The role of physician assistants in a pediatric emergency department: a center review and survey.

Abstract:

OBJECTIVES:The objectives of this study were to outline the clinical conditions presenting to a Canadian pediatric emergency department (ED), survey the opinions of physician assistants (PAs) and emergency pediatricians to determine which conditions they consider could be managed by PAs, and to estimate the proportion of the total pediatric ED volume that PAs could potentially manage. METHODS:We reviewed the 2007 British Columbia Children's Hospital database of ED visits to identify clinical presentation and chief complaint of all patients seen. International Classification of Diseases, 10th Revision codes were used to categorize the presenting complaint of each ED visit. Following categorization, the results were discussed by a focus group composed of pediatric emergency medicine-trained physicians and PAs, to review the list of chief complaints. We then surveyed via e-mailed questionnaire a group of emergency pediatricians (n = 17) and PAs (n = 5) to seek their opinion on the categories of clinical presentation appropriate for PA management. RESULTS:Of 38,722 visits, 9.2% were triaged as "resuscitation" or "emergent." We sorted the remaining 35,077 ED visits into 57 clinical categories. More than 85% of respondents selected 30 clinical categories for PA management with physician supervision, representing 74% of the total ED volume. Of these, 3 were also deemed appropriate for PA management without direct physician supervision. There were statistically significant differences in mean length of stay, waiting time, and admission rates between the clinical conditions selected for PA involvement. However, the difference in waiting time was not clinically meaningful. CONCLUSIONS:A large proportion of pediatric ED visits are designated as semiurgent or nonurgent. Clinicians (ED physicians and PAs) thought that the majority of these ED visits could be managed by PAs.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Doan Q,Sabhaney V,Kissoon N,Johnson D,Sheps S,Wong H,Singer J

doi

10.1097/PEC.0b013e3182627ce5

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

783-8

issue

8

eissn

0749-5161

issn

1535-1815

journal_volume

28

pub_type

杂志文章
  • Encephalopathy from unintentional donepezil and memantine ingestion.

    abstract::Donepezil and memantine are commonly prescribed antidementia drugs. There is a paucity of literature concerning pediatric ingestions of these drugs. We describe a case of a 2-year-old child who developed encephalopathy after an unintentional ingestion of donepezil and memantine. A 2-year-old girl was found by her fami...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000216

    authors: Thornton SL,Clark RF

    更新日期:2014-09-01 00:00:00

  • An 8-year-old boy with bilateral lower extremity pain and weakness.

    abstract::We illustrate a case of an 8-year-old boy presenting acutely with bilateral lower extremity pain and weakness. This case illustrates the presentation and progression of a rare and potentially lethal diagnosis and highlights the use of computed tomography angiography in the setting of a patient with acute onset of pain...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e31822c2896

    authors: Herliczek TW,Brown LL

    更新日期:2011-09-01 00:00:00

  • Comparison of electrocardiographic characteristics of adults and children for automated external defibrillator algorithms.

    abstract::Accurate rhythm identification is vital for appropriate shock delivery during pediatric resuscitation with an automated external defibrillator. Currently, extensive testing of pediatric algorithms is recommended. The aims of our study were to determine age-related differences in electrocardiographic (ECG) tracings in ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000149

    authors: Rustwick BA,Atkins DL

    更新日期:2014-12-01 00:00:00

  • Leaving Without Being Seen From a Pediatric Emergency Department: Identifying Caregivers' Perspectives Using Q-methodology.

    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

    authors: Moskalewicz RL,Pham PK,Liberman DB,Hall JE

    更新日期:2019-04-11 00:00:00

  • Is Serum Bicarbonate Level Associated With Negative Outcomes in Pediatric Patients?: A Retrospective Cohort Study.

    abstract:OBJECTIVES:Early identification of children at risk for adverse outcomes is important. Serum bicarbonate is easily collected and widely available. We described the relationship between bicarbonate and adverse outcomes in children presenting to the emergency department (ED). METHODS:We conducted a retrospective cohort ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000937

    authors: Poonai N,Mainprize D,Travers C,Vivas LLY,Tryphonopoulos P,Sangha G,Arbeau R,Seabrook J,Miller M,Sarpal A,Lim R

    更新日期:2017-11-01 00:00:00

  • A Rare Pediatric Case of Posttraumatic Pseudoaneurysm: Case Report and Literature Review.

    abstract::Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thri...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/PEC.0000000000001236

    authors: Gu A,Kam AJ

    更新日期:2019-12-01 00:00:00

  • Acute pancreatitis due to rotavirus gastroenteritis in a child.

    abstract:OBJECTIVES:Serum amylase can be elevated in various pathological conditions, but its primary application is as a biochemical test for the diagnosis of acute pancreatitis. Acute gastroenteritis has not been widely recognized as a cause for hyperamylasemia and pancreatitis. METHODS:We describe a case of acute pancreatit...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3181ea72a8

    authors: Parri N,Innocenti L,Collini S,Bechi F,Mannelli F

    更新日期:2010-08-01 00:00:00

  • Abdominal Cerebrospinal Fluid Pseudocyst Diagnosed by Point-of-Care Ultrasound.

