Pediatric emergency care
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A model was constructed to predict pediatric asthmatic wheezing visits to the emergency department. All wheezing visits to the Children's Hospital of Philadelphia Emergency Department were analyzed for 1982 and 1983, for ages two to 18. Nine thousand four hundred twenty-five visits fit the study requirements, 27% of the total number of emergency department visits for all causes. ⋯ Carbon monoxide, barometric pressure, and relative humidity were also statistically significant predictors but were clinically insignificant, explaining only a few percentage points of the total variation. By taking advantage of the seasonal pattern of wheezing through the use of temperature velocity, predictive models for asthmatic wheezing can be greatly improved. They may also aid in planning emergency department staffing, and even help prevent emergency department visits by premedication or lifestyle change during high-risk periods.
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Pediatric emergency care · Dec 1986
Utilization of emergency services among patients of a pediatric group practice.
Pediatric group practices in university hospitals provide primary care to children who are often from indigent families. Those practices that attempt to provide care in a continuous way often encounter difficulty in attempting to change their patients' patterns of emergency department utilization. This study attempts to define the relationship between patient characteristics such as access to a telephone and inappropriate utilization of the emergency department. ⋯ However, within the cohort of emergency department utilizers, phone access was not a predictor of use. Of those who used the emergency department, babies and young children and those of indigent status were more likely to inappropriately access care than were older children and those at a higher socioeconomic level. We conclude that the demographic information of clients in a pediatric group practice can be utilized to predict inappropriate utilization of emergency department services and that this information can be used to implement programs to help foster continuity of care.
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Pediatric emergency care · Dec 1986
Case ReportsVentricular septal defect following blunt chest trauma in childhood: a case report.
We report a case of a six-year-old male who sustained a ventricular septal defect following blunt trauma to the chest. Traumatically acquired VSD is rare in children. The diagnosis is made by characteristic history and physical examination and confirmed by echocardiogram or cardiac catheterization. Treatment is medical until surgical repair can be safely accomplished.
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Fifty-six hypothermic infants (23 to 34 degrees C), aged four to 113 days, admitted during the winter months over a three-year period are reported. Low weight and malnutrition were frequent findings on admission. One or more severe associated disturbances, including metabolic abnormalities, bleeding tendency, infection, and respiratory failure were observed in most cases. ⋯ Of the three who died, none was rapidly warmed, and two of them had severe underlying central nervous system infection. Hypothermia of infancy and the associated disturbances are treatable today, on condition that modern medical facilities are available. It appears that the warming method has been overly stressed.