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Pediatric non-urgent emergency visits

Mattia Bellan, Rossella Molinari, Luigi Castello, Daniele Sola, Antonello Gibbin, Giulia Guaschino, Roberta Pedrazzoli, Alessia Puma, Mario Pirisi, Gian Carlo Avanzi, Pier Paolo Sainaghi
Non-traumatic musculoskeletal complaints are often dealt with by emergency room (ER) physicians. We aimed to quantify how many patients with such complaints have conditions requiring immediate recognition and treatment, versus specialist referral, versus primary care. We retrieved the clinical records of all the patients admitted to the ER department of our hospital along 1 year. Pediatric (age <14 years) and obstetrics/gynecology cases were excluded. Data from all patients visiting the ER for non-traumatic musculoskeletal complaints were classified as follows: true emergencies (i...
June 17, 2016: Clinical Rheumatology
Kathleen S W Zoltowski, Rakesh D Mistry, David C Brousseau, Travis Whitfill, Paul L Aronson
OBJECTIVE: Satisfaction is an important measure of care quality. Interventions to improve satisfaction in the pediatric emergency department (ED) are limited, especially for patients with nonurgent conditions. Our objective was to determine if clinician knowledge of written parental expectations improves parental satisfaction for nonurgent ED visits. METHODS: This randomized controlled trial was conducted in a tertiary-care pediatric ED. Parents of children presenting for nonurgent visits (Emergency Severity Index level 4 or 5) were randomized into 3 groups: 1) the intervention group completed an expectation survey on arrival, which was reviewed by the clinician, 2) the control group completed the expectation survey, which was not reviewed, and 3) the baseline group did not complete an expectation survey...
May 2016: Academic Pediatrics
P Richier, X Gocko, O Mory, B Trombert-Paviot, H Patural
BACKGROUND: The number of visits to the pediatric emergency services has increased in the past 20 years in France and around the world, especially for neonates (under 28 days of age). OBJECTIVES: Determine for neonates the reasons requiring medical consultation in the emergency pediatric unit of Saint-Etienne University Hospital (France) and isolate the proportion of "non-urgent" preventable consultations that could be managed outside of emergency units. METHOD: Epidemiological, retrospective study on computerized data on neonates who were referred to the pediatric emergency unit of the Saint-Étienne University Hospital from 1 January to 31 December 2011...
February 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Mark Nimmer, Raymond G Hoffmann, Mahua Dasgupta, Julie Panepinto, David C Brousseau
BACKGROUND: Emergency department (ED) visits by children with sickle cell disease (SCD) are often classified as urgent based on resource utilization. This classification may not accurately reflect the potentially preventable nature of SCD visits. We sought to determine the proportion of SCD crisis-related pediatric ED visits that are possibly preventable. PROCEDURE: We reviewed 2 years of ED visits with a diagnosis of SCD with crisis at a hospital with an established sickle cell program...
January 2015: Journal of Pediatric Hematology/oncology
J Joelle Donofrio, Genevieve Santillanes, Bradley D McCammack, Chun Nok Lam, Michael D Menchine, Amy H Kaji, Ilene A Claudius
STUDY OBJECTIVE: We assess whether screening laboratory tests obtained to medically clear pediatric psychiatric patients altered management or disposition. METHODS: This was a retrospective chart review of consecutive patients younger than 18 years and presenting to an academic pediatric emergency department for medical clearance of an acute psychiatric emergency potentially requiring an involuntary hold (danger to self, danger to others, grave disability) from July 2009 to December 2010...
June 2014: Annals of Emergency Medicine
Bin Xia, Man Qin, Ye Han, Sun Zhang
OBJECTIVE: To assess dental treatment needs and oral health status among children under 18-year-old in Beijing and to examine how these are affected by age, gender. METHODS: In the retrospective study, 3 148 children aged 0.8-18.0 years were selected from patients who first visit the Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, from May 2010 to January 2011. The treatment needs were evaluated and analysed. RESULTS: Mean age of the group was 6...
