Pediatric emergency care
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Pediatric emergency care · Dec 2019
Comparative StudyA Qualitative Analysis of General Emergency Medicine Providers' Perceptions on Pediatric Emergency Telemedicine.
Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers. ⋯ General ED providers identified 7 specific potential uses of pediatric emergency video telemedicine. However, they also identified several limitations of telemedicine in caring for pediatric emergency patients. Further studies after implementation of telemedicine program and comparing provider perceptions with actual practice may be helpful. Furthermore, studies on telemedicine's effect on patient-related outcomes and studies on cost-effectiveness might be necessary before the widespread implementation of a telemedicine program.
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Pediatric emergency care · Dec 2019
Case ReportsKawasaki Disease in a 3-Month-Old Infant: How to Remain Vigilant?
Kawasaki disease is an acute vasculitis occurring between 6 months and 5 years old. Patients younger than 6 months have mostly incomplete form. This clinical symptoms lead to confusion and delayed diagnosis. ⋯ We highlight the possibilities of Kawasaki disease in infants younger than 6 months. Indeed, every diagnostic delay increases cardiovascular risk. Nonetheless, in our case, treatment was prescribed in the first 5 days, and the patient developed aneurysms.
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Pediatric emergency care · Dec 2019
Comparative StudyTransitions of Care: The Presence of Written Interfacility Transfer Guidelines and Agreements for Pediatric Patients.
Every year, emergency medical services agencies transport approximately 150,000 pediatric patients between hospitals. During these transitions of care, patient safety may be affected and contribute to adverse events when important clinical information is missing, incomplete, or inaccurate. Written interfacility transfer policies are one way to standardize procedures and facilitate communication between the hospitals leading to improved patient safety and satisfaction for children and families. ⋯ Although there was improvement over time, opportunities exist for increasing the presence of written interfacility transfer guidelines as well as agreements for pediatric patients. Further studies are needed to demonstrate whether improved delivery of patient care is associated with the presence of written interfacility transfer guidelines and agreements and to identify other elements in the process to ensure optimal pediatric patient care.
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Pediatric emergency care · Dec 2019
Review Case ReportsSudden Onset of Severe Cervical Pain in an Adolescent Girl: Case Report and Review of Literature.
A previously healthy 13-year-old girl presented with a 9-day history of acute onset severe neck pain associated with limited range of movement. Medical evaluation at day 2 was suggestive of muscle contracture, and she was discharged home with diazepam, antiinflammatory agents, and rest; however, she returned because of progressive clinical worsening with left arm distal paresthesia and paralysis since day 3. There was no history of trauma or other systemic complaints, and her familial medical history was unremarkable. ⋯ It usually presents acutely with neurologic deficits, but the initial presentation may be atypical or insidious, delaying diagnosis and intervention. Definitive diagnosis is made by magnetic resonance imaging and implies a high index of suspicion. Surgical drainage of the hematoma is the mainstay of treatment with favorable prognosis even in cases with a delayed diagnosis.