Pediatric emergency care
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Pediatric emergency care · Aug 2007
Characterizing the teachable moment: is an emergency department visit a teachable moment for intervention among assault-injured youth and their parents?
Injury interventions often invoke the teachable moment (TM); however, there is scant empirical research examining this construct with violent injuries. We sought to operationalize the TM construct and to determine whether an emergency department (ED) visit was a TM for intervention among assault-injured adolescents and their parents. ⋯ This study provides preliminary support for the TM after assault injuries. The TM index may be a first step toward an assessment that can differentiate individuals who are amenable to violence prevention intervention from those who are not.
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Pediatric emergency care · Aug 2007
Comparative StudyAppropriateness of children's nonurgent visits to selected Michigan emergency departments.
To explore parental rationale and the appropriateness of children's visits to emergency departments (EDs) for nonurgent complaints. ⋯ Half of all nonurgent ED visits were rated as high appropriateness. Considering parental information sources, it would be incorrect to label all nonurgent ED visits as inappropriate. Questions remain as to whether primary care outpatient sites are an appropriate source of care for minor injuries.
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Pediatric emergency care · Aug 2007
Comparative StudyTest characteristics of parent's visual analog scale score in predicting ventriculoperitoneal shunt malfunction in the pediatric emergency department.
Many parents of children with ventriculoperitoneal shunts present to the emergency department for evaluation of a possible shunt malfunction. No study to date has evaluated their ability to predict a shunt malfunction. Our study objective was to evaluate parents' accuracy for predicting a shunt malfunction in their child. We hypothesize that parents more experienced with prior shunt malfunctions are better able to predict subsequent malfunctions in their child. ⋯ Experienced parents are better able to predict a shunt malfunction in their child.
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Pediatric emergency care · Aug 2007
Lack of evidence to support routine digital rectal examination in pediatric trauma patients.
Current advanced trauma life support guidelines recommend that a digital rectal examination (DRE) should be performed as part of the initial evaluation of all trauma patients. Our primary goal was to estimate the test characteristics of the DRE in pediatric patients for the following injuries: (1) spinal cord injuries, (2) bowel injuries, (3) rectal injuries, (4) pelvic fractures, and (5) urethral disruptions. ⋯ The DRE has poor sensitivity for the diagnosis of spinal cord, bowel, rectal, bony pelvis, and urethral injuries. Our findings suggest that the DRE should not be routinely used in pediatric trauma patients.
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Pediatric emergency care · Aug 2007
Case ReportsThe use of an emergency physician-directed bedside ultrasound examination to clarify a diagnosis in an 8-year-old boy with chronic abdominal pain.
Abdominal pain is a common presenting complaint to the emergency department. Often, patients with chronic, intermittent histories of abdominal pain with multiple visits to medical providers find it difficult to be taken seriously. We describe a patient with a history of episodic abdominal pain who was found to have intermittent ureteropelvic junction obstruction after a timely ultrasound examination by the treating emergency physician.