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Laboratory length of stay emergency pediatric

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https://www.readbyqxmd.com/read/28238158/acute-kidney-injury-during-a-pediatric-sickle-cell-vaso-occlusive-pain-crisis
#1
Sujatha Baddam, Inmaculada Aban, Lee Hilliard, Thomas Howard, David Askenazi, Jeffrey D Lebensburger
BACKGROUND: Patients who develop sickle cell disease (SCD) nephropathy are at a high risk for mortality. The pathophysiology of vaso-occlusive pain crisis may contribute to acute kidney injury (AKI). Non-steroidal anti-inflammatory drugs, known inducers of AKI, are used to treat pain crises. Multiple gaps exist in the knowledge about the impact of AKI in SCD. METHODS: We conducted a 2-year retrospective review of AKI events in patients admitted for vaso-occlusive crisis...
February 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28119350/a-systematic-review-of-management-strategies-for-children-s-mental-health-care-in-the-emergency-department-update-on-evidence-and-recommendations-for-clinical-practice-and-research
#2
Amanda S Newton, Lisa Hartling, Amir Soleimani, Scott Kirkland, Michele P Dyson, Mario Cappelli
OBJECTIVE: Children with mental health crises require access to specialised resources and services which are not yet standard in general and paediatric EDs. In 2010, we published a systematic review that provided some evidence to support the use of specialised care models to reduce hospitalisation, return ED visits and length of ED stay. We perform a systematic review to update the evidence base and inform current policy statements. METHODS: Twelve databases and the grey literature were searched up to January 2015...
January 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#3
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/27935745/does-abnormal-laboratory-results-notification-with-the-short-message-service-shorten-length-of-stay-in-the-pediatric-emergency-department-observation-unit
#4
Ibrahim Hakan Bucak, Habip Almis
BACKGROUND: A new age in communications began with the entry into use of cell phones and their applications. Cell phones and their various applications must be actively used in patient monitoring in the healthcare system. INTRODUCTION: The purpose of this study was to determine the length of stay in the pediatric emergency department observation unit (PEDOU) based upon the notification of abnormal laboratory results (ALRs) via the short message service (SMS). MATERIALS AND METHODS: Patients with ALRs notified through the SMS (April-May-June 2015: study period) were evaluated retrospectively, and those admitted to hospital after such notification were enrolled as the study group (SG)...
December 9, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27697316/time-driven-activity-based-costing-to-identify-opportunities-for-cost-reduction-in-pediatric-appendectomy
#5
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
PURPOSE: As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. METHODS: Process maps were created using medical record time stamps...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26958849/incidence-of-hospitalization-for-respiratory-syncytial-virus-infection-amongst-children-in-ontario-canada-a-population-based-study-using-validated-health-administrative-data
#6
Andrea Pisesky, Eric I Benchimol, Coralie A Wong, Charles Hui, Megan Crowe, Marc-Andre Belair, Supichaya Pojsupap, Tim Karnauchow, Katie O'Hearn, Abdool S Yasseen, James D McNally
IMPORTANCE: RSV is a common illness among young children that causes significant morbidity and health care costs. OBJECTIVE: Routinely collected health administrative data can be used to track disease incidence, explore risk factors and conduct health services research. Due to potential for misclassification bias, the accuracy of data-elements should be validated prior to use. The objectives of this study were to validate an algorithm to accurately identify pediatric cases of hospitalized respiratory syncytial virus (RSV) from within Ontario's health administrative data, estimate annual incidence of hospitalization due to RSV and report the prevalence of major risk factors within hospitalized patients...
2016: PloS One
https://www.readbyqxmd.com/read/26683392/the-use-of-an-institutional-pediatric-abdominal-trauma-protocol-improves-resource-use
#7
Sara C Fallon, David Delemos, Adesola Akinkuotu, Daniel Christopher, Bindi J Naik-Mathuria
BACKGROUND: A novel protocol to standardize the emergency center (EC) management of abdominal trauma in children was developed and implemented at our trauma center. The purpose of this study was to evaluate whether this protocol improved patient safety by decreasing unnecessary computed tomography (CT) radiation and improved quality of care by decreasing EC length of stay (LOS) and laboratory costs. METHODS: We performed a prospective, longitudinal study of children who presented to the EC with a mechanism for abdominal trauma and received an abdominal CT scan from January 2011 to September 2014...
