Pediatric emergency care
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Pediatric emergency care · Mar 2005
Observation medicine: the expanded role of the nurse practitioner in a pediatric emergency department extended care unit.
The use of observational units (OUs) in pediatric emergency departments (EDs) has become an important adjunct to emergency care. An extended observation period (4 to 23 hours) in the ED has decreased both the number of admissions and prolonged use of acute ED beds. This serves to increase patient satisfaction as well as optimizing care. The use of OUs allows for the most appropriate allocation of resources. These units are typically located within the ED or immediately adjacent to it. The ED physicians are the gatekeepers of the unit and serve as the medical supervision for these patients. The Children's Hospital of Philadelphia developed an OU known in the hospital as the Emergency Department Extended Care Unit (EDECU) approximately 5 years ago. In order for the EDECU to function at its fullest potential, the ED at The Children's Hospital of Philadelphia has opted to use the ED nurse practitioners (NPs) to enhance the care for these patients. ⋯ The use of the EDECU has become an important part of the services offered in the ED at The Children's Hospital of Philadelphia. The integration of the NP in a pivotal role allows for optimal use of human resources, and provides efficient, cost-effective patient care in the ED.
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Pediatric emergency care · Mar 2005
Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers.
To obtain epidemiologic outcome information about pediatric lawsuits that originate in the emergency department and urgent care center. ⋯ Malpractice suits most often involved fractures, meningitis, and appendicitis. Most suits are settled; many are apparently frivolous. Paid indemnities have dramatically increased in recent years. Verdicts decided by juries favored the doctor in 80% of suits.
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Pediatric emergency care · Mar 2005
Factors predicting early diagnosis of foreign body aspiration in children.
To analyze the clinical spectrum of tracheobronchial foreign bodies in children and explore the clinical features which could facilitate early diagnosis. ⋯ In children with an unequivocal choking event while eating even with normal physical and radiographic findings, FBA requires to be excluded by thorough investigations in such instances. Similarly, in toddlers with unexplained persistent cough with refractory parenchymal infiltrates, unrecognized FBA should also be considered. A witnessed choking event is the most important historical information to make an early diagnosis of FBA.