Abstract:
OBJECTIVES:Emergency medical services (EMS) prenotifications are critical, although they oftentimes inaccurately convey the arriving patient's true acuity, resulting in inappropriate preparation in the emergency department. The objectives of this study were (1) to determine interrater reliability of acuity prediction based on prenotifications among physicians and (2) to compare predicted versus actual patient acuity based on prenotifications. METHODS:A panel of physicians reviewed recordings of EMS prenotifications and then predicted the patient's acuity using the Emergency Severity Index (ESI). The scores were analyzed for interrater reliability using the weighted κ statistic. In the prospective phase of the study, physicians predicted an ESI before patient arrival based solely on the EMS prenotification and then calculated an actual ESI upon arrival. Descriptive statistics were calculated, and comparisons between the predicted and actual ESI were performed using Wilcoxon signed rank for matched pairs. RESULTS:Panelists reviewed a total of 23 recordings, and the interrater reliability was 0.23 overall (SE, 0.026; P < 0.001), indicating only fair agreement. One hundred patients were enrolled in the prospective analysis. There was a statistically significant difference between the predicted and actual ESI made by physicians (P = 0.0001). For 46 patients, the predicted and actual scores matched, but 13 patients were "undertriaged," and 41 patients were "overtriaged" based on predicted acuity. CONCLUSIONS:Interpretation of acuity using EMS prenotifications among physicians was only fairly reliable, and physicians had difficulty predicting actual acuity based on prenotifications. Improper preparation based on these prenotifications can potentially impact patient care and resource allocation.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Williamson K,Gochman R,Bullaro F,Kaufman B,Krief Wdoi
10.1097/PEC.0000000000001015subject
Has Abstractpub_date
2018-04-01 00:00:00pages
253-257issue
4eissn
0749-5161issn
1535-1815journal_volume
34pub_type
杂志文章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::Serious to fatal toxicity may occur with amanitin-containing mushrooms ingestions. A Lepiota brunneoincarnata familial poisoning with hepatic toxicity is reported. In such poisonings, acute gastroenteritis may be firstly misdiagnosed leading to delay in preventing liver dysfunction by silibinin or penicillin G. Mushro...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000399
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:Pediatric care is increasingly regionalized, increasing rates of interfacility transport (IFT). However, it is unknown what conditions most frequently require IFT. This study's objective was to identify high-frequency pediatric conditions requiring IFT. METHODS:This is a statewide retrospective observationa...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001578
更新日期:2018-09-11 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::The following cases describe children who presented to the emergency department (ED) with a constellation of symptoms consistent with delirium. In each case, there was no identified inciting cause (eg, fever, medications) other than the presence of influenza. All children had variable workups, with 2 children undergoi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001175
更新日期:2018-08-01 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:OBJECTIVE:To evaluate computed tomography (CT) findings in pediatric patients with viral gastroenteritis who presented with clinical features of acute abdomen. PATIENTS AND METHODS:During 2 seasons of viral gastroenteritis from 2005 to 2007, 302 children with acute gastrointestinal symptoms were admitted to our center...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181850cc8
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:The purposes of the study were (1) to assess the acceptability of mental health screening in the pediatric emergency department (ED) for children and their parents; (2) to measure providers' perceptions on whether screening has an impact on patient care; and (3) to determine the impact of screening status on...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318222554e
更新日期:2011-07-01 00:00:00
abstract::Ultrasound-guided regional anesthesia is a growing modality within the pediatric emergency department. Here we present a case where a posterior tibial nerve block was used for anesthesia during foreign body removal from the plantar foot. We further review the technique and literature regarding this straightforward and...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001897
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:This study aimed to describe the epidemiology and clinical burden of unintended carbon monoxide (CO) poisoning among children in the Negev region of southern Israel. METHODS:This was a cross-sectional retrospective study of CO poisoning patients admitted to Soroka University Medical Center in 2011 through 2...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001484
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:This study was performed to determine the doses of midazolam used for sedation during procedures in children, and the frequency of adverse events. METHODS:We performed a retrospective analysis of data collected for a prospective study of flumazenil in children who had received midazolam for a procedure (n = ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199906000-00001
更新日期:1999-06-01 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: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:OBJECTIVE:To assess whether Web-based teaching is at least as effective as traditional classroom didactic in improving the proficiency of pediatric novice learners in the image acquisition and interpretation of pneumothorax and pleural effusion using point-of-care ultrasound (POCUS). METHODS:We conducted a randomized ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001482
更新日期:2020-07-01 00:00:00
