Abstract:
OBJECTIVES:Children returning to the emergency department (ED) within 72 hours of their visit may increase overcrowding and health care costs. Identifying the characteristics of returning children who need admission may help distinguish who might need admission on their first visit. The objective of this study was to compare the characteristics of children who returned to the ED and needed admission to the characteristics of those discharged. METHODS:The study used a retrospective chart review of patients 19 years and younger visiting a tertiary pediatric ED during a 1-year period. We excluded patients who left without being seen and those leaving against medical advice. We determined the rate of return visits and then performed χ² and Student t test analyses. Main outcome measures were return and subsequent hospital admission rate to the ED. RESULTS:Of 47,655 eligible children, 2115 (4.4%) returned to the ED within 72 hours. The admission rate for the second visit was 353 (16.7%). There was no significant difference in age, sex, language spoken at home, or time elapsing from the first visit to the re-presentation to the ED between children who needed admission on the returned visit and those discharged when returning. The acuity was significantly lower among children discharged after returning (P < 0.001) but not among those admitted (P < 0.22). CONCLUSIONS:More than 4% of our pediatric ED visits are for children returning within 72 hours. Progression of illness resulting in higher acuity, not age, sex, time from previous visit, or change in chief complaint category, was associated directly with admission on the second visit.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Goldman RD,Kapoor A,Mehta Sdoi
10.1097/PEC.0b013e31822c1273subject
Has Abstractpub_date
2011-09-01 00:00:00pages
808-11issue
9eissn
0749-5161issn
1535-1815journal_volume
27pub_type
杂志文章abstract:OBJECTIVES:To describe an expedited process for collecting social and cultural data before program planning to develop emergency medical services for children in La Paz, Bolivia. The overall goal was to understand the relevant issues from the point of view of those most affected. METHODS:An interdisciplinary collabora...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000139737.08474.b0
更新日期:2004-09-01 00:00:00
abstract::Tooth decay is common in US children, especially for children in low-income families. More than half of second-grade children have cavities. Therefore, root canal procedures are becoming more common in children. We report a case of a 2-year-old boy with a rare complication of a root canal procedure secondary to sodium...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318226e166
更新日期:2011-08-01 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::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::The use of the emergency department by children on Medicaid was documented, and the effect of new adult Medicaid criteria on a pediatric emergency department was investigated. Eight percent of daytime visits by all patients were nonemergencies, compared to 15% by Medicaid patients. More Medicaid patients required admi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198709000-00003
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVES:Previous research has demonstrated that accidental unsupervised ingestions (AUIs) were responsible for the majority of cough and cold medication (CCM) ingestions leading to significant adverse events (AEs) in children. The objective of this analysis was to characterize the role of AUIs in the morbidity assoc...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002166
更新日期:2020-06-22 00:00:00
abstract:INTRODUCTION:Escitalopram is rarely associated with prolongation of the QTc interval; however, there are no reported cases of QRS complex widening associated with escitalopram overdose. We report a case of a patient who presented with both QRS complex widening and QTc interval prolongation after an escitalopram overdos...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a314b7
更新日期:2013-09-01 00:00:00
abstract::Meningoencephalitis and acute disseminated encephalomyelitis (ADEM) are both neurological disease processes, but there have been few cases of meningoencephalitis progressing to ADEM in the pediatric population. A case of a 4-year-old girl with an initial diagnosis of meningoencephalitis is presented here, whose initia...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000107
更新日期:2014-04-01 00:00:00
abstract::Foreign body aspirations in children are relatively uncommon occurrences, but they can be a serious events, causing respiratory distress, atelectasis, chronic pulmonary infections, or death. Safety pins are not commonly aspirated objects and account for less than 3% of all foreign bodies found in the tracheobronchial ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199712000-00011
更新日期:1997-12-01 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::Urinary retention can be described as the inability to void volitionally despite an adequate volume of urine in the bladder. It is a common complaint in adults, especially among elderly males with benign prostatic hyperplasia. Children, in contrast, are more likely to have voluntary retention of urine due to urethral ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31812eef59
更新日期:2007-08-01 00:00:00
abstract::Emergency department (ED) overcrowding has been a serious issue on the national agenda for the past 2 decades and is rapidly becoming an increasingly significant problem for children. The goal of this report is to focus on the issues of overcrowding that directly impact children. Our findings reveal that although over...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000280518.36408.74
