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Resource utilization pediatric transport

Francis J Real, Andrew F Beck, Jeanne R Spaulding, Heidi Sucharew, Melissa D Klein
Introduction Neighborhood location has been shown to impact childhood health and well-being. It follows that neighborhood context-the risks and assets present within a patient's neighborhood-may be an important consideration during provision of primary care. Pediatric residents often serve as the primary care physicians for high risk populations though are often unfamiliar with local neighborhoods. As such, education interventions that deepen residents' understanding of a patient's neighborhood context may allow for targeted care provision...
August 1, 2016: Maternal and Child Health Journal
Remle P Crowe, Roger Levine, Melissa A Bentley
OBJECTIVE: In the prehospital setting, helicopter air ambulances (HAAs) are used to bring advanced care to patients and reduce time to definitive care. Research related to emergency medical service (EMS) professionals' access to medical helicopters, protocols for HAA use, and prevalence of HAA transport for different patient types is sparse. Our first objective was to describe EMS professionals' access to HAA and the prevalence of written protocols regarding their use. Next, we looked at HAA use for specific patient types (trauma, nontraumatic chest pain, stroke, and pediatric)...
November 2015: Air Medical Journal
Maria Michailidou, Seth D Goldstein, Jose Salazar, Jonathan Aboagye, Dylan Stewart, David Efron, Fizan Abdullah, Elliot R Haut
BACKGROUND: Helicopter Emergency Medical Services (HEMS) have been designed to provide faster access to trauma center care in cases of life-threatening injury. However, the ideal recipient population is not fully characterized, and indications for helicopter transport in pediatric trauma vary dramatically by county, state, and region. Overtriage, or unnecessary utilization, can lead to additional patient risk and expense. In this study we perform a nationwide descriptive analysis of HEMS for pediatric trauma and assess the incidence of overtriage in this group...
November 2014: Journal of Pediatric Surgery
Orgul D Ozturk, Suzanne McDermott, Joshua R Mann, James W Hardin, Julie A Royer, Lijing Ouyang
BACKGROUND: For people with muscular dystrophy (MD) health care access is crucial and utilization is expected to be high. A multidisciplinary approach is needed for optimal management of symptoms of this rare condition. Regular primary care, specialty care, therapy, and medicine use can improve quality of care and reduce need for emergency treatment and hospitalization. We analyzed health insurance and administrative data to test for racial disparities in regular care use among teenagers and young adults with MD...
October 2014: Medical Care
Rosemary Nabaweesi, Laura Morlock, Charles Lule, Susan Ziegfeld, Andrea Gielen, Paul M Colombani, Stephen M Bowman
PURPOSE: To examine the association of prehospital criteria with the appropriate level of trauma team activation (TTA) and emergency department (ED) disposition among injured children at a level I pediatric trauma center. METHODS: Injured children younger than 15 years and transported by emergency medical services (EMS) from the scene of injury between January 1, 2008 and December 31, 2011 were identified using the institution's trauma registry. Logistic regression was used to study the main outcomes of interest, full TTA (FTTA) and ED disposition...
November 2014: Pediatric Surgery International
Philip D Rowell, Paul Pincus, Megan White, Anthony C Smith
BACKGROUND: Telemedicine is a patient consultation method commonly available to patients in rural and remote areas throughout Australia. Its use in paediatric orthopaedics has been rarely described. The primary aim of this study was to identify the patient cohort accessing the orthopaedic paediatric telehealth service through the Royal Children's Hospital Queensland, so as to better allocate this resource. The secondary aims were to identify the orthopaedic conditions the patients utilizing this service suffered and to follow-up on treatment outcomes to potentially assess clinical benefit...
December 2014: ANZ Journal of Surgery
Stephanie J Fessler, Harold K Simon, Arthur H Yancey, Michael Colman, Daniel A Hirsh
INTRODUCTION: The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as "low-acuity" by initial EMS protocols...
