Articles: emergency-department.
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We aimed to determine the inter-rater reliability of ultrasonographic optic nerve sheath diameter measurements performed by emergency nurses. ⋯ There is good inter-rater reliability among emergency nurses with no previous experience in measuring the optic nerve sheath diameter with point-of-care ultrasound.
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Identification of a neonatal horseshoe kidney in the emergency department is uncommon but has implications for future healthcare planning for patients. We present a case of a neonate with bloody diapers who was evaluated with renal point-of-care ultrasound (POCUS) that identified a horseshoe kidney. ⋯ Midline interrogation is not part of the routine technique for ultrasound imaging of the kidney but should be considered when the limits of the lower pole of bilateral kidneys are difficult to visualize. This case highlights the importance of understanding normal anatomical landmarks when performing renal POCUS to identify renal anomalies.
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Pediatric emergency care · Dec 2024
"Room of Horrors": A Proof-of-Concept Simulation Model for Error Reduction Training in the Emergency Department.
This pilot study aimed to assess the effectiveness of a "room of horrors" (RoH) simulation in identifying patient safety threats in a pediatric emergency department (PED) and to evaluate health care workers' (HCWs') perceptions of the experience. ⋯ The RoH simulation experience was effective in evaluating the level of retention of earlier training and the ability of multidisciplinary teams to correctly identify major safety threats in a PED setting. The participants found the experience valuable and engaging. Future research should focus on other means by which the retention of learned skills can be reinforced and new safety threats can be identified with a high level of alertness.
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Pediatric emergency care · Dec 2024
Suicide Prevention and Telehealth in Children's Hospital Emergency Departments.
Suicide is a leading cause of death among adolescents. Emergency department (ED) visits for mental health concerns are rising, and telehealth is increasingly used to provide emergency mental health care. We conducted a national survey to describe suicide prevention practices and tele-mental health care in children's hospital EDs. ⋯ Approximately half of children's hospital EDs use tele-mental health care, and hospitals with versus without tele-mental health care report similar rates of suicide prevention practice use. Opportunities exist to increase use of discharge safety practices.
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Pediatric emergency care · Dec 2024
Use of Emergency Telemedicine Physicians for Telephone Triage Disposition of Pediatric Patients.
Telemedicine is a growing field, with limited data around its utility supporting pediatric emergency care telephone triage. We instituted telemedicine physician support for nurse telephone triage decisions. When the nursing protocols recommended urgent or emergent care, a telemedicine physician reviewed and modified care urgency if appropriate. Our primary study objectives were to evaluate the proportion of patients who were downgraded to less urgent care and assess for potential harm related to the downgrade in care urgency. ⋯ Our data suggests that telemedicine physicians can safely downgrade nurse triage care recommendations for pediatric patients. Most downgraded patients sought outpatient care, avoiding unnecessary utilization of the emergency department without evidence of associated harm.