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Length of stay pediatric emergency

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https://www.readbyqxmd.com/read/29777269/pediatric-appendicitis-severity-in-kwazulu-natal-south-africa-a-retrospective-cohort-analysis
#1
Matthew C Hernandez, Victor Y Kong, John L Bruce, Johnathon M Aho, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Acute appendicitis is a common pediatric surgical emergency; however, there are few grading systems to assign disease severity. The American Association for the Surgery of Trauma (AAST) recently developed a grading system for a variety of emergency surgical conditions, including appendicitis. The severity of acute appendicitis in younger patients in KwaZulu-Natal (South Africa) is unknown. We aimed to describe the disease severity in this patient population using the AAST grading system hypothesizing that the AAST grade would correlate with morbidity, management type, and duration of stay...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#2
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29742551/exploring-research-topics-and-trends-in-nursing-related-communication-in-intensive-care-units-using-social-network-analysis
#3
Youn-Jung Son, Soo-Kyoung Lee, SeJin Nam, Jae Lan Shim
This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses...
May 4, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29734348/the-impact-of-tackle-football-injuries-on-the-american-healthcare-system-with-a-neurological-focus
#4
Michael J McGinity, Ramesh Grandhi, Joel E Michalek, Jesse S Rodriguez, Aron M Trevino, Ashley C McGinity, Ali Seifi
BACKGROUND: Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. OBJECTIVE: Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013...
2018: PloS One
https://www.readbyqxmd.com/read/29694459/characterizing-hospitalizations-for-pediatric-concussion-and-trends-in-care
#5
Tara Rhine, Terri Byczkowski, Mekibib Altaye, Shari L Wade, Lynn Babcock
BACKGROUND: Children hospitalized for concussion may be at a higher risk for persistent symptoms, but little is known about this subset of children. OBJECTIVE: Delineate a cohort of children admitted for concussion, describe care practices received, examine factors associated with prolonged length of stay (LOS) or emergency department (ED) readmission, and investigate changes in care over time. DESIGN, SETTING: Retrospective analysis of data submitted by 40 pediatric hospitals to the Pediatric Health Information System...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29681446/reduction-of-radiography-with-point-of-care-elbow-ultrasonography-for-elbow-trauma-in-children
#6
Julia Tokarski, Jeffrey R Avner, Joni E Rabiner
OBJECTIVES: To determine whether point-of-care elbow ultrasound (US), with history and physical examination, can decrease radiography for patients with elbow trauma. Secondary outcomes included evaluation of pediatric emergency department (PED) length of stay (LOS) and test performance characteristics. STUDY DESIGN: This was a prospective study of patients up to age 21 years with elbow trauma necessitating radiography. After clinical examination and before radiography, pediatric emergency physicians performed elbow ultrasonography of the posterior fat pad and determined whether radiography was required...
April 19, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29680415/home-antibiotics-at-discharge-for-pediatric-complicated-appendicitis-friend-or-foe
#7
Kathryn Tinsley Anderson, Marisa A Bartz-Kurycki, Akemi L Kawaguchi, Mary T Austin, Galit Holzmann-Pazgal, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: The role of home discharge antibiotics in children after perforated appendicitis is unclear. This study evaluates the outcomes of complicated appendicitis patients being discharged with or without home antibiotics after initial surgery and in-patient treatment. STUDY DESIGN: The 2015 and 2016 National Surgical Quality Improvement-Pediatric (NSQIP-P) database was queried for patients <18 years of age with complicated appendicitis. Home antibiotics (HA) were prescribed or not (No Home Antibiotics- NHA)...
April 19, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29655399/system-outcomes-associated-with-a-pediatric-emergency-department-clinical-decision-unit
#8
Derin Karacabeyli, Garth D Meckler, David K Park, Quynh Doan
CLINICIAN'S CAPSULE What is known about the topic? Clinical decision units (CDUs) may reduce short-stay hospitalizations (<48 hours), which are associated with longer lengths of stay, increased staffing needs and higher costs. What did this study ask? What are the disposition outcomes and emergency department (ED) return rates following CDU care? Has CDU implementation changed short-stay hospitalization rates? What did this study find? Most CDU patients were discharged, and short-stay hospitalization rate significantly decreased by 0...
