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triage pediatrics

Catherine T Recznik, Lynn M Simko
INTRODUCTION: The objective of this study was to review the currently published literature on the topic of pediatric triage education. METHOD: An integrative review of the literature was conducted using database searching and historical record review. RESULTS: A wide variety of pediatric triage educational methods exist, but studies with the highest-quality ratings most often used simulation programs or a standardized curriculum. Although there was a good deal of heterogeneity in terms of the outcomes measured, the accuracy of triage improved following educational interventions...
March 6, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Sarah B Cairo, Malachi Fisher, Brian Clemency, Charlotte Cipparone, Evelyn Quist, Kathryn D Bass
PURPOSE: Patient triage to the appropriate destination is critical to prehospital trauma care. Triage decisions are challenging in a region without collocated pediatric and adult trauma centers. METHODS: A regional survey was administered to emergency medical response units identifying variability and confusion regarding factors influencing patient disposition. A course was developed to guide the triage of pediatric and pregnant trauma patients. Pre- and posttests were administered to address course principles, including decision making and triage...
February 11, 2018: Journal of Pediatric Surgery
Holger Moch, Riuko Ohashi, Jatin S Gandhi, Mahul B Amin
An important emerging role of the surgical pathologist besides the traditional tasks of establishment of the diagnosis and documentation of prognostic and predictive factors, is to recognize the possibility of a hereditary condition in cases where the histology is suggestive for a familial cancer syndrome. In recent years, the knowledge regarding all of the above roles, including the role of recognition of familial cancer, has particularly expanded in renal neoplasms with the close scrutiny to morphology, molecular correlates and clinical features of the different sub-types of renal cell carcinoma...
February 14, 2018: Seminars in Diagnostic Pathology
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Botswana is notable among countries with high rates of Road Traffic Collisions (RTC); like many other lower-middle-income countries (LMICs), it lacks trauma systems. The World Health Organization recommends 'Essential Trauma Care' in countries with no formal trauma systems. The proportion of injuries in Emergency Departments and the care process were investigated to gain an overview for enabling the design of a relevant LMICs trauma system. METHOD: Blunt and penetrating trauma patients were included from three major hospitals, examining the proportion of injuries, patient characteristics, the care process and comparing these between pediatrics and adults...
February 15, 2018: World Journal of Surgery
Chiaki Toida, Takashi Muguruma, Takeru Abe, Mafumi Shinohara, Masayasu Gakumazawa, Naoki Yogo, Aya Shirasawa, Naoto Morimura
BACKGROUND: Triage has an important role in providing suitable care to the largest number of casualties in a disaster setting, but there are no secondary triage methods suitable for children. This study developed a new secondary triage method named the Pediatric Physiological and Anatomical Triage Score (PPATS) and compared its accuracy with current triage methods. METHODS: A retrospective chart review of pediatric patients under 16 years old transferred to an emergency center from 2014 to 2016 was performed...
February 12, 2018: Prehospital and Disaster Medicine
Sandra R DiBrito, Marcelo Cerullo, Seth D Goldstein, Susan Ziegfeld, Dylan Stewart, Isam W Nasr
BACKGROUND: Discordant assessments of Glasgow Coma Score (GCS) following trauma can result in inappropriate triage. This study sought to determine the reliability of prehospital GCS compared to emergency department (ED) GCS. METHODS: We conducted a retrospective review of traumas from 01/2000 to 12/2015 at a Level-1 pediatric trauma center. We evaluated reliability between field and ED GCS using Pearson's correlation. We ascertained the difference between prehospital and ED GCS (delta-GCS)...
January 31, 2018: Journal of Pediatric Surgery
J Herman Kan, Robert C Orth, Terry A Yen, Erica K Schallert, Wei Zhang, Lane F Donnelly
PURPOSE: The proliferation of pediatric urgent care centers has increased the need for diagnostic imaging support, but the impact of employing radiology technologists at these centers is not known. The purpose of this study was to evaluate radiographic impact and quality at urgent care centers with and without radiology technologists. METHODS: A retrospective case-control study was conducted comparing 235 radiographic examinations (study) performed without and 83 examinations (control) performed with a radiology technologist at the authors' pediatric urgent care centers...
February 2, 2018: Journal of the American College of Radiology: JACR
Tanya Holt, Nazmi Sari, Gregory Hansen, Matthew Bradshaw, Michael Prodanuk, Veronica McKinney, Rachel Johnson, Ivar Mendez
BACKGROUND: Providing acutely ill children in isolated communities access to specialized care is challenging. This study aimed to evaluate remote presence robotic technology (RPRT) for enhancing pediatric remote assessments, expediting initiation of treatment, refining triaging, and reducing the need for transport. METHODS: We conducted a pilot prospective observational study at a primary/urgent care clinic in an isolated northern community. Participants (n = 38) were acutely ill children <17 years presenting to the clinic, whom local healthcare professionals had considered for interfacility transportation (IFT)...
