Abstract:
OBJECTIVES:The goals of this study were to (1) conduct a cost-benefit analysis, from a hospital's perspective, of using a pediatrician in triage (PIT) in the emergency department (ED) and (2) assess the impact of a physician in triage on provider satisfaction. METHODS:This was a prospective, controlled trial of PIT (intervention) versus conventional registered nurse-driven triage (control), at an urban, academic, tertiary level pediatric ED, which led to a cost-benefit analysis by looking at the effect that PIT has on length of stay (LOS) and thus on ED revenue. Provider satisfaction was assessed through surveys. RESULTS:During the 8-week study period, a total of 6579 patients were triaged: 3242 in the PIT group and 3337 in the control group. The 2 groups were similar in age, sex, admission rate, left-without-being-seen rate, and level of acuity. The mean LOS in the PIT group was 24.3 minutes shorter than in the control group. The costs of PIT seem to be increased and are not offset by savings; the net margin (total revenue minus costs) was $42,883 per year lower in the PIT than in the control group. Sensitivity analysis showed that if the LOS were reduced by more than 98.4 minutes, the cost savings would favor PIT. Most of the physicians and nurses (67%) reported that PIT facilitated their job. CONCLUSIONS:Placement of a PIT during periods of peak census resulted in shorter stay and notable provider satisfaction but at an incremental cost of $42,883 per year.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Kezirian J,Muhammad WT,Wan JY,Godambe SA,Pershad Jdoi
10.1097/PEC.0b013e31826c6dc4subject
Has Abstractpub_date
2012-10-01 00:00:00pages
971-6issue
10eissn
0749-5161issn
1535-1815journal_volume
28pub_type
杂志文章,多中心研究abstract::A two-year, eight-month-old boy was diagnosed clinically with perianal warts and treated with topical 5-Fluorouracil, with subsequent resolution of the lesions. The child disclosed sexual abuse, and subsequent physical abuse was also documented. Attempts to identify the perpetrator have been hampered by the child's yo...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199312000-00005
更新日期:1993-12-01 00:00:00
abstract::Zolpidem is a widely prescribed anti-insomnia agent. Although most pediatric zolpidem ingestions are benign, large ingestions can cause significant central nervous system (CNS) depression. Flumazenil has been reported to reverse the CNS effects of zolpidem. We describe a case of a large pediatric zolpidem ingestion re...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182aa139c
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment. METHODS:We conducted a prospective, randomized comparison of treatments of fecal impaction in children in a pediatric emergency department (ED). Treatment arms were a single milk and m...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e3182442c0a
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:National rates of left (or leaving) without being seen (LWBS) in pediatric emergency departments (PED) are higher than general emergency departments. We investigated coexisting perspectives on LWBS. METHODS:Q-methodology was implemented through a mixed-methods design. Semistructured interviews elicited a con...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001792
更新日期:2019-04-11 00:00:00
abstract:OBJECTIVE:Injury and poisoning from metallic mercury has become a rare event. Review of the literature and a case report of pediatric metallic mercury injury are presented. DESIGN:A case report. SETTING:The Emergency Department at St. Louis Children's Hospital. PATIENTS OR PARTICIPANTS:A 15-year-old boy. INTERVENTI...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199704000-00008
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To determine whether injection of patients with Bicillin CR is less painful than injection with Bicillin LA. To discover if Bicillin CR with the addition of procaine, which doubles the volume, causes the injection to be less painful. DESIGN:An experimental, double-blinded crossover design was used for this s...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006565-200012000-00004
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVES:The aim of this study is to explore current community emergency department (ED) experiences available to pediatric emergency medicine (PEM) trainees and estimate the proportion of graduates taking positions that involve working in a community ED setting. METHODS:We conducted an e-mail-based survey among PEM...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001349
更新日期:2020-10-01 00:00:00
abstract::Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000591
更新日期:2017-08-01 00:00:00
abstract:UNLABELLED:Clavicle fractures are a common injury among pediatric patients. Few data exist regarding specific etiologies and their management in the preadolescent patient. Our objective was to determine the specific source of injury and treatment techniques used in the youngest patient population. METHODS:Study Design...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181bec7fc
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The prevalence of pneumonia in infants with high fever without source (FWS; temperature, > or =39.0 degrees C) and a white blood cell (WBC) count greater than 20 x 10(9)/L (occult pneumonia) has been reported to be 20% before the introduction of the 7-valent pneumococcal conjugated vaccine (PCV7). This is th...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181e582e4
更新日期:2010-07-01 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: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:BACKGROUND:Interfacility transfers occur frequently and often involve critically ill patients. Clear communication at the time of patient referral is essential for patient safety. OBJECTIVES:The objective of this work was to study whether a standardized inter-emergency department (ED) transfer communication template f...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318289d7c1
