2 hours after the onset of symptoms with intravenous recombinant tissue plasminogen activator (r-TPA). Recanalization of the middle cerebral artery was documented with transcranial Doppler during the first 5 minutes of intravenous r-TPA perfusion, and progressive recovery of the neurological deficits occurred. Although lack of evidence regarding safety and efficacy in children precludes the recommendation of systematic use of r-TPA in pediatric stroke, we propose that this option should be considered and discussed with the parents, especially in older children presenting within 3 hours in centers with experience in adult thrombolysis.