更新日期:2007-07-01 00:00:00
abstract::Constipation is a common cause of pediatric abdominal pain seen in pediatric emergency departments (EDs). We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000166
更新日期:2014-07-01 00:00:00
abstract::Since its introduction into clinical practice, it has been known that fentanyl and other synthetic opioids may cause skeletal muscle rigidity. Involvement of the respiratory musculature, laryngeal structures, or the chest wall may impair ventilation, resulting in hypercarbia and hypoxemia. Although most common with th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182535a2a
更新日期:2012-05-01 00:00:00
abstract::Fructose-1,6-diphosphatase (FDPase) enzyme deficiency is a rare inherited metabolic disease. Affected patients usually present with metabolic crisis including hypoglycemia, acidosis, ketonuria, and hyperuricemia. A previously healthy 8-month-old male infant presented with fever, vomiting, and hypoactivity. He had tach...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823b412d
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:Although retropharyngeal infection (RPI) may present with voice change, drooling, fever, and a toxic appearance, diagnosis based on symptoms alone is unreliable. As incidence is increasing in children and drug-resistant bacterial strains such as methicillin-resistant Staphylococcus aureus are becoming more...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001318
更新日期:2020-05-01 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::Most fire-related deaths are attributable to smoke inhalation rather than burns. The inhalation of fire smoke, which contains not only carbon monoxide but also a complex mixture of gases, seems to be the major cause of morbidity and mortality in fire victims, mainly in enclosed spaces. Cyanide gas exposure is quite co...
journal_title:Pediatric emergency care
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1097/PEC.0b013e3182aa4ee1
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario. METHODS:Children who presented with fever and had presumptive clinical diagnosis of pneumonia were evalua...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181e05779
更新日期:2010-06-01 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:OBJECTIVES:QTc interval is significant because prolongation may lead to ventricular dysrhythmia. Computerized electrocardiogram machines typically measure QT interval length and, using an algorithm assessment of multiple leads, calculate a QTc value. Manual measurement of the QT interval used to calculate the QTc value...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002125
更新日期:2020-06-01 00:00:00
abstract::An 8-year-old girl presented to the pediatric emergency department (ED) with left-sided weakness. Workup consisted of labs and imaging including magnetic resonance imaging showing an acute ischemic stroke. Literature regarding pediatric acute ischemic stroke is minimal, and there are few protocols guiding care in the ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000436
更新日期:2017-03-01 00:00:00
abstract::Chronic hematomas are defined as hematomas with slow, progressive growth over many weeks. They are an extremely rare cause of acute neck swelling in the pediatric population. They consist of an organized central mass of blood with granulation tissue and fibrotic changes peripherally. The presence of a capsule prevents...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001402
更新日期:2018-02-01 00:00:00
abstract::Expected clinical manifestations of intussusception include paroxysmal abdominal pain, vomiting, abdominal mass, and with time, rectal bleeding. We report a case where lethargy and vomiting are the presenting complaints. Diagnostic delay was encountered for this infant who had altered sensorium without accompanying pa...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198706000-00015
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:To identify the source of acquisition of infant walkers and attitudes regarding the continuing use of walkers following an injury to an infant in order to design preventive strategies. DESIGN:Descriptive and retrospective. SETTING:Emergency department of a children's hospital involved in primary, secondary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199606000-00008
更新日期:1996-06-01 00:00:00
abstract::Although the prevalence of hypertension in the pediatric population is estimated at only 1% to 2%, hypertensive urgencies and emergencies may be encountered in the emergency department. Efficient management of these children is of utmost importance to avoid some of the life-threatening complications associated with hy...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000166733.08965.23
更新日期:2005-06-01 00:00:00
abstract::Although brachial plexus injury occurring during multitrauma is frequent in adults, it is rarely observed in childhood. The most common cause of pediatric traumatic brachial palsy is motor vehicle accidents followed by pedestrian struck. Generally, phrenic nerve palsy accompanying brachial plexus trauma is observed in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31829ec20b
更新日期:2013-08-01 00:00:00
abstract::Infective uvulitis is a rare condition in children. In this report, we describe the case of a 4-year old-patient who presented a group A Streptococcus pharyngitis with uvulitis. No signs of epiglottitis were detected at nasal fibroscopy. She recovered rapidly with intravenous antibiotic therapy and 2 days of corticost...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002258
更新日期:2020-10-07 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: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