Abstract:
OBJECTIVES:High patient volumes have a deleterious effect on care in the pediatric emergency department (PED). Our study assessed the motivation for PED visits that could have been assessed by a primary care physician. METHODS:We identified a convenience sample of patients presenting to the SickKids Hospital PED in June and July 2011 with a Paediatric Canadian Triage and Acuity Score 4 or 5. Patients completed a forced answer yes/no survey describing potential motivators for visiting the PED. Visit appropriateness was determined by a modified version of the DeAngelis tool, an explicit criteria-based tool frequently used for this purpose. RESULTS:Of the included 635 patients with Paediatric Canadian Triage and Acuity Score 4 and 5, 25% were truly inappropriate as per DeAngelis criteria. Of these, perceived expertise at the tertiary care hospital (93.1%) and ease of getting tests (80.8%) were the most common reasons behind PED presentation. CONCLUSIONS:Patients presenting to our PED typically have primary care physicians; however, access to their physicians during off-hours and availability of off-site testing is limited. Public policy aimed at decreasing overcrowding in the PED should address these themes.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Haasz M,Ostro D,Scolnik Ddoi
10.1097/PEC.0000000000001598subject
Has Abstractpub_date
2018-09-01 00:00:00pages
647-649issue
9eissn
0749-5161issn
1535-1815pii
00006565-201809000-00010journal_volume
34pub_type
杂志文章abstract::Retropharyngeal abscess is a rather rare, deep-neck infection of children and may seriously compromise the airway and mimic other diseases. A retrospective review of 17 cases of retropharyngeal abscess presenting to The Children's Hospital, Denver, from 1976 to 1986 was performed. Nine children (56%) had stridor or ai...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198803000-00003
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations have altered practice. We sought to determine if a temporal change exists in the number of prehospital pediatric trauma intubations since the 20...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000759
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:This study aimed to describe the epidemiology of headache in children attending a community mixed adult-pediatric emergency department (ED) in Australia with a view to providing scoping data for future headache-related projects for the pediatric ED research networks. METHODS:This is a retrospective cohort st...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002000
更新日期:2020-01-21 00:00:00
abstract:BACKGROUND:Extreme leukocytosis, defined as a peripheral white blood cell count greater than 25,000/mm, may alarm clinicians and prompt extensive evaluation in infants with fever, especially in the pediatric emergency department. METHODS:We reviewed data from children aged 3 to 36 months with extreme leukocytosis, fev...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000454
更新日期:2015-06-01 00:00:00
abstract::Yersinia enterocolitica infection, or yersiniosis, is a common cause of gastroenteritis in developing nations, but the disease is less common in the developed world. Yersiniosis typically presents as a self-limited gastroenteritis in an immunocompetent patient and rarely progresses to the more fulminant disseminated f...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001873
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Poisoning is the leading cause of injury death in pediatric patients. Hospital and provider readiness, including pharmacy stocking, depends on reliable surveillance data describing local patterns of age-specific clinically significant exposures and the therapeutic modalities employed in their t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001893
更新日期:2019-08-23 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::We applied pediatric pneumatic antishock trousers to five young patients who had severe pelvic fractures with evidence of significant retroperitoneal hemorrhage. The trousers were in place for 24 to 96 hours. Utilization of the trousers resulted in stabilization of vital signs and appeared to have decreased ongoing pe...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198706000-00006
更新日期:1987-06-01 00:00:00
abstract::Adolescents infected with the human immunodeficiency virus (HIV) often confront the clinician with difficult medical problems. Besides the host of opportunistic infections, which can affect these patients, side effects from medications can be frequent and, at times, life-threatening. We report a case of aseptic mening...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199706000-00010
更新日期:1997-06-01 00:00:00
abstract::Meningoencephalitis and acute disseminated encephalomyelitis (ADEM) are both neurological disease processes, but there have been few cases of meningoencephalitis progressing to ADEM in the pediatric population. A case of a 4-year-old girl with an initial diagnosis of meningoencephalitis is presented here, whose initia...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000107
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Immobilization of torus fractures of the distal forearm, for 1 to 4 weeks in a slab, cast, or splint, produces good radiological and functional outcomes. This study assesses the pain associated with 2 forms of immobilization used for these injuries. METHODS:A randomized controlled trial comparing fiberglass...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e318163db13
