Pediatric emergency care
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In summary, the emergency department or office-based physician should distinguish first between inflammation and injury. A clinical diagnosis of fracture should be made before obtaining and reading films. ⋯ A neurologic examination should be documented before undertaking reduction. Finally, if in doubt, a splint for 24 to 48 hours until an orthopedic opinion is available causes no harm.
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Twenty-four percent of all medical care contacts are made on the telephone. Practicing pediatricians and emergency physicians often manage children's illnesses by telephone. Studies have shown that there is a need for improved communication between physicians and patients, and it is believed that quality of, and satisfaction with, health care services will improve with increased emphasis on interpersonal communication skills in medical training. ⋯ K. is outlined. Topic sessions in the pediatric emergency department and individual resident review sessions are discussed. The guidelines designed to follow the conceptual framework are presented.
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A survey of all known pediatric emergency medicine fellowship programs as of December 1990 was conducted in order to characterize and compare certain attributes of these programs with those that existed in 1988. The following attributes of the training programs were studied: number of programs, length of training, number of first-year positions, number of graduates, program participation in the National Resident Match Program, amount of clinical time required, elective rotations, didactic, research, administrative, and teaching experience, patient volumes, and attending staffing. ⋯ Patient volumes vary between 15,000 and 90,000, with a median of 39,000. The data offered are meant to act as a guide to further development of new and existing programs.
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Pediatric emergency care · Apr 1991
The spectrum and frequency of illness presenting to a pediatric emergency department.
Knowledge of the spectrum and relative frequencies of pediatric emergencies is an important factor in developing appropriate training curricula for physicians treating children in emergency departments. To provide these data, we reviewed the records for four one-week periods (January, April, July, and October) of a large pediatric emergency department to describe the population in terms of age, chief complaints, diagnoses, time of arrival, seasonal variation, and disposition. There were 3796 log entries. ⋯ More than half of the patients arrived on the evening shift, between 4 pm and 12 am. Eleven percent of the children seen on day and evening shifts and 13% from the night shift were admitted. From the analysis of our data we recommend expanded skills in the management of minor trauma for pediatric residents, an emphasis on management of infections for nonpediatric emergency specialists, and extensive training in both pediatric and adult trauma for physicians in pediatric emergency medicine fellowships.