Abstract:
OBJECTIVE:To estimate the prevalence of and to identify factors associated with prolonged emergency department length-of-stay (ED-LOS) for admitted children. METHODS:Data were from the 2001-2006 National Hospital Ambulatory Medical Care Survey. The primary outcome was prolonged ED-LOS (defined as total ED time >8 hours) among admitted children. Predictor variables included patient-level (eg, demographics including race/ethnicity, triage score, diagnosis, and admission to inpatient bed vs intensive care unit), physician-level (intern/resident vs attending physician), and system-level (eg, region, metropolitan area, ED and hospital type, time and season, and diagnostic and therapeutic procedures) factors. Multivariable logistic regression was performed to identify independent predictors of prolonged ED-LOS. RESULTS:Median ED-LOS for admitted children was 3.7 hours. Thirteen percent of pediatric patients admitted from the ED experienced prolonged ED-LOS. Factors associated with prolonged ED-LOS for admitted children were Hispanic ethnicity (odds ratio [OR], 1.76; 95% confidence interval [95% CI], 1.10-2.81), ED arrival between midnight and 8 a.m. (OR, 2.80; 95% CI, 1.87-4.20), winter season (January-March: OR, 1.81; 95% CI, 1.20-2.74), computed tomography scan or magnetic resonance imaging (OR, 1.65; 95% CI, 1.05-2.58), and intravenous fluids or medications (OR, 1.81; 95% CI, 1.10-2.97). Children requiring ICU admissions (OR, 0.29; 95% CI, 0.11-0.77) or receiving pulse oximetry in the ED (OR, 0.52; 95% CI, 0.34-0.81) had a lower risk of experiencing prolonged ED-LOS. CONCLUSIONS:We found that prolonged ED-LOS occurs frequently for admitted pediatric patients and is associated with Hispanic ethnicity, presentation during winter season, and early morning arrival. Potential strategies to reduce ED-LOS include improved availability of interpreter services and enhanced staffing and additional inpatient bed availability during winter season and overnight hours.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Bekmezian A,Chung PJ,Cabana MD,Maselli JH,Hilton JF,Hersh ALdoi
10.1097/PEC.0b013e31820943e4subject
Has Abstractpub_date
2011-02-01 00:00:00pages
110-5issue
2eissn
0749-5161issn
1535-1815journal_volume
27pub_type
杂志文章abstract:OBJECTIVE:A brief resolved unexplained event (BRUE) in infancy is a common reason for visiting the emergency department. However, little is known about the long-term outcomes of such an event. This study evaluates future mortality, morbidity, and/or developmental outcome after a BRUE. METHODS:A single-center retrospec...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001816
更新日期:2019-11-01 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 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:OBJECTIVES:Pediatricians routinely advise parents to seek immediate medical attention if their young infant develops a fever. Many parents rely on palpation to assess their child's temperature. Our objective was to determine the prevalence and accuracy of parental palpation for fever in young infants. METHODS:We enrol...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819dac6
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate cervical spine motion using 2 manual inline immobilization techniques with the use of a human simulator model. METHODS:Medical students, pediatric and family practice residents, and pediatric emergency medicine fellows were recruited to maintain cervical manual in line im...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000245
更新日期:2015-09-01 00:00:00
abstract::Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovas...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000992
更新日期:2019-06-01 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::Of the multitude of neurologic injuries related to roller-coaster rides, a majority of them are reported about adults. In this case, we present a patient who presented to the pediatric emergency department with new-onset seizure and hemiplegia 2 days after a roller-coaster ride. She was ultimately diagnosed with a sub...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001802
更新日期:2019-04-01 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:OBJECTIVE:To develop a clinical prediction rule that would be easy to apply and be useful for predicting success or failure of peripheral intravenous line insertion in children. METHODS:This was a prospective cohort study of children aged 0 to 21 years undergoing peripheral intravenous placement by staff nurses in a p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181666f32
更新日期:2008-03-01 00:00:00
abstract::Tongue entrapment in bottles and cans is rare, but occurs. The following is a case report of a 10-year-old female who got her tongue entrapped in an aluminum juice can. The anatomy of the tongue, complications from injury, and a proposed removal procedure are described. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000121245.99242.2e
更新日期:2004-04-01 00:00:00
abstract::A case of Salmonella vertebral osteomyelitis with epidural abscess in a child with sickle cell anemia is presented. Spinal osteomyelitis is a rare event in children. Although osteomyelitis in sickle cell anemia may occur in any bone, it has most often been documented as beginning in the medullary cavity of the long an...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::The sting from Centuroides sculpturatus, commonly known as the bark scorpion, is a serious medical problem and can be potentially fatal to young children. Centuroides sculpturatus envenomation can cause a wide spectrum of symptoms, often including autonomic dysfunction, cranial nerve abnormalities, and somatic motor a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001301
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVES:The Accreditation Council for Graduate Medical Education requires pediatric residency training programs to provide exposure to the prehospital management and transport of patients. The authors hypothesized that compared with a similar study a decade prior, current pediatric residency training programs have r...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823ed4ab
