Pediatric emergency care
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Pediatric emergency care · Oct 1996
Femoral fractures: are children at risk for significant blood loss?
To quantify the frequency of blood loss necessitating transfusion and identify the clinical factors predictive of severe hemorrhage in children with femoral fractures. ⋯ Otherwise healthy pediatric patients with isolated femoral fractures rarely lose sufficient amounts of blood to necessitate blood transfusion. The majority may be managed by observation alone. Multiple trauma (multiple fractures, pelvic disruptions, retroperitoneal injuries) and underlying disorders are indications for careful monitoring, Hct determination, and cross match for blood. Patients who are older, present with a Hct < 30%, or who have multiple traumatic injuries have a relatively greater risk of needing a transfusion.
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Pediatric emergency care · Oct 1996
Confidence in performance of pediatric emergency medicine procedures by community emergency practitioners.
To survey a cohort of physicians who work in general community emergency departments (ED) in order to assess their comfort levels in performing urgent and emergent medical procedures on children. ⋯ While emergency physicians within the catchment area of a tertiary care children's hospital feel comfortable with most pediatric procedures, they express a significant degree of discomfort with many potentially life-saving skills. Because of the infrequent need for many of these interventions in children, the high levels of discomfort are not surprising. These procedures may most comfortably be performed at pediatric centers but can be accomplished well at all EDs if personnel are adequately trained. A strong working relationship with pediatric emergency centers and an enhanced teaching of these procedures may increase comfort levels with these potentially life-saving measures.
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To evaluate the experience of a pediatric trauma system with specific reference to prehospital, trauma center resuscitation, and critical care phases of treatment. ⋯ Deviations from care occur, even in a dedicated pediatric trauma system. Mortality of and by itself is not an adequate indicator of the quality of function of a trauma system. Since most primary filters occurred outside of the trauma center, improvement in trauma outcome may be expected with better training of personnel involved in the prehospital care of injured children. A comprehensive review of death and disability should include audit filters of prehospital care, triage, definitive care, and rehabilitation.
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Pediatric emergency care · Aug 1996
Family member presence during pediatric emergency department procedures.
Exclusion of family members (FM) during pediatric procedures in the emergency department (ED) is an accepted practice. This study questions the validity of such a practice. ⋯ FM presence during ED procedures is a practice favored by both parents and ED staff at our institutions. This practice should not be limited to minimally invasive procedures in stable patients but should be considered for procedures such as lumbar punctures and intubations even in critically ill patients.