更新日期:2008-02-01 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::The differential diagnosis for patients presenting in shock can be broad, making rapid diagnosis and management challenging. We present a case of a medically complex patient with presumed septic shock, diagnosed with a large pericardial effusion with evidence of tamponade using the rapid ultrasound in shock and hypote...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001891
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The goal of this retrospective cohort study of pediatric patients exposed to flumazenil was to identify the frequency of seizures. METHODS:Included patient were those aged 12 years or younger who received flumazenil, who had evidence of clinical poisoning as defined by an altered mental status, and who were ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182531d0d
更新日期:2012-05-01 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:INTRODUCTION:Viral gastroenteritis with dehydration is one of the most frequent reasons for visits to pediatric emergency departments (ED). Parental intervention before presentation to the ED can make a significant difference in the course of a child's illness. There is a discrepancy between medical knowledge of dehydr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/pec.0b013e3181d6d9de
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Somatization is associated with increased health care use in adults. Whether mothers with somatic symptoms use more health care resources for their children has not been investigated. OBJECTIVE:This study aimed to explore the association of maternal somatic symptoms and emergency department (ED) use. DESIG...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182809a10
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:This study examined whether the withdrawal of over-the-counter cough and cold medication labeled for use in children younger than 2 years in October 2007 and the warning against use of the products in children younger than 4 years in October 2008 affected cough and cold medication ingestions by young children...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3182587b0c
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:As emergency department (ED) waiting times and volumes increase, substantial numbers of patients leave without being seen (LWBS) by a physician. The objective of this study was to identify ED conditions reflecting patient input, throughput, and output associated with the number of patients who LWBS in a pedi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a5cbc2
更新日期:2013-10-01 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::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
abstract::A 10-year-old boy presented with a 2.5-week history of right leg pain and limp. A right flank mass was noted by a parent on the day of presentation. The child's past medical history was remarkable for perforated appendicitis treated with an interval laparoscopic appendectomy 2 years before this presentation. Abdominal...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181f39d84
更新日期:2010-10-01 00:00:00
abstract::Priapism is an adverse effect of medications used to treat psychiatric disorders. Often, this condition is self-limiting but may require urologic intervention involving aspiration and injection to induce detumescence. A case of a 15-year-old patient with priapism secondary to a long-acting stimulant is presented to de...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000485
更新日期:2015-07-01 00:00:00
abstract::The etiology of acute liver failure varies widely in children, but the most common causes are viral hepatitis, drugs, and toxins. We report herein a case of autoimmune hepatitis and acute liver failure caused by leptospirosis, which is involved rarely in etiology. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182309e79
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Literature demonstrates that pediatric residents are not graduating with procedural confidence and competency. This was confirmed with our own institution's Accreditation Council for Graduate Medical Education and internal surveys. Our primary objective was to improve procedural confidence among pediatric re...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002324
更新日期:2020-12-21 00:00:00
abstract::Dilutional hyponatremia, although not uncommon, is an underestimated problem in the pediatric population. In most cases, it results from excessive hydration or water retention, also described as the so-called water intoxication. One of the most known causes is the use of desmopressin in enuretic children. This drug en...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181e5bf9e
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:The National Pediatric Readiness Project of the Emergency Medical Services for Children surveyed emergency departments in the United States in 2013 for readiness to provide emergency care to children. However, that survey did not query for many elements considered essential to Advanced Trauma Life Support (A...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002144
更新日期:2020-06-09 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:OBJECTIVE:Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METH...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001249
更新日期:2017-09-01 00:00:00
abstract::Children who seek attention for painful or painless alteration of gait provide a challenge to the emergency department physician who confronts such cases. Children with acute onset of limp or refusal to walk may become the center of diagnostic and therapeutic concern in approximately 4 percent of pediatric patient enc...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198503000-00003
更新日期:1985-03-01 00:00:00