Pediatric emergency care
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Pediatric emergency care · Jun 2011
Multicenter Study Comparative Study"Inappropriate" pediatric emergency medical services utilization redefined.
Previous reports on emergency medical services (EMS) transportation of pediatric patients have demonstrated a high rate of overutilization. However, there is also a concern that pediatric patients may underutilize EMS for emergencies that might benefit from EMS. This article compares EMS utilization rate between adult and pediatric patients for high-acuity patients and for the most common reasons for transport. ⋯ As compared with adults, pediatric patients are less likely to utilize EMS for transport to the hospital for both routine and emergent complaints. The definition of inappropriate utilization of EMS for pediatric transport, which has largely focused on inappropriate overutilization, should also incorporate the potential of underutilization for critical patients.
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Pediatric emergency care · Jun 2011
Comparative StudyInterexaminer agreement in physical examination for children with suspected soft tissue abscesses.
This study aimed to measure interexaminer agreement for physical examination (PE) findings in children with a suspected soft tissue abscess. ⋯ Interexaminer agreement of examination findings and diagnosis of an abscess was fair to moderate, implying a lack of precision of PE as the primary means for diagnosis. Future studies of diagnostic adjuncts, such as bedside ultrasonography, may lead to improved management of soft tissue infections in children.
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Pediatric emergency care · Jun 2011
Comparative StudyA content analysis of parents' written communication of needs and expectations for emergency care of their children.
We investigated the potential value of information shared by parents on a written form designed to capture needs and expectations for care to an emergency department (ED) system that values patient-centeredness. ⋯ Information shared by parents on written forms designed to capture needs and expectations provides potential value to a patient-centered ED system. The high level of informational value is consistent across patient type and acuity level.
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Pediatric emergency care · Jun 2011
Comparative StudyIs there a role for intravenous acetaminophen in pediatric emergency departments?
As a nonopioid parenteral analgesic intravenous (IV) acetaminophen is potentially attractive for emergency department (ED) use. However, there is little experience with its use in the pediatric ED setting. We introduced the agent into a pediatric ED with a preliminary restrictive prescribing regimen and describe its use. ⋯ In the setting of an initial restrictive prescribing regimen, IV acetaminophen was used in a small number of pediatric ED patients. In addition to use in patients at risk of opioid adverse events, the medication was also used in complex patients who were unable to tolerate an enteral formulation. Emergency department prescribing guidelines have been modified accordingly.
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Pediatric emergency care · Jun 2011
Case ReportsLate migration of a foreign body in the foot 5 years after initial trauma.
An 11-year-old boy presented to our emergency department because of the extrusion of a small piece of glass through the plantar skin, 5 years after the initial trauma. Another foreign body was identified on ultrasounds and removed surgically. Ultrasound is an accurate test for detection of foreign bodies and to assess potential complications. ⋯ Migrations of foreign bodies are not uncommon. Ultrasounds could help for localization and removal as an intraoperative procedure. In case of suspicion of a foreign body after trauma, complementary examinations are required.