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https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#1
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29149903/improving-access-to-school-health-services-as-perceived-by-school-professionals
#2
Janine Bezem, Debbie Heinen, Ria Reis, Simone E Buitendijk, Mattijs E Numans, Paul L Kocken
BACKGROUND: The organisation of health assessments by preventive health services focusing on children's health and educational performance needs to be improved due to evolving health priorities such as mental health problems, reduced budgets and shortages of physicians and nurses. We studied the impact on the school professionals' perception of access to school health services (SHS) when a triage approach was used for population-based health assessments in primary schools. The triage approach involves pre-assessments by SHS assistants, with only those children in need of follow-up being assessed by a physician or nurse...
November 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29148638/factors-associated-with-treatment-outcome-of-pediatric-cancerpatients-admitted-with-febrile-neutropenia-in-tikuranbessa-specialized-teaching-hospital-addis-ababa-ethiopia
#3
Selamawit Assefa, Tinsae Alemayehu, Workeabeba Abebe
Background: Cancer treatment is associated with variable degrees of myelosupression. Infection is often a life-threatening complication of chemotherapy-induced neutropenia, and it is also considered an oncologic emergency. Febrile neutropenia is a common, costly and potentially fatal complication in oncology. Objective: To assess factors affecting treatment outcome of cancer patients with chemotherapy induced febrile neutropenia. Method: We conducted a review of records of pediatric patients hospitalized and treated for chemotherapy-induced febrile neutropenia from January 1, 2013 to December 31, 2013 and met the selection criteria...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29126459/emergency-department-waiting-times-in-a-tertiary-children-s-hospital-in-israel-a-retrospective-cohort-study
#4
Oren Feldman, Raviv Allon, Ronit Leiba, Itai Shavit
BACKGROUND: The purpose of this study was to assess ethnic differences in Emergency Department (ED) waiting times between Jewish and Arab children in a tertiary childrens' hospital in Israel. METHODS: This was a retrospective cohort study of all children who were admitted to the pediatric ED of the largest hospital in northern Israel, between January 2011 and December 2015. Univariate and multivariate analyses were used to assess the strength of association between ethnicity category and waiting time...
November 10, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29123603/paediatric-appropriate-facilities-in-emergency-departments-of-community-hospitals-in-ontario-a-cross-sectional-study
#5
Muhammad Akhter Hamid, Sohaib Siddiqui, Jabeen Fayyaz, Ayesha Chandna, Aliya Ariz, Joe Butchey, Elancheliyan Ambalavanar, Niraj Mistry, Aftab Muhammad Azad, Junaid A Bhatti, Dennis Scolnik
BACKGROUND: We assessed whether the paediatric-appropriate facilities were available at Emergency Departments (ED) in community hospitals in a Canadian province. METHODS: We conducted a cross-sectional survey of EDs in community hospitals in Ontario, Canada that had inpatient paediatric facilities and a neonatal intensive care unit. Key informants were ED chiefs, clinical educators, or managers. The survey included questions about paediatric facilities related to environment, triage, training, and staff in EDs...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108845/validation-of-the-age-adjusted-shock-index-using-pediatric-trauma-quality-improvement-program-data
#6
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Shannon Acker, Denis Bensard, Brian Kenney
PURPOSE: In adults, shock index (SI; heart rate/systolic blood pressure) >0.9 predicts injury severity and trauma outcomes. However, age-adjusted shock index (SIPA) out-performs SI in blunt trauma patients 4-16years old. We sought to confirm these findings and expand this tool to include penetrating trauma and children aged 1-4years. METHODS: We developed cutoff values for patients 1-3years old using age-based vital signs and queried the 2014 Pediatric Trauma Quality Improvement Program (TQIP) database for patients aged 1-16years sustaining blunt or penetrating trauma...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29084070/utility-of-soft-tissue-lateral-neck-radiographs-in-the-emergency-department-the-5-year-experience-of-a-large-tertiary-care-pediatric-hospital
#7
Tais Sao Pedro, Dennis Scolnik, Jeffrey Traubici, Derek Stephens
INTRODUCTION: Although retropharyngeal infection (RPI) may present with voice change, drooling, fever, and a toxic appearance, diagnosis based on symptoms alone is unreliable. As incidence is increasing in children and drug-resistant bacterial strains such as methicillin-resistant Staphylococcus aureus are becoming more common, we decided to assess the clinical utility of lateral neck radiography. OBJECTIVE: The aim of this study was to review the experience of a large tertiary care pediatric emergency department (ED) in using lateral soft tissue neck radiographs in the diagnosis of suspected RPI...