February 18, 2013: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Stuart J Yoffe, Robert W Moore, John O Gibson, Nemat M Dadfar, Rebecca L McKay, David A McClellan, Tse-Yang Huang
BACKGROUND AND OBJECTIVES: A substantial proportion of emergency department (ED) visits by children are for non-urgent care. The objective of this research is to determine whether a parent-focused educational intervention can reduce non-urgent ED visits. METHODS: A regional hospital system (which includes a central hospital, four satellite hospitals, and two primary care clinics) provided monthly data retrospectively from January 2006 to October 2007 on ED visits by children...
February 2011: Family Medicine
Nicolás F Vinelli, Carla Mannucci, Natalia I Laba, Lorenzo del Vecchio, Andrea Valerio, María I Lago, María M Nieto
INTRODUCTION: The primary function of an Emergency Department is to assist patients with acute conditions; however, many visits are for nonurgent reasons. The objectives of this study were to estimate the prevalence of nonurgent emergency department visits and to describe the reasons for them. POPULATION AND METHODS: Cross-sectional and descriptive study, conducted in a Pediatric Hospital. We included patients aged between 1 month and 18 years, who presented to the emergency department during the whole day, in working and non-working days...
February 2011: Archivos Argentinos de Pediatría
Worapant Kriengsoontornkij, Busaba Homcheon, Chulathida Chomchai, Wipapen Neamsomboon
BACKGROUND: Siriraj Hospital is a busy 2500-bed hospital located in Bangkok, Thailand It has over 1.7 million outpatients, including 120,000 emergency room visits a year, 20,000 of which are pediatric patients. The Pediatric Triage (Pedtriage) system has been in used since the year 2001, but the factors that affect the performance of triage nurse have not been evaluated. OBJECTIVE: To compare the performance non-pediatric nurses who are responsible for pediatric patients in the emergency room before and after pediatric triage training at Siriraj Hospital...
October 2010: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Jean Stagnara, Jacques Vermont, Julie Jacquel, Gilles Bagou, Sandrine Masson, Behrouz Kassaï, Pierre Chatelain
INTRODUCTION: Non-justified and non-scheduled visits to emergency units are ever increasing and consequently overburden their staff. Because it seems necessary to meet this heavy demand of urgent health care, a possible solution could be to set up phone call centers dedicated to pediatric care. First, when people call the emergency number, the SAMU doctors will field these calls and immediately determine the degree of urgency of the situation before transferring the call to the appropriate standardized call center who will then advise the caller as to how to proceed...
November 2010: La Presse Médicale
Katherine A Haltiwanger, Jesse M Pines, Marcus L Martin
OBJECTIVES: Pediatric emergency department (PED) patients often present with non-urgent complaints. We attempted to estimate the perceived degree of urgency of the visit and to identify reasons for seeking non-urgent care in the PED by patients and parents. METHODS: A prospective survey was completed by parents (for children 17 and younger) and patients (18-21) presenting to a suburban academic PED that sees approximately 15,000 patients per year. A convenience sample of participants was enrolled...
2006: California Journal of Emergency Medicine
Sara Farchi, Arianna Polo, Francesco Franco, Domenico Di Lallo, Gabriella Guasticchi
BACKGROUND: The aim of this study was to evaluate the association between different primary paediatric practice models (individual, network -affiliated but in separate office-, and group practice) and non urgent utilization of the Emergency Department (ED). METHODS: The data sources were: the 2006 Regional Paediatric Patient files (0-6 years old), the Regional Community-based paediatrician (CBP) file and the 2006 Emergency Information System. We recorded and studied the ED visits of children, excluding planned ED visits, visits for trauma/poisoning and those that were assigned non deferrable/critical triage codes...
2010: BMC Family Practice
Barbara J Polivka, Marcel Casavant, S David Baker
Poison control centers have been shown to be a cost-effective alternative to healthcare visits for poisoning exposures, yet emergency departments (ED) and urgent care centers (UCC) continue to be frequently accessed for poisoning exposures in young children. We sought to identify predictors of young children who obtain healthcare for a nontoxic poisoning exposure. Poisoning exposure cases for children ≤5 years old who sought ED, UCC, or clinic care between 2001 and 2005 from an urban regional pediatric hospital system were identified from poisoning ICD-9 codes in the hospital administrative data and from a poisoning designation in the National Electronic Injury Surveillance System (NEISS) data...
