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Length of stay pediatric emergency

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https://www.readbyqxmd.com/read/28644934/fingertip-injuries-in-children-epidemiology-financial-burden-and-implications-for-prevention
#1
Rachel R Yorlets, Kathleen Busa, Kyle R Eberlin, Mohammad Ali Raisolsadat, Donald S Bae, Peter M Waters, Brian I Labow, Amir H Taghinia
BACKGROUND: Although fingertip injuries are common, there is limited literature on the epidemiology and hospital charges for fingertip injuries in children. This descriptive study reports the clinical features of and hospital charges for fingertip injuries in a large pediatric population treated at a tertiary medical center. METHODS: Our hospital database was queried using International Classification of Diseases, Revision 9 (ICD-9) codes, and medical records were reviewed...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28632577/outcome-of-pediatric-forearm-fracture-reductions-performed-by-pediatric-emergency-medicine-providers-compared-with-reductions-performed-by-orthopedic-surgeons-a-retrospective-cohort-study
#2
Donna Milner, Ernest Krause, Karen Hamre, Andrew Flood
OBJECTIVE: The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions. METHODS: We performed an analysis of patients between 1 and 14 years of age who presented to the emergency department (ED) with a forearm fracture requiring reduction. Data collected included reducing provider (PEM or orthopedist) and prereduction, postreduction, and follow-up fracture angles and displacements of both radius and ulna...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#3
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#4
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28625173/return-visits-to-the-pediatric-emergency-department-a-multicentre-retrospective-cohort-study
#5
Colin B Meyer-Macaulay, Mimi Truong, Garth D Meckler, Quynh H Doan
OBJECTIVE: Return visits to the emergency department (RTED) for the same clinical complaint occur in 2.7% to 8.1% of children presenting to pediatric emergency departments (PEDs). Most studies examining RTEDs have focused solely on PEDs and do not capture children returning to other local emergency departments (EDs). Our objective was to measure the frequency and characterize the directional pattern of RTED to any of 18 EDs serving a large geographic area for children initially evaluated at a PED...
June 19, 2017: CJEM
https://www.readbyqxmd.com/read/28604548/pediatric-lower-extremity-lawn-mower-injuries-and-reconstruction-retrospective-10-year-review-at-a-level-1-trauma-center
#6
Leslie G Branch, John C Crantford, James T Thompson, Shruti C Tannan
INTRODUCTION: From 2004 to 2013, there were 9341 lawn mower injuries in children under 20 years old. The incidence of lawn mower injuries in children has not decreased since 1990 despite implementation of various different prevention strategies. In this report, the authors review the results of pediatric lawn mower-related lower-extremity injuries treated at a tertiary care referral center as well as review the overall literature. METHODS: A retrospective review was performed at a level 1 trauma center over a 10-year period (2005-2015)...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28602381/variability-of-care-in-infants-with-severe-bronchiolitis-less-invasive-respiratory-management-leads-to-similar-outcomes
#7
Sandrine Essouri, Florent Baudin, Laurent Chevret, Mélanie Vincent, Guillaume Emeriaud, Philippe Jouvet
OBJECTIVE: To compare the management of children with severe bronchiolitis requiring intensive care (based on duration of ventilatory support and duration of pediatric intensive care unit [PICU] stay) in 2 countries with differing pediatric transport and PICU organizations. STUDY DESIGN: This was a prospective observational care study in 2 PICUs of tertiary care university hospitals, 1 in France and 1 in Canada. All children with bronchiolitis who required admission to the PICU between November 1, 2013, and March 31, 2014, were included...
June 8, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28590994/a-collaborative-behavioral-model-for-psychiatric-visits-in-a-pediatric-emergency-department
#8
Kelsey Caffy, Tamekia L Jones, Barry G Gilmore
OBJECTIVES: Psychiatric pediatric emergency department (PED) visits are associated with extended length of stay (LOS) compared with nonpsychiatric visits. To address delays in definitive care, our PED incorporated a Collaborative Behavioral Model for patients with a psychiatric complaint. We evaluated LOS and 6-month readmission by comparing patients who received a psychiatric consultation through the model with a control group of nonpsychiatric patients. In addition, we assessed the utilization of laboratory tests and imaging and the impact of testing on final patient disposition...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590991/risk-factors-associated-with-emergency-department-return-visits-following-trauma-system-discharge
#9
Timothy Ruttan, Karla A Lawson, Karen Piper, Matthew Wilkinson
OBJECTIVES: Little evidence exists in the pediatric trauma literature regarding what factors are associated with re-presentation to the hospital for patients discharged from the emergency department (ED). METHODS: This was a retrospective cohort study of trauma system activations at a pediatric trauma center from June 30, 2007, through June 30, 2013, who were subsequently discharged from the ED or after a brief inpatient stay. Returns within 30 days were reviewed...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#10
REVIEW
Yao Cheng, Xianze Xiong, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: Appendiceal phlegmon and abscess account for 2% to 10% of acute appendicitis. People with appendiceal phlegmon or abscess usually need an appendicectomy to relieve their symptoms and avoid complications. The timing of appendicectomy for appendiceal phlegmon or abscess is controversial. OBJECTIVES: To assess the effects of early versus delayed appendicectomy for appendiceal phlegmon or abscess, in terms of overall morbidity and mortality. SEARCH METHODS: We searched the Cochrane Library (CENTRAL; 2016, Issue 7), MEDLINE Ovid (1950 to 23 August 2016), Embase Ovid (1974 to 23 August 2016), Science Citation Index Expanded (1900 to 23 August 2016), and the Chinese Biomedical Literature Database (CBM) (1978 to 23 August 2016)...