October 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29066581/reducing-time-to-antibiotics-in-children-with-intestinal-failure-central-venous-line-and-fever
#8
Joel D Hudgins, Vera Goldberg, Gillian L Fell, Mark Puder, Matthew A Eisenberg
BACKGROUND: Children with intestinal failure (IF) on parenteral nutrition (PN) are at high risk for bacteremia, and delays in antibiotic administration have been associated with increased morbidity and mortality. We designed an emergency department (ED) quality improvement (QI) initiative to reduce time to administration of intravenous antibiotics in febrile children with IF on PN. METHODS: Our aim was to decrease the mean time for febrile children with IF on PN to receive intravenous antibiotics by 50% to <60 minutes over a 12-month period...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29027646/prevalence-of-obstructive-sleep-apnea-among-obese-toddlers-and-preschool-children
#9
Saadoun Bin-Hasan, Sherri Katz, Zoe Nugent, Joy Nehme, Zihang Lu, Abdullah Khayat, Suhail Al-Saleh, Reshma Amin, Indra Narang
BACKGROUND: Obstructive sleep apnea (OSA) is a common disorder estimated at 1-5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4-5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA...
October 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29020436/short-course-versus-long-course-intravenous-therapy-with-the-same-antibiotic-for-severe-community-acquired-pneumonia-in-children-aged-two-months-to-59-months
#10
REVIEW
Zohra S Lassi, Aamer Imdad, Zulfiqar A Bhutta
BACKGROUND: Pneumonia is a leading cause of childhood mortality from infectious disease, responsible for an estimated 1.3 million deaths annually in children under five years of age, many of which are in low-income countries. The World Health Organization recommends intravenous antibiotics for five days as first-line treatment for children with severe pneumonia. Although controversy exists regarding the specific clinical features used to diagnose pneumonia, the criteria for diagnosis of severe pneumonia are better defined and are widely used to triage children for referral and second-line therapy...
October 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29020298/use-of-a-dual-antigen-rapid-diagnostic-test-to-screen-children-for-severe-plasmodium-falciparum-malaria-in-a-high-transmission-resource-limited-setting
#11
Ross Boyce, Raquel Reyes, Michael Matte, Moses Ntaro, Edgar Mulogo, Mark J Siedner
Background: In rural areas, many patients with malaria seek care at peripheral health facilities or community case management programs. While this strategy is effective for the management of uncomplicated malaria, severe malaria necessitates prompt detection and referral to facilities with adequate resources. Methods: In this prospective, observational cohort study, we assessed the accuracy of a dual-band (histidine-rich protein-2/pan-lactate dehydrogenase [HRP2/pLDH]) rapid diagnostic test (RDT) to differentiate uncomplicated from severe malaria...
August 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29016979/attention-mediated-neurocognitive-profiles-in-survivors-of-pediatric-brain-tumors-comparison-to-children-with-neurodevelopmental-adhd
#12
Kristina K Hardy, Victoria W Willard, Anthony Gioia, Christina Sharkey, Karin S Walsh
Background: Attention and working memory symptoms are among the most common late effects in survivors of pediatric brain tumors, and are often associated with academic and psychosocial difficulties. Diagnostic and treatment approaches derived from the attention-deficit hyperactivity disorder (ADHD) literature have frequently been applied to survivors, yet the extent of overlap in cognitive profiles between these groups is unclear. The objective of the present study is to compare neurocognition in survivors of brain tumors and children with neurodevelopmental ADHD...
