Pediatric emergency care
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Pediatric emergency care · Oct 1993
The educational value of pediatric emergency transport: by design or by default?
Pediatric emergency transport teams provide an important and challenging clinical experience in many residency training programs. However, the educational value of this experience has not been carefully examined. A 32-item questionnaire was developed to assess curricular components of the three phases of the transport experience in residency training: phase 1 included pretransport training and qualifications and curricular planning, phase 2 addressed intratransport phone backup for the team analogous to online medical command, and phase 3 included posttransport feedback and performance evaluation. ⋯ Thirty percent routinely provide feedback within one week of the transport. Sixty-three percent of chief residents view the experienced transport nurse as an equal member of the transport team. The study found that the educational structure of transports is largely unplanned and that basics such as preservice training and timely performance feedback are not usually addressed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Pediatric emergency care · Oct 1993
Review Case ReportsSoaring suppurative sea shells from the sea shore: Pseudomonas aeruginosa and Klebsiella pneumoniae septic arthritis after a marine sea shell injury.
Septic arthritis is the most important diagnosis to consider in patients presenting with acute monarticular arthritis. We present the case of an eight-year-old girl who developed a Pseudomonas aeruginosa and Klebsiella pneumoniae septic arthritis of her knee following an injury with a marine sea shell. ⋯ We could find no previously reported cases of Pseudomonas aeruginosa or Klebsiella pneumoniae septic arthritis resulting from an injury in a marine environment. The pathogenesis and treatment of septic arthritis and infection following marine injuries are discussed.
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Pediatric emergency care · Oct 1993
Critical care pediatrician-led aeromedical transports: physician interventions and predictiveness of outcome.
This article reviews the one-year experience (March 28, 1987 to March 27, 1988) of the pediatric transport service of the University of Wisconsin Hospital and Clinics (UWHC). The UWHC pediatric transport team consisted of a critical care flight nurse and a pediatric critical care attending physician or fellow. The aims of the study were to: 1) determine the types and number of interventions performed by the physicians to gauge the need for physician presence on transport; and 2) determine which variables (severity of illness scores, age, gender, distance from hospital) recorded at the time of the referral telephone call best predicted outcome of the patient. ⋯ Among trauma patients, if gender, age, distance from UWHC, and telephone PRISM scores were known, outcome could be predicted 74% of the time. Unless studies show the benefit of pediatrician-accompanied transport, transports could probably be done without critical care pediatricians. Severity of illness scoring at this time is probably not sufficiently accurate to warrant its use for deciding the appropriateness of transport of pediatric patients.