February 2, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Reiko Kawai, Osamu Nomura, Yutaro Tomobe, Yoshihiko Morikawa, Koichi Miyata, Hiroshi Sakakibara, Masaru Miura
AIM: We examined whether the paediatric assessment triangle (PAT) could predict the severity of Kawasaki disease. METHODS: We enroled patients diagnosed with Kawasaki disease between July 2012 and June 2016 at the emergency department of Tokyo Metropolitan Children's Medical Center in Tokyo, Japan. Triage nurses assigned participants to unstable or stable PAT groups. We compared the incidence of coronary artery aneurysms (CAA), the Kobayashi score, which measures resistance to intravenous immunoglobulin treatment, and the incidence of initial treatment resistance...
January 31, 2018: Acta Paediatrica
Emel Ataş Berksoy, Özlem Bağ, Selçuk Yazici, Tanju Çelik
We compared the accuracy and utility of 3 infrared (IFR) thermographs fitted with axillary digital thermometers used to measure temperature in febrile and afebrile children admitted to an emergency triage room.A total of 184 febrile and 135 afebrile children presenting to a triage room were consecutively evaluated. Axillary temperature was recorded using a digital electronic thermometer. Simultaneously, IFR skin scans were performed on the forehead, the neck (over the carotid artery), and the nape by the same nurse...
February 2018: Medicine (Baltimore)
Anna Lin, Kristine Taylor, Ronald S Cohen
OBJECTIVE: To develop a disaster triage tool for the evacuation of hospitalized neonatal and pediatric populations. METHODS: We expanded an existing neonatal disaster triage tool for the evacuation of a children's hospital. We assessed inpatients using bedside visual assessments and chart review to categorize patients transport level based on local emergency medical services protocols and expert opinion. The tool was refined by using multiple Plan Do Study Act cycles...
January 31, 2018: Disaster Medicine and Public Health Preparedness
Kristin Schoolman-Anderson, Roni D Lane, Jeff E Schunk, Nancy Mecham, Richard Thomas, Kathleen Adelgais
BACKGROUND: Pain management guidelines in the emergency department (ED) may reduce time to analgesia administration (TTA). Intranasal fentanyl (INF) is a safe and effective alternative to intravenous opiates. The effect of an ED pain management guideline providing standing orders for nurse-initiated administration of intranasal fentanyl (INF) is not known. The objective of this study was to determine the impact of a pediatric ED triage-based pain protocol utilizing intranasal fentanyl (INF) on time to analgesia administration (TTA) and patient and parent satisfaction...
January 16, 2018: American Journal of Emergency Medicine
Andrea N Doud, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, John K Petty, Joel D Stitzel, Ashley A Weaver
BACKGROUND: Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC)...
January 19, 2018: Accident; Analysis and Prevention
Youwei Li, Qunfeng Lu, Hua Du, Jianping Zhang, Lingling Zhang
OBJECTIVE: To identify the need to revise the program triage nurse-ordered diagnostic tests in the emergency department (ED) of pediatric hospital, and to evaluate implementation of this program with three laboratory routine tests, namely blood, urine and stool, which the triage nurses ordered as relevant to pediatric patients' symptoms. METHODS: The authors retrospectively reviewed the data of patients who registered in their ED between December 2015 and April 2016, including the tests as per the orders by triage nurses, and the time they arrived and the time they had their final payments...
January 24, 2018: Indian Journal of Pediatrics
Itai Gross, Daniel J Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BACKGROUND: Electric bike (e-bike) usage is growing worldwide, and so is the e-bike-related injury rate. OBJECTIVE: This study was undertaken to characterize e-bike-related injuries. METHODS: Data of all e-bike-related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike-related injuries were then analyzed separately and compared. RESULTS: Forty-eight patients suffering from e-bike-related injuries presented to our trauma center between January 1, 2014 and December 31, 2016...
January 15, 2018: Journal of Emergency Medicine
Felicity Fitzgerald, Kevin Wing, Asad Naveed, Musa Gbessay, J C G Ross, Francesco Checchi, Daniel Youkee, Mohamed Boie Jalloh, David E Baion, Ayeshatu Mustapha, Hawanatu Jah, Sandra Lako, Shefali Oza, Sabah Boufkhed, Reynold Feury, Julia Bielicki, Elizabeth Williamson, Diana M Gibb, Nigel Klein, Foday Sahr, Shunmay Yeung
We compared children who were positive for Ebola virus disease (EVD) with those who were negative to derive a pediatric EVD predictor (PEP) score. We collected data on all children <13 years of age admitted to 11 Ebola holding units in Sierra Leone during August 2014-March 2015 and performed multivariable logistic regression. Among 1,054 children, 309 (29%) were EVD positive and 697 (66%) EVD negative, with 48 (5%) missing. Contact history, conjunctivitis, and age were the strongest positive predictors for EVD...
February 2018: Emerging Infectious Diseases
Yurena Aguilar de la Red, Gema Manrique Martín, Gloria Guerrero López, Concepción González Herrero, Paula López Vázquez, Concepción Míguez Navarro
INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered...
February 1, 2018: Archivos Argentinos de Pediatría
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Shu-Ling Chong, Gene Yong-Kwang Ong, Wendy Yi Wen Chin, John Mingzhou Chua, Praseetha Nair, Alicia Shu Zhen Ong, Kee Chong Ng, Ian Maconochie
OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED...
2018: PloS One
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