Abstract：
PURPOSE:Beginning in 2003, the pediatric emergency medicine (PEM) physician replaced the surgeon as the team leader for all level II trauma resuscitations at a busy pediatric trauma center. The purpose was to review the outcomes 10 years after implementing this practice change. METHODS:Trauma registry data for all level II activations requiring admission were extracted for the 21 months (April 1, 2001-December 31, 2002) prior to policy change (period 1, **n=627) and compared to the admitted patients from the 10 subsequent years (2003-2013; period 2, n=2694). Data included demographics, length of stay (LOS), injury severity score (ISS), readmissions, complications, and mortality. RESULTS:Mean ISS scores for admitted patients during period 1 (8.5) were higher than during period 2 (7.8). During period 1, 53.6% of patients underwent abdominal CT versus 41.8% in period 2 (p<.001), and the median ED LOS was 135 versus 191 minutes in period 2. From 2000 to 2003, 91% of patients seen as level II trauma alerts were admitted compared to 56.6% of patients in period 2 (p<0.001). There were no missed abdominal injuries identified, and readmission rate was low. CONCLUSIONS:We conclude that level II trauma resuscitations can be safely evaluated and managed without immediate surgeon presence. Although ED LOS increased, admission rate and CT scan usage decreased significantly without an increase in missed injuries.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Boomer LA,Nielsen JW,Lowell W,Haley K,Coffey C,Nuss KE,Nwomeh BC,Groner JIdoi
10.1016/j.jpedsurg.2014.10.041subject
Has Abstractpub_date
2015-01-01 00:00:00pages
182-5issue
1eissn
0022-3468issn
1531-5037pii
S0022-3468(14)00691-5journal_volume
50pub_type
杂志文章abstract：PURPOSE:The aim of this study was to evaluate postoperative anal function of high-type imperforate anus after laparoscopically assisted anorectoplasty (LAARP). METHODS:Between 2000 and 2002, LAARP was performed in 13 patients with high-type imperforate anus. Clinical data of the LAARP group were compared with the post...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.08.008
更新日期：2005-12-01 00:00:00
abstract：OBJECTIVES:Superior mesenteric artery syndrome (SMAS) is an uncommon cause of duodenal obstruction in pediatric patients. It is extremely rare in young infants. The classic treatment for SMAS has been an open or laparoscopic duodenojejunostomy when conservative medical therapy failed to resolve the obstruction. We here...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.07.004
更新日期：2020-03-01 00:00:00
abstract：:We describe 3 children with dilatation of the intrahepatic bile duct, who had anomalous junctions of the cystic duct, 2 high and 1 low, without pancreaticobiliary maljunction. They were all male, and underwent excision of the gallbladder and the extrahepatic bile duct followed by a Roux-en-Y hepaticojejunostomy as a d...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.08.025
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:Open Ladd's procedure is the gold standard for the correction of intestinal malrotation and laparoscopic approach remains controversial. This study aimed to evaluate our experience in laparoscopic management of malrotation. METHODS:Single center retrospective study including patients who underwent a laparos...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2018.09.023
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND/PURPOSE:To date, there are hardly any data on the treatment costs of infantile short bowel syndrome (SBS), despite growing interest in evidence-based and cost-effective medicine. Therefore, the aim of the study was to evaluate resource consumption and costs, next to studying nutritional and growth outcomes, ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.08.009
更新日期：2010-03-01 00:00:00
abstract：:The case of a child who fell a relatively short distance and had clinical and x-ray findings consistent with a ruptured aorta is presented. At surgery, a mediastinal hematoma was found. Diagnostic and therapeutic implications are discussed. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80518-8
更新日期：1986-05-01 00:00:00
abstract：BACKGROUND/PURPOSE:Best results in experimental tracheal allotransplantation are obtained when metachronous revascularization by omentopexy and immunosuppression are used. Nevertheless, this method of revascularization implies in a 4-day period of ischemia to the graft. The aim of this study was to assess the influence...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90156-2
更新日期：1999-08-01 00:00:00
abstract：PURPOSE:The purpose of this study was to evaluate the effectiveness of a new approach to repair the giant prostatic utricle (pseudovagina) associated with proximal hypospadias. METHODS:Three patients with giant prostatic utricle associated with proximal hypospadias sought medical advice in our department from 1998 to ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.07.015
更新日期：2007-11-01 00:00:00
abstract：:Intracranial pressure (ICP) monitoring is an important adjunct in the management of the severely injured child with major head trauma. From a series of 18 patients with multiple trauma, smoke inhalation, and near-drowning, we report an illustrative case of head injury and pulmonary aspiration in which ICP monitoring w...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(80)80769-x
更新日期：1980-08-01 00:00:00
abstract：:A 10-month-old boy was noted to have hepatomegaly, and hepatic angiography showed a huge tumor of the medial segment of the left lobe, located close to the hepatic hilum and involving the anterior segment of the right lobe in contiguity. We considered at first that resection would not be possible, but at operation the...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80109-5
更新日期：1989-11-01 00:00:00
abstract：:In one case of extrabiliary atresia, reconstruction of the biliary tract was performed by using the appendix. The child, who was 2 years old, is doing well without ascending cholangitis. This operation seems simple and satisfying because it seems to be more anatomic and more physiologic than the standard Kasai operati...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80030-7
更新日期：1988-11-01 00:00:00
abstract：:Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the pat...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(76)90093-2
更新日期：1976-10-01 00:00:00
abstract：:Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic a...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80711-0
更新日期：1989-07-01 00:00:00
abstract：INTRODUCTION:The purpose of this study was to evaluate clinical outcomes in children with asymptomatic congenital lung malformations (CLM) who were initially managed nonoperatively. METHODS:An IRB-approved retrospective review was performed on all CLMs at a single tertiary care referral center (Jan 2006-Dec 2016, n=14...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2018.02.065
