Pediatric emergency care
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Pediatric emergency care · Feb 2020
Success Rates for Reduction of Pediatric Distal Radius and Ulna Fractures by Emergency Physicians.
Emergency physicians are trained in urgent fracture reduction. Many hospitals lack readily available in-house orthopedic coverage. ⋯ The literature reveals 7% to 39% of children with fracture reductions performed in the ED by orthopedic surgeons/residents require remanipulation. Our rate of 11% is consistent within that range. With training, PEM physicians have similar success rates as orthopedists in forearm fracture reductions.
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Pediatric emergency care · Feb 2020
Parents' Perspective on Trainees Performing Invasive Procedures: A Qualitative Evaluation.
When obtaining informed permission from parents for invasive procedures, trainees and supervisors often do not disclose information about the trainee's level of experience. The objectives of this study were 3-fold: (1) to assess parents' understanding of both academic medical training and the role of the trainee and the supervisor, (2) to explore parents' preferences about transparency related to a trainee's experience, and (3) to examine parents' willingness to allow trainees to perform invasive procedures. ⋯ Physicians must find a way to improve transparency when caring for pediatric patients while still developing critical procedural skills.
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Pediatric emergency care · Feb 2020
Case ReportsWhat Is That? Innumerable Mysterious Densities Identified on Abdominal Imaging.
Radiopaque densities can be observed on imaging after the ingestion of either foreign bodies or some medications. Our case report discusses an 11-year-old boy with autism spectrum disorder and attention deficient disorder who presented to the emergency department because of concerns for constipation and dehydration. ⋯ He was admitted, and his home regimen was reviewed to attempt to identify a potential source for these radiopaque densities. This case presented an interesting teaching opportunity in the identification of the radiopaque densities and review of pharmacokinetics.
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Pediatric emergency care · Feb 2020
Does the Role of A Rapid Triage Provider Improve Pain Control in an Academic Pediatric Emergency Department?
Pediatric pain control in the emergency department (ED) remains problematic. This quantifiable metric may be positively affected by the utilization of a rapid triage provider (RTP). This is a retrospective case control study of pediatric patients requiring either ketorelac intravenous (IV) or morphine IV for painful conditions. ⋯ The mean time from arrival to pain medication administration for the RTP group as compared with the control group was 47 and 64 minutes (P = 0.02). Similarly, the mean time from arrival to IV pain medication order placement was 15 and 43 minutes (P < 0.01). An RTP improves pain control in the pediatric ED via more efficient order placement and IV pain medication administration.
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Pediatric emergency care · Feb 2020
Using Low-Cost Models for Training First-Year Pediatric Residents on 4 Accreditation Council for Graduate Medical Education-Required Procedures: A Pilot Study.
The aims of the study were to assess the feasibility of using low-cost models to train first-year pediatric residents and to examine whether residents who receive such training will be as competent as their experienced colleagues in performing 4 American College of Graduate Education-required procedures, including suturing, splinting, lumbar puncture, and venipuncture. ⋯ This pilot study supports the feasibility of using low-cost models to train residents on invasive and painful procedures. Furthermore, residents trained on models showed maintenance of skills for a 9-month period.