Pediatric emergency care
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Pediatric emergency care · Jan 2022
Screening Electrocardiograms Have Low Utility in Medical Clearance Before Pediatric Inpatient Psychiatric Admission.
Children presenting to the emergency department (ED) requiring psychiatric admission often undergo screening electrocardiograms (ECG) as part of the medical clearance process. The diagnostic yield of screening ECGs for this purpose has not been reported. The purpose of this study was to determine the clinical utility of screening ECGs in children and adolescents requiring acute inpatient psychiatric admission. ⋯ In the absence of concerning individual or family history or cardiac symptoms, routine screening ECGs as part of medical clearance for psychiatric admission are not warranted given the low yield of meaningful findings. The decision to obtain an ECG should be made with careful consideration of medical history and in the presence of specific indications.
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Pediatric emergency care · Jan 2022
Self-reported Symptoms of Anxiety Predict Positive Suicide Risk Screening in Adolescents Presenting to the Emergency Department.
The objective of this study was to assess whether patient-reported anxiety symptoms are associated with suicide risk in pediatric emergency department (ED) patients. An additional objective was to examine differences between patients presenting for medical/surgical or psychiatric complaints. ⋯ Self-reported suicidal ideation and feelings of unbearable anxiety are prevalent among patients presenting to pediatric EDs. Patients who self-report recent feelings of unbearable anxiety are significantly more likely to screen positive for suicide risk, regardless of whether their presenting complaint is medical/surgical or psychiatric in nature.
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Pediatric emergency care · Jan 2022
Sexual History Documentation and Sexually Transmitted Infection Screening for Mental Health Patients in a Pediatric Emergency Department.
Adolescents with psychiatric conditions more commonly engage in high-risk sexual behaviors and are at increased risk of sexually transmitted infections (STIs) and when presenting to pediatric emergency departments (PEDs) may be an important population in which to target screening efforts. This study aimed to determine frequency of physician-documented sexual history and STI screening in adolescents presenting to a PED with mental health-related complaints. ⋯ In a high-risk PED population, physicians documented sexual history only 27% of the time. Female patients were more likely to have a sexual history documented. In patients with sexual history indicating risk for STI, less than half were screened.
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Pediatric emergency care · Jan 2022
The Dynamics of Patient Visits to a Public Hospital Pediatric Emergency Department: A Time-Series Model.
The overcrowding of emergency departments (EDs) is an increasingly relevant public health problem. The main aims of this study were to identify and analyze temporal periodicities of a self-referred pediatric ED (PED), correlate them with meteorological and calendar variables and build a robust forecasting model. ⋯ Although PED visits are multifactorial, they may be predicted and explained by a relatively small number of variables. Such a model may be easily reproduced in different settings and represents a relevant tool to improve quality in EDs through correctly adapting human resources to ED demand.
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The aim of the study was to determine whether point-of-care ultrasound (US) can decrease x-rays in children with ankle injuries. Secondary objectives were to determine the test performance characteristics for ankle US, analyze diagnostic errors, and compare US with the Ottawa Ankle Rules (OAR). ⋯ Point-of-care US has the potential to reduce x-rays for children with ankle injuries; however, nondisplaced, intra-articular tibial fractures may be missed. Ultrasound with OAR may reduce radiographs without missed fractures in this population.