Pediatric emergency care
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Pediatric emergency care · Dec 2021
A Pulse Check on Leadership and Teamwork: An Evaluation of the First 5 Minutes of Emergency Department Resuscitation During Pediatric Cardiopulmonary Arrests.
Effective leadership and teamwork are imperative during pediatric cardiopulmonary resuscitations (CPR). The initial phase of pediatric CPR, termed the "first 5 minutes," has significant care delivery gaps in both leadership and team performance. The aim of the study was to describe the performance data of emergency department (ED) teams who performed CPR in a pediatric ED. ⋯ Our study of leadership and teamwork during the first 5 minutes of pediatric CPR care noted wide variation in team performance. Opportunities for improvements in CPR readiness can be incorporated into education and quality programs to drive improvements in the care of future pediatric patients experiencing cardiac arrest.
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Pediatric emergency care · Dec 2021
Randomized Controlled TrialA Provider-Focused Intervention to Promote Optimal Care of Pediatric Patients With Suspected Elbow Fracture.
Emergency department (ED) and urgent care (UC) physicians' accurate assessment of the neurovascular and musculoskeletal (NV/MSK) examination in pediatric patients with suspected elbow fracture is crucial to the early recognition of neurovascular compromise. Our objective was to determine the impact of computer-based simulation (CBS) and computerized clinical decision support systems (CCDSS) on ED and UC physicians' assessment of the NV/MSK examination of pediatric patients with elbow fracture as noted in their documentation. ⋯ Compared with single CBS training alone, repeated exposure to CCDSS after CBS training resulted in improved documentation of the NV/MSK status of pediatric patients with elbow fracture.
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Pediatric emergency care · Dec 2021
Impact of Guidelines Regarding Brief Resolved Unexplained Events on Care of Patients in a Pediatric Emergency Department.
This study aimed to determine if the 2016 clinical practice guidelines regarding brief resolved unexplained events (BRUE) impacted our institutional approach to infants with BRUE. We sought to determine the statement's impact on admission rates, emergency department (ED) length of stay, and return ED visits or readmissions. ⋯ This study revealed significant reduction in invasive testing, shorter lengths of ED stays, and lower admission rates at a tertiary care children's hospital after the release of the American Academy of Pediatrics BRUE guideline with no increase in return ED visits or readmissions.
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Pediatric emergency care · Dec 2021
A Framework for Quality Assurance of Pediatric Revisits to the Emergency Department.
Emergency department return visits significantly impact medical costs and patient flow. A comprehensive approach to understanding these patients is required to identify deficits in care, system level inefficiencies, and improve diagnosis specific management protocols. We aimed to identify factors needed to successfully analyze return visits to explore root causes leading to unplanned returns and inform system-level improvements. ⋯ Seventy-two-hour ED revisits were efficiently and systematically categorized with determination of root causes and preventability. This process resulted in shared provider-level feedback, identifying trends in revisits, and implementation of system-level actions, therefore, encouraging other institutions to adopt a similar process.
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The aim of this study was to examine and compare the efficacy of external fixation strategies of toddler's fracture (TF) in acute care settings. Specifically, we aim to identify whether immobilization optimizes clinical outcomes for patients (based on immobilization duration, time to weight-bear/ambulate, and associated complications) compared with nonimmobilization, with a systematic review. ⋯ Further large-scale prospective studies examining the clinical outcomes of TF management techniques should be conducted to establish a consistent standardized guideline for TF treatment across acute care settings.