更新日期:2013-04-01 00:00:00
abstract::We describe the case of an 18-month-old child with recurrent apneic episodes, often requiring resuscitation, who was admitted to an academic pediatric medical center after previous evaluations had been unrevealing. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180ff44
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:To describe a case series of 4 children who developed acute rhabdomyolysis as a complication of acute respiratory failure secondary to status asthmaticus. METHODS:A retrospective review of all children who were admitted to our pediatric intensive care unit (PICU) with status asthmaticus from November 1998 t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230711.81646.7a
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Life-saving procedures are rarely performed on children in the emergency department, making it difficult for trainees to acquire the skills necessary to provide proficient resuscitative care for children. Studies have demonstrated that residents in general pediatrics and emergency medicine lack exposure to p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002195
更新日期:2020-08-28 00:00:00
abstract:OBJECTIVE:Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METH...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001249
更新日期:2017-09-01 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::We report an extremely rare case of homicidal lithium battery ingestion in a neonate hitherto unreported in the medical literature. Although a definitive diagnosis was initially missed in the baby, the patient survived with no complications whatsoever even after retention of the said foreign body for 10 days. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825d23df
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To describe pediatric advanced life support (PALS) in a single urban environment and clarify educational priorities for ALS pre-hospital providers and pediatric medical control physicians. METHODS:Retrospective observational review of all pediatric pre-hospital PALS transport and medical control records of t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200102000-00002
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:Few studies of children with toxicological emergencies describe those undergoing acute resuscitation, and most describe exposures to single agents. We describe a 12-month sample of patients evaluated in the resuscitation area of a pediatric emergency department (ED) for a toxicological emergency. METHODS:We ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000858
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:The object of this study was to assess, in cost-effective measures, 3 different models for pediatric first-aid training among caregivers and teachers. METHODS:Quasi-experimental design was used. A stratified random sampling method was used to obtain 1282 teachers working at nurseries and kindergartens in Shang...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e318216a5f0
更新日期:2011-05-01 00:00:00
abstract::A study was carried out to determine the influence of telemedicine on management of facial lacerations in children. Proforma was designed, and information was collected retrospectively over a 4-month period. Of the 2524 telemedicine referrals, 27% (693/2524) were pediatric referrals. One hundred forty-five of these we...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31829ec25c
更新日期:2013-08-01 00:00:00
abstract::A 4-year-old Indian girl was seen in our emergency department for unintentional ingestion of topical medication oil with subsequent salicylate poisoning. Serum levels were 52 mg/dL at 12 hours after ingestion.She was started on urine alkalization therapy to enhance salicylate elimination. This was achieved by a bicarb...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182131556
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:Although National Asthma Guidelines recommend that emergency department (ED) physicians consider initiating controller medications, research suggests that this practice occurs infrequently. The goal of this study was to assess primary care pediatricians' (PCP) beliefs and attitudes regarding ED initiation of...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000389
更新日期:2015-08-01 00:00:00
abstract::We present a case of a 4-month-old girl referred to the emergency department with a provisional diagnosis of acute life-threatening event with a recent episode of heart block and a history of long-lasting fever. Soon after admission, the child suddenly deteriorated rapidly; she became pulseless with complete heart blo...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000195757.74328.68
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001538
更新日期:2020-07-01 00:00:00
abstract::A case history of a young girl who sustained a small posterior laceration of her cervical trachea after blunt trauma is presented. She was brought to the emergency department (ED) by her parents roughly two hours after the incident with only minor symptoms. While in the ED, she developed significant airway compromise ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199110000-00008
更新日期:1991-10-01 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:OBJECTIVE:To develop a computer-assisted learning (CAL) model and evaluate its effectiveness in improving medical trainees' knowledge of pediatric emergency procedures. METHODS:Three common pediatric emergency procedures were selected: laceration repair, splinting of fractures, and lumbar puncture. Web-based computeri...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e31816ecb5c
更新日期:2008-05-01 00:00:00