Abstract:
OBJECTIVES:Acute asthma exacerbations are among the most common reasons for childhood emergency department (ED) visits and hospitalizations. Although early ED administration of asthma medication has been shown to decrease hospitalizations, studies of factors associated with early ED asthma medication delivery have been limited. The objective of our study was to identify patient- and ED-related factors associated with early medication delivery among children treated in the ED for asthma exacerbations. METHODS:This retrospective study used electronic health record data from all encounters for a primary diagnosis of asthma in an academic children's hospital ED during the study period 2009 to 2013. Using multivariate logistic regression, we identified the association between patient- and ED-related factors and the time to first medication defined as a binary outcome using a threshold of 1 hour from ED arrival. We then stratified our analysis by triage level (Emergency Severity Index [ESI]). RESULTS:Of the 4846 encounters during the study period, 62% were male, mean age was 7.30 years, 76% had public insurance, and 57% had an ESI level of 3. Medication was administered within 1 hour of arrival in 2236 encounters (46%). After adjusting for covariates, multivariate logistic regression revealed that patients were less likely to have medications within 1 hour when they had less severe ESI (ESI 2 vs ESI 4: odds ratio [OR], 0.139; confidence interval [CI], 0.114-0.170), arrived via non-emergency medical services (OR, 0.525; CI, 0.413-0.665), or arrived to a crowded ED (OR, 0.574; CI, 0.505-0.652). Age, sex, and insurance type were not associated with timeliness of initial medication administration. Stratified analyses demonstrated that the crowding effect was larger for less severely ill patients. CONCLUSIONS:Our study found that patient severity (acuity level, arrival mode) and level of ED crowing-but not demographic factors-are associated with the administration of medication in the first hour to pediatric patients with asthma. Our findings may be helpful in redesigning asthma care management strategies.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Jang H,Ozkaynak M,Ayer T,Sills MRdoi
10.1097/PEC.0000000000001609subject
Has Abstractpub_date
2021-01-01 00:00:00pages
e42-e47issue
1eissn
0749-5161issn
1535-1815pii
00006565-202101000-00021journal_volume
37pub_type
杂志文章abstract:INTRODUCTION:Cooperation for a diagnostic study is a frequent indication for pediatric procedural sedation. This study examines the continued need for sedation in the era of fast helical computerized tomography (CT) scanners. METHODS:Medical records of children younger than 72 months undergoing CT scans were systemati...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000159072.40067.c8
更新日期:2005-05-01 00:00:00
abstract::The use of the emergency department by children on Medicaid was documented, and the effect of new adult Medicaid criteria on a pediatric emergency department was investigated. Eight percent of daytime visits by all patients were nonemergencies, compared to 15% by Medicaid patients. More Medicaid patients required admi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198709000-00003
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Stress may impair the success of procedures in emergency medicine. The aims were to assess residents' stress during simulated and clinical lumbar punctures (LPs) and to explore the correlation of stress and performance. METHODS:A prospective study (2013-2016) was carried out in a pediatric emergency departm...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001962
更新日期:2020-01-20 00:00:00
abstract::Grunting respirations are recognized as a sign of serious illness in infants and children, but have not been well studied beyond the newborn period. We present three illustrative cases and the results of a descriptive study which elucidates the causes of grunting in infants and children and suggests guidelines for ass...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199506000-00004
更新日期:1995-06-01 00:00:00
abstract:PURPOSE:Multiple studies have documented the nonclinical characteristics of physician assistant (PA) practices in the emergency department (ED). This study examines the clinical care PAs provide to younger pediatric patients in a general community ED. METHODS:The electronic medical record database of an urban communit...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000949
更新日期:2017-01-01 00:00:00
abstract::Colchicine is an anti-inflammatory drug, which has been used for the treatment of familial Mediterranean fever for several decades with narrow therapeutic-toxicity window. Colchicine poisoning is rare but frequently a life-threatening emergency condition in pediatric practice. It may occur by excessive ingestion of co...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000545
更新日期:2015-09-01 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::Honeycomb gallbladder is a rare congenital malformation of the gallbladder. In some cases, it may be asymptomatic, whereas in others, it may lead to symptoms consistent with biliary colic even in the absence of cholelithiasis. We present the clinical and imaging findings of a case of a 10-year-old boy who was admitted...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000030
更新日期:2013-12-01 00:00:00
abstract::Obstruction caused by strangulation internal hernia secondary to incarceration within the falciform ligament, although rare, has been previously reported in the literature. These cases, however, were unrelated to trauma. We report on the first case in the pediatric literature of a strangulated internal hernia secondar...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181e15e7d
更新日期:2010-06-01 00:00:00
abstract:INTRODUCTION:Escitalopram is rarely associated with prolongation of the QTc interval; however, there are no reported cases of QRS complex widening associated with escitalopram overdose. We report a case of a patient who presented with both QRS complex widening and QTc interval prolongation after an escitalopram overdos...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a314b7
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to identify common presenting signs, symptoms, and laboratory findings of imported pediatric malaria presenting to a US pediatric emergency department (ED). METHODS:This is a retrospective chart review of all patients presenting to an urban pediatric ED between July 1, 2004, a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318276c88c