abstract::Inconsolable crying is a disturbing symptom in young infants. The following is a case report of an infant who presented with inconsolable crying caused by a corneal abrasion. Corneal abrasion should be considered when inconsolable crying appears in an otherwise asymptomatic infant. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198912000-00012
更新日期:1989-12-01 00:00:00
abstract::Visceral injuries are not uncommon in nonaccidental trauma and often require emergent operative intervention. However, sometimes it can be difficult to assess the extent of injury. In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to ou...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000883
更新日期:2018-03-01 00:00:00
abstract::Children who have been sexually abused develop a variety of emotional and physical complaints, often unrelated to the genital area. Emergency department records of children diagnosed as being sexually abused were reviewed for the period covering January 1984 through June 1985. Of 26,000 patients seen, 300 cases of sex...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198609000-00002
更新日期:1986-09-01 00:00:00
abstract::Chlamydia trachomatis is a common cause of subacute, afebrile pneumonia with onset from 1 to 3 months of age. On physical examination, crepitant inspiratory rales are commonly heard. Infiltration is usually bilateral and interstitial; reticulonodular pattern and atelectasis have also been described, which distinct the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181b922e3
更新日期:2009-09-01 00:00:00
abstract::Neisseria meningitidis serogroup A septicemia and the development of Kawasaki disease in a 10-month-old male infant are described. The patient also experienced a number of primary/septic manifestations as consequences of the direct infectious assault and secondary/hypersensitivity immune-mediated complications. The pr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819a8bab
更新日期:2009-03-01 00:00:00
abstract:AIM:To explore effective interventions for child accidental injury prevention and to reduce the incidence of injury. METHODS:Cluster random sampling method was adopted, and children in 19 kindergartens in Henggang, Shenzhen and their parents were selected as the objects of study. Nineteen kindergartens were randomly d...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000563
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Acute appendicitis is the most common surgical emergency during childhood. Accurate early diagnosis is important to avoid complications and unnecessary interventions. In 2002, Samuel developed the Pediatric Appendicitis Score (PAS) based on a series of data obtained from anamnesis, physical examination, and ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182586d34
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:: To report a case of unexpected shaken baby syndrome, the diagnosis of which was possible after an incidental funduscopic examination. METHODS:: Observational case report. An infant was to be sent back home with an apparent unprovoked seizure diagnosis when a funduscopic examination was made because of an i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000227385.46143.20
更新日期:2006-07-01 00:00:00
abstract::Tears of the lingual and labial frena have been associated with accidental and nonaccidental injury. Three cases of infants are presented who were evaluated in the hospital with frena tears which were not recognized as manifestations of abuse, discharged home, and subsequently returned with manifestations of severe ab...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181568039
更新日期:2007-10-01 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::Curanderismo, folk medicine, is an important and common aspect of Hispanic culture. Its use is not well understood by US medical physicians and is often overlooked when Hispanic patients present to US hospitals. We present a case of isopropyl alcohol toxicity in a 4-year-old child due to the use of a curanderismo trea...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31816b7a92
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:Emergency department (ED) crowding is an increasingly common problem in the United States. Crowding can lead to ED closure and diversion, poor patient satisfaction, and patient safety issues. The purpose of this study was to examine measures of ED census and measures of crowding to determine if a correlation ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318226c7dd
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:We compare pediatric cardiac risk classification and management recommendations between emergency physicians (EPs) and pediatric cardiologists (PCs) in children with a suspected new cardiac disorder. METHODS:We prospectively compared the work-up, assessment, classification, and disposition of patients aged 0...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000655
更新日期:2017-10-01 00:00:00
abstract::Serious intra-abdominal injuries in neonates are very rare. In addition, the signs and symptoms of hemoperitoneum caused by bleeding from solid viscera are vague and nonspecific and often are not recognized before the onset of hypovolemic shock or death. In this report, we describe a 2-day-old infant who presented wit...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-200002000-00009
更新日期:2000-02-01 00:00:00
abstract::Diaphragmatic hernia in pediatric emergency department poses a diagnostic challenge because of the acute or subtle timing of onset and the wide variety of clinical features. We describe 3 different late presentations of Bochdalek diaphragmatic hernia in a pediatric emergency department. These reports may help physicia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000425
更新日期:2015-05-01 00:00:00
abstract::Deep vein thrombosis (DVT) and pulmonary embolism (PE) are relatively rare occurrences in the pediatric population. However, DVT and PE are associated with significant morbidity and mortality to the patient if not promptly diagnosed and treated. We describe the case of a 5-year-old boy that was diagnosed in our emerge...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318267ea4e
更新日期:2012-09-01 00:00:00