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) after ingestions using retrospective chart review; and attempt to identify factors associated with unplanned IP admission after an OU admission. METHODS:This was a retrospective chart review of children seen in the emergency department (ED) after potentially toxic suspected ingestions and then admitted to the OU, IP service, or ICU from June 2003 to September 2007. RESULTS:One thousand twenty-three children were seen in the ED for ingestions: 18% were admitted to the OU, 15% to the IP service service, and 6% to the ICU. Observation unit patients had less mental status changes reported and were less frequently given medications while in the ED. Eighty-one percent of OU patients were admitted with poison center recommendation. Ninety-four percent of OU patients were discharged within 24 hours, and less than half of IP service/ICU patients were discharged that quickly. No significant associations were found between specific historical and physical examination or laboratory characteristics in the ED and the need for unplanned IP admission. CONCLUSIONS:Observation unit patients admitted after ingestions were young, typically ingested substances found in the home, and required observation according to poison center recommendations. Ninety-four percent were able to be discharged home within 24 hours even after ingesting some of the most concerning substances such as central nervous system depressants, cardiac/antihypertension medications, hypoglycemics, and opiates. All OU patients did well without any adverse events reported. Many patients requiring prolonged observation after an ingestion, and who do not require ICU care, may be appropriate for OU management. This study suggests a potential underutilization of observation units in this setting.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Plumb J,Dudley NC,Herman BE,Kadish HAdoi
10.1097/PEC.0b013e3182717329subject
Has Abstractpub_date
2012-11-01 00:00:00pages
1169-72issue
11eissn
0749-5161issn
1535-1815journal_volume
28pub_type
杂志文章abstract::A one-year-old white female ingested approximately two to three grams of caffeine (200-300 mg/kg). The patient survived the ingestion with a maximum caffeine concentration of 385 micrograms/ml four hours postingestion. The child developed ventricular arrhythmias, seizures, metabolic disturbances, and severe pulmonary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199012000-00012
更新日期:1990-12-01 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:OBJECTIVES:Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect. Children with this anomaly are usually asymptomatic at birth and develop symptoms later on in life, which may mimic myocarditis. We sought to delineate clinical, laboratory, and epidemiological aspects of thi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000511
更新日期:2016-04-01 00:00:00
abstract::Point-of-care ultrasound (POCUS) is being used for clinical decision making with increasing frequency across a broad range of indications in pediatric emergency medicine (PEM). We present a series of 4 patients in whom POCUS was used to facilitate a diagnosis of perforated appendicitis. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002082
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS:We analyzed data from the National Pediatric Readines...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001920
更新日期:2019-11-13 00:00:00
abstract:OBJECTIVE:Trauma is a leading cause of death among children. Detailed knowledge of the epidemiology of traumatic childhood deaths is necessary for allocating available treatment resources and for preventing injuries at both community and regional levels. To our knowledge, there has been no report comparing urban to rur...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e31827b50a7
更新日期:2013-01-01 00:00:00
abstract::A survey was conducted to determine the current standard of care with regard to team composition and training, mobilization time, and vehicle use for pediatric critical care transport. An evaluation of 30 pediatric referral centers revealed that 60% provide a critical care transport team. Of those teams, the mean numb...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to understand parents' awareness of and reactions to a slide presentation based waiting-room educational initiative. METHODS:This was a prospective observational study at a Canadian tertiary-care pediatric emergency department (ED) with an annual census of 68,000 visits. An anonymou...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001140
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To determine the percentage of cases of epididymitis in pediatric patients that is of bacterial cause and to identify factors that predict a positive urine culture. METHODS:We conducted a retrospective chart review of patients diagnosed with acute epididymitis or epididymo-orchitis in 1 pediatric emergency ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820d647a
更新日期:2011-03-01 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:OBJECTIVES:The objective of this study was to determine whether adolescents in emergency departments (EDs) who report engaging in high-risk sexual behaviors are less likely to identify a primary care provider (PCP) and more likely to access the ED than their sexually inexperienced peers. METHODS:This was a secondary a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001456
更新日期:2020-07-01 00:00:00
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 Ju...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001598
更新日期:2018-09-01 00:00:00
