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Pediatric critical and emergency care

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https://www.readbyqxmd.com/read/28238501/is-tachycardia-at-discharge-from-the-pediatric-emergency-department-a-cause-for-concern-a%C3%A2-nonconcurrent-cohort-study
#1
Paria M Wilson, Todd A Florin, Guixia Huang, Matthew Fenchel, Matthew R Mittiga
STUDY OBJECTIVE: We evaluate the association between discharge tachycardia and (1) emergency department (ED) and urgent care revisit and (2) receipt of clinically important intervention at the revisit. METHODS: The study included a nonconcurrent cohort of children aged 0 to younger than 19 years, discharged from 2 pediatric EDs and 4 pediatric urgent care centers in 2013. The primary exposure was discharge tachycardia (last recorded pulse rate ≥99th percentile for age)...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#2
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#3
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28202249/mutual-expectations-of-mothers-of-hospitalized-children-and-pediatric-nurses-who-provided-care-qualitative-study
#4
Dilek Konuk Şener, Aysel Karaca
PURPOSE: This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. DESIGN AND METHODS: A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital...
February 12, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28176924/high-stakes-and-high-emotions-providing-safe-care-in-canadian-emergency-departments
#5
Samina Ali, Denise Thomson, Timothy A D Graham, Sean E Rickard, Antonia S Stang
BACKGROUND: The high-paced, unpredictable environment of the emergency department (ED) contributes to errors in patient safety. The ED setting becomes even more challenging when dealing with critically ill patients, particularly with children, where variations in size, weight, and form present practical difficulties in many aspects of care. In this commentary, we will explore the impact of the health care providers' emotional reactions while caring for critically ill patients, and how this can be interpreted and addressed as a patient safety issue...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#6
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28168989/pediatric-surgical-capacity-in-africa-current-status-and-future-needs
#7
Asra Toobaie, Sherif Emil, Doruk Ozgediz, Sanjay Krishnaswami, Dan Poenaru
BACKGROUND: African pediatric surgery (PS) faces multiple challenges. Information regarding existing resources is limited. We surveyed African pediatric surgeons to determine available resources and clinical, educational, and collaborative needs. METHODS: Members of the Pan-African Pediatric Surgical Association (PAPSA) and the Global Pediatric Surgery Network (GPSN) completed a structured email survey covering PS providers, facilities, resources, workload, education/training, disease patterns, and collaboration priorities...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28168987/injury-severity-in-pediatric-all-terrain-vehicle-related-trauma-in-nova-scotia
#8
Samuel Jessula, Nadia Murphy, Natalie L Yanchar
BACKGROUND/PURPOSE: In 2004-2005, legislation restricting all-terrain vehicle (ATV) use by children and an extensive social marketing campaign intended to reduce pediatric ATV-related morbidity. The frequency, nature, and severity of pediatric ATV-associated trauma were compared before and after such interventions. METHODS: A retrospective cohort study was performed for all pediatric ATV-related injuries that presented to the provincial level 1 pediatric trauma center from 1998 to 2014...
January 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28152138/effect-of-reverse-triage-on-creation-of-surge-capacity-in-a-pediatric-hospital
#9
Gabor D Kelen, Ruben Troncoso, Joshua Trebach, Scott Levin, Gai Cole, Caitlin M Delaney, J Lee Jenkins, James Fackler, Lauren Sauer
Importance: The capacity of pediatric hospitals to provide treatment to large numbers of patients during a large-scale disaster remains a concern. Hospitals are expected to function independently for as long as 96 hours. Reverse triage (early discharge), a strategy that creates surge bed capacity while conserving resources, has been modeled for adults but not pediatric patients. Objective: To estimate the potential of reverse triage for surge capacity in an academic pediatric hospital...
February 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#10
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/28103632/global-health-and-emergency-care-defining-clinical-research-priorities
#11
Bhakti Hansoti, Adam R Aluisio, Meagan A Barry, Kevin Davey, Brian A Lentz, Payal Modi, Jennifer A Newberry, Melissa H Patel, Tricia A Smith, Alexandra M Vinograd, Adam C Levine
OBJECTIVES: Despite recent strides in the development of Global Emergency Medicine (EM), the field continues to lag in applying a scientific approach to identifying critical knowledge gaps and advancing evidence-based solutions to clinical and public health problems seen in emergency departments worldwide. Here, progress on the Global EM research agenda created at the 2013 Academic Emergency Medicine Global Health and Emergency Care Consensus Conference is evaluated and critical areas for future development in emergency care research internationally are identified...
