Pediatric emergency care
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The aim of this study was to identify the types of pediatric orthopedic extremity fractures that are sustained as a result of hoverboard (self-balancing, self-propelling, 2-wheeled boards) use. ⋯ The overall incidence of extremity fractures due to hoverboard riding seen in our emergency department during the holiday season was relatively high compared with other common childhood activities. The vast majority of these fractures involved the upper extremities. A moderate percentage of these injuries required closed reduction in the emergency department or surgical treatment. Additional studies examining the use of protective equipment while riding hoverboards, time from initial hoverboard use to injury, supervision, and the cost of treating these injuries should be conducted to further elucidate the nature of these injuries and work toward prevention.
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Pediatric emergency care · May 2017
Case ReportsFemale Adolescent Presenting With Abdominal Pain: Accidental Wire Bristle Ingestion Leading to Colonic Perforation.
Abdominal pain in female adolescents is a common presentation to both the emergency department and the outpatient pediatric clinic. The broad differential diagnosis for abdominal pain requires a high index of suspicion to make an accurate diagnosis of foreign body ingestion as the etiology. Foreign body ingestion occurs in all age groups, but sequelae of gastrointestinal tract perforation in children are rare. Treatment for perforation requires consultation of the pediatric general surgeon. Clinicians should take care to not overlook subtle imaging findings or dietary/exposure history, even in the context of a patient with known history of abdominal pain. ⋯ Reports of unintended ingestion of wire bristles have been increasingly reported in the literature; however, most focus on injury to the upper airway or upper digestive tract and subsequent endoscopic or laryngoscopic removal. Most reports detail injury in adult patients, pediatric case reports with digestive tract injury are uncommon, and foreign body removal after lower digestive tract injury in children from a wire bristle has not been reported. We caution pediatric emergency medicine and ambulatory providers to consider such an ingestion and perforation in the differential diagnosis of acute-onset, focal, and localizable abdominal pain in children.
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Pediatric emergency care · May 2017
Case ReportsAn Unusual Cause of Back Pain in a 10-Year-Old Girl.
A 10-year-old girl with a 2-week history of atraumatic back pain presented to the emergency department with difficulty ambulating and a history of 2 episodes of urinary incontinence in the past week. Her examination was significant for pain with movement, tenderness to palpation in the lower thoracic spine, and no neurological deficits. In this case, the child was found to have a Schmorl node at T8 in the superior aspect of the vertebral body. ⋯ The diagnosis was made by magnetic resonance imaging. The child's symptoms significantly resolved with ibuprofen anti-inflammatory therapy. In children with atraumatic back pain lasting greater than 2 weeks with a sudden increase in severity and associated with a neurological deficit, advanced imaging is strongly recommended.
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Pediatric emergency care · May 2017
Consideration of Cost of Care in Pediatric Emergency Transfer-An Opportunity for Improvement.
Pediatric interhospital transfers are an economic burden to the health care, especially when deemed unnecessary. Physicians may be unaware of the cost implications of pediatric emergency transfers. A cost analysis may be relevant to reduce cost. ⋯ Significant number of transfers was discharged 12 hours or less without any additional intervention in PED. Fixed charges contribute to majority of total charges. Cost saving can be achieved by preventing unnecessary transfer.
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Pediatric emergency care · May 2017
Comparative StudyPredicting Flow in the Pediatric Emergency Department: Are Holidays Lighter?
The aim of this study was to determine whether patient volume in an urban pediatric emergency department (ED) can be predicted based on holidays and thus aid in staffing and resource allocation. ⋯ Fewer patient visits on Thanksgiving and Christmas Days, as well as during the late afternoon/evening on several other holidays, point to the possibility of small adjustments to staffing in ways that can more efficiently balance demand with available resources.