Pediatric emergency care
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Pediatric emergency care · Dec 2022
No Difference in Mortality and Outcomes After Addition of Nearby Pediatric Trauma Center.
Previous studies demonstrate that higher volume pediatric trauma centers (PTCs) offer improved outcomes. This study evaluated pediatric trauma volume and outcomes at an existing level I (L-I) adult and level II (L-II) PTC after the addition of a new children's hospital L-II PTC within a 2-mile radius, hypothesizing no difference in mortality and complications. ⋯ After opening a second L-II PTC within a 2-mile radius, there was an increase in the rate of admissions and self-transportation to the preexisting L-II PTC. Despite a nearly 26% decrease in pediatric trauma volume, there was no difference in length of stay, hospital complications, or mortality.
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Pediatric emergency care · Dec 2022
Overutilization of Radiographs for Pulled Elbow Among Orthopedic Surgeons Compared With Pediatricians.
Electronic medical records of the largest health provider in Israel, which provides health services to more than 50% of the population, were reviewed for pulled elbow cases between 2005 and 2020. Patients aged 4.5 months to 7 years were included. Demographic information, the discipline of the treating physician, and acquisition of elbow radiographs were gathered. ⋯ Orthopedic surgeons use elbow radiographs much more than pediatricians; effort should aim at reducing the imaging rate for this population.
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Pediatric emergency care · Dec 2022
Adequacy of Emergency Department Documentation of Child Restraint Use After a Motor Vehicle Crash.
There are limited data on how often providers collect and document adequate restraint information in children seen in the emergency department (ED) after motor vehicle crashes (MVCs). The objectives of this study are to determine (1) how often adequate child restraint information to determine age-appropriate use is documented after MVC; (2) the frequency of incorrect use of the child restraint when adequate details are documented; and (3) for those discharged from the ED with identified incorrect use, the frequency of provision of information on child passenger safety (CPS). ⋯ Adequate details to determine proper age-appropriate restraint use are documented in only half of ED visits for MVC. Very few are given CPS instructions on discharge, even when incorrect use has been identified. Identification of incorrect restraint use in the ED is an opportunity for a teachable moment that is being underused.
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Pediatric emergency care · Dec 2022
Case ReportsUltrasound-Guided Supraclavicular Brachial Plexus Blocks Performed by Pediatric Emergency Medicine Physicians for Painful Orthopedic Procedures in a Pediatric Emergency Department-A Case Series.
The aim of this study was to describe our experience with ultrasound-guided supraclavicular brachial plexus blocks performed by pediatric emergency physicians for the purpose of forearm fracture reductions in the emergency department. ⋯ We conclude that in select pediatric cases ultrasound-guided brachial plexus blocks can be a safe, swift, and efficient means of pain management and procedural analgesia. This approach obviates the need for sedation, thus shortening the time lag between presentation and the reduction procedure, as well as overall length of stay.