March 2014: American Journal of Emergency Medicine
Meredith J Sorensen, Friedrich M von Recklinghausen, Gwendolyn Fulton, Kenneth W Burchard
IMPORTANCE: Unnecessary interfacility transfer of minimally injured patients to a level I trauma center (secondary overtriage) can cause inefficient use of resources and personnel within a regional trauma system. OBJECTIVE: To describe the burden of secondary overtriage in a rural trauma system with a single level I trauma center. DESIGN: Retrospective analysis of institutional trauma registry data. SETTING: Dartmouth Hitchcock Medical Center, a rural level I trauma center...
August 2013: JAMA Surgery
Amy H Kaji, Genevieve Santillanes, Ilene Claudius, Manoj K Mittal, Katie Hayes, Jumie Lee, Marianne Gausche-Hill
BACKGROUND: Some emergency medical services (EMS) systems transport infants with an apparent life-threatening event (ALTE) directly to hospitals capable of pediatric critical care (PCC) monitoring. OBJECTIVE: To describe factors identifiable by EMS providers that distinguish ALTE patients who may require PCC monitoring and management. METHODS: This was an observational analysis of ALTE patients who were transported by EMS and presented to four emergency departments (EDs)...
July 2013: Prehospital Emergency Care
Nicole E Leahy, Roger W Yurt, Eliot J Lazar, Alfred A Villacara, Angela C Rabbitts, Laurence Berger, Carri Chan, Laurence Chertoff, Kathe M Conlon, Arthur Cooper, Linda V Green, Bruce Greenstein, Yina Lu, Susan Miller, Frank P Mineo, Darrin Pruitt, Daniel S Ribaudo, Chris Ruhren, Steven H Silber, Lewis Soloff
Since its inception in 2006, the New York City (NYC) Task Force for Patients with Burns has continued to develop a city-wide and regional response plan that addressed the triage, treatment, transportation of 50/million (400) adult and pediatric victims for 3 to 5 days after a large-scale burn disaster within NYC until such time that a burn center bed and transportation could be secured. The following presents updated recommendations on these planning efforts. Previously published literature, project deliverables, and meeting documents for the period of 2009-2010 were reviewed...
September 2012: Journal of Burn Care & Research: Official Publication of the American Burn Association
Scott G Weiner, Ronald P Ruffing, Brien A Barnewolt
OBJECTIVES: Pediatric patients in the emergency department (ED) are typically seen either by general emergency physicians (EPs) or by pediatric emergency physicians (PEPs) who have completed either a fellowship in pediatric emergency medicine or both pediatric and emergency medicine residencies. This study evaluates admission rates, turnaround times, and test and medication utilization for EPs versus PEPs. METHODS: A retrospective chart analysis was conducted at an academic tertiary care hospital with a dedicated pediatric ED...
September 2012: Pediatric Emergency Care
Jill S Sweney, W Bradley Poss, Colin K Grissom, Heather T Keenan
OBJECTIVE: A pediatric triage tool is needed during times of resource scarcity to optimize critical care utilization. This study compares the modified sequential organ failure assessment score (M-SOFA), the Pediatric Early Warning System (PEWS) score, the Pediatric Risk of Admission Score II (PRISA-II), and physician judgment to predict the need for pediatric intensive care unit (PICU) interventions. METHODS: This retrospective cohort study evaluates three illness severity scores for all non-neonatal pediatric patients transported and admitted to a single center in 2006...
June 2012: Disaster Medicine and Public Health Preparedness
Praveen Khilnani, Rajiv Chhabra
Safe transport of critically ill children remains a globally important issue, particularly in the developing countries such as India and Africa where the high risk mortality and morbidity exists during the transport process that may be less than optimal due to personnel and resource limitation. This article is intended to familiarize the reader with essential components of a good ground pediatric critical care transport program with special reference to developing countries. Essential equipment, medications, training requirement and responsibilities of transport team have been discussed in detail...
