Abstract:
INTRODUCTION:Since 1987 the average length of stay for infants following hospital delivery has decreased 1.8 days. This study was undertaken to evaluate the null hypothesis that early discharge of newborns from nurseries does not result in increased emergency department (ED) utilization during the first 10 days of life. SITE: Thirty community EDs, one university ED. METHODS:Retrospective review of ED visits of patients two to 10 days of age from 1989 to 1995. The absolute number of ED neonatal visits (NVs) was compared to the total number of ED visits for each year and the ratio of NV/10,000 ED visits determined. The disposition and diagnosis of each patient was noted, and the number and percent of infants admitted to the hospital calculated. RESULTS:A total of 3.1 million ED visits were reviewed, and 2094 NVs identified. The ratio of NV/10,000 ED visits increased from 4.3 in 1989 to 7.8 in 1995 (P < 0.001), while the average length of stay for deliveries decreased from 2.79 days to 1.85 days. The mean percent of patients admitted from the ED was 10.3% and showed no statistically significant changes over the study period. The majority of visits were for minor medical or educational problems. CONCLUSION:The null hypothesis is rejected. Early discharge of neonates does result in increased ED utilization. No increase in admission rates for these infants was documented, indicating that patient severity did not increase with ED utilization. There is a need for improved predischarge education and greater access for episodic ambulatory complaints.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Sacchetti AD,Gerardi M,Sawchuk P,Bihl Idoi
10.1097/00006565-199712000-00001subject
Has Abstractpub_date
1997-12-01 00:00:00pages
365-8issue
6eissn
0749-5161issn
1535-1815journal_volume
13pub_type
杂志文章abstract::Foreign body aspirations in children are relatively uncommon occurrences, but they can be a serious events, causing respiratory distress, atelectasis, chronic pulmonary infections, or death. Safety pins are not commonly aspirated objects and account for less than 3% of all foreign bodies found in the tracheobronchial ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199712000-00011
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare the sensitivity and specificity of 2- and 4-film x-ray series when interpreted by pediatric emergency medicine physicians in the diagnosis of skull fracture in children. METHODS:A noninferiority crossover study was performed. The skull radiographs of the 50 most rec...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a9f7c1
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:Although child abuse pediatricians are frequently asked to evaluate risk of abuse based on photographs, the effect of photographic quality on this process is presently unknown. Photographs of abused children are often taken by professionals without photographic training, and quality varies widely. This artic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31828e848e
更新日期:2013-05-01 00:00:00
abstract: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 electri...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000991
更新日期:2019-08-01 00:00:00
abstract::The development of leadership and management skills requires a commitment to personal introspection and the development of self-knowledge. Difficult decisions concerning the determination of that which is truly important is central to the process. At both the personal and organizational levels, this process can be fac...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199506000-00014
更新日期:1995-06-01 00:00:00
abstract::We present a case of a six-week-old infant who developed life-threatening complications after unintentional sodium bicarbonate intoxication. Baking soda was being used by the mother as a home remedy to "help the baby burp." A review of the literature regarding the use (or misuse) of baking soda follows. Our patient, a...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:
更新日期:1995-04-01 00:00:00
abstract::Necrotizing soft tissue infections are a serious medical emergency that involve necrosis within the soft tissue space including the dermis, subcutaneous tissue, superficial fascia, deep fascia, and muscle. Inciting factors include recent varicella infection, omphalitis, trauma, intramuscular injections, perianal traum...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001888
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Guidelines from the American Academy of Pediatrics define urinary tract infection (UTI) as the growth of greater than 50,000 ufc/mL of a single bacterium in a urine culture with a positive urine dipstick or with a urinalysis associated. Our objective was to evaluate the adequacy of this cutoff...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000935
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The time window for possible salvage and survival of a torsed testicle is commonly thought to be 6 to 8 hours. However, survival of torsed testicles with or without subsequent atrophy is known to occur outside that critical time window. In this article, we performed a systematic review of the English literat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001287
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to determine whether adolescents in emergency departments (EDs) who report engaging in high-risk sexual behaviors are less likely to identify a primary care provider (PCP) and more likely to access the ED than their sexually inexperienced peers. METHODS:This was a secondary a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001456
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries. DESIGN:A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006. SETTING:The C...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181cd7f3f
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Pediatric traumatic brain injury (TBI) and abusive head trauma (AHT) are leading causes of morbidity and mortality. Clinicians may not be aware of AHT at presentation to the emergency department (ED). OBJECTIVE:The objective of this study was to determine which clinical features associated with head injury ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002239
更新日期:2020-09-10 00:00:00
abstract:OBJECTIVES:The Internet may be the first source of information used by parents during a suspected poisoning of their children. Our primary aim was to assess the reliability of the Internet as a resource for information for parents to initially manage a suspected poisoning involving their child without outside consultat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000022
