Abstract:
OBJECTIVE:Each day, children incur more than 69,000 emergency department (ED) visits, with 58% to 82% of them for nonurgent reasons. The objectives of this study were to elicit and to describe guardians' and health professionals' opinions on reasons for nonurgent pediatric ED visits. METHODS:Focus groups sessions were held with 3 groups of guardians, 2 groups of primary care practitioners, and 1 group of pediatric emergency medicine physicians. Participants identified unique factors and their importance related to nonurgent ED use. RESULTS:A total of 25 guardians and 42 health professionals participated. Guardians had at least 1 child younger than 5 years, most were self-identified racial/ethnic minorities, and nearly all had taken a child to an ED. Guardians focused on perceived illness severity in their children and needs for diagnostic testing or other interventions, as well as accessibility and availability at times of day that worked for them. Professionals focused on systems issues concerning availability of appointments, as well as parents' lack of knowledge of medical conditions and sense of when use of the ED was appropriate. CONCLUSIONS:Guardians' concerns about perceptions of severity of illness in children and their schedules must be considered to effectively reduce nonurgent ED use, which may differ from the perceptions of professionals. Health professionals and systems seeking ways to decrease ED utilization may be able to better match capacity to demand both by increasing accessibility to primary care and by working to overcome guardians' perceptions that only EDs can handle acute illnesses or injuries.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Fieldston ES,Alpern ER,Nadel FM,Shea JA,Alessandrini EAdoi
10.1097/PEC.0b013e318248b431subject
Has Abstractpub_date
2012-03-01 00:00:00pages
220-5issue
3eissn
0749-5161issn
1535-1815journal_volume
28pub_type
杂志文章abstract::It has been estimated that up to 27% of all medical emergencies presenting to emergency departments are due to hypertension, predominantly in the adult population. Although this often is an insidious process, acutely, a hypertensive emergency occurs when a patient presents with severe hypertension and evidence of end ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181a34816
更新日期:2009-05-01 00:00:00
abstract::Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. We present a case of a newborn girl, where intraoss...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000150
更新日期:2014-06-01 00:00:00
abstract::We describe the first ziprasidone overdose with quantitative serum levels of a pediatric patient in coma and with pinpoint pupils. This case is an important contribution to the pediatric ziprasidone literature because it illustrates that ingestion of just 1 pill may result to profound mental status and respiratory dep...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819e3775
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:To assess the effect of adding a shared research nurse on patient enrollment in an ongoing clinical study. DESIGN:Before/after comparison of recruitment rates and consent rates involving patients eligible for a study of blood culture collection strategies for methods on the detection of bacteremia and deter...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199610000-00004
更新日期:1996-10-01 00:00:00
abstract::We report a case of baby powder inhalation (BPI), causing adult respiratory distress syndrome (ARDS) in a 16-month-old girl, with follow-up after six years. Pulmonary function studies in the child and her monozygotic twin, used as a control, were normal. The testing consisted of diffusing capacity to carbon monoxide a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198903000-00014
更新日期:1989-03-01 00:00:00
abstract::A 22-month-old girl without any significant medical history accidentally consumed a small amount of a therapeutic compounding cream that contained camphor, gabapentin, clonidine, ketoprofen, and lidocaine. Upon presentation to the emergency department, the child exhibited immediate onset of altered mental status with ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000790
更新日期:2018-04-01 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:OBJECTIVE:To determine if intramuscular (IM) penicillin is more effective than oral (PO) amoxicillin in the early outpatient treatment of pediatric patients with presumed bacterial pneumonia. METHODS:Prospective, randomized, evaluator-blinded, clinical trial. SETTING:Pediatric emergency department (ED) of an urban ch...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:The emergency department (ED) can be an effective site for pediatric injury prevention initiatives, including child passenger safety. The objectives of this study were to evaluate the implementation of an ED child passenger safety program and to analyze the effectiveness of a computerized screening tool to i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000210
更新日期:2014-09-01 00:00:00
abstract::The ingestion of foreign bodies remains a common occurrence in children. Most ingested foreign bodies pass spontaneously, although up to 1% will result in intestinal perforation. Specific foreign bodies such as sharp, pointed, or corrosive objects have been typically associated with perforation. The initial diagnosis ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3180302be6