    abstract::Abdominal cerebrospinal fluid pseudocyst is an uncommon complication of ventriculoperitoneal shunt and is seen more commonly in the pediatric population. The diagnosis of an abdominal cerebrospinal fluid pseudocyst is typically made by ultrasonography, which demonstrates a simple or loculated fluid collection in the a...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000826

    authors: Ivan Y,Hauptman J,Marin JR

    更新日期:2016-06-01 00:00:00

  • A Pulse Check on Leadership and Teamwork: An Evaluation of the First 5 Minutes of Emergency Department Resuscitation During Pediatric Cardiopulmonary Arrests.

    abstract:OBJECTIVES:Effective leadership and teamwork are imperative during pediatric cardiopulmonary resuscitations (CPR). The initial phase of pediatric CPR, termed the "first 5 minutes," has significant care delivery gaps in both leadership and team performance. The aim of the study was to describe the performance data of em...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001923

    authors: Grimsley EA,Cochrane NH,Keane RR,Sumner BD,Mullan PC,OʼConnell KJ

    更新日期:2019-12-13 00:00:00

  • Simulated pediatric trauma team management: assessment of an educational intervention.

    abstract:OBJECTIVES:Trauma is the leading cause of death in children. The quality of initial medical care received by injured children contributes to outcomes. Our objective was to assess effectiveness of an educational intervention on performance of emergency department (ED) teams during simulated pediatric trauma resuscitatio...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/PEC.0b013e31815a0653

    authors: Hunt EA,Heine M,Hohenhaus SM,Luo X,Frush KS

    更新日期:2007-11-01 00:00:00

  • Occult pneumonia in infants with high fever without source: a prospective multicenter study.

    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

    authors: Mintegi S,Benito J,Pijoan JI,Marañon R,Peñalba A,Gonzalez A,Muñoz G,Luaces C,Claret G

    更新日期:2010-07-01 00:00:00

  • Imported pediatric malaria presenting to an urban pediatric emergency department: a case series.

    abstract:OBJECTIVE:The objective of this study was to identify common presenting signs, symptoms, and laboratory findings of imported pediatric malaria presenting to a US pediatric emergency department (ED). METHODS:This is a retrospective chart review of all patients presenting to an urban pediatric ED between July 1, 2004, a...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e318276c88c

    authors: Schwartz KR,Vinci R

    更新日期:2012-12-01 00:00:00

  • Presentation and evaluation of sexual misuse in the emergency department.

    abstract::Children who have been sexually abused develop a variety of emotional and physical complaints, often unrelated to the genital area. Emergency department records of children diagnosed as being sexually abused were reviewed for the period covering January 1984 through June 1985. Of 26,000 patients seen, 300 cases of sex...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-198609000-00002

    authors: Seidel JS,Elvik SL,Berkowitz CD,Day C

    更新日期:1986-09-01 00:00:00

  • Importance of Urine Dipstick in Evaluation of Young Febrile Infants With Positive Urine Culture: A Spanish Pediatric Emergency Research Group Study.

    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

    authors: Velasco R,Benito H,Mozun R,Trujillo JE,Merino PA,de la Torre M,Gomez B,Mintegi S,Group for the Study of Febrile Infant of the RiSEUP-SPERG Network.

    更新日期:2016-12-01 00:00:00

  • Anticoagulation therapy: indications, monitoring, and complications.

    abstract::Anticoagulation for thromboembolic disease and bleeding, the main complication of anticoagulation therapy, are uncommon but are potentially life- or limb-threatening conditions that may present in the pediatric emergency department. Thromboembolic disease in children usually occurs as a complication of vascular access...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/PEC.0b013e31820461b1

    authors: Long E,Pitfield AF,Kissoon N

    更新日期:2011-01-01 00:00:00

  • Her belly button is leaking: a case of patent urachus.

    abstract::Patent urachus is one of the least commonly seen of the urachal anomalies. In this report, we present a case of a patent urachus in a15-day-old female who presented with leakage from the umbilical site. The purpose of this article is to discuss the embryology, clinical manifestations, diagnosis, and management of pate...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000280

    authors: Sherman JM,Rocker J,Rakovchik E

    更新日期:2015-03-01 00:00:00

  • Emergency department presentation and management of pediatric heart transplant recipients.

    abstract::The object of this study was to review and delineate the presenting complaints, signs, symptoms, and Emergency Department (ED) management of pediatric heart transplant recipients who presented to Loma Linda University Medical Center's (LLUMC) Emergency Department. A retrospective chart review was made of all of the pe...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-199512000-00006

    authors: Chinnock R,Sherwin T,Robie S,Baum M,Janner D,Mellick L

    更新日期:1995-12-01 00:00:00

  • Association of Socioeconomic Characteristics With Where Children Receive Emergency Care.

    abstract:OBJECTIVE:Outcomes of emergency care delivered to children vary by patient-level socioeconomic factors and by emergency department (ED) characteristics, including pediatric volume. How these factors intersect in emergency care-seeking patterns among children is not well understood. The objective of this study was to ch...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000002244

    authors: Chang L,Rees CA,Michelson KA

    更新日期:2020-09-16 00:00:00

  • The Use of Routine Blood Cultures in Pediatric Appendicitis.