January 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28086760/education-of-pediatric-subspecialty-fellows-in-transport-medicine-a-national-survey
#12
Geoffrey E Mickells, Denise M Goodman, Ranna A Rozenfeld
BACKGROUND: The transport of critically ill patients to children's hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education. METHODS: Internet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM)...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#13
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28005912/benchmarking-prehospital-and-emergency-department-care-for-argentine-children-with-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#14
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Gustavo J Petroni, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Anthony Fabio, Michael J Bell
OBJECTIVE: There is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0)...
2016: PloS One
https://www.readbyqxmd.com/read/27999228/barriers-to-the-development-of-pediatric-palliative-care-in-italy
#15
Franca Benini, Marcello Orzalesi, Anna de Santi, Sabrina Congedi, Pierina Lazzarin, Federico Pellegatta, Lucia De Zen, Marco Spizzichino, Enrico Alleva
INTRODUCTION: In recent years the emergence of new types of patient, clinical situations, technological frontiers and "health" objectives have changed considerably the needs of ill children, this also concerns pediatric palliative care (PPC). In Italy, despite the introduction of legislation (Law 38/2010) stipulating the right of children and families to access appropriate services for pain control and pediatric palliative care, the availability of these services is still limited. AIM: The aim of this study is to highlight, through a review of the existing data and published literature, the critical issues that obstacle the planning and development of PPC services in Italy...
October 2016: Annali Dell'Istituto Superiore di Sanità
https://www.readbyqxmd.com/read/27997480/health-care-provider-knowledge-and-attitudes-regarding-reporting-diseases-and-events-to-public-health-authorities-in-tennessee
#16
Mary-Margaret A Fill, Rendi Murphree, April C Pettit
CONTEXT: In the United States, state laws require health care providers to report specific diseases and events to public health authorities, a fundamental facet of disease surveillance. However, reporting by providers is often inconsistent, infrequent, and delayed. OBJECTIVE: To examine knowledge, attitudes, and practices regarding provider disease reporting and to understand current barriers to provider disease reporting. DESIGN: A cross-sectional study was conducted via an anonymous, standardized electronic survey...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27982393/the-culture-of-patient-safety-from-the-perspective-of-the-pediatric-emergency-nursing-team
#17
Taise Rocha Macedo, Patricia Kuerten Rocha, Andreia Tomazoni, Sabrina de Souza, Jane Cristina Anders, Karri Davis
OBJECTIVE: To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD: A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS: Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork...
September 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/27977530/a-survey-assessment-of-perceived-importance-and-methods-of-maintenance-of-critical-procedural-skills-in-pediatric-emergency-medicine
#18
Matthew R Mittiga, Michael R FitzGerald, Benjamin T Kerrey
OBJECTIVE: The aim of this study was to delineate pediatric emergency medicine provider opinions regarding the importance of, and to ascertain existing processes by which practitioners maintain, the following critical procedural skills: oral endotracheal intubation, intraosseous line placement, pharmacologic and electrical cardioversion, tube thoracostomy, and defibrillation. METHODS: A customized survey was administered to all members of the Listserv for the American Academy of Pediatrics Section on Emergency Medicine...
December 12, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27940682/definitions-and-assessment-approaches-for-emergency-medical-services-for-children
#19
Susan Fuchs, Mark Terry, Kathleen Adelgais, Marlene Bokholdt, Jane Brice, Kathleen M Brown, Arthur Cooper, Mary E Fallat, Katherine E Remick, Keith Widmeier, Wendy Simon, Melissa Marx
Pediatric Life Support (PLS) courses and instructional programs are educational tools developed to teach resuscitation and stabilization of children who are critically ill or injured. A number of PLS courses have been developed by national professional organizations for different health care providers (eg, pediatricians, emergency physicians, other physicians, prehospital professionals, pediatric and emergency advanced practice nurses, physician assistants). PLS courses and programs have attempted to clarify and standardize assessment and treatment approaches for clinical practice in emergency, trauma, and critical care...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27931533/care-transition-interventions-for-children-with-asthma-in-the-emergency-department
#20
REVIEW
Molly A Martin, Valerie G Press, Sharmilee M Nyenhuis, Jerry A Krishnan, Kim Erwin, Giselle Mosnaim, Helen Margellos-Anast, S Margaret Paik, Stacy Ignoffo, Michael McDermott
The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many interventions on care transition for pediatric asthma have been tested, only a few were actually conducted in the ED setting. Most of these targeted both care coordination and self-management education but ultimately did not improve attendance at follow-up appointments with primary care providers, improve asthma control, or reduce health care utilization...
December 2016: Journal of Allergy and Clinical Immunology
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