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:Determine prevalence of participation and underimmunization rate in a regional immunization registry (IR) among patients presenting to a university pediatric emergency department (PED). Rate of agreement between parental report and documented immunization status was also measured. METHODS:A convenience samp...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000125657.05196.55
更新日期:2004-05-01 00:00:00
abstract::The umbilical hernia is common in children. Most of the cases have a spontaneous regression around the age of 3 years. Complications are very rare, and thus surgery is not routinely indicated before the age of 3 years. We report an exceptional case of spontaneous rupture of an umbilical hernia with emphasis on the man...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002200
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:The aim of this study is to assess the adherence of Austrian physicians to International Society for Pediatric and Adolescent Diabetes guidelines 2009 concerning treatment in diabetic ketoacidosis and whether there is a difference between specialty (endocrinologists or intensivists) or clinical experience. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001551
更新日期:2018-07-24 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:OBJECTIVES:The study evaluates whether facial landmarks can be used to estimate an appropriate laryngoscope blade length for oral endotracheal intubation in children. We tested the hypothesis that the laryngoscope blade measuring 10 mm or less distal or proximal to the angle of the mandible (when the flat portion of th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000210171.17892.7a
更新日期:2006-04-01 00:00:00
abstract::The object of this study was to review and delineate the presenting complaints, signs, symptoms, and Emergency Department (ED) management of pediatric heart transplant recipients who presented to Loma Linda University Medical Center's (LLUMC) Emergency Department. A retrospective chart review was made of all of the pe...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199512000-00006
更新日期:1995-12-01 00:00:00
abstract::Antidotes are playing an increasing role in therapy for pediatric poisonings. Although initial response to all pediatric poisonings begins with basic stabilization, knowledge of specific antidotes, their mechanisms of action, safety profile in pediatrics, and dosing regimens can be life-saving for pediatric victims of...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000245174.21041.bc
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:To describe a case series of 4 children who developed acute rhabdomyolysis as a complication of acute respiratory failure secondary to status asthmaticus. METHODS:A retrospective review of all children who were admitted to our pediatric intensive care unit (PICU) with status asthmaticus from November 1998 t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230711.81646.7a
更新日期:2006-08-01 00:00:00
abstract::We describe two related cases of pertussis infection ("whooping cough"). This disease entity was almost completely eradicated through successful mass immunization programs. In the past decade it has demonstrated a steady rise in incidence. The epidemiology, clinical manifestations, treatment, and current vaccines for ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:
更新日期:1993-08-01 00:00:00
abstract::Ultrasonography can be useful in the evaluation of children with abdominal complaints and may be the initial imaging modality in patients presenting with a newly recognized abdominal mass. Hepatoblastoma is an uncommon cause of acute abdominal pain in children and can rarely metastasize to the heart through vascular i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001629
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Unintentional acid ingestion is less commonly encountered than alkali ingestion. The injury develops for hours to days after ingestion and often results in progressively increasing difficulty in airway management. However, gastric perforation is rare. CASE:A 3-year-old boy presented to us with an orotonsill...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000382
更新日期:2015-03-01 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:OBJECTIVE:This study aimed to determine the prevalence of complementary health approaches (CHAs) specifically for acute complaints in patients assessed in a pediatric emergency department (ED) and factors associated with use. METHODS:A cross-sectional survey was offered to patients between the age of 28 days and 18 ye...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001424
更新日期:2020-07-01 00:00:00
abstract::Candidates for fellowship training in Pediatric Emergency Medicine may be residency-trained in pediatrics or emergency medicine. The fellows who are emergency medicine-trained have different needs than those with pediatric training. Training programs for these individuals should focus on normal and abnormal developmen...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199504000-00003
更新日期:1995-04-01 00:00:00
abstract::The purpose of this study is to report 18 cases of membranous laryngotracheobronchitis (MLTB) and to review 143 published cases in order to accurately characterize the epidemiology, presentation, clinical course, treatment, and outcome of patients with this disorder. The male:female ratio was 2:1; mean age was four ye...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199112000-00004
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:To identify the source of acquisition of infant walkers and attitudes regarding the continuing use of walkers following an injury to an infant in order to design preventive strategies. DESIGN:Descriptive and retrospective. SETTING:Emergency department of a children's hospital involved in primary, secondary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199606000-00008
更新日期:1996-06-01 00:00:00
abstract::A case of Salmonella vertebral osteomyelitis with epidural abscess in a child with sickle cell anemia is presented. Spinal osteomyelitis is a rare event in children. Although osteomyelitis in sickle cell anemia may occur in any bone, it has most often been documented as beginning in the medullary cavity of the long an...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVES:The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. METHODS:We performed a secondary analys...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000421
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Evaluation of a child with POC/OC is complicated due difficulties in physical examination and risks of imaging by computed tomography. METHOD:Retrospective review of children 0-16 years admitted to the pediatric emergency department for POC/OC from 2009 to 2019. RESULTS:Ten years study period, 243 children...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002083
更新日期:2020-03-19 00:00:00