Pediatric emergency care
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Pediatric emergency care · Feb 2006
Children requiring psychiatric consultation in the pediatric emergency department: epidemiology, resource utilization, and complications.
A cohort of children younger than 18 years presenting to an urban pediatric emergency department (PED) who underwent psychiatric consultation was analyzed. A standardized data collection sheet was prospectively completed and included: patient characteristics, extent of medical evaluation and findings, ancillary diagnostic studies, resources utilized, dangerous behaviors, and disposition. ⋯ PED patients requiring psychiatric consultation and psychiatric admission had a prolonged PED stay and a high incidence of dangerous behaviors requiring intervention. History and physical examination adequately identified medical illness. Laboratory evaluation obtained for psychiatric transfer or admission purposes was of low yield.
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Describe the pattern of utilization and effectiveness of outpatient fracture pain medication. ⋯ Most children with fractures have the "worst" pain in the first 48 hours after injury and used analgesia for 3 days after injury. There are noteworthy functional limitations for both children and their caregivers. Ibuprofen and acetaminophen with codeine are the analgesics most commonly used, with no clear superiority.
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Pediatric emergency care · Feb 2006
Local weather effects on emergency department visits: a time series and regression analysis.
The ability to forecast atypical emergency department (ED) volumes may aid staff/resource allocation. We determine whether deviations from short-term predictions of weather can be used to forecast deviations from short-term predictions of ED volumes. ⋯ Deviations from short-term predictions of temperature correlate poorly with deviations from predictions of patient volume after adjusting for natural trends and cycles in these variables and controlling for precipitation. These weather variables are of little practical benefit for predicting fluctuations in the rates of ED utilization.
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Pediatric emergency care · Feb 2006
Effects of initial pain treatment on sedation recovery time in pediatric emergency care.
The purpose of this study is to compare the sedation recovery times of children receiving ketamine/midazolam (K/M) versus K/M and initial pain treatment (morphine or meperidine) in pediatric emergency care. ⋯ Sedation (K/M) recovery time is significantly greater for children receiving initial pain treatment (morphine or meperidine). Children receiving meperidine had the longest recovery time. Considering this prolonged recovery time and the unique adverse effects of meperidine compared with morphine, we recommend meperidine not be used for initial ED pain treatment of children.