Pediatric emergency care
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Pediatric emergency care · Nov 2010
Emergency department utilization patterns and health care needs assessment among parents of Chinese American children in New York City.
A limited number of publications have addressed the health care needs of Chinese American children of recently immigrated parents. We administered a Chinese-language survey to parents presenting to an urban pediatric emergency department (PED) in New York City and at community venues. The survey assessed demographics, access to health care, and utilization/expectations of the PED. ⋯ Of those completed in the PED, 79% sought emergency services because of pediatric referral or because their pediatrician's office was closed. Of our sickest patients with an Emergency Severity Index score of 3 or less, 28% of parents felt that the child was somewhat sick or not sick at all. Although the majority of our Chinese American families utilize the emergency department appropriately, 28% of the parents of our sickest patients did not appreciate the degree of illness of their children.
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Pediatric emergency care · Nov 2010
Case ReportsThe 2009 PEMpix photo competition award winner: David Kessler, MD, MSc: hey doc, what's this bump? A 3-month-old male infant with tender bony growths on his extremities.
This is a case report of an infant with bony growths and pain. Differential diagnosis of this chief complaint and the management of the suspected condition are discussed. This case was presented at the Section of Emergency Medicine Meeting at the National Conference and Exhibition of the American Academy of Pediatrics in 2009 and was awarded first place in the PEMpix photo competition.
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Up to 3 million US children are cared for by emergency medical services (EMSs) annually. Limited research exists on pediatric prehospital care. The Pediatric Emergency Care Applied Research Network (PECARN) mission is to perform high-quality research for children, including prehospital research. Our objective was to develop a pediatric-specific prehospital research agenda. ⋯ PECARN has identified high-priority EMS research topics for children using a consensus-derived method. These research priorities include novel EMS system topics. The PECARN EMS pediatric research priority list will help focus future pediatric prehospital research both within and outside the network.
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Pediatric emergency care · Oct 2010
Comparative StudyAlignment of cricoid cartilage and esophagus and its potential influence on the effectiveness of Sellick maneuver in children.
The effectiveness of cricoid pressure in preventing aspiration of gastric contents during rapid sequence intubation may be limited if the esophagus is laterally displaced from the trachea at the level of the cricoid cartilage. Esophageal lateral displacement has been reported to occur in 50% to 90% of adults. Children 8 years and older assume the anatomic airway characteristics of adults, and therefore, we hypothesized that esophageal displacement would be significantly more common in older versus younger children. The purposes of this study were to determine the alignment of the trachea to the esophagus at the level of the cricoid cartilage on cervical spine or neck computed tomographic (CT) scans and to compare the frequency and quantity of esophageal displacement between children younger than 8 years and children 8 years and older. ⋯ This is the first pediatric study on the rate and degree of esophageal displacement from the airway at the level of the cricoid cartilage. Lateral displacement of the esophagus occurred at a significantly greater rate in the younger (45%) compared with the older (15%) children, which was directly opposite of our hypothesis. Of the 36 children (30%) with esophageal displacement, all had displacement to the left of the cricoid cartilage.