Abstract:
OBJECTIVE:The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation. METHODS:We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents of children presenting with asthma exacerbation. The treating provider completed a survey after finishing the examination and immediately upon exiting the patient's room. Providers predicted the disposition of the child. Additionally, the providers indicated the likelihood of admission using several 10-cm visual analog scales (VASs). Physician accuracy was calculated, and logistic regression models and receiver operator characteristic curves were generated. RESULTS:Complete data were available for 177 subjects. Medical doctors/nurse practitioners made correct predictions in 129 (79.6%; 95% confidence interval [CI], 73.4-85.8) of 162 encounters. Respiratory therapists were correct in 69 (67.6%; 95% CI, 58.6%-76.7%) of 102 encounters, and parents were correct in 116 (67.4%; 95% CI, 60.4%-74.4%) of 172 encounters. Logistic regression with disposition as the dependent variable revealed that provider VAS for likelihood of admission (odds ratio, 23.717; 95% CI, 9.298-60.495) was associated with admission. A receiver operator characteristic curve generated for actual disposition versus "likelihood of admission" VAS had an area under the curve of 0.856 (95% CI, 0.793-0.919). For admission, a VAS of greater than 7 was 89.9% specific, greater than 7.6 was 92.9% specific, and greater than 8.6 was 96% specific. CONCLUSIONS:Emergency department providers correctly predicted disposition 80% of the time. Providers were particularly likely to correctly predict admission. A VAS score of 7 or greater is nearly 90% specific for admission, with specificity increasing at higher values.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Caperell K,Pettigrew J,Gerughty A,Stevenson Mdoi
10.1097/PEC.0000000000001723subject
Has Abstractpub_date
2019-02-01 00:00:00pages
108-111issue
2eissn
0749-5161issn
1535-1815pii
00006565-201902000-00005journal_volume
35pub_type
杂志文章abstract::Unwind or incise has been the standard of management for removing hair tourniquets. The hair ends are usually difficult to hold and unwind as they break at the ends easily, and using scalpels or needles to get under the hair tourniquet is difficult when the involved appendage is swollen and leads to more trauma to the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820d65b7
更新日期:2011-03-01 00:00:00
abstract::Bone and joint infection complicating tuberculosis is most likely to involve vertebrae. Pott disease, or tuberculous spondylitis, represents a small proportion of tuberculosis cases, but it can be associated with significant morbidity and mortality. Our case report details Pott disease in a teenage girl, which present...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181fb0e38
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Few studies have addressed the presentation and clinical impact of pediatric pelvic fractures. We sought to describe pediatric blunt trauma patients with pelvic fracture (PF) and to evaluate the sensitivity and specificity of physical examination at presentation for diagnosis. METHODS:Retrospective analysis...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200102000-00004
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:This study aimed to determine the most important reasons for pediatric nonurgent (NU) emergency department (ED) visits as perceived by caregivers, primary care pediatricians (PCPs), and ED personnel and to assess the differences among these 3 groups in perceived reasons and solutions to NUED visits. METHODS...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823f2412
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:National guidelines for routine pediatric acute asthma care recommend providing corticosteroids, and discourage routinely obtaining chest radiographs (CXRs) and using antibiotics. We examined rates of adherence to all 3 of these aspects during emergency department (ED) visits and compared performance between...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001706
更新日期:2019-01-07 00:00:00
abstract::Astemizole (Hismanal-Janssen, New Brunswick, NJ) is a nonsedating antihistamine that has the advantage of a once-daily dosage schedule. This article reports the case of a 14-year-old female who intentionally ingested 270 mg of Astemizole and developed torsade de pointes, a form of polymorphic ventricular tachycardia t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199302000-00008
更新日期:1993-02-01 00:00:00
abstract::Pneumomediastinum is a relatively uncommon occurrence in pediatric patients. After mediastinal air leak, air may dissect through a variety of tissue planes within the chest, neck, and abdomen. We report the case of a 16-year-old adolescent boy who presented with spontaneous pneumomediastinum accompanied by the presenc...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31828a38ad
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Injury and poisoning from metallic mercury has become a rare event. Review of the literature and a case report of pediatric metallic mercury injury are presented. DESIGN:A case report. SETTING:The Emergency Department at St. Louis Children's Hospital. PATIENTS OR PARTICIPANTS:A 15-year-old boy. INTERVENTI...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199704000-00008
更新日期:1997-04-01 00:00:00
abstract::Ménétrier disease is a protein-losing gastroenteropathy, characterized clinically by nonspecific gastrointestinal symptoms and generalized edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. Distinct from its adult counterpart, Ménétrier disease of childhood usually remits spontaneou...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e3181887e89
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:Blood culture contamination rates (CRs) in emergency departments (EDs) vary from 1% to 9% in previous studies. High CRs cause unnecessary admissions, antibiotics, and costs. Different measures have been tried to improve CR. This study sought to determine the ED CR at Arkansas Children's Hospital (ACH) and eva...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318230285b
更新日期:2011-10-01 00:00:00
abstract: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 child...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000877
更新日期:2017-12-01 00:00:00
abstract::When an emergency medicine physician evaluates a child with abdominal pain and a history of appendectomy, appendicitis is often excluded from the differential. We present a case of a 16-year-old boy who developed stump appendicitis 3 years after laparoscopic appendectomy. Knowledge of this rare phenomenon in children ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31827b54db
更新日期:2013-01-01 00:00:00