June 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#11
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28570315/assessment-of-outreach-by-a-regional-burn-center-could-referral-criteria-revision-help-with-utilization-of-resources
#12
Nicholas H Carter, Clint Leonard, Lisa Rae
The objective of this study was to identify trends in preburn center care, assess needs for outreach and education efforts, and evaluate resource utilization with regard to referral criteria. The authors hypothesized that many transferred patients were discharged home after brief hospitalizations and without need for operation. Retrospective chart review of all adult and pediatric transfers to our regional burn center from July 2012 to July 2014. Details of initial management including TBSA estimation, fluid resuscitation, and intubation status were recorded...
May 19, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28556543/westley-score-and-clinical-factors-in-predicting-the-outcome-of-croup-in-the-pediatric-emergency-department
#13
Wen-Chieh Yang, Jung Lee, Chun-Yu Chen, Yu-Jun Chang, Han-Ping Wu
BACKGROUND: Westley croup score has been generally used to assess the severity of croup. This study aimed to identify the individual factors associated with Westley score (WS) and other clinical factors in predicting the outcomes in the pediatric emergency department (PED). POPULATION AND METHOD: We prospectively recruited patients with croup from the PED. The individual factors of WS, fever, age, and the length of hospital stay were analyzed to predict clinical outcomes...
May 29, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28548898/comparison-of-a-rapid-albuterol-pathway-with-a-standard-pathway-for-the-treatment-of-children-with-a-moderate-to-severe-asthma-exacerbation-in-the-emergency-department
#14
Matthew Wilkinson, Ben King, Sujit Iyer, Eric Higginbotham, Anna Wallace, Collin Hovinga, Coburn Allen
OBJECTIVE: The objective of this study was to determine if a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce emergency department (ED) length of stay (LOS), while maintaining admission rates and side effects, when compared to a traditional asthma pathway with a standard jet nebulizer. METHODS: Children aged 3-18 presenting to a large urban pediatric ED for asthma were enrolled if they were determined by pediatric asthma score to have a moderate to severe exacerbation...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28486385/validation-of-the-vasoactive-inotropic-score-in-pediatric-sepsis
#15
Amanda M McIntosh, Suhong Tong, Sara J Deakyne, Jesse A Davidson, Halden F Scott
OBJECTIVES: To assess the validity of Vasoactive-Inotropic Score as a scoring system for cardiovascular support and surrogate outcome in pediatric sepsis. DESIGN: Secondary retrospective analysis of a single-center sepsis registry. SETTING: Freestanding children's hospital and tertiary referral center. PATIENTS: Children greater than 60 days and less than 18 years with sepsis identified in the emergency department between January 2012 and June 2015 treated with at least one vasoactive medication within 48 hours of admission to the PICU...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28484868/treatment-patterns-of-children-with-spine-and-spinal-cord-tumors-national-outcomes-and-review-of-the-literature
#16
Faris Shweikeh, Carolyn Quinsey, Roger Murayi, Ryan Randle, Miriam Nuño, Mark D Krieger, J Patrick Johnson
BACKGROUND: Tumors of the spine in children are rare, and further clinical description is necessary. OBJECTIVE: This study investigated epidemiology, interventions, and outcomes of pediatric patients with spine and spinal cord tumors. METHODS: The National Inpatient Sample and Kids' Inpatient Database were used for the study. Outcomes were studied, and bivariate significant trends were analyzed in a multivariate setting. RESULTS: Analysis of 2870 patients between 2000 and 2009 found a median age of diagnosis of 11 years (Tables 1 and 2)...
May 8, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28480284/similar-clinical-severity-and-outcomes-for-methicillin-resistant-and-methicillin-susceptible-staphylococcus-aureus-pediatric-musculoskeletal-infections
#17
Thomas J An, Michael A Benvenuti, Megan E Mignemi, Jeffrey Martus, James B Wood, Isaac P Thomsen, Jonathan G Schoenecker
BACKGROUND: Prior studies of pediatric musculoskeletal infection have suggested that methicillin-resistant Staphylococcus aureus (MRSA) infections result in worse outcomes compared with infections with methicillin-susceptible S aureus (MSSA) strains. Based on these results, clinical prediction algorithms have been developed to differentiate between MRSA and MSSA early in a patient's clinical course. This study compares hospital outcomes for pediatric patients with MRSA and MSSA musculoskeletal infection presenting to the emergency department at a large tertiary care children's hospital...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28445242/increased-mortality-and-length-of-stay-associated-with-medical-emergency-team-review-in-hospitalized-pediatric-patients-a-retrospective-cohort-study
#18
Brianna McKelvie, James Dayre McNally, Jason Chan, Franco Momoli, Christa Ramsay, Anna-Theresa Lobos
OBJECTIVE: Rapid response systems using medical emergency teams reduce hospital wide cardiorespiratory arrest and mortality. While rapid response systems improve hospital-wide outcomes, children receiving medical emergency team review may still be at increased risk for morbidity and mortality. The study purpose was to compare the length of stay and mortality rate in children receiving a medical emergency team review with those of other hospitalized children. DESIGN: Retrospective cohort study...
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#19
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28419017/the-evaluation-of-trauma-care-the-comparison-of-2-high-level-pediatric-emergency-departments-in-the-united-states-and-turkey
#20
Alkan Bal, Michael Cooper, Amanda Lee, Murat Anil, Halim Hennes
OBJECTIVE: The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey. METHODS: The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed...
April 18, 2017: Pediatric Emergency Care
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