更新日期:2007-02-01 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:OBJECTIVES:This study aimed to estimate the incidence of emergency department (ED) visits in the neonatal period in a nationally representative sample and to examine variation by race. METHODS:The National Hospital Ambulatory Medical Care Survey is a nationally representative survey of utilization of ambulatory care s...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000120
更新日期:2014-05-01 00:00:00
abstract::Serious intra-abdominal injuries in neonates are very rare. In addition, the signs and symptoms of hemoperitoneum caused by bleeding from solid viscera are vague and nonspecific and often are not recognized before the onset of hypovolemic shock or death. In this report, we describe a 2-day-old infant who presented wit...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-200002000-00009
更新日期:2000-02-01 00:00:00
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
更新日期:2007-11-01 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: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::Visual disturbances resulting from acute nerve paralysis of the muscles controlling eye movements can be challenging to evaluate in the pediatric population. Children may not be capable of describing symptoms or providing an adequate history. Therefore, it is important to have an understanding of the anatomical course...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000391
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Children with status asthmaticus (SA) often present with fever and are evaluated with chest radiographs (CXRs). In the absence of a confirmatory test for bacterial infection, antibiotics are started whenever there are radiological infiltrates or if there is a suspicion of pneumonia. We undertook this study t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001259
更新日期:2019-10-01 00:00:00
abstract::The purpose of this study is to report 18 cases of membranous laryngotracheobronchitis (MLTB) and to review 143 published cases in order to accurately characterize the epidemiology, presentation, clinical course, treatment, and outcome of patients with this disorder. The male:female ratio was 2:1; mean age was four ye...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199112000-00004
更新日期:1991-12-01 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::Retropharyngeal abscess is a rather rare, deep-neck infection of children and may seriously compromise the airway and mimic other diseases. A retrospective review of 17 cases of retropharyngeal abscess presenting to The Children's Hospital, Denver, from 1976 to 1986 was performed. Nine children (56%) had stridor or ai...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198803000-00003
更新日期:1988-03-01 00:00:00
abstract::Neisseria meningitidis serogroup A septicemia and the development of Kawasaki disease in a 10-month-old male infant are described. The patient also experienced a number of primary/septic manifestations as consequences of the direct infectious assault and secondary/hypersensitivity immune-mediated complications. The pr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819a8bab
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:Pediatric care is increasingly regionalized, increasing rates of interfacility transport (IFT). However, it is unknown what conditions most frequently require IFT. This study's objective was to identify high-frequency pediatric conditions requiring IFT. METHODS:This is a statewide retrospective observationa...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001578
更新日期:2018-09-11 00:00:00
abstract::Isolated torsion of the fallopian tube is a rare cause of an acute lower abdominopelvic pain in adolescent females that is difficult to recognize preoperatively. This is a case report of an 11-year-old girl who presented with a right lower quadrant abdominal pain, nausea, and vomiting secondary to isolated torsion of ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318177a727
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:Patients returning to the emergency department (ED) within 72 hours of their visit may contribute to crowding and might indicate failure to give a proper assessment, treatment, or follow-up instructions. The aim of this study was to describe the rate of return visits in a tertiary care pediatric ED (PED) and...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230553.01917.05
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVES:Ondansetron has been shown to decrease admission rate and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001343
更新日期:2020-03-01 00:00:00
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
更新日期:1986-09-01 00:00:00
abstract::Diaphragmatic hernia in pediatric emergency department poses a diagnostic challenge because of the acute or subtle timing of onset and the wide variety of clinical features. We describe 3 different late presentations of Bochdalek diaphragmatic hernia in a pediatric emergency department. These reports may help physicia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000425
更新日期:2015-05-01 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::The development of leadership and management skills requires a commitment to personal introspection and the development of self-knowledge. Difficult decisions concerning the determination of that which is truly important is central to the process. At both the personal and organizational levels, this process can be fac...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199506000-00014
更新日期:1995-06-01 00:00:00