Pediatric emergency care
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Pediatric emergency care · Feb 2022
Settling the Score: Injury Severity Score Fails to Capture Nuances in Pediatric Trauma.
Recent work has questioned the accuracy of the Injury Severity Score (ISS) and the Abbreviated Injury Scale (AIS) in the pediatric population. We sought to determine mortality rates in pediatric trauma patients at ISSs considered "severe" in adults and whether mortality would vary substantially between adults and children sustaining injuries with the same AIS. ⋯ Although the ISS predicts mortality well, children have lower mortality than do adults for the same ISS, and therefore, the accepted definition of severe injury is not equivalent between these 2 cohorts. Mortality risk is highly dependent on the specific nature of the injury, with large variability in outcomes despite identical AIS scores.
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Pediatric emergency care · Feb 2022
Can Use of Default Dispensing Quantities in Electronic Medical Record Lower Opioid Prescribing?
Leftover opioids can contribute to misuse and abuse. Recommended dosing quantities in the electronic medical record can guide prescribing patterns. We hypothesized that decreasing the default from 30 doses to 12 doses would decrease the overall number of opioids prescribed without increasing second opioid prescriptions or additional health utilization. ⋯ Lowering the default dispensing quantity of opioids in the electronic medical record decreases the number of opioids prescribed without increasing second prescriptions or additional health care utilization. These findings suggest that a further reduction in the number of opioids prescribed for upper-extremity fractures may be possible.
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Pediatric emergency care · Feb 2022
Factors Associated With Repeat Emergency Department Visits in a State-wide Cohort of Pediatric Patients With Mild Traumatic Brain Injury.
To describe demographic, injury, and clinical characteristics of pediatric patients treated in the ED for mild traumatic brain injury (mTBI), and to evaluate characteristics associated with mTBI-related return emergency department (ED) visit within 1 month of initial presentation. ⋯ Although return to the ED for mTBI-related complaints is uncommon, girls, older children, and publicly insured individuals may be at increased risk. Future targeted study may identify areas to improve access to appropriate longitudinal care and justify ED programs to better coordinate follow-up for mTBI.
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Pediatric emergency care · Feb 2022
Characteristics of Injuries Sustained Under the Influence of Alcohol in a Group of Adolescents: Is it Possible to Establish a Typical Clinical Picture of an Underage Patient Who Suffered From an Injury Under the Influence of Alcohol?
Fractures of the limbs and craniocerebral trauma are the most common injuries in children and adolescents. Their frequency ranges widely from 32% to 85% and is the main reason for hospitalization in pediatric population. The number of injuries sustained under the influence of alcohol is increasing although the data concerning that subject is limited and usually includes both adult and teenage patients. ⋯ Traumatic brain injury under the influence of alcohol in adolescents differs from trauma in patients who had not drunk alcohol. Similar areas of injury result in a more severe course of illness in the examined group.
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Pediatric emergency care · Feb 2022
Development of a Parent-Reported Outcome Measure for Febrile Infants ≤60 Days Old.
We aimed to develop a parent-reported outcome measure for febrile infants 60 days or younger evaluated in the emergency department. ⋯ The 23-item parent-reported outcome measure includes the experiences and outcomes important to parents. Further studies are needed to evaluate the measure's psychometric properties.