Pediatric emergency care
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Pediatric emergency care · Nov 2009
Comparative StudyPatients' and caregivers' beliefs about depression screening and referral in the emergency department.
To explore patients' and parents'/caregivers' beliefs about the acceptability of universal depression screening in the emergency department (ED) and their perceptions of the barriers and facilitators to a mental health referral following a positive screen. ⋯ Patients and caregivers generally support depression screening in the pediatric ED but identified several barriers to screening and referral for treatment. Recommendations include introduction of universal screening early in the ED visit, provision of specific information about the meaning of screening results, and support from family and health care providers to help reduce stigma and increase referral acceptability.
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Pediatric emergency care · Nov 2009
ReviewThe reimbursement gap: providing and paying for pediatric procedural sedation in the emergency department.
A number of medical, ethical, and legal obligations compel physicians to provide procedural sedation and analgesia (PSA) to pediatric patients requiring painful procedures in the emergency department (ED). Recognizing the additional demands that PSA places on ED physicians, the American Medical Association has approved Current Procedural Terminology codes for PSA in conjunction with ED procedures. However, some insurers have indicated reluctance or refusal to pay for PSA in the ED, despite these Current Procedural Terminology codes and the legal and ethical imperatives. ⋯ We found significant variability among private and public insurers in their willingness to pay for PSA. Emergency department PSA charges at one tertiary care pediatric center are reimbursed at less than half the rate of other ED services. Although existing state laws and federal regulations arguably require that insurers provide reimbursement for pediatric PSA, certain legislative and regulatory initiatives could clarify insurers' payment obligations.
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Pediatric emergency care · Oct 2009
Randomized Controlled TrialHigh-fidelity medical simulation as a technique to improve pediatric residents' emergency airway management and teamwork: a pilot study.
High-fidelity medical simulation is a technique used for training residents. Simulation is used to teach procedural skills and teamwork. There are limited data on the efficacy of this educational technique. We hypothesize that simulation is effective for teaching pediatric residents airway skills and teamwork. ⋯ This study supports simulation-enhanced educational strategies for improving performance and teamwork skills. This technique is effective in teaching pediatric residents airway skills and teamwork fundamentals required to efficiently manage an acute airway situation.