September 8, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28992737/asenapine-iloperidone-and-lurasidone-exposures-in-young-children-reported-to-u-s-poison-centers
#13
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: Asenapine, iloperidone and lurasidone are relatively new atypical antipsychotics. There is limited information on toxicity on pediatric exposures to these drugs. The objective of this study was to compare toxicity associated with asenapine, iloperidone and lurasidone exposures in young children. METHODS: A retrospective study of U.S. National Poison Data System from 2010 to 2015 of single substance exposures to asenapine, iloperidone or lurasidone in children <6 years of age that were followed to known outcome was performed...
October 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28983578/the-singapore-paediatric-triage-scale-validation-study
#14
Sashikumar Ganapathy, Joo Guan Yeo, Xing Hui Michelle Thia, Geok Mei Andrea Hei, Lai Peng Tham
INTRODUCTION: This study aimed to determine the usefulness and validity of the triaging scale used in our emergency department (ED) by analysing its association with surrogate clinical outcome measures of severity consisting of hospitalisation rate, intensive care unit (ICU) admission, length of ED stay, predictive value for admission and length of hospitalisation. METHODS: A retrospective observational study was conducted of the performance markers of Singapore Paediatric Triage Scale (SPTS) to identify children that needed immediate and greater care...
October 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28971883/to-gp-or-not-to-gp-a-natural-experiment-in-children-triaged-to-see-a-gp-in-a-tertiary-paediatric-emergency-department-ed
#15
Laurie Smith, Yajur Narang, Ana Belen Ibarz Pavon, Karl Edwardson, Simon Bowers, Katharine Jones, Steve Lane, Mary Ryan, David Taylor-Robinson, Enitan Carrol
OBJECTIVE: To evaluate the impact of integrating a general practitioner (GP) into a tertiary paediatric emergency department (ED) on admissions, waiting times and antibiotic prescriptions. DESIGN: Retrospective cohort study. SETTING: Alder Hey Children's NHS Foundation Trust, a tertiary paediatric hospital in Liverpool, UK. PARTICIPANTS: From October 2014, a GP was colocated within the ED, from 14:00 to 22:00 hours, 7 days a week...
September 29, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#16
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28952326/education-on-the-brain-a-partnership-between-a-pediatric-primary-care-center-and-neurology-residency
#17
Eric Zwemer, Miya Bernson-Leung, Corinna Rea, Archana A Patel, Rejean Guerriero, David K Urion, Sara L Toomey
The national shortage of pediatric neurologists is worsening, yet referral rates by pediatricians are high. Suboptimal training of pediatric residents in care of patients with neurologic disease may be a contributing factor. We formed a partnership between the Boston Children's Primary Care at Longwood clinic and Child Neurology Residency Training Program. The educational intervention included lectures, observed neurologic examinations, in-person and virtual triage, and an electronic medical record-based consult system...
February 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28945629/critical-care-resource-utilization-and-outcomes-of-children-with-moderate-traumatic-brain-injury
#18
Theerada Chandee, Vivian H Lyons, Monica S Vavilala, Vijay Krishnamoorthy, Nophanan Chaikittisilpa, Arraya Watanitanon, Abhijit V Lele
OBJECTIVES: To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: National Trauma Data Bank. PATIENTS: Children under 18 years old with a diagnosis of moderate traumatic brain injury (admission Glasgow Coma Scale score of 9-13) in the National Trauma Data Bank between 2007 and 2014. MEASUREMENT AND MAIN RESULTS: We examined clinical characteristics, critical care resource utilization, and discharge outcomes...
September 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28926508/racial-ethnic-variation-in-emergency-department-care-for-children-with-asthma
#19
Heather G Zook, Nathaniel R Payne, Susan E Puumala, Katherine M Ziegler, Anupam B Kharbanda
OBJECTIVE: To assess the variation between racial/ethnic groups in emergency department (ED) treatment of asthma for pediatric patients. METHODS: This study was a cross-sectional analysis of pediatric (2-18 years) asthma visits among 6 EDs in the Upper Midwest between June 2011 and May 2012. We used mixed-effects logistic regression to assess the odds of receiving steroids, radiology tests, and returning to the ED within 30 days. We conducted a subanalysis of asthma visits where patients received at least 1 albuterol treatment in the ED...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#20
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
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