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triage pediatrics

Graham Cameron Thompson, Ellen Morrison, Marshall Ross, Helena Liu, Otto G Vanderkooi, Robin Eccles
OBJECTIVES: To determine the proportion of true-positive blood culture results in children presenting to the ED with suspected appendicitis. To describe the current practice of obtaining blood cultures in children with suspected appendicitis. METHODS: We performed a 2-year retrospective health record review of all children aged 2 through 17 years investigated for suspected appendicitis at a tertiary Pediatric Emergency Department. Subjects were identified by searching (a) institutional records for ICD-10-CA coding, (b) diagnostic imaging records of ultrasounds for appendicitis, and (c) surgical database records for nonincidental appendectomies...
October 17, 2016: Pediatric Emergency Care
Francesca Valent, Anna Busolin
OBJECTIVES: Our objective was to assess how the distance from home to the closest pediatric emergency department (ED) affects nonurgent emergency room visits among the child population of the Northeastern Italian region of Friuli Venezia Giulia. METHODS: The study was based on the administrative databases of the Regional Health Information System of Friuli Venezia Giulia. For the year 2014, we abstracted the records of all white-triage-tag visits of children younger than 16 years from the databases of the 3 regional pediatric EDs located in the 3 main cities...
September 30, 2016: Pediatric Emergency Care
Mark Xavier Cicero, Travis Whitfill, Frank Overly, Janette Baird, Barbara Walsh, Jorge Yarzebski, Antonio Riera, Kathleen Adelgais, Garth D Meckler, Carl Baum, David Christopher Cone, Marc Auerbach
OBJECTIVE: Paramedics and emergency medical technicians (EMTs) triage pediatric disaster victims infrequently. The objective of this study was to measure the effect of a multiple-patient, multiple-simulation curriculum on accuracy of pediatric disaster triage (PDT). METHODS: Paramedics, paramedic students, and EMTs from three sites were enrolled. Triage accuracy was measured three times (Time 0, Time 1 [two weeks later], and Time 2 [6 months later]) during a disaster simulation, in which high and low fidelity manikins and actors portrayed 10 victims...
October 17, 2016: Prehospital Emergency Care
Gang-Xi Lin, Yin-Ling Yang, Denise Kudirka, Colleen Church, Collin K K Yong, Fiona Reilly, Qi-Yi Zeng
BACKGROUND: Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale. METHODS: In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system...
2016: Chinese Medical Journal
Ariel Brandwein, Kavita Patel, Myriam Kline, Peter Silver, Sandeep Gangadharan
OBJECTIVES: Patients with obstructive airway disease have varying degrees of pulsus paradoxus that correlate with illness severity. Pulsus paradoxus can be measured using plethysmography. We investigated whether plethysmograph (pleth) variability on admission to the pediatric emergency department (ED) could predict patient disposition. We hypothesized that patients with a larger pleth variability would have a higher likelihood of being admitted to a general pediatrics unit or the intensive care unit (ICU)...
October 6, 2016: Pediatric Emergency Care
Ilaria Bergese, Simona Frigerio, Marco Clari, Emanuele Castagno, Antonietta De Clemente, Elena Ponticelli, Enrica Scavino, Paola Berchialla
OBJECTIVES: Return visit (RV) to the emergency department (ED) is considered a benchmarking clinical indicator for health care quality. The purpose of this study was to develop a predictive model for early readmission risk in pediatric EDs comparing the performances of 2 learning machine algorithms. METHODS: A retrospective study based on all children younger than 15 years spontaneously returning within 120 hours after discharge was conducted in an Italian university children's hospital between October 2012 and April 2013...
October 6, 2016: Pediatric Emergency Care
E Brooke Lerner, Amy L Drendel, Jeremy T Cushman, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines for Field Triage of Injured Patients assist EMS providers in identifying children who need the resources of a trauma center. OBJECTIVE: To determine the accuracy of the Physiologic Criteria (Step 1) of the Field Triage Guidelines in identifying injured children who need the resources of a trauma center. METHODS: EMS providers who transported injured children 15 years and younger to pediatric trauma centers in 3 mid-sized cities were interviewed regarding patient demographics and the presence or absence of each of the Field Triage Guidelines criteria...
October 6, 2016: Prehospital Emergency Care
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...
September 15, 2016: Journal of Pediatric Surgery
Madison M Hunt, Austin M Stevens, Kristine W Hansen, Stephen J Fenton
PURPOSE: To expedite flow of injured children suspected to require operative intervention, a "trauma 1 OP" (T1OP) activation classification was created. The purpose of this study was to review this strategy at a level 1 pediatric trauma center. METHODS: A retrospective review of T1OP activations between 2003 and 2015 was performed. Children suspected of requiring neurosurgical intervention were classified as trauma 1 OP neuro (T1OP(N)). Comparisons were made to trauma 1 (T1) patients who required emergent operative intervention, excluding orthopedic injuries...
September 14, 2016: Journal of Pediatric Surgery
Keisuke Jimbo, Masahiro Takeda, Eri Miyata, Hiroshi Murakami, Reiko Kyodo, Hideki Orikasa, Geoffrey J Lane, Toshiaki Shimizu, Atsuyuki Yamataka
PURPOSE: The purpose of this study was to examine whether acute non-perforated appendicitis (ANPA) can be safely triaged by a pediatrician for conservative management (CM) using gray-scale ultrasonography with power Doppler (GSPD). METHOD: Seventy five cases of ANPA assessed by a pediatrician with GSPD (2013-2015) were reviewed. GSPD grading for ANPA was: I: slightly irregular wall/normal blood flow; II: irregular wall/increased blood flow; III: irregular wall/decreased blood flow; and IV: absence of wall/blood flow...