abstract::Many of the causes of complaints can be reduced but not completely eliminated. Appropriate attention through education and quality management keeps the department's attention focused on increasing patient satisfaction. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199404000-00009
更新日期:1994-04-01 00:00:00
abstract::There are numerous immediate and delayed complications associated with endotracheal intubation. Tracheal rupture is a rare complication whose diagnosis is often delayed. This can result in significant morbidity and mortality. We present a case of therapeutic misadventure resulting in a significant tracheal rupture in ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000279
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess whether increased time from emergency department (ED) triage to appendectomy is associated with a greater risk of children developing appendiceal perforation. METHODS:We performed a multicenter retrospective cohort study of children younger than 18 years hospitalized with ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000850
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:This study examined whether utilization of the Florida State Health Online Tracking System (SHOTS) immunization registry to determine Haemophilus influenzae type B and heptavalent pneumococcal conjugate (PCV7) vaccine status impacts the protocolized decision to perform a screening blood draw for occult bacte...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825cfd3e
更新日期:2012-07-01 00:00:00
abstract:ABSTRACT:A child with acute abdomen with gross hematuria occasionally visits the emergency department (ED). Usually, such a condition is subject to differential diagnosis for stones, injuries, or sometimes malignancies in the urinary tract. Here we introduce an unusual case of a 9-year-old girl who presented to ED with...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001527
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001262
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The aim of this study is to assess the adherence of Austrian physicians to International Society for Pediatric and Adolescent Diabetes guidelines 2009 concerning treatment in diabetic ketoacidosis and whether there is a difference between specialty (endocrinologists or intensivists) or clinical experience. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001551
更新日期:2018-07-24 00:00:00
abstract:OBJECTIVE:The objective of this study was to describe the demographics, epidemiology, and characteristics associated with survival of children younger than 18 years who had an out-of-hospital respiratory arrest (OOHRA) during a 1-year period in a large urban area. METHODS:A prospective observational cohort of consecut...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182675b61
更新日期:2012-09-01 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:OBJECTIVE:The aim of this study was to measure the impact of a simple parent health literacy intervention on emergency department and primary care clinic usage patterns. METHODS:Study participants consisted of parents who brought their children to the Harbor-UCLA Medical Center pediatric emergency department for nonur...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181ab78c7
更新日期:2009-07-01 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:OBJECTIVES:Acetaminophen (APAP) elixir is a widely used pediatric antipyretic medication. It has been shown that up to 30% of febrile children presenting to a large urban pediatric emergency department received inadequate APAP dosages at home with errors primarily due to age-based dosing. Parental education material in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000665
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:Fever in young infants frequently triggers a laboratory evaluation because of the increased likelihood of serious bacterial infections. Reported fever by methods other than rectal thermometry is of concern. This study evaluates the validity of perceived, pacifier, and temporal artery (TA) temperatures. METH...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000086231.54586.15
更新日期:2003-08-01 00:00:00
abstract::Hair-thread tourniquet syndrome is defined as the ischemic strangulation of hair resulting in edema and severe pain and may cause amputation of organs. Strangulation of the external genitalia (clitoris, labia minora) has rarely been described in girls. Here, we present a case of hypertrophic clitoris injury secondary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000341
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare the sensitivity and specificity of 2- and 4-film x-ray series when interpreted by pediatric emergency medicine physicians in the diagnosis of skull fracture in children. METHODS:A noninferiority crossover study was performed. The skull radiographs of the 50 most rec...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a9f7c1
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Resuscitation skills decay as early as 4 months after course acquisition. Gaps in research remain regarding ideal educational modalities, timing, and frequency of curricula required to optimize skills retention. Our objective was to evaluate the impact on retention of resuscitation skills 8 months after th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001849
更新日期:2019-07-11 00:00:00
abstract::The Pediatric Assessment Triangle (PAT) has become the cornerstone for the Pediatric Education for Prehospital Professionals course, sponsored by the American Academy of Pediatrics. This concept for emergency assessment of children has been taught to more than 170,000 health care providers worldwide. It has been incor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181d6db37
更新日期:2010-04-01 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