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 to 21 years presenting to the emergency department with a potential cardiac etiology in whom an electrocardiogram (ECG) was performed. The criterion standard was a blinded assessment by the PC-electrophysiologist after review of the history, physical examination, ancillary tests, and ECG. RESULTS:In 508 subjects, the median age was 15 years (interquartile range, 11-17 years), with a slight female predominance (281, 55.3%). The most common reasons for obtaining an ECG were: chest pain (158, 31.1%) and syncope, presyncope, or possible seizure (146, 28.7%). The most common auxiliary study was a chest radiograph (432, 85% of subjects). A total of 617 electrocardiographic diagnoses were made by EPs and 984 diagnoses by PCs. Sensitivities and specificities varied by discrete class, but disposition decisions were concordant (home or admission). The EPs were highly accurate for the need for emergent cardiology involvement (area under the curve, 0.89). CONCLUSIONS:The EPs and PCs agreed on the evaluation and disposition of children at either low risk or high risk for an acute cardiac presentation in the emergency department. There was considerable variation in management recommendations in the intermediate risk children needing cardiology outpatient follow-up. We recommend the development and implementation of focused training modules on emergency pediatric cardiology and increased communication with pediatric cardiology to improve patient safety and resource utilization.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Horeczko T,Park JK,Mann C,Milazzo Adoi
10.1097/PEC.0000000000000655subject
Has Abstractpub_date
2017-10-01 00:00:00pages
e79-e86issue
10eissn
0749-5161issn
1535-1815journal_volume
33pub_type
杂志文章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
abstract::Inflammatory causes of bloody diarrhea during infancy include necrotizing enterocolitis and allergic colitis, often due to cow's milk protein. We report this case of cow's milk protein allergy, managed successfully with elimination of dietary antigen, to highlight the unusual finding of pneumatosis intestinalis on abd...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001369
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To determine if intramuscular (IM) penicillin is more effective than oral (PO) amoxicillin in the early outpatient treatment of pediatric patients with presumed bacterial pneumonia. METHODS:Prospective, randomized, evaluator-blinded, clinical trial. SETTING:Pediatric emergency department (ED) of an urban ch...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-10-01 00:00:00
abstract::Guillain-Barré syndrome (GBS) in children can present with early symptoms of limb and back pain that progress to acute generalized paralysis. Although the clinical course of this illness may be benign with spontaneous recovery, treatment is indicated for more severe cases. We report a three-year-old patient with GBS, ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199808000-00007
更新日期:1998-08-01 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::This article describes a small series of injuries resulting from a new fad activity among children in Baltimore. "Flipping" involves jumping from an elevated surface and executing an aerial flip, with the intent to land upright. Because this activity takes place frequently on hard surfaces such as concrete, injuries o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199304000-00010
更新日期:1993-04-01 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::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:OBJECTIVE:We present a case of Kasabach-Merritt syndrome with discussion of hemangiomas of childhood relevant to the emergency physician. DESIGN:This is a case report. SETTING:The case is described in the setting of a tertiary care hospital level I pediatric emergency department. PATIENTS:A single case is discussed....
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199612000-00009
更新日期:1996-12-01 00:00:00
abstract::To determine the rationale for using a community hospital's emergency department for minor illness care on weekdays, we surveyed 150 parents of children 15 years of age or younger. Fifty (33.3%) participants had no identified source of routine pediatric care, and 31 (20.7%) had pediatric providers not locally availabl...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198806000-00005
更新日期:1988-06-01 00:00:00
abstract:PURPOSE:To determine the requirements in all states and the District of Columbia for use of restraints on patients in ambulances. MATERIALS AND METHODS:A structured telephone survey was conducted with all state Emergency Medical Services (EMS) agencies or the agency responsible for the regulation of ambulances. Questi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199806000-00014
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:A brief resolved unexplained event (BRUE) in infancy is a common reason for visiting the emergency department. However, little is known about the long-term outcomes of such an event. This study evaluates future mortality, morbidity, and/or developmental outcome after a BRUE. METHODS:A single-center retrospec...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001816
更新日期:2019-11-01 00:00:00
abstract::Pediatric skin diseases are a common presenting complaint to emergency medicine physicians but often pose a significant diagnostic challenge. Skin eruptions that are unusually severe for the diagnosis in question, lasting beyond the typical time of resolution, or not responding to conventional therapy should raise con...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001218
更新日期:2017-08-01 00:00:00
abstract::Asplenia may refer to the spleen's surgical removal, functional impairment, or congenital absence. It is a risk factor for the development of severe bacterial infection. Functional asplenia is likely the most common presentation of this entity and has many etiologies. Those that are previously undiagnosed may present ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31822255f4
更新日期:2011-07-01 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
abstract::Constipation is a common cause of pediatric abdominal pain seen in pediatric emergency departments (EDs). We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000166
更新日期:2014-07-01 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:OBJECTIVE:To describe the clinical course and determine the minimal observation period required following isopropanol ingestion in children. METHODS:The emergency department records of children less than 6 years of age with isopropanol ingestion who presented between June 1992 and December 1998 were identified. Demogr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200008000-00005
更新日期:2000-08-01 00:00:00
abstract::We present a case of acute Candida epiglottitis in an otherwise healthy and Haemophilus influenzae type B-immunized 4-year-old child. A query of the literature reveals this disease to be commonly found in patients who are immunocompromised by problems including human immunodeficiency virus disease and lymphoma and leu...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001082
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:This study aimed to assess urban adolescents' knowledge of and attitudes about emergency contraception (EC) and to assess the intention to use EC in particular hypothetical situations. We hypothesized that knowledge about EC would be limited, but that adolescents would support using EC in certain situations....
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31828a3249
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:This study aimed to survey pediatric emergency medicine (PEM) providers on their management of 2 hypothetical acute concussion scenarios. We hypothesized that most providers would recommend a management strategy based on cognitive and physical rest. METHODS:Fifty-nine percent (46/78) of PEM providers that w...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001727
更新日期:2019-01-21 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: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:OBJECTIVE:The objectives of this study were to provide population-based incidence estimate of abusive head trauma (AHT) in children aged 0 to 5 years from inpatient and emergency department (ED) and identify risk characteristics for recognizing high-risk children to improve public health surveillance. METHODS:This was...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31828503ea
更新日期:2013-03-01 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: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::Radial neck fractures in children are not uncommon. Most are minimally displaced or nondisplaced. Severely displaced fractures or angulated radial neck fractures in children often have poor outcomes, especially if not reduced, and even after open reduction. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000235839.44449.36
更新日期:2006-09-01 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: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...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001609
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To assess outcomes between 2 groups of patients receiving ketamine for procedural sedations in our pediatric emergency department. Our hypothesis is that there is no difference in the number of adverse events in ketamine sedations with and without morphine pretreatment. METHODS:This was a retrospective cohor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000221339.26873.14
更新日期:2006-06-01 00:00:00