Pediatric emergency care
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Pediatric emergency care · Dec 2021
Real-Time Measurement of Crowding in Pediatric Emergency Department: Derivation and Validation Using Consensual Perception of Crowding (SOTU-PED).
Our study aimed to develop and validate a real-time crowding composite scale for pediatric emergency department (PED). The study took place in one teaching PED for 2 months. The outcome was the perception of crowding evaluated by triage nurses and pediatricians on a 10-level Likert scale. ⋯ To predict crowded hours (hourly crowding perception >5), the area under the curve was 0.957 (0.933-0.980). The positive and negative likelihood ratios were 8.16 (3.82-17.43) and 0.153 (0.111-0.223), respectively. Using a simple model, it is possible to estimate in real time how crowded a PED is.
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Pediatric emergency care · Dec 2021
Factors Associated With Antibiotic Prescribing and Outcomes for Pediatric Pneumonia in the Emergency Department.
Chest radiographs (CXRs) are often performed in children with respiratory illness to inform the decision to prescribe antibiotics. Our objective was to determine the factors associated with clinicians' plans to treat with antibiotics prior to knowledge of CXR results and the associations between preradiograph plans with antibiotic prescription and return to medical care. ⋯ Intention to prescribe antibiotics based on clinical impression was the strongest predictor of antibiotic prescription in our study. Prescribing antibiotics may lead to subsequent medical care after controlling for radiographic pneumonia.
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Pediatric emergency care · Dec 2021
Screening for Intimate Partner Violence in a Pediatric ED: A Quality Improvement Initiative.
Intimate partner violence (IPV) is a serious public health concern and impacts the entire family unit, particularly children. We implemented an IPV screening and referral program in an urban pediatric emergency department (ED) and aimed to screen 30% of patient families for IPV by January 1, 2017. ⋯ An innovative multiphase quality improvement approach to screen for IPV using a nonverbal screening card and technology within the EMR was successfully implemented in our pediatric ED. Both IPV screening and documentation rates demonstrated greatest improvement and sustainability after process improvements over other initiatives.
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Trauma is one of the leading causes of morbidity and mortality in the pediatric population. In many centers, microhematuria is used as a screening tool for the presence of significant abdominal injury and as an indication for further imaging. Our objective was to evaluate the role of microhematuria by dipstick as an indicator of significant abdominal injury in children. ⋯ The diagnostic role of dipstick urine analysis in the assessment of intra-abdominal injury has low sensitivity and specificity. Nevertheless, it is still a valuable screening tool for the evaluation of the severity of injury.