April 15, 2018: CJEM
https://www.readbyqxmd.com/read/29617940/intraosseous-versus-intravenous-access-in-pediatric-septic-shock-patients-admitted-to-alexandria-university-pediatric-intensive-care-unit
#9
Ahmed A El-Nawawy, Omneya M Omar, Mona Khalil
The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose of this study was to evaluate the effect of intraosseous (IO) vs. intravenous (IV) access for resuscitation of patients with septic shock admitted to pediatric intensive care unit. This prospective interventional randomized clinical trial study was conducted on 60 patients with septic shock who need rapid administration of fluids and drugs; 30 cases were randomly chosen for IO vascular access, while the other 30 were selected for IV access...
April 1, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29606410/disparities-in-pediatric-gonadal-torsion-does-gender-race-and-insurance-status-affect-outcomes
#10
Jessica L Buicko, Shevonne S Satahoo, Krishnamurti A Rao, Juan E Sola, Holly L Neville
PURPOSE: Ovarian and testicular torsions are emergencies requiring prompt surgical treatment to preserve gonadal function. However, diagnosis in females is often delayed owing to nonspecific symptoms. We sought to assess disparities in management and outcomes between males and females with torsion. METHODS: The National Inpatient Sample was queried for pediatric patients with "emergent", "urgent", or "trauma center" admission and ICD-9 codes for ovarian torsion and testicular torsion...
February 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29605191/a-quality-improvement-intervention-to-reduce-emergency-department-radiography-for-bronchiolitis
#11
Joel Reiter, Adin Breuer, Oded Breuer, Saar Hashavya, David Rekhtman, Eitan Kerem, Malena Cohen-Cymberknoh
INTRODUCTION: Bronchiolitis is one of the most common infectious diseases in children and the most frequent cause of hospitalization in infants. Clinical practice guidelines recommend that a chest X-ray (CXR) should not be routinely obtained in the diagnosis of bronchiolitis, as studies have shown that they do not affect clinical outcomes, but rather lead to overuse of pharmacological agents and a longer length of hospital stay. OBJECTIVE: To determine whether active institution of bronchiolitis practice guidelines as part of a quality improvement project decreased the use of CXRs in the Pediatric Emergency Department (ED)...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29603317/innovative-discharge-process-for-families-with-pediatric-short-bowel-syndrome-a-prospective-nonrandomized-trial
#12
Bram P Raphael, Maria Jorina, Mary Gallotto, Glendalis Grullon, Meghan Dalton, Melissa Takvorian-Bené, Christina Tascione, Carolyn Rosa, Jennifer McClelland, Megan Gray, Alexis K Potemkin, Courtney Glavin, Kathleen M Gura, Margaret K Murphy, Kierrah Leger, Judith Mahoney, Jessica Kerr, Al Ozonoff, Christopher P Duggan
BACKGROUND: Home parenteral nutrition (HPN) is a life-sustaining therapy for short bowel syndrome (SBS) and other severe digestive diseases, but complications are common. We evaluated a predischarge HPN hands-on training course to reduce complications in children with SBS, including hospital readmissions. METHODS: We conducted a prospective, nonrandomized controlled research study between April 1, 2014, and April 30, 2017. Eligible participants were children aged <18 years old with SBS and anticipated HPN dependence duration ≥6 months...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29596285/rising-clinical-burden-of-psychiatric-visits-on-the-pediatric-emergency-department
#13
Ariella Nadler, Deena Avner, Hnin Khine, Jeffrey R Avner, Daniel M Fein
OBJECTIVE: The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period. METHODS: A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2)...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29554038/trauma-surgeon-performance-of-appendectomy-in-5-10-year-old-children-is-safe-and-decreases-length-of-hospital-stay
#14
Derek B Wall, Carlos Ortega
BACKGROUND: Even in metropolitan areas, on-call pediatric surgeons may not always be immediately available for surgical care of appendicitis, potentially leading to delays in care. In 2012, the in-house trauma group at a suburban Level 1 trauma center (none with formal pediatric fellowship training) assumed surgical care of 5-10 year-old children with appendicitis, who had previously been cared for by pediatric surgeons. We propose to compare the outcomes of the trauma and pediatric surgery groups...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29531447/comparative-study-between-noninvasive-continuous-positive-airway-pressure-and-hot-humidified-high-flow-nasal-cannulae-as-a-mode-of-respiratory-support-in-infants-with-acute-bronchiolitis-in-pediatric-intensive-care-unit-of-a-tertiary-care-hospital
#15
Mihir Sarkar, Rajasree Sinha, Satyabrata Roychowdhoury, Sobhanman Mukhopadhyay, Pramit Ghosh, Kalpana Dutta, Shibarjun Ghosh
Background: Early initiation of appropriate noninvasive respiratory support is utmost important intervention to avoid mechanical ventilation in severe bronchiolitis. Aim: This study aims to compare noninvasive continuous positive airway pressure (nCPAP) and hot humidified high-flow nasal cannulae (HHHFNC) as modes of respiratory support in infants with severe bronchiolitis. Methods: Prospective, randomized, open-label pilot study done in a tertiary-care hospital Pediatric Intensive Care Unit (PICU)...