September 15, 2016: Journal of Pediatric Surgery
Emma C Hamilton, Charles C Miller, Bryan A Cotton, Charles Cox, Lillian S Kao, Mary T Austin
BACKGROUND/PURPOSE: The purpose of this study was to evaluate the association of insurance status on the probability of transfer of pediatric trauma patients to level I/II centers after initial evaluation at lower level centers. METHODS: A retrospective review of all pediatric trauma patients (age<16years) registered in the 2007-2012 National Trauma Data Bank was performed. Multiple regression techniques controlling for clustering at the hospital level were used to determine the impact of insurance status on the probability of transfer to level I/II trauma centers...
September 16, 2016: Journal of Pediatric Surgery
Elizabeth D Ballard, Mary Cwik, Kathryn Van Eck, Mitchell Goldstein, Clarissa Alfes, Mary Ellen Wilson, Jane M Virden, Lisa M Horowitz, Holly C Wilcox
The pediatric emergency department (ED) is a critical location for the identification of children and adolescents at risk for suicide. Screening instruments that can be easily incorporated into clinical practice in EDs to identify and intervene with patients at increased suicide risk is a promising suicide prevention strategy and patient safety objective. This study is a retrospective review of the implementation of a brief suicide screen for pediatric psychiatric ED patients as standard of care. The Ask Suicide Screening Questions (ASQ) was implemented in an urban pediatric ED for patients with psychiatric presenting complaints...
September 27, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Philippe Cavailler, Arnaud Tarantola, Yee Sin Leo, Andrew A Lover, Anne Rachline, Moniboth Duch, Rekol Huy, Ai Li Quake, Yuvatha Kdan, Veasna Duong, Jeremy L Brett, Philippe Buchy
BACKGROUND: Dengue is endemic throughout Cambodia, a country faced with significant health and economic challenges. We undertook a clinical study at the National Paediatric Hospital in Phnom Penh to evaluate clinical diagnostic parameters for dengue and predictors of disease outcome. METHODS: Between September 2011 and January 2013, all consecutive inpatients aged between 1 and 15 years and presenting with suspected dengue were enrolled. They were clinically assessed using both the 1997 and 2009 WHO dengue classifications...
2016: BMC Infectious Diseases
Alexander Leung, Patrick Bonasso, Kevin Lynch, Dustin Long, Richard Vaughan, Alison Wilson, Jorge Con
Secondary overtriage is a term that describes patients who are discharged home shortly after being transferred, an indication that transfer and hospitalization were unnecessary. The study goal was to identify factors associated with secondary triage. A statewide trauma registry was used to identify trauma patients aged less than 18 years during a 6-year period (2007-2012) who were discharged within 48 hours from arrival and did not undergo a surgical procedure. We compared those that were treated at initial facility and those transferred to a second facility using clinical indices including patterns of injury pattern using multivariate logistic regression...
September 2016: American Surgeon
Heather VanderMeulen, Jeffrey M Pernica, Madan Roy, April J Kam
Objective To assess the promptness and appropriateness of management in pediatric cases of necrotizing fasciitis (NF). Methods A retrospective chart review examined cases of pediatric NF treated at a pediatric tertiary care center over a 10-year period. Results Twelve patients were identified over the 10-year period. The median (25th to 75th centile) times to appropriate antibiotic administration, infectious disease consults, surgical consults and debridement surgeries were 2.6 (2.1-3.2), 7.7 (3.4-24.4), 4...
September 23, 2016: Clinical Pediatrics
Gillian A Beauchamp, Benjamin T Kerrey, Matthew R Mittiga, Andrea S Rinderknecht, Shan Yin
OBJECTIVE: Few studies of children with toxicological emergencies describe those undergoing acute resuscitation, and most describe exposures to single agents. We describe a 12-month sample of patients evaluated in the resuscitation area of a pediatric emergency department (ED) for a toxicological emergency. METHODS: We conducted a retrospective chart review of patients in a high-volume, academic pediatric ED. We identified patients evaluated in the ED resuscitation area for toxicological exposure and conducted structured chart reviews to collect relevant data...
September 20, 2016: Pediatric Emergency Care
Roni D Lane, Tomohiko Funai, Ron Reeder, Gitte Y Larsen
BACKGROUND AND OBJECTIVE: Septic shock impacts mortality, morbidity, and health care costs. A quality improvement (QI) initiative was launched to improve early recognition and timely treatment of patients with septic shock in a pediatric emergency department (PED). Our primary aim was to describe the longitudinal effectiveness of the program, iterative changes in clinical practice, and associated outcomes. METHODS: We implemented multiple interventions during our QI initiative (February 2007 to December 2014)...
September 7, 2016: Pediatrics
Camila Amthauer, Maria Luzia Chollopetz da Cunha
OBJETIVE: to characterize the care services performed through risk rating by the Manchester Triage System, identifying demographics (age, gender), main flowcharts, discriminators and outcomes in pediatric emergency. METHOD: cross-sectional quantitative study. Data on risk classification were obtained through a search of computerized registration data from medical records of patients treated in the pediatric emergency within one year. Descriptive statistics with absolute and relative frequencies was used for the analysis...
2016: Revista Latino-americana de Enfermagem
Ashley L Merianos, Cinnamon A Dixon, E Melinda Mahabee-Gittens
INTRODUCTION: This study aimed to determine the relationship between patients presenting to the pediatric emergency department (PED) and potential tobacco smoke exposure (TSE)-related illnesses. METHODS: A retrospective review of electronic medical records of pediatric emergency department patients (N = 116,084) was conducted. Sociodemographic characteristics, TSE-related illnesses, and TSE documentation were extracted. Logistic regression analyses were performed...
August 16, 2016: Journal of Pediatric Health Care
Emílio Carlos Elias Baracat
No abstract text is available yet for this article.
September 2016: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
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