June 2008: Indian Journal of Pediatrics
Mona L McPherson, Larry S Jefferson, E O'Brian Smith, Garry C Sitler, Jeanine M Graf
INTRODUCTION: The purpose of this study was to determine the epidemiology and resources used and to study the potential savings of pediatric reverse transport patients. METHODS: A case control study was performed with patients undergoing a reverse or outbound transport from a large, pediatric hospital. Twenty-five children undergoing reverse transport were compared with matched controls. Lengths of stay and costs were compared between the reverse transport and matched control patients...
July 2007: Air Medical Journal
Nathan Timm, Scott Reeves
Mass casualty incidents involving contaminated children are a rare but ever-present possibility. In this article we outline one such event that resulted in 53 pediatric patients and 3 adults presenting to the emergency department of a children's hospital for decontamination and treatment. We pay special attention to the training that allowed this responses to occur. We also outline the institutional response with emphasis on incident command, communication, and resource utilization. Specific lessons learned are explored in detail...
April 2007: Disaster Management & Response: DMR: An Official Publication of the Emergency Nurses Association
Peter L Havens, Diana M Gibb
Although there have been great gains in the prevention of pediatric HIV infection and provision of antiretroviral therapy for children with HIV infection in resource-rich countries, many barriers remain to scaling up HIV prevention and treatment for children in resource-limited areas of the world. Appropriate testing technologies need to be made more widely available to identify HIV infection in infants. Training of practitioners in the skills required to care for children with HIV infection is required to increase the number of children receiving antiretroviral therapy...
April 2007: Pediatrics
Christopher J Haines, R Esther Lutes, Mark Blaser, Norman C Christopher
INTRODUCTION: In a time of emergency department overcrowding and increased utilization of emergency medical services, a highly functional prehospital system will balance the needs of the individual patient with the global needs of the community. Our community addressed these issues through the development of a multitiered prehospital care system that incorporated EMS initiated non-transport of pediatric patients. OBJECTIVE: To describe the outcome of pediatric patients accessing a progressive prehospital system that employed EMS initiated non-transport...
April 2006: Prehospital Emergency Care
Robert J Freishtat, Bruce L Klein, Stephen J Teach, Christina M S Johns, Linda S Arapian, Michael E Perraut, James M Chamberlain
OBJECTIVE: The objective of this investigation was to determine if an existing general severity of illness measure describing pediatric emergency patients, calculated at referring hospitals, predicts the need for hospital admission and intensive care unit (ICU) admission at receiving hospitals. METHODS: A consecutive series of interhospital transports to an urban pediatric tertiary care hospital from other emergency departments (EDs) during a 1-year period were studied...
July 2004: Pediatric Emergency Care
Carla DiScala, Robert Sege
OBJECTIVES: To compare outcomes by intent of nonfatal firearms-related injuries in a hospitalized population, newborn to 19 years of age, and estimate the national incidence of ensuing disability. METHODS: Descriptive statistics and comparative analysis using chi(2), odds ratio, and t test were applied to data from the National Pediatric Trauma Registry (NPTR) and the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission. Demographics, preinjury medical history, scene of injury, primary body part injured, severity of injury, utilization of resources, short-term and long-term disability, medical cause of disability, and disposition at discharge were studied...
May 2004: Pediatrics
A Y Goh, Q Mok
OBJECTIVES: To evaluate the appropriateness of emergency referrals for inter-hospital transfers by local physicians in hospitals without intensive care facilities to a regional tertiary paediatric intensive care unit (PICU). DESIGN: A prospective, descriptive study in a tertiary PICU and hospitals without paediatric intensive care facilities in and around the London area, UK. PATIENTS: All patients (< 18 years) referred for emergency admission to the PICU from district hospitals (n = 436) as well as those admitted through other modes of admission (n = 286) between 1 October 1998 and 30 June 1999 were prospectively studied...
April 2001: Intensive Care Medicine
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