abstract::A 4-year-old boy, who had no prior history of convulsions, presented with inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation) following the instillation of 1% cyclopentolate, a commonly used mydriatic in pediatric practice. This case demonstrates the uncommon, alt...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182417a63
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:This study aimed to assess physician comfort, knowledge, and implementation barriers regarding the use of intranasal fentanyl (INF) for pain management in patients with long-bone fractures in a pediatric emergency department (ED) with an INF pain pathway. METHODS:A retrospective chart review was conducted o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001375
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:Superior mesenteric artery syndrome (SMAS) is a rare cause of small intestinal obstruction in pediatric patients. Children with intellectual disabilities are a challenging patient population in which to make this diagnosis. The goal of this study was to determine the frequency, presenting symptoms, and outco...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31824d9bc5
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To obtain social and cultural data about factors affecting the development of Emergency Medical Services for Children (EMS-C) in La Paz, Bolivia. The points-of-view of potential consumers and providers were sought. METHODS:A Rapid Assessment Procedure (RAP) was conducted. RAP is a qualitative ethnographic te...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000142950.58265.15
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to describe a single institutional experience with pediatric diffuse pulmonary hemorrhage, with an emphasis on etiology, clinical course, and outcome. METHODS:The medical records of pediatric patients admitted to Assaf Harofeh Medical Center between the years 2002 and 2011 beca...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318271c107
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:The emergency department (ED) can be an effective site for pediatric injury prevention initiatives, including child passenger safety. The objectives of this study were to evaluate the implementation of an ED child passenger safety program and to analyze the effectiveness of a computerized screening tool to i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000210
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitai...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001045
更新日期:2019-09-01 00:00:00
abstract::To determine the accuracy and reliability of a labeled leukocyte imaging technique in the early diagnosis of pediatric appendicitis, we prospectively studied patients presenting to the pediatric emergency department with abdominal pain suggestive of appendicitis. Patients scheduled for urgent laparotomy were excluded,...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199510000-00005
更新日期:1995-10-01 00:00:00
abstract::We describe the first ziprasidone overdose with quantitative serum levels of a pediatric patient in coma and with pinpoint pupils. This case is an important contribution to the pediatric ziprasidone literature because it illustrates that ingestion of just 1 pill may result to profound mental status and respiratory dep...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819e3775
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:To assess the effect of adding a shared research nurse on patient enrollment in an ongoing clinical study. DESIGN:Before/after comparison of recruitment rates and consent rates involving patients eligible for a study of blood culture collection strategies for methods on the detection of bacteremia and deter...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199610000-00004
更新日期:1996-10-01 00:00:00
abstract::Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and the most common cause of gastrointestinal bleeding in children. Although it usually follows the rule of 2's, exceptions to this rule are reported in the literature. Often asymptomatic, MD is commonly an incidental finding ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001388
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment. METHODS:We conducted a prospective, randomized comparison of treatments of fecal impaction in children in a pediatric emergency department (ED). Treatment arms were a single milk and m...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e3182442c0a
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:To develop the infrastructure and demonstrate the feasibility of conducting microarray-based RNA transcriptional profile analyses for the diagnosis of serious bacterial infections in febrile infants 60 days and younger in a multicenter pediatric emergency research network. METHODS:We designed a prospective ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000324
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The utility of testing for urinary tract infection (UTI) in febrile infants with bronchiolitis is indeterminate. OBJECTIVE:The objective of this study was to investigate if the incidence of UTIs in febrile infants 2 to 12 months of age with bronchiolitis is higher than the presumed incidence of asymptomatic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001912
更新日期:2019-12-03 00:00:00
abstract:OBJECTIVES:Head trauma is one of the main causes of death in childhood and often leaves severe disability with serious neurological damage. Appropriate treatment must be provided immediately to improve outcomes. This study was performed to identify factors associated with a poor prognosis at an early stage of severe he...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000001321
更新日期:2018-12-01 00:00:00
abstract::Guidelines for Pediatric Emergency Medicine (PEM) fellowship programs were published by the Curriculum Subcommittee, Section of Emergency Medicine, American Academy of Pediatrics in February 1993. The guideline listed 120 technical skills that the subcommittee felt all fellows should be able to perform at the completi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199602000-00003
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:Treating or referring patients who are found to be anemic during pediatric emergency department (ED) encounters should lead to improved health in children and young adults. Before establishing guidelines how to approach the anemic in the pediatric ED, it is essential to determine the prevalence of anemia in t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31824d8a2f
更新日期:2012-04-01 00:00:00
abstract::The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual nee...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001050
更新日期:2017-03-01 00:00:00