Articles: emergency-department.
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The heptavalent pneumococcal conjugate vaccine (PCV7) has produced a shift in the epidemiology of invasive infections from Streptoccoccus pneumoniae. ⋯ Rates of SPB have decreased since the introduction of PCV7, yet SPB still occurs among children in the ED. NVT are increasing in prevalence, and SPB from PCV7-serotypes have decreased.
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Pediatric emergency care · Dec 2013
ReviewShake, rattle, and roll: an update on pediatric seizures.
Seizure is a common presenting complaint for patients in the pediatric emergency department (PED) setting. In some cases, protocols are in place on how to manage this group of patients, for example, a patient with a simple febrile seizure already back to baseline or a patient with known epilepsy already back to baseline. However, many scenarios present dilemmas for physicians in the PED, specifically patients with status epilepticus (SE). ⋯ Current practices are constantly changing because new medications arise, and more information is gathered regarding existing medications and guidelines. Here we will review the basics about first-time afebrile seizures presenting to the PED and common treatments specific to seizure types. We will then review SE management basics and medical therapy, including both older and newer agents and their routes of administration for both the prehospital and the hospital setting.
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Alcohol use in college-age individuals is associated with increased injury risk. Many college drinkers end up in the emergency department (ED) as a result of their drinking, providing a unique opportunity to intervene. ⋯ Seven studies were identified that measured the outcomes of ED interventions for alcohol use in the college-age population. The studied interventions showed promise but had variable success. More research is needed to establish short- and long-term efficacy, specifically in high-risk underage college students.
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Pediatric emergency care · Dec 2013
Impact of Case Exposures on Physician Behavior Responses in Childhood Poisoning: Quality and Cost Implications.
When measuring physicians' competencies, there is no consensus as to what would constitute an optimum exposure in unintentional pediatric poisoning. In the absence of universal protocols and poison centers' support, the behavior responses of the physicians can vary depending on their exposure to cases. We sought to determine if there was a correlation between the case exposure and physicians' behavior choices that could affect quality and cost of care. ⋯ Physicians' practice effectiveness may improve if they manage at least 3 cases of childhood poisoning in a year. Physicians training modules could be developed for those physicians who do not get the optimum exposure necessary in improving physicians' behaviors associated with effective quality and cost efficiency.
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The Journal of pediatrics · Dec 2013
Diagnostic testing and treatment of pediatric headache in the emergency department.
To describe the variability in diagnostic testing and treatment of headaches in children presenting to the emergency department (ED) with use of a nationally representative sample. ⋯ There is significant variability in the evaluation and treatment of pediatric headache in the ED. Despite evidence-based clinical guidelines for migraine headache, a large number of children continue to receive opioids and ionizing radiation in the ED.