Articles: emergency-department.
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Pediatric emergency care · Dec 2013
Development and Evaluation of a Program for the Use of Ultrasound for Central Venous Catheter Placement in a Pediatric Emergency Department.
A growing body of literature supports the use of ultrasound (US) to assist central venous catheter (CVC) placement, and in many settings, this has become the standard of care. However, this remains a relatively new and uncommonly performed procedure for pediatric emergency medicine physicians. ⋯ The development of an emergency US program was associated with significantly increased physician use of US for CVC placement.
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Child abuse & neglect · Dec 2013
A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment.
Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) based on characteristics of parents who attend the Emergency Department (ED) because they have the following problems: (1) intimate partner violence, (2) substance abuse, or (3) suicide attempt or other serious psychiatric problems. The goal of this protocol is to enable the Reporting Center for Child Abuse and Neglect (RCCAN) to rapidly assess family problems and offer voluntary community based support to these parents. ⋯ The protocol has a high positive predictive value of 91% and can substantially increase the detection rate of child abuse in an ED setting. Parental characteristics are strong predictors of child abuse. Implementing guidelines to detect child abuse based on parental characteristics of parents attending the adult section of the ED can increase the detection rate of child abuse and neglect allowing appropriate aid to be initiated for these families.
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Boarding of admitted patients in the emergency department (ED) is a major cause of crowding. One alternative to boarding in the ED, a full-capacity protocol where boarded patients are redeployed to inpatient units, can reduce crowding and improve overall flow. ⋯ Patients overwhelmingly preferred the inpatient hallway rather than the ED hallway when admitted to the hospital.
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The Journal of pediatrics · Dec 2013
Comparative StudyDistinguishing cardiac syncope from vasovagal syncope in a referral population.
To identify characteristics that distinguish cardiac from vasovagal syncope. ⋯ Cardiac and vasovagal syncope have dramatic differences in presentation. A screening rule that uses historic features, physical examination findings, and electrocardiogram will accurately separate patients requiring further evaluation for cardiac etiology from those with vasovagal syncope in whom cardiology referral is unnecessary.
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Emerg Med Australas · Dec 2013
Alcohol-related violence presenting to the emergency department: Is 'glassing' the big issue?
The study aims to describe the characteristics of patients presenting to EDs within Queensland, Australia with injuries because of assault with a glass implement ('glassing') and to set this within the broader context of presentations because of alcohol-related violence. ⋯ Contrary to public perception generated by media, 'glassing' incidents, particularly at licensed venues, constitute a relatively small proportion of all alcohol-related violence. The current study highlights the predominance of young men injured following alcohol-related violence, demonstrating a key focus area within the population for aiming prevention strategies.