Pediatric emergency care
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Pediatric emergency care · Oct 2008
Randomized Controlled TrialParental factors influence teen alcohol use after an emergency department visit.
To determine if parental factors are significant predictors of short-term adolescent drinking after an alcohol-related emergency department (ED) visit. ⋯ Parental factors may significantly influence subsequent adolescent drinking after an ED visit. These factors should be assessed when treating alcohol-positive teens, and parents should be advised to closely monitor their teens.
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Pediatric emergency care · Oct 2008
Comparative StudyBronchiolitis management in pediatric emergency departments in Australia and New Zealand: a PREDICT study.
Bronchiolitis is the most frequent reason for admission in infants. We set out to compare clinical practice guideline (CPG) recommendations and physician management of bronchiolitis at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites in Australia and New Zealand as a baseline for prospective trials. ⋯ Management of bronchiolitis was similar across PREDICT sites. Practice is equally split between i.v. and n.g. rehydration. This reflects a lack of evidence which should be addressed through a multicenter comparative trial.
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Pediatric emergency care · Oct 2008
Bedside ultrasound in pediatric emergency medicine fellowship programs in the United States: little formal training.
Bedside ultrasound (BUS) can provide critical information in a rapid and noninvasive manner to the emergency physician. It is widely used in emergency departments (ED) throughout the nation. Literature shows that BUS shortens patient stay and increases patient satisfaction. General emergency medicine (EM) residencies incorporate BUS training in their curricula. However, there are limited data about the training that pediatric emergency medicine (PEM) fellows receive. ⋯ Despite literature supporting the benefits of BUS in the ED, many PEM fellowship programs do not incorporate BUS training for their PEM fellows. Most PEM fellows who receive training in BUS are instructed by physicians trained in EM, not PEM.
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Pediatric emergency care · Oct 2008
Access to outpatient follow-up orthopedic care after pediatric emergency department visits: impact of implementation of a managed Medicaid program.
A Medicaid managed care (MMC) program was instituted regionally with the goal of improving quality and access to care for underserved populations. The purpose of this study was to determine whether the implementation of an MMC program has affected access to timely orthopedic follow-up care. ⋯ After the implementation of a regional MMC program, patients were increasingly unable to access routine outpatient follow-up. This may shift additional cost and resource load to PED, while limiting access to vital services for medically vulnerable patients.
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The polymerase chain reaction (PCR)-based test to detect herpes simplex virus (HSV) genome in cerebrospinal fluid (CSF) has become the test of choice for diagnosing this infection. The utility of this test in young infants undergoing sepsis evaluations is unknown. ⋯ The occurrence of a seizure, the performance of CSF enteroviral PCR testing, and the decision to obtain hepatic transaminases were independently associated with the decision to perform CSF HSV PCR testing. Features traditionally associated with neonatal HSV infection, such as elevated numbers of CSF white blood cells or red blood cells, did not appear to influence the decision to perform CSF HSV PCR testing. The yield of testing in this population was low. Clinicians should weigh the benefits of early diagnosis in a few patients against the consequences of excessive testing in this population.