January 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26582080/hyperglycemia-is-a-risk-factor-for-high-grade-envenomations-after-european-viper-bites-vipera-spp-in-children
#8
I Claudet, E Grouteau, L Cordier, N Franchitto, C Bréhin
CONTEXT: Hyperglycemia has been described in severe scorpion envenomation, we wanted to analyze if it was applicable to viper bites in children. AIM: To describe clinical, biological, and therapeutic characteristics of 83 children bitten by European viper (Vipera spp.) and to confirm that hyperglycemia is a risk factor for high-grade envenomation. MATERIAL AND METHODS: A retrospective study was conducted between 2001 and 2014 in the pediatric emergency department of a tertiary level children's hospital...
2016: Clinical Toxicology
https://www.readbyqxmd.com/read/26260722/impact-of-physician-scorecards-on-emergency-department-resource-use-quality-and-efficiency
#9
Shabnam Jain, Gary Frank, Kelly McCormick, Baohua Wu, Brent A Johnson
BACKGROUND AND OBJECTIVES: Variability in practice patterns and resource use in the emergency department (ED) can affect costs without affecting outcomes. ED quality measures have not included resource use in relation to ED outcomes and efficiency. Our objectives were to develop a tool for comprehensive physician feedback on practice patterns relative to peers and to study its impact on resource use, quality, and efficiency. METHODS: We evaluated condition-specific resource use (laboratory tests; imaging; antibiotics, intravenous fluids, and ondansetron; admission) by physicians at 2 tertiary pediatric EDs for 4 common conditions (fever, head injury, respiratory illness, gastroenteritis)...
September 2015: Pediatrics
https://www.readbyqxmd.com/read/26095285/glucocorticoids-and-hospital-length-of-stay-for-children-with-anaphylaxis-a-retrospective-study
#10
Kenneth A Michelson, Michael C Monuteaux, Mark I Neuman
OBJECTIVE: To evaluate whether glucocorticoid administration is associated with improved outcomes in children with anaphylaxis. STUDY DESIGN: We included children from the Pediatric Health Information System database who were diagnosed with anaphylaxis at 35 US children's hospitals between 2009 and 2013. Patients were stratified by disposition from the emergency department (ED), either hospitalized or discharged. We evaluated the association between glucocorticoid administration and prolonged length of stay (LOS), defined as hospital stay ≥ 2 days, and subsequent epinephrine administration among hospitalized children...
September 2015: Journal of Pediatrics
https://www.readbyqxmd.com/read/25960801/minimally-invasive-transxiphoid-approach-for-management-of-pediatric-cardiac-tamponade-one-center-s-experience
#11
Ireneusz Haponiuk, Ewelina Kwasniak, Maciej Chojnicki, Radoslaw Jaworski, Mariusz Steffens, Aneta Sendrowska, Katarzyna Gierat-Haponiuk, Katarzyna Leszczyńska, Konrad Paczkowski, Jacek Zielinski
INTRODUCTION: Cardiac tamponade is excessive collection of fluid in the pericardial sac surrounding the heart that leads to restriction of cardiac function and causes critical cardiogenic shock and rapid circulatory depression. Despite the potential variety of different etiologies in the face of a dangerous decrease of cardiac output, the emergency life-saving procedure is surgical pericardial fluid evacuation. AIM: To perform a retrospective analysis of clinical data and the results of minimally invasive transxiphoid pediatric cardiac tamponade evacuation procedures performed in a cardiac surgery center...
April 2015: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/25795525/laundry-pack-exposures-in-children-0-5-years-evaluated-at-a-single-pediatric-institution
#12
Shan Yin, Alysha Behrman, Jonathan Colvin
BACKGROUND: Case reports and poison center series have highlighted increased safety concerns with laundry packs, especially when compared to traditional laundry detergents. OBJECTIVE: The purpose of this study was to examine the clinical experience with laundry pack exposures at a single institution. METHODS: A retrospective chart review was performed for exposures to laundry packs seen at a single tertiary care children's hospital medical center...
May 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25272071/changes-in-practice-patterns-with-the-opening-of-a-dedicated-pediatric-emergency-department
#13
COMPARATIVE STUDY
Adam J Singer, Gregory Garra, Henry C Thode
OBJECTIVES: Dedicated pediatric emergency departments (ED) staffed by pediatric emergency medicine physicians are becoming more common. We compared processes of care and outcomes before and after opening a dedicated pediatric ED. METHODS: A before and after trial design was used to estimate whether there were any changes in ordering of laboratory tests, radiographic imaging, admission rates, ED length of stay (LOS), rates of left without being seen (LWBS) and patient satisfaction scores after opening a dedicated pediatric ED staffed by pediatric emergency medicine physicians...