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:There have been increasing job opportunities for pediatric emergency medicine (PEM) specialists within community emergency departments (CEDs), where 90% of children receive emergency care. The majority of training for PEM fellows occurs in academic children's hospitals, which may expose fellows to different r...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002103
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVES:In 1997, a Canadian task force published evidence-based guidelines for diagnosing pediatric pneumonia, concluding that the absence of each of four signs (ie, respiratory distress, tachypnea, crackles, and decreased breath sounds) accurately excludes pneumonia. The study was performed to evaluate the accuracy...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00003
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVES:To examine attitudes toward the use of oral rehydration therapy (ORT) by pediatric emergency medicine physicians before and after being given recent data that might affect their practice and to see if there is a difference in responses based upon year of graduation from medical school. METHODS:A national su...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318149f66f
更新日期:2007-09-01 00:00:00
abstract::Two children who presented with fever, rash, and hypotension were found to have group A beta hemolytic streptococcal toxic shock syndrome. These cases are reported to remind physicians who care for acutely ill children that exotoxin-producing streptococci can produce clinical features and multisystem failure similar t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199208000-00008
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:Forearm fractures are common injuries in children. Displaced and angulated fractures usually require reduction. Ultrasound diagnosis and guided reduction offer several potential advantages: (1) the procedure does not involve ionizing radiation; (2) compared with fluoroscopy units, the newer ultrasound units ...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章
doi:10.1097/PEC.0b013e318128f85d
更新日期:2007-08-01 00:00:00
abstract::Foreign body ingestion is a common occurrence in children. Morbidity associated with ingestion is rare and is dependent on the type of foreign body ingested. We report a case of a 9-year-old boy who developed intestinal obstruction and perforation following ingestion of magnetic-backed earrings. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000134926.03030.a7
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:Patients returning to the emergency department (ED) within 72 hours of their visit may contribute to crowding and might indicate failure to give a proper assessment, treatment, or follow-up instructions. The aim of this study was to describe the rate of return visits in a tertiary care pediatric ED (PED) and...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230553.01917.05
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Life-saving procedures are rarely performed on children in the emergency department, making it difficult for trainees to acquire the skills necessary to provide proficient resuscitative care for children. Studies have demonstrated that residents in general pediatrics and emergency medicine lack exposure to p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002195
更新日期:2020-08-28 00:00:00
abstract:OBJECTIVES:Fever in young infants frequently triggers a laboratory evaluation because of the increased likelihood of serious bacterial infections. Reported fever by methods other than rectal thermometry is of concern. This study evaluates the validity of perceived, pacifier, and temporal artery (TA) temperatures. METH...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000086231.54586.15
更新日期:2003-08-01 00:00:00
abstract::Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubat...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000093
更新日期:2014-03-01 00:00:00
abstract:STUDY OBJECTIVE:To document the current epidemiology of pediatric injury-related deaths in a rural state and evaluate changes over time. DESIGN:Retrospective review of injury-related deaths in children less than 15 years of age. Data were obtained from death certificates and coroner, autopsy, prehospital, and hospital...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199812000-00002
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:Human immunodeficiency virus (HIV) continues to be a significant public health concern for adolescents and young adults. Since 2006, the Centers for Disease Control and Prevention has recommended more aggressive routine screening for HIV for patients presenting to the emergency department (ED). Our objectives...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182767add
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxic megacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000444
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:To develop and validate predictive models to determine the need for hospitalization in children treated for acute asthma in the emergency department (ED). METHODS:Prospective cohort study of children aged 2 years and older treated at 2 pediatric EDs for acute asthma. The primary outcome was successful ED di...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e31818c268f
更新日期:2008-11-01 00:00:00
abstract::Scorpion envenomation is a dangerous and common global event that can result in a variety of toxic clinical effects. These are typically managed with supportive care or antivenom. Antivenom use is controversial because of conflicting evidence of effectiveness for adrenergic toxicity. However, both controlled and uncon...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182228dfa
更新日期:2011-07-01 00:00:00
abstract::Recent epidemiological studies have shown that childhood back pain is a common complaint often prompting medical attention and that it is infrequently the result of serious etiology. This challenges the traditional view that childhood back pain was an uncommon and ominous symptom, always indicative of significant path...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181f054a9
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Described since 1939 in the adult population, spontaneous pneumomediastinum is less known in children. Because of its symptoms and a generally benign evolution, it is probably an underestimated diagnosis. However, it has to be considered in the differential diagnosis of acute thoracic pain. METHODS:The in...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000625
更新日期:2017-05-01 00:00:00