Articles: emergency-department.
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Pediatric emergency care · May 2024
National Survey on the Emergency Department Management of Febrile Infants 29 to 60 Days Old With an Abnormal Urinalysis.
Recent clinical practice guidelines recommend that decisions regarding lumbar puncture (LP) for febrile infants older than 28 days should no longer be based on urinalysis results, but rather independently determined by inflammatory markers and sometimes guided by shared decision-making (SDM). This study sought to assess management decisions for febrile infants aged 29 to 60 days with an abnormal urinalysis. ⋯ Knowledge translation initiatives reflecting current evidence should target use of inflammatory markers rather than urinalysis results to guide decisions regarding LP. Efforts emphasizing outpatient management with oral antibiotics and SDM for low-risk infants with an abnormal urinalysis could also further align management with current evidence and guidelines.
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Geriatric patients discharged from the emergency department (ED) after an injury are at risk for adverse outcomes. Older patients are at a higher risk for sensory impairments and cognitive problems which can make comprehension of discharge instructions more difficult. Moreover, geriatric patients often have limited skills with or access to alternative sources of information, such as hospital web pages or phone applications, which could put them at a higher risk of undertreatment. Implementing telephone follow-up after discharge presents a potential solution to enhance information transfer and address problems related to the injury. ⋯ Telephone follow-up is a feasible intervention that may be able to enhance older patients' comprehension of discharge instructions and help identify new problems after discharge. During the follow-up call, the majority of patients received additional advice, indicating a potential demand for this intervention. The main limitation was that not all eligible patients were approached or did not want to participate in the intervention. Future studies should investigate whether telephone follow-up can effectively reduce adverse events and improve the quality of life for these patients.
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Pediatric emergency care · May 2024
A Review of an Interfacility Transport Program Pediatric Stroke Clinical Practice Guideline.
Pediatric acute ischemic stroke is a rare diagnosis that requires timely recognition and definitive management to prevent morbidity and mortality. Children often present to primary care offices, urgent care clinics, and adult emergency departments for evaluation of symptoms that may be signs and symptoms of stroke. Currently, there are no published prehospital or transport protocols specific to pediatric acute ischemic stroke. The Children's Mercy Hospital Critical Care Transport Team (CMCCT) created a pediatric-specific clinical practice guideline (CPG) for suspected acute ischemic stroke. ⋯ To our knowledge, the CMCCT CPG is the first pediatric transport protocol aimed at recognition and management of pediatric stroke described in the literature. Retrospective calculation of LVO scores show that they may be helpful in application to pediatric patients.
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Foam tape is commonly used in the emergency department as a dressing over chest tubes owing to its occlusive and compressible properties. There is a paucity of data regarding the incidence of significant cutaneous reactions to this material. We conducted a prospective trial to evaluate the incidence of dermatitis following application of foam tape to the upper arm of a cohort of healthy volunteers. ⋯ #NCT06059417.
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This study investigates the association between Methamphetamine (MA) intoxication and suicidal ideation/behavior in patients presenting to emergency departments. Amidst rising MA use and co-use with opioids, this "twin epidemic" has manifested in increasing admissions for MA intoxication, often accompanied by psychiatric symptoms that can escalate to suicidal behaviors. ⋯ These results underscore the urgent need for targeted interventions to address the complex interplay between MA use and suicidal risks in the emergency department setting, as well as broader public health strategies to combat the increasing prevalence of MA use.