Pediatric emergency care
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Pediatric emergency care · Feb 2022
Pediatric Emergency Department Return Visits Within 72 Hours: Caregivers' Motives and Analysis of Ethnic and Primary Language Disparities.
In the United States, approximately 2.2% to 5% of children discharged from the emergency department (ED) return within 72 hours. There is limited literature examining caregivers' reasons for return to the ED, and none among Hispanics and Spanish-speaking caregivers. We sought to examine why caregivers of pediatric patients return to the ED within 72 hours of a prior ED visit, and assess roles of ethnicity and primary language. ⋯ Most caregivers returned to the ED because their child's condition was not better or had worsened. Ethnicity and language were not associated with variations in reasons for return. Non-Hispanic and English-speaking caregivers were less likely to recall being informed of time to improvement and may require additional intervention.
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Pediatric emergency care · Feb 2022
Agreement With Pediatric Suprapatellar Bursa Effusion Assessments by Point-of-Care Ultrasound After Remote Training.
The ease of instruction for point-of-care ultrasound (POCUS) to detect suprapatellar bursa (SPB) effusions in pediatric patients is unknown. Considering in person limitations because of the coronavirus pandemic, strategies for POCUS education by remote learning are necessary. ⋯ After a remote teleconference didactic session, PEM fellows were able to successfully diagnose SPB effusions using a longitudinal view with substantial interobserver reliability. Knee radiography exhibited limited sensitivity to rule out SPB effusions.
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Pediatric emergency care · Feb 2022
Randomized Controlled TrialPutting Theory to Practice: Applying Cognitive Load Theory to Resident Medical Education.
We built 2 versions of an asynchronous pediatric orthopedic educational intervention for emergency medicine residents and sought to compare the two. We hypothesized that the version incorporating more instructional scaffolding in the form of a cognitive aid (CA) would optimize germane cognitive load for our target novice learners and result in higher test scores. ⋯ Emergency medicine residents performed better after completing the CA version of our educational intervention. Applying cognitive load theory to an educational intervention may increase its success among target learners.
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Pediatric emergency care · Feb 2022
Electrocardiogram in Pediatric Syncope: Practice Variation Among Pediatric Emergency Physicians.
We intended to assess emergency department physician's practice pattern and their motivations for obtaining electrocardiograms (ECGs) in pediatric vasovagal syncope presentations. We also explored if borderline ECG findings alters emergency department physicians' management in this population. ⋯ This study highlights the significant practice variation in the evaluation and management of typical vasovagal syncope among physicians, which is informed by complex interactions of patient, provider, and institutional factors and the perceived clinical significance of borderline ECG findings.
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Pediatric emergency care · Feb 2022
Adults Followed by Pediatric Subspecialists: A Growing Population in the Pediatric Emergency Department.
Adults are being seen with increasing frequency in pediatric emergency departments (PEDs), but the drivers behind this increase are unknown. Our primary aim was to compare adults seen in the PED followed by pediatric subspecialists to those who are not. ⋯ Pediatric subspecialty adults are presenting to the PED at a greater rate, and they require more time and resources compared with other presenting adults. As frontline providers, PEDs, physicians, and staff must be prepared to address this growing subset of patients driving the increase in adults presenting to the PED.