Articles: emergency-department.
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This study investigates pediatric injuries involving amusement rides treated in US emergency departments by retrospectively analyzing data from the National Electronic Injury Surveillance System. From 1990 to 2010, an estimated 92 885 children ≤17 years sought treatment in US hospital emergency departments for injuries involving amusement rides, yielding an annual average of 4423 injuries. The average annual injury rate was 6.24 injuries per 100 000 US children, and the mean patient age was 8.73 years. ⋯ Only 1.5% of injuries resulted in hospitalization. An improved national system for monitoring injuries involving amusement rides is needed. There are opportunities to improve the safety of amusement rides for children, especially to prevent injuries from falls.
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Lumbar puncture (LP) is an essential procedure in the diagnosis and treatment of several critical situations. This procedure is routinely performed by palpating external landmarks to find the most appropriate inter-spinous space. In the current study, we compared surface landmark and ultrasound (US) guided LP in different aspects. ⋯ This study showed that US was able to find pertinent landmarks to facilitate the LP in patients admitted to ED and resulted in less pain and less time wasting. Moreover, patients who have high BMI may benefit more than others.
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Children who require emergency care have unique needs, especially when emergencies are serious or life-threatening. The majority of ill and injured children are brought to community hospital emergency departments (EDs) by virtue of their geography within communities. Similarly, emergency medical services (EMS) agencies provide the bulk of out-of-hospital emergency care to children. ⋯ These guidelines are consistent with the recommendations of the Institute of Medicine's report on the future of emergency care in the United States health system. Although resources within emergency and trauma care systems vary locally, regionally, and nationally, it is essential that hospital ED staff and administrators and EMS systems' administrators and medical directors seek to meet or exceed these guidelines in efforts to optimize the emergency care of children they serve. This statement has been endorsed by the Academic Pediatric Association, American Academy of Family Physicians, American Academy of Physician Assistants, American College of Osteopathic Emergency Physicians, American College of Surgeons, American Heart Association, American Medical Association, American Pediatric Surgical Association, Brain Injury Association of America, Child Health Corporation of America, Children's National Medical Center, Family Voices, National Association of Children's Hospitals and Related Institutions, National Association of EMS Physicians, National Association of Emergency Medical Technicians, National Association of State EMS Officials, National Committee for Quality Assurance, National PTA, Safe Kids USA, Society of Trauma Nurses, Society for Academic Emergency Medicine, and The Joint Commission.
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Clin Pediatr Emerg Med · Mar 2013
Asking Youth Questions About Suicide Risk in the Pediatric Emergency Department: Results From a Qualitative Analysis of Patient Opinions.
The emergency department (ED) is a promising setting to screen youth for suicide risk. Patient reactions to questions about suicidal thoughts and behaviors during their ED visit have implications for how screening is introduced, developed, and implemented. The current study is a qualitative investigation into patient opinions about screening for suicide risk in the pediatric ED. ⋯ A small subset of youth (10%; 17/165) did not support screening for reasons that included a desire to focus on their chief (i.e., nonpsychiatric) presenting concern and fear of iatrogenic risk. Understanding patient opinions, including those in support of and in opposition to screening, can inform implementation practices. Further education about the importance of suicide risk assessment may be a helpful first step in instituting universal screening efforts.
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To determine the agents used by emergency medicine (EM) physicians in pediatric procedural sedation and the associated adverse events (AEs) and to provide recommendations for optimizing drug therapy in pediatric patients. ⋯ EM-trained physicians can safely perform pediatric procedural sedation in the ED. In the pediatric ED, the most common procedure requiring conscious sedation is fracture reduction, with ketamine as the preferred agent.