October 2014: Pediatric Emergency Care
https://www.readbyqxmd.com/read/25003673/application-of-endoscopic-hemoclips-for-nonvariceal-upper-gastrointestinal-bleeding-in-children
#14
Fatih Ünal, Murat Çakır, Maşallah Baran, Şengül Duygulu, Sema Aydoğdu
BACKGROUND/AIMS: Data about the efficiency and outcome of therapeutic endoscopic techniques in children with nonvariceal upper gastrointestinal bleeding (UGB) are scarce. We aimed to analyze our experience with endoscopic hemoclip application in children with non-variceal UGB. MATERIALS AND METHODS: During a 3-year period, a total of 1715 endoscopies were performed in our pediatric endoscopy unit; 182 (10.6%) of them were performed for UGB to 158 patients. Fifty-six of them had emergent endoscopy...
April 2014: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/24851855/testing-for-pediatric-obstructive-sleep-apnea-when-health-care-resources-are-rationed
#15
COMPARATIVE STUDY
Linda Horwood, Robert T Brouillette, Christine D McGregor, John J Manoukian, Evelyn Constantin
IMPORTANCE: Evaluation of pediatric obstructive sleep apnea in resource-limited health care systems necessitates testing modalities that are accurate and more cost-effective than polysomnography. OBJECTIVE: To trace the clinical pathway of children referred to our sleep laboratory for possible obstructive sleep apnea who were evaluated using nocturnal pulse oximetry and the McGill Oximetry Score. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study of children 2 to 17 years old with suspected obstructive sleep apnea due to adenotonsillar hypertrophy, conducted at a Canadian pediatric tertiary care center...
July 2014: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/24689910/rapid-c-reactive-protein-and-white-cell-tests-decrease-cost-and-shorten-emergency-visits
#16
Eeva Kokko, Matti Korppi, Merja Helminen, Nina Hutri-Kähönen
BACKGROUND: Elevated white blood cells (WBC) in blood and C-reactive protein (CRP) in serum are often used as non-specific markers for bacterial etiology of infection in children. The aim of the present study was to evaluate how rapid WBC and CRP testing influences patient flow and cost in the pediatric emergency room (ER). METHODS: This study was a retrospective chart review. In all, 166 children who were treated during 3 months in the ER of a children's hospital, and in whom rapid tests for WBC and CRP were done, were included...
October 2014: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/24563785/children-s-mental-health-visits-to-the-emergency-department-factors-affecting-wait-times-and-length-of-stay
#17
Amanda S Newton, Sachin Rathee, Simran Grewal, Nadia Dow, Rhonda J Rosychuk
Objective. This study explores the association of patient and emergency department (ED) mental health visit characteristics with wait time and length of stay (LOS). Methods. We examined data from 580 ED mental health visits made to two urban EDs by children aged ≤18 years from April 1, 2004, to March 31, 2006. Logistic regressions identified characteristics associated with wait time and LOS using hazard ratios (HR) with 95% confidence intervals (CIs). Results. Sex (male: HR = 1.48, 95% CI = 1.20-1.84), ED type (pediatric ED: HR = 5...
2014: Emergency Medicine International
https://www.readbyqxmd.com/read/24439605/trauma-surgeon-becomes-consultant-evaluation-of-a-protocol-for-management-of-intermediate-level-trauma-patients
#18
Sara C Fallon, David Delemos, Daniel Christopher, Mary Frost, David E Wesson, Bindi Naik-Mathuria
PURPOSE: At our level 1 pediatric trauma center, 9-54 intermediate-level ("level 2") trauma activations are received per month. Previously, the surgery team was required to respond to and assume responsibility for all patients who had "level 2" trauma activations. In 8/2011, we implemented a protocol where the emergency room (ER) physician primarily manages these patients with trauma consultation for surgical evaluation or admission. The purpose of this study was to prospectively evaluate the effects of the new protocol to ensure that patient safety and quality of care were maintained...
January 2014: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/24219903/clinical-utility-of-screening-laboratory-tests-in-pediatric-psychiatric-patients-presenting-to-the-emergency-department-for-medical-clearance
#19
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
https://www.readbyqxmd.com/read/24172674/improving-diagnostic-efficiency-analysis-of-pelvic-mri-versus-emergency-hip-aspiration-for-suspected-hip-sepsis
#20
Hilton P Gottschalk, Molly A Moor, Abd R Muhamad, Dennis R Wenger, Burt Yaszay
BACKGROUND: Accurately diagnosing and treating childhood hip sepsis is challenging. Adjacent bone and soft-tissue infections are common and can lead to delayed and inappropriate treatment. This study evaluated the effect of early advanced imaging (bone scan, magnetic resonance imaging) in the management of suspected hip sepsis. METHODS: A retrospective review of pediatric patients admitted between 2003 and 2009 with suspected hip sepsis was performed. Patients were classified into 2 categories: group I-immediate hip aspiration or group II-advanced imaging performed before intervention...
April 2014: Journal of Pediatric Orthopedics
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