Pediatric emergency care
-
Pediatric emergency care · Apr 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of interventions to improve clinic follow-up compliance after a pediatric emergency department visit.
A randomized prospective study was made to compare two interventions to improve compliance with follow-up appointments (FA) after a pediatric emergency department (ED) visit. The study population was 253 patients and families seen during daytime hours at a large pediatric ED and who required follow-up for their diagnosed condition. A control group of patients were told to call the clinic for FA, an appointment group of patients were given a FA in the ED prior to discharge and written reminder, and an intense group of patients were given a FA in the ED prior to discharge, a written reminder; they were offered a work excuse, child care, and transportation assistance; they were sent mailed reminders and had attempts at telephone reminders. ⋯ If telephone contact is successful, telephone reminders also improve compliance. If follow-up is recommended, the majority of patients do not make their own appointments. A one-time intervention does not result in a long-term behavioral change in use of clinics or the ED.
-
Pediatric emergency care · Apr 1996
Comparative StudyInfluence of referring physicians on interventions by a pediatric and neonatal critical care transport team.
The objective of this study was to determine the influence of: a) pediatrician versus nonpediatrician referrals on a transport team's therapeutic interventions and b) referring physician's year of graduation on interventions performed by the transport team. From November 1987 through December 1989 we prospectively compared the therapeutic interventions performed by the critical care transport team on newborns and pediatric patients with the referring physician's specialty and year of graduation. The transport team (critical care physician [PL3 or greater], registered respiratory therapist, critical care nurse), recorded all therapeutic interventions, including both procedural and pharmacologic, for 213 newborn and 149 consecutive pediatric transports. ⋯ We found that the referring physicians' medical training affected the number of interventions their patients received. Similarly, patients were likely to receive more interventions if the referral physicians training was not recent. These data have educational implications and support the concepts of continuing medical education, recertification, and maintenance of skills among physicians providing care to critically ill newborns and pediatric patients.
-
Pediatric emergency care · Apr 1996
Case ReportsIntraosseous needle: use of the miniature C-arm imaging device to confirm placement.
Intraosseous infusions are commonly used in pediatric emergencies. Although this technique is often lifesaving, significant complications can develop from incorrect needle placement. Current methods of evaluating needle position rely on the operator's experience with the procedure. We describe the use of a miniature C-arm imaging device to accurately confirm proper needle placement.