Pediatric emergency care
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Pediatric emergency care · Sep 2008
Utilization and unexpected hospitalization rates of a pediatric emergency department 23-hour observation unit.
The 23-hour observation units (OUs) may be used to avoid unnecessary hospital admissions. However, unexpected hospitalizations from the 23-hour OUs involve transfer of care and may decrease the efficiency and safety of care of the patient and the unit itself. The primary objective of this study was to determine the predictors of unexpected hospitalization for admissions to a pediatric 23-hour OU. ⋯ Most of the patients (80%) were successfully discharged from the 23-hour OU. Demographics of the patient and practitioner characteristics did not influence the risk of unexpected hospitalizations; however, certain patient diagnoses, use of resources,and subspecialty consultation did increase the risk of unexpected hospitalization and, therefore, may guide future admission criteria for pediatric 23-hour OU.
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Pediatric emergency care · Sep 2008
Does a pain scale improve pain assessment in the pediatric emergency department?
Pain management in children requires rapid and sensitive assessment. The Wong-Baker FACES pain scale (WBFPS) is a widely accepted, validated tool to assess pain in children. Our objective was to determine whether incorporation of the WBFPS into the emergency medical record (EMR) improves pain documentation in the pediatric emergency department. We also examined whether this intervention improves the management of children who present with pain. ⋯ Incorporating the WBFPS into the EMR significantly improves pain assessment in children. Despite this, there was neither improvement in analgesia administration nor reduction in time to administer analgesia in children with pain.
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Pediatric emergency care · Sep 2008
Case ReportsCetirizine-induced dystonic reaction in a 6-year-old boy.
Dystonia is a movement disorder that causes involuntary contractions of the muscles. Dystonia can affect just 1 muscle, a group of muscles, or all of the muscles. The most common cause acquired dystonia in childhood is drugs. ⋯ It is without central nervous system side effects at recommended dosages. There is only 1 case of cetirizine-induced dystonia in the literature. We report a second case of cetirizine-induced acute acquired dystonia whose symptoms completely resolved after the discontinuation of the drug.
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Pediatric emergency care · Sep 2008
Case ReportsEcstasy (3,4-methylenedioxymethamphetamine)-induced inappropriate antidiuretic hormone secretion.
3,4-Methylenedioxymethamphetamine (MDMA), popularly known as the illicit drug "Ecstasy," is an amphetamine derivative that has become widely abused throughout the United States and other industrialized nations. 3,4-Methylenedioxymethamphetamine has an undeserved reputation as a "safe" drug among its users, but MDMA shares the toxicity profile of other amphetamines. Its use may result in lethal cardiovascular, hepatic, metabolic, or neurological toxicity. ⋯ We describe a 13-year-old girl who experienced MDMA-induced SIADH with symptomatic hyponatremia. Toxicity of MDMA, in particular, the pathophysiology and treatment of MDMA-induced hyponatremia, is discussed.
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Pediatric emergency care · Sep 2008
Quality of orders for medication in the resuscitation room of a pediatric emergency department.
The aim of this study was to evaluate both the errors and completeness of orders for intravenous medications and fluids in the resuscitation/trauma room of a pediatric emergency department before and after implementation of a standard order form. ⋯ A standard designated order form was associated with an increase in completeness and with a decrease in prescribing errors in the resuscitation/trauma room of a pediatric emergency department.