Pediatric emergency care
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Pediatric emergency care · Aug 2014
The Role of Medical Home in Emergency Department Use for Children With Developmental Disabilities in the United States.
Children with developmental disabilities (DDs) have higher rates of emergency department use (EDU) than their typically developing peers do. This study sought to elucidate the relationship between EDU frequency and access to a comprehensive medical home for children with DD. ⋯ The study suggests that children with DD reporting 3 or more EDU per year would likely reduce their EDU by having access to usual source of primary care services and to clinicians with skills in building meaningful partnership with the parents. The inclusion of these medical home attributes in the adoption of patient-centered medical homes with the implementation of the Affordable Care Act presents a mechanism to improve care at lower cost as well as facilitate chronic disease management and coordination between emergency medicine and primary care physicians that may lead to reductions in EDU and unnecessary hospitalization.
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Pediatric emergency care · Aug 2014
Motivation to Quit Smoking in Parental Smokers in the Pediatric Emergency Department.
To examine if motivation to quit is associated with parental smoker's perceived presence of a personal or child health illness or risk due to tobacco use. ⋯ A significant proportion of parental smokers who present to the pediatric emergency department endorse strong motivation to quit. Parents who endorse health risk or quitting-related health benefits in their child are more likely to have high motivation to quit smoking. Future studies are needed to determine if high motivation translates into smoking cessation.
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Pediatric emergency care · Aug 2014
Case ReportsIncidental mucocele of the appendix in a 15-year-old girl.
Mucocele of the appendix is an exceedingly uncommon pathology in the pediatric population that may present with abdominal pain or represent an incidental finding after routine abdominal imaging. Etiologies may be inflammatory or neoplastic, but all share the commonality of chronic appendiceal obstruction. Early diagnosis is critical for positive long-term outcomes because the operative management will differ from that of a dilated appendix secondary to acute appendicitis.
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Pediatric emergency care · Aug 2014
J-Splint Use for Temporizing Management of Pediatric Femur Fractures: A Review of 18 Cases.
Pediatric femoral fractures are common injuries encountered in the field and in emergency departments. Currently described temporizing management strategies include skeletal traction, skin traction, traction splinting, and posterior splinting, all of which are suboptimal in some instances. J-splinting femur fractures may be advantageous in temporizing management of pediatric femur fractures. The objective of this study was to evaluate the safety and effectiveness of J-splint use for temporizing management of pediatric femur fractures. ⋯ The J-splint is a reliable, simple, and rapidly applied splint that prevents many of the complications and downfalls of other described temporizing measures and helps to provide excellent pain management in the acute setting.
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Pediatric emergency care · Aug 2014
Case ReportsTumor lysis syndrome: risk factors, diagnosis, and management.
Tumor lysis syndrome (TLS) is a potentially fatal complication of induction therapy for several types of malignancies. Electrolyte derangements and even downstream complications may also occur prior to the initial presentation to a medical provider, before an oncologic diagnosis has been established. ⋯ Careful evaluation of serum electrolytes, uric acid, and renal function must occur. Patients at risk for TLS and those who already exhibit laboratory or clinical evidence of TLS require close monitoring, aggressive hydration, and appropriate medical treatment.