    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

    authors: Thompson GC,Morrison E,Ross M,Liu H,Vanderkooi OG,Eccles R

    更新日期:2017-12-01 00:00:00

  • Epidemic Adolescent Binge Drinking at Lollapalooza, A Music Festival in Chicago.

    abstract:OBJECTIVES:Lollapalooza (LP) is an annual 3-day outdoor music festival in Chicago. Underage drinking and drug use are believed to be common, but the burden on emergency departments (EDs) has not been documented. We assessed the burden on health care resources associated with this music festival. METHODS:We performed a...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001072

    authors: McAndrew SE,Smith TL,Groothuis E,Koressel LR,Unti SM,Powell EC,Tanz RR

    更新日期:2019-06-01 00:00:00

  • Ultrasound-Guided Posterior Tibial Nerve Block for Plantar Foot Foreign Body Removal.

    abstract::Ultrasound-guided regional anesthesia is a growing modality within the pediatric emergency department. Here we present a case where a posterior tibial nerve block was used for anesthesia during foreign body removal from the plantar foot. We further review the technique and literature regarding this straightforward and...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/PEC.0000000000001897

    authors: Moake MM,Presley BC,Barnes RM

    更新日期:2020-05-01 00:00:00

  • A Case of Child Physical Abuse With a Rolling Pin Insertion, Resulting in Bladder and Rectal Perforation.

    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

    authors: Kondolot M,Doganay S,Turan C,Asil H,Oztop DB,Ozdemir C

    更新日期:2018-03-01 00:00:00

  • Holiday hazards.

    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

    authors: Baker MD

    更新日期:1985-12-01 00:00:00

  • Efficacy of vibration on venipuncture pain scores in a pediatric emergency department.

    abstract:OBJECTIVE:Venipuncture is a frequent source of painful procedures for infants. It has been well documented that infants react to pain with a combination of physiologic and behavioral responses. Infants are unable to describe pain and at particularly high risk for inadequate pain management. The Vibration Anesthesia Dev...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/PEC.0000000000000228

    authors: Secil A,Fatih C,Gokhan A,Alpaslan GF,Gonul SR

    更新日期:2014-10-01 00:00:00

  • Why not your pediatrician's office? A study of weekday pediatric emergency department use for minor illness care in a community hospital.

    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

    authors: Smith RD,McNamara JJ

    更新日期:1988-06-01 00:00:00

  • Pediatric prehospital evaluation of NYC respiratory arrest survival (PHENYCS).

    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

    authors: Tunik MG,Richmond N,Treiber M,Skomorowsky A,Galea S,Vlahov D,Blaney S,Kusick M,Silverman R,Foltin GL

    更新日期:2012-09-01 00:00:00

  • Chlamydia Conjunctivitis in 2 Prepubertal Children: An Uncommon Presentation of Child Sexual Abuse.

    abstract::Sexually transmitted infection as the result of child sexual abuse in prepubertal children is uncommon. Chlamydia trachomatis conjunctivitis is an even less common entity in prepubertal children outside the newborn period. This report details the presentation of 2 children with conjunctivitis who were subsequently dia...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001449

    authors: Brownell AD,Miraldi Utz V,Makoroff KL,Shapiro RA,Mortensen JE

    更新日期:2020-08-01 00:00:00

  • The edematous toddler: a case of pediatric Ménétrier disease.

    abstract::Ménétrier disease is a protein-losing gastroenteropathy, characterized clinically by nonspecific gastrointestinal symptoms and generalized edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. Distinct from its adult counterpart, Ménétrier disease of childhood usually remits spontaneou...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/PEC.0b013e3181887e89

    authors: Blackstone MM,Mittal MK

    更新日期:2008-10-01 00:00:00

  • Comminuted lumbar vertebral fracture with spinal cord compromise in an adolescent female after a minor fall.

    abstract::A 17-year-old adolescent girl with no past medical history presented to the emergency department with a chief complaint of lower back pain after sustaining a minor fall several hours earlier. Physical examination revealed mild to moderate back tenderness, and the result of review of systems was negative. Laboratory ev...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3181bec953

    authors: Arhinful E,Rosenthal A

    更新日期:2009-11-01 00:00:00

  • An adolescent with thigh pain.

    abstract::Musculoskeletal pain is a common symptom among active adolescent in the emergency department. The etiologic list is broad and range from benign to potential life-threatening conditions. Deep vein thrombosis is a rare cause of lower extremity pain in children. We report an adolescent who presented with lower extremity ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e31818c2856

    authors: Waseem M,Aslam M,Kumar K,Hernandez W

    更新日期:2008-11-01 00:00:00