Pediatric emergency care
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Pediatric emergency care · Feb 2022
Racial/Ethnic Differences in Pediatric Emergency Department Wait Times.
Wait time for emergency care is a quality measure that affects clinical outcomes and patient satisfaction. It is unknown if there is racial/ethnic variability in this quality measure in pediatric emergency departments (PEDs). We aim to determine whether racial/ethnic differences exist in wait times for children presenting to PEDs and examine between-site and within-site differences. ⋯ In unadjusted analyses, non-White children experienced longer PED wait times than NHW children. After adjusting for illness severity, patient demographics, and overcrowding measures, wait times for NHB and other race children were largely determined by site of care. Hispanic children experienced longer within-site and between-site wait times compared with NHW children. Additional research is needed to understand structures and processes of care contributing to wait time differences between sites that disproportionately impact non-White patients.
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Pediatric emergency care · Feb 2022
Nonindicated Brain Computed Tomography Scans for Children: Adaptation of an American Measurement Tool and Contrast of Current Practice in an Australian Hospital.
Clinical guidelines state brain computed tomography (CT) for atraumatic headache or first generalized afebrile, atraumatic seizure as nonindicated in neurologically normal children. We aimed to adapt 2 rigorously validated United States-based measures that examine overuse of CT in children with these conditions, and to determine whether these measures can be used in an Australian setting to determine rates of CT scanning in current practice. ⋯ Using the tool developed in this study, rigorous measurement of the overuse of CT scans in other settings may determine the reasons for the lower rates observed in this study; inform future interventions to minimize overuse; and provide safer, higher quality care to children.
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Pediatric emergency care · Feb 2022
Observational StudyDon't Hold Your Breath-A Video-Based Study of Procedural Intervals During Pediatric Rapid Sequence Intubation.
Develop a framework for data collection to determine the contributions of both laryngoscopy and tube delivery intervals to the apneic period in unsuccessful and successful attempts among patients undergoing rapid sequence intubation (RSI) in a pediatric emergency department (PED). ⋯ We successfully developed a specific, time-based framework for the contributors to prolonged apnea in RSI. Prolonged tube delivery accounted for more of the apneic period. Future studies and improvement should focus on problems during tube delivery in the PED.
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Pediatric emergency care · Feb 2022
Multivariable Analysis of Patient Satisfaction in the Pediatric Emergency Department.
Published data on predictive factors associated with parent satisfaction from care in a pediatric emergency department (ED) visit are limited to be descriptive and obtained from small data sets. Accordingly, the purpose of this study was to determine both modifiable and nonmodifiable demographic and operational factors that influence parental satisfaction using a large and ethnically diverse site data set. ⋯ Parental rating of an ED is associated with nonmodifiable variables such as ethnicity and modifiable variables such as timeliness of care and managing discomfort.
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Pediatric emergency care · Feb 2022
Pediatric Foreign Body Aspiration: Time of Occurrence and Factors Affecting Outcomes.
The goal of this study was to assess which factors could affect outcomes in pediatric patients undergoing bronchoscopy for foreign body aspiration (FBA). ⋯ Most FBA s occurred in the evening while the children were with their parents. Education of families regarding the risk of aspiration is crucial, so they are always attentive to this issue. Although the focus on prevention tends to be with younger patients, it is essential to emphasize the risk of FBA in older patients with developmental delay. Because most episodes of aspiration occur later in the day, it is imperative that tertiary pediatric centers ensure that the evening staff is trained and have the available equipment for these complex cases.