December 2010: Journal of Community Health
Kenji Maeda, Shigeru Okamoto, Hiroki Mishina, Takeo Nakayama
Pediatric telephone triage programs have been initiated to reduce overcrowding of pediatric medical facilities, yet it is unclear what impact these programs have on reducing after hours room visits. This study used a decision analysis model and data from reference literature to investigate the effectiveness of this program and determine the factors that influence the results. The decision analysis model focused on a hypothetical group of children who were not undergoing ongoing treatment but developed symptoms or sustained injuries thought to require a nighttime visit to a medical facility...
October 2009: Bioscience Trends
Regan H Marsh, Cynthia J Mollen, Frances S Shofer, Jill M Baren
OBJECTIVE: To identify characteristics of adolescents who access health care in a children's hospital emergency department (ED) compared with a general ED. METHODS: We performed a retrospective comparative study of an urban children's ED and the adjacent general ED. Participants included randomly selected ED visits of adolescents aged 15 to 19 years who presented during a 1-year period. Demographic data, triage category, chief complaint, and comorbid conditions were collected and analyzed by site of care...
June 2009: Pediatric Emergency Care
Miwa Geiger, Danielle Harake, Nancy Halnon, Juan Carlos Alejos, Daniel S Levi
As the pediatric OHT population expands, there is increasing demand for convenient, yet sensitive screening techniques to identify children with acute rejection when they present to acute care facilities. In children, symptoms of acute rejection or other causes of graft dysfunction are often non-specific and can mimic other childhood illnesses. The aim of this study was to assess the utility of BNP as a biomarker to assist providers in clinical decision-making when evaluating symptomatic pediatric heart transplant patients...
August 2008: Pediatric Transplantation
Hai-Lun Sun, Yea-Huei Kao, Tsung-Hsueh Lu, Ming-Chieh Chou, Ko-Huang Lue
BACKGROUND: In many countries, the burden of asthma is sufficient to warrant recognition as a high-priority disorder in governmental health strategies. However, the components of the total health-care costs for pediatric patients with asthma have not been well studied, and an overall understanding of health-care utilization patterns in this population is lacking in Taiwan. METHODS: A total of 33 461 patients aged 3-17 years who were enrolled in the National Health Insurance Research database from 1 January to 31 December 2002 were evaluated...
February 2007: Pediatrics International: Official Journal of the Japan Pediatric Society
Peter A Maningas, Derek A Hime, Donald E Parker
There has been a recent move toward the adoption of five-level triage systems in the United States. However, there have been no studies in this country that have critically evaluated the use of these systems in children. The purpose of this study was to evaluate the reliability and validity of a new five-level triage system, the Soterion Rapid Triage System, for stratifying acuity levels in children under the age of 13 years. The study was conducted in a 389-bed Level II mixed adult and pediatric Trauma Center that experiences approximately 12,000 patient visits/year of children under the age of 13 years...
November 2006: Journal of Emergency Medicine
Teresita E Ladrillo, Martin H Hobdell, A Chantal Caviness
BACKGROUND: Hospital emergency department (ED) visits for non-urgent care have been increasing since the late 1950s. This study investigated the prevalence and characteristics of pediatric ED visits for dental problems during a five-year period. METHODS: This retrospective study included newborns through 17-year-olds with dental complaints identified from the electronic register of the ED of Texas Children's Hospital, Houston, between January 1997 and December 2001...
March 2006: Journal of the American Dental Association
Mary Ryan, Maureen Spicer, Carlie Hyett, Peter Barnett
OBJECTIVES: To identify factors that influence the attendance of children with non-urgent medical problems to a tertiary paediatric ED and to define parental expectations of the hospital visit. METHODS: A questionnaire administered to a convenience sample of 200 parents/carers who attended the paediatric ED and whose children were categorized as having non-urgent problems that had been present for at least 4 weeks. Subsequent outpatient attendances were then analysed retrospectively...
October 2005: Emergency Medicine Australasia: EMA
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