February 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29525274/emergency-pediatric-surgery-comparing-the-economic-burden-in-specialized-versus-nonspecialized-children-s-centers
#16
Charlotte L Kvasnovsky, Kimberly Lumpkins, Jose J Diaz, Jeannie Y Chun
BACKGROUND: The American College of Surgeons has developed a verification program for children's surgery centers. Highly specialized hospitals may be verified as Level I, while those with fewer dedicated resources as Level II or Level III, respectively. We hypothesized that more specialized children's centers would utilize more resources. STUDY DESIGN: We performed a retrospective study of the Maryland Health Services Cost Review Commission (HSCRC) database from 2009 to 2013...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29489898/effects-of-clinical-pathway-implementation-on-antibiotic-prescriptions-for-pediatric-community-acquired-pneumonia
#17
Daniele Donà, Silvia Zingarella, Andrea Gastaldi, Rebecca Lundin, Giorgio Perilongo, Anna Chiara Frigo, Rana F Hamdy, Theoklis Zaoutis, Liviana Da Dalt, Carlo Giaquinto
BACKGROUND: Italian pediatric antimicrobial prescription rates are among the highest in Europe. As a first step in an Antimicrobial Stewardship Program, we implemented a Clinical Pathway (CP) for Community Acquired Pneumonia with the aim of decreasing overall prescription of antibiotics, especially broad-spectrum. MATERIALS AND METHODS: The CP was implemented on 10/01/2015. We collected antibiotic prescribing and outcomes data from children aged 3 months-15 years diagnosed with CAP from 10/15/2014 to 04/15/2015 (pre-intervention period) and from 10/15/2015 to 04/15/2016 (post-intervention period)...
2018: PloS One
https://www.readbyqxmd.com/read/29456086/low-dose-propofol-for-pediatric-migraine-a-prospective-randomized-controlled-trial
#18
David C Sheridan, Matthew L Hansen, Amber L Lin, Rongwei Fu, Garth D Meckler
BACKGROUND: Migraine headaches are a common reason for pediatric emergency department (ED) visits. Small studies suggest the potential efficacy of sub-anesthetic doses of propofol for migraine with a favorable side effect profile and potentially decreased length of stay (LOS). OBJECTIVE: The objective of this study was to compare the efficacy of low-dose propofol (LDP) to standard therapy (ST) in pediatric migraine treatment. METHODS: We conducted a prospective, pragmatic randomized controlled trial from April 2014 through June 2016 in the ED at two pediatric hospitals...
February 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29437883/cerebrospinal-fluid-reference-values-for-young-infants-undergoing-lumbar-puncture
#19
Joanna Thomson, Heidi Sucharew, Andrea T Cruz, Lise E Nigrovic, Stephen B Freedman, Aris C Garro, Fran Balamuth, Rakesh D Mistry, Joseph L Arms, Paul T Ishimine, Dina M Kulik, Mark I Neuman, Samir S Shah
OBJECTIVES: To determine age-specific reference values and quantify age-related changes for cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein and glucose concentrations in infants ≤60 days of age. METHODS: This multicenter, cross-sectional study included infants ≤60 days old with CSF cultures and complete CSF profiles obtained within 24 hours of presentation. Those with conditions suspected or known to cause abnormal CSF parameters (eg, meningitis) and those with a hospital length of stay of >72 hours were excluded...
February 2, 2018: Pediatrics
https://www.readbyqxmd.com/read/29419604/assessment-of-recovery-following-pediatric-traumatic-brain-injury
#20
Julia C Slovis, Nachi Gupta, Natasha Y Li, Steven G Kernie, Darryl K Miles
OBJECTIVES: We analyzed a prospective database of pediatric traumatic brain injury patients to identify predictors of outcome and describe the change in function over time. We hypothesized that neurologic status at hospital discharge would not reflect the long-term neurologic recovery state. DESIGN: This is a descriptive cohort analysis of a single-center prospective database of pediatric traumatic brain injury patients from 2001 to 2012. Functional outcome was assessed at hospital discharge, and the Glasgow Outcome Scale Extended Pediatrics or Glasgow Outcome Scale was assessed on average at 15...
April 2018: Pediatric Critical Care Medicine
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