Pediatric emergency care
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Trauma is one of the leading causes of morbidity and mortality in the pediatric population. In many centers, microhematuria is used as a screening tool for the presence of significant abdominal injury and as an indication for further imaging. Our objective was to evaluate the role of microhematuria by dipstick as an indicator of significant abdominal injury in children. ⋯ The diagnostic role of dipstick urine analysis in the assessment of intra-abdominal injury has low sensitivity and specificity. Nevertheless, it is still a valuable screening tool for the evaluation of the severity of injury.
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Pediatric emergency care · Dec 2021
Association Between Insurance and the Transfer of Children With Mental Health Emergencies.
This study sought to investigate the association between a patient's insurance coverage and a hospital's decision to admit or transfer pediatric patients presenting to the emergency department (ED) with a mental health disorder. ⋯ Children presenting to an ED with a mental health emergency who do not have insurance are more likely to be transferred to another hospital than to be admitted and treated locally compared with those with private insurance. Future studies are needed to determine factors that may protect patients without insurance from disparities in access to care.
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Pediatric emergency care · Dec 2021
Evaluation of Learning Effectiveness After a Simulation-Based Training Pediatric Course for Emergency Physicians.
For emergency physicians, pediatric emergencies represent rare and challenging situations. Simulation-based training (SBT) is increasingly used in medical education and recommended for implementation in the curriculum and postgraduate training. ⋯ Self-assessment of the Pediatric Emergency Procedures university course was very positive. According to the participants, this type of SBT on very specific pediatric emergency cares should be integrated to the emergency resident's curriculum. As regards pediatric emergency care, particularly dealing with low-volume, high-stake procedures, the participants were favorable to further, more regular simulation training.
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Pediatric emergency care · Dec 2021
Diagnostic Performance of a Staged Pathway for Imaging Acute Appendicitis in Children.
The objective of this work is to assess the performance of our staged diagnostic pathway in the evaluation of suspected appendicitis cases in children. The pathway consisted of clinical assessment by the emergency physician, performing initial ultrasound (US), consultation, and clinical reevaluation by the surgery team followed by a repeat focused US scan in inconclusive cases. Computed tomography (CT) was limited to cases where the repeat US remained inconclusive and the clinical reassessment indicated persistent concerns for appendicitis. ⋯ The strategy of repeating limited focused US followed by CT scan in cases that remain inconclusive has good diagnostic accuracy and reasonable NAR and decreases the number of CT scans.
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Pediatric emergency care · Dec 2021
Closing the Loop: Program Description and Qualitative Analysis of a Pediatric Posttransfer Follow-up and Feedback Program.
Follow-up and feedback foster improvement. General emergency medicine providers working in community hospitals desire follow-up and feedback on pediatric patients transferred to children's hospitals. We implemented a novel program to provide these data to our colleagues. The objective of this study was to explore stakeholder perspectives of our program. ⋯ Stakeholders of our pediatric posttransfer follow-up and feedback program reported many benefits and provided key suggestions that may promote successful dissemination of similar programs nationwide. Examining data trends in transferred children may focus efforts to improve the care of children across all emergency care settings.