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 pediatric setting. METHODS:This study was a retrospective, descriptive study using data from 1 urban, tertiary care pediatric ED. The study population consisted of all patient visits to the ED from April 2005 to March 2007. Multivariate Poisson regression analyses were used to examine the impact of the timing of patient arrival and ED conditions including patient acuity, volume, and waiting times on the number of patients who LWBS. RESULTS:During the study period, there were 138,361 patient visits corresponding to 2190 consecutive shifts; 11,055 patients (8%) left without being seen by a physician.In the multivariate analysis, the throughput variables, time from triage to physician assessment (rate ratio, 2.11; 95% confidence interval, 2.01-2.21), and time from registration to triage (rate ratio, 1.55; 95% confidence interval, 1.25-1.90) had the largest association with the number of patients who LWBS. CONCLUSIONS:In the study ED, throughput variables played a more important role than input or output variables on the number of patients who LWBS. This finding, which contrasts with a work done previously in an ED serving primarily adults, highlights the importance of pediatric specific research on the impacts of increasing ED waiting times and volumes.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Stang AS,McCusker J,Ciampi A,Strumpf Edoi
10.1097/PEC.0b013e3182a5cbc2subject
Has Abstractpub_date
2013-10-01 00:00:00pages
1082-90issue
10eissn
0749-5161issn
1535-1815journal_volume
29pub_type
杂志文章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 b...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001015
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVES:Although child abuse pediatricians are frequently asked to evaluate risk of abuse based on photographs, the effect of photographic quality on this process is presently unknown. Photographs of abused children are often taken by professionals without photographic training, and quality varies widely. This artic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31828e848e
更新日期:2013-05-01 00:00:00
abstract::Paracetamol is a common antipyretic often used to treat children with fever and pain. With the increasing administration of intravenous (IV) paracetamol, there will be the associated risk of medication dosing errors. We report a case of IV paracetamol overdose in a child with fever during hospital admission. A IV para...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001432
更新日期:2019-02-01 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:The objectives of this study were to evaluate the efficacy and utilization of an observation unit (OU) for admission of pediatric patients after a toxicologic ingestion; compare the characteristics and outcomes of patients admitted to the pediatric OU, inpatient (IP) service, and intensive care unit (ICU) af...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182717329
更新日期:2012-11-01 00:00:00
abstract::The unique characteristics of the pediatric population expose them to errors in the emergency department (ED) with few standard practices for the safety of care. Young children and high-acuity patients are at increased risk of adverse events both in the prehospital and ED settings. We provide an overview of the proble...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000278393.32752.9f
更新日期:2007-06-01 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::Anaphylaxis is a life-threatening, severe, generalized, or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing especially in pediatric age. Our aim in this study was to investigate the knowledge and attitudes of the physicians on the diagnosis and treatment of anaphylaxis. METHODS:A questio...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002064
更新日期:2020-02-24 00:00:00
abstract::We report a case involving accidental ingestion of a marble that was detected by point-of-care ultrasonography of the abdomen with the patient in the upright and slightly forward tilting position, which we term the "bowing position." Using this position for abdominal ultrasonography may be more useful than the usual s...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001125
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Exclusion of family members (FM) during pediatric procedures in the emergency department (ED) is an accepted practice. This study questions the validity of such a practice. SUBJECTS:FM of ED pediatric patients undergoing procedures and ED staff performing procedures. SITES: ED of a tertiary care university-a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199608000-00008
更新日期:1996-08-01 00:00:00
abstract::Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an underdiagnosed disease that has been described thus far only in case series. Patients, the majority of which are females, develop neuropsychiatric symptoms that can often be misdiagnosed as purely psychiatric illness. Although teratomas are nearly pathognom...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001853
更新日期:2019-09-01 00:00:00
abstract::To determine the accuracy and reliability of a labeled leukocyte imaging technique in the early diagnosis of pediatric appendicitis, we prospectively studied patients presenting to the pediatric emergency department with abdominal pain suggestive of appendicitis. Patients scheduled for urgent laparotomy were excluded,...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199510000-00005
更新日期:1995-10-01 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::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: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::Caring for children of adolescent parents presents unique challenges. Because adolescent parents may lack parenting skills and knowledge of medical terminology, symptoms of life-threatening illnesses may be misinterpreted. We present two cases of unexpected acute abdomen in young infants with adolescent mothers. The f...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200112000-00022
更新日期:2001-12-01 00:00:00
abstract::A case of albuterol abuse by a pediatric patient with the development of hypokalemia with electrocardiographic changes is presented. The hypokalemic effects of beta2-agonists are discussed in regard to the production of significant cardiac symptoms. Additionally, guidance regarding the evaluation of similar patients p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199804000-00015
更新日期:1998-04-01 00:00:00
abstract::Hand injuries are a common chief complaint in the pediatric population presenting for emergency care. Adolescents, in particular, often present with trauma to their hands after punching objects. The most frequent result of this action is a fracture to one or more of their metacarpals, also known as a boxer's fracture....
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000188
更新日期:2014-08-01 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::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: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::We present two cases of pediatric patients initially presenting with a clinical suspicion of acute appendicitis. In these cases, point-of-care ultrasonography was performed early in the patient's emergency department course, leading to alternate diagnoses. This article highlights a role for point-of-care ultrasound in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000623
更新日期:2016-04-01 00:00:00
abstract::Brugada syndrome is an increasingly discussed entity in the emergency medicine and cardiology literature. However, there are few cases reported in the pediatric population. Seizure is a presentation common to pediatric emergency departments. This case report describes the clinical course, workup, and differential diag...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001508
更新日期:2018-08-01 00:00:00
abstract::Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovas...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000992
更新日期:2019-06-01 00:00:00
abstract::Superior ophthalmic vein thrombosis (SOVT) usually results from inflammatory, infectious, or malignant causes. This case describes a 2-year-old boy with severe prolapsing chemosis and proptosis due to thrombosis of the right superior ophthalmic vein resulting from midfacial and right orbital fractures 1 week after the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000066
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:Sickle cell disease is the most common hemoglobin variant in the world and can present with recurrent vaso-occlusive painful crises. Pain control in these patients is often difficult and requires a multimodal approach. In patients with uncontrolled pain after traditional pain control methods, ketamine infusi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000978
更新日期:2019-01-01 00:00:00
abstract::Presented is a selective review of the toxicities of various plants, decorations, and miscellaneous items popularly used during the holiday season. Particularly hazardous agents include mistletoe, holly, bubble lights, fireplace flame colors, alkaline batteries, and mothballs. Specific questions regarding management o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198512000-00011
更新日期:1985-12-01 00:00:00
abstract::Oral phosphate preparations are used for constipation and bowel preparation in adults but with potential for fatal electrolyte disturbances. Use in children is not recommended due to similar concerns. We report a 7-week-old infant who received an over-the-counter oral phosphate preparation. He developed profound hypoc...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000199565.02383.34
更新日期:2006-02-01 00:00:00
abstract::The aim of this report is to describe the successful use of pralidoxime in a pediatric patient who accidentally ingested 12 mg of rivastigmine and presented to the emergency department with weakness, drowsiness, hyporeactivity to environmental stimuli, and full cholinergic syndrome. CASE:The patient presented to the ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001086
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:Limited literature has investigated caregiver sharing of prescription medications with children. Our primary aim was to determine the frequency of and factors associated with prescription medication sharing within families. Our secondary aim was to determine the source and type of medications shared. METHOD...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001804
更新日期:2019-04-30 00:00:00