更新日期:2012-01-01 00:00:00
abstract::Astemizole (Hismanal-Janssen, New Brunswick, NJ) is a nonsedating antihistamine that has the advantage of a once-daily dosage schedule. This article reports the case of a 14-year-old female who intentionally ingested 270 mg of Astemizole and developed torsade de pointes, a form of polymorphic ventricular tachycardia t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199302000-00008
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To describe the clinical course and determine the minimal observation period required following isopropanol ingestion in children. METHODS:The emergency department records of children less than 6 years of age with isopropanol ingestion who presented between June 1992 and December 1998 were identified. Demogr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200008000-00005
更新日期:2000-08-01 00:00:00
abstract::A 5-year-old female with Charcot-Marie-Tooth neuropathy and a history of constipation presented to the emergency department with a new blistering buttocks rash, which was initially concerning for nonaccidental burn. Upon further investigation, it was found that Ex-Lax had been given to the patient for constipation. Th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001498
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to describe a single institutional experience with pediatric diffuse pulmonary hemorrhage, with an emphasis on etiology, clinical course, and outcome. METHODS:The medical records of pediatric patients admitted to Assaf Harofeh Medical Center between the years 2002 and 2011 beca...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318271c107
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:This study was performed to determine the doses of midazolam used for sedation during procedures in children, and the frequency of adverse events. METHODS:We performed a retrospective analysis of data collected for a prospective study of flumazenil in children who had received midazolam for a procedure (n = ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199906000-00001
更新日期:1999-06-01 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:BACKGROUND:Single-use detergent sacs (SUDS) are widely used in North America and Europe with emerging literature on their toxicity. This is the first Canadian multicenter study aimed to quantify and compare SUDS exposures to traditional detergent exposures. METHODS:A retrospective review of the Canadian Hospitals Inju...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000835
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:Acute asthma exacerbations are among the most common reasons for childhood emergency department (ED) visits and hospitalizations. Although early ED administration of asthma medication has been shown to decrease hospitalizations, studies of factors associated with early ED asthma medication delivery have been...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001609
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Child abuse is a leading pediatric public health problem. Pediatric emergency physicians are on the front line to identify and respond to child abuse. The physician's response to suspected child abuse cases is influenced by educational content and experience. OBJECTIVE:To determine pediatric emergency medic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199912000-00002
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVES:Head trauma is one of the main causes of death in childhood and often leaves severe disability with serious neurological damage. Appropriate treatment must be provided immediately to improve outcomes. This study was performed to identify factors associated with a poor prognosis at an early stage of severe he...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000001321
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The objective was to derive a simple clinical scoring instrument for assessing children with croup by telephone for use in clinical research studies. METHODS:We reviewed published literature on croup scores, surveyed experienced pediatric emergency nurses and physicians, and conducted a prospective cohort st...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000796
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:Real-time audiovisual consultation (telemedicine) has been proven feasible and is a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000957
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Despite rapidly increasing incidence of skin and soft tissue infections (SSTIs) presenting to emergency departments (EDs), outcome data for these infections are limited. METHODS:This is a retrospective cohort study of children with culture-positive SSTI, managed as outpatients from a large pediatric ED in t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318203ca1c
更新日期:2011-01-01 00:00:00
abstract::Vomiting in young infants is a common presentation to the pediatric emergency department with a broad differential diagnosis. We present 2 cases seen in our emergency department of infant females with symptomatic complex ovarian cysts who presented with vomiting. The first case study describes a patient with a prenata...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002209
更新日期:2020-08-10 00:00:00
abstract::Omeprazole; the first proton pump inhibitor (PPI) showing an effective acid inhibitory ability, provides the satisfactory therapy either in gastro-esophageal reflux symptom relief or in healing of erosive esophagitis. It's also effective in peptic ulcer disease. Up to date, omeprazole efficacy and safety are well esta...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000173350.45648.9b
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations have altered practice. We sought to determine if a temporal change exists in the number of prehospital pediatric trauma intubations since the 20...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000759
更新日期:2016-08-01 00:00:00