更新日期：2018-06-01 00:00:00
abstract：PURPOSE:We examined the effectiveness of a postoperative ruptured appendicitis protocol that eliminated Pseudomonas coverage and based the duration of IV antibiotic treatment and length of hospital stay on the patient's clinical response. METHODS:In our new protocol, IV antibiotics were administered until the patient ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.09.012
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:Primary hyperhidrosis affects 1%-3% of the general population, with increased incidence in teenagers, having an important impact in the quality of life. This study evaluates the efficacy and patients' satisfaction after bilateral thoracoscopic sympathotomy. METHODS:Retrospective analysis of pediatri...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.11.024
更新日期：2020-11-01 00:00:00
abstract：PURPOSE:The relationship between congenital abdominal wall defects (AWDs) and undescended testes (UDTs) is poorly defined. We report a study of infants with AWD and UDT. METHODS:Hospital records of newborns with AWD managed during 1998 to 2008 were reviewed. Data analyzed included nature of AWD, position of the testes...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.03.011
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:The main aim of the present study was to investigate how fecal incontinence might influence different aspects of quality of life (QOL) in children and adolescents with anorectal malformations (ARMs). We considered both the influence of fecal incontinence at time 1 of the study and the influence of fecal inco...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.01.068
更新日期：2012-07-01 00:00:00
abstract：:Pulmonary hydatid disease is prevalent in many parts of world including India. In our small series of 5 pediatric patients, all patients were diagnosed with clinical and radiological findings on plain X-ray chest and CT (Computed Tomography) chest. All of them received oral albendazole 10 mg/kg/day soon after diagnosi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.11.029
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:In continued efforts to further improve the advantages of minimally invasive surgery to patients, surgeons have developed single-incision laparoscopic techniques. We report our initial experience in children with a variety of single-site procedures. METHOD:A retrospective chart review was performed on patie...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.02.020
更新日期：2011-05-01 00:00:00
abstract：:The development of hydrops fetalis and maternal mirror syndrome in the setting of fetal sacrococcygeal teratoma (SCT) carries a grave prognosis. Fetal surgery is not typically offered for hydropic fetuses beyond 26 weeks of gestational age. Few options exist for these families, and they are typically counseled to cont...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.04.010
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:Accurate identification of child physical abuse is crucial during the evaluation of injured children. Retinal hemorrhages (RH) are used for diagnosis, but clear criteria for screening with direct fundoscopic exam are lacking. We sought to identify key factors associated with RH to guide evaluations. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2020.07.031
更新日期：2020-08-05 00:00:00
abstract：:Tracheal duplication is a very rare infant congenital airway anomaly. We report a bronchogenic cyst communicating with a tracheal duplication. This is the first reported case of pathologically confirmed duplication of trachea communicating with a bronchogenic cyst. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.10.090
更新日期：2007-03-01 00:00:00
abstract：:This study was undertaken to search for a rational basis for the use of anal dilatation and internal sphincterotomy as the treatment for chronic intractable constipation in children. Sixteen children, age 5 months to 13 years, who had constipation resistant to conservative treatment were compared with 39 age-matched c...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90395-x
更新日期：1997-07-01 00:00:00
abstract：PURPOSE:The aim of this study was to assess the risk of child abuse in children younger than 18 months admitted to a pediatric trauma service with lower extremity injuries. METHODS:An Institutional Review Board-approved retrospective case series of children admitted to a regional pediatric trauma center with lower ext...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.09.003
更新日期：2005-01-01 00:00:00
abstract：:Because lymph node (LN) involvement continues to be an adverse prognostic factor in the later National Wilms' Tumor Study (NWTS) trials, the NWTS-3 Surgical Committee undertook a project to determine the accuracy of the present method of sampling. The committee concludes that: (1) there is a relatively low potential e...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90079-o
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:In addition to trauma center levels and types, trauma volume may be an important factor impacting outcomes in severe pediatric trauma. METHODS:All severely injured pediatric patients treated at adult trauma centers were identified from the National Trauma Data Bank. All qualifying centers were stratified in...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.01.066
更新日期：2017-11-01 00:00:00
abstract：AIM OF THE STUDY:Persistent pulmonary hypertension (PH) continues to be a major cause of high mortality in congenital diaphragmatic hernia (CDH). The receptor for advanced glycation end products (RAGE) is a member of the immunoglobulin protein family. Recently, RAGE has been implicated in mediating pulmonary arterial s...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.02.024
更新日期：2015-05-01 00:00:00
abstract：BACKGROUND/PURPOSE:Femoral herniae are uncommon in children and easily misdiagnosed. To evaluate performance with femoral hernia in children, the authors reviewed their experience for the past two decades. METHODS:All patients under 15 years of age with femoral hernia (January 1977 to January 1998) were reviewed. Age,...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90576-6
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND/PURPOSE:Papillary cystic neoplasms are rare pancreatic tumors that typically present in women in their third decade of life. Few cases have been reported in children. METHODS/RESULTS:The authors report on three pediatric patients: a 10-year-old boy, an 11-year-old girl, and a 14-year-old girl. The authors h...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/s0022-3468(98)90655-8
更新日期：1998-06-01 00:00:00
