Abstract:
BACKGROUND:Published rates of delayed diagnosis of injury (DDI) in pediatric trauma vary from 1.0% to 18%. The purpose of this study was to determine the long-term trend of DDI over 10 years, to identify risk factors associated with DDI, and to elucidate patterns of DDI. METHODS:All patients aged 14 and younger who were admitted to Parkview Hospital for major trauma between January 1, 1997 and December 31, 2006 were included (1100 patients). Data were collected from a trauma registry that is maintained of all trauma admissions. RESULTS:A total of 47 delayed diagnoses of injury were found in 44 patients for a rate of 4.0%. Patients with a DDI were more likely to have been intubated in the emergency department, transported by air, have an Injury Severity Score greater than 15, and have a Glasgow Coma Scale below 8 (P < 0.05). Mean intensive care unit and overall length of stay was longer in the DDI group. Missed injuries resulted in a change in therapy in 80% of cases. There were 5 missed intra-abdominal injuries, 4 of which required surgery. Three injuries were discovered upon outpatient follow-up. There was a trend for more missed upper extremity injuries in older patients and missed lower extremity injuries in younger patients. CONCLUSIONS:The rate of missed injuries remained relatively constant over the past 10 years at our institution. More severely injured patients are more likely to have missed injuries. Special attention to the lower extremities of the younger trauma patient may be warranted.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Williams BG,Hlaing T,Aaland MOdoi
10.1097/PEC.0b013e3181b0a07dsubject
Has Abstractpub_date
2009-08-01 00:00:00pages
489-93issue
8eissn
0749-5161issn
1535-1815journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. METHODS:Four electronic databases were searched to identify screening in...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001020
更新日期:2017-12-01 00:00:00
abstract::Vertebral artery dissection is an unusual cause of stroke especially in children. The majority of dissections are thought to be caused by trauma although in many cases the trauma may be trivial. In other cases, certain underlying pathological processes are thought to be risk factors. We report a case of vertebral arte...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200006000-00014
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were (1) to evaluate dog bite-related injuries and associated medical documentation and (2) to compare these results with a study of dog bites from the same institution 10 years prior. METHODS:Data were retrospectively collected from a pediatric emergency department from July 20...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001132
更新日期:2019-09-01 00:00:00
abstract::The cause of a fever of unknown origin (FUO, fever of >21 days without an identified etiology) may be a common illness, an atypical presentation of a common illness, or an unusual illness. A patient with an FUO occasionally presents to the emergency department (ED). The differential diagnosis of an FUO is extensive. A...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181bec8df
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:This study aimed to explore a dose-response relationship of delta-9-tetrahydrocannabinol (THC) in THC-naïve children after unintentional acute exposure and compare clinical outcomes with non-naïve children. METHODS:A retrospective review was performed on children aged 31 days to 20 years who presented to Ch...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000770
更新日期:2018-07-01 00:00:00
abstract::Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have b...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31826d1e9a
更新日期:2012-10-01 00:00:00
abstract::Hair-thread tourniquet syndrome is defined as the ischemic strangulation of hair resulting in edema and severe pain and may cause amputation of organs. Strangulation of the external genitalia (clitoris, labia minora) has rarely been described in girls. Here, we present a case of hypertrophic clitoris injury secondary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000341
更新日期:2015-05-01 00:00:00
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
更新日期:2014-12-01 00:00:00
abstract::The diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significan...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001104
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:To examine attitudes toward the use of oral rehydration therapy (ORT) by pediatric emergency medicine physicians before and after being given recent data that might affect their practice and to see if there is a difference in responses based upon year of graduation from medical school. METHODS:A national su...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318149f66f
更新日期:2007-09-01 00:00:00
abstract:PURPOSE:To determine the requirements in all states and the District of Columbia for use of restraints on patients in ambulances. MATERIALS AND METHODS:A structured telephone survey was conducted with all state Emergency Medical Services (EMS) agencies or the agency responsible for the regulation of ambulances. Questi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199806000-00014
更新日期:1998-06-01 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:BACKGROUND:The utility of testing for urinary tract infection (UTI) in febrile infants with bronchiolitis is indeterminate. OBJECTIVE:The objective of this study was to investigate if the incidence of UTIs in febrile infants 2 to 12 months of age with bronchiolitis is higher than the presumed incidence of asymptomatic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001912
更新日期:2019-12-03 00:00:00
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
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To evaluate computed tomography (CT) findings in pediatric patients with viral gastroenteritis who presented with clinical features of acute abdomen. PATIENTS AND METHODS:During 2 seasons of viral gastroenteritis from 2005 to 2007, 302 children with acute gastrointestinal symptoms were admitted to our center...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181850cc8
更新日期:2008-09-01 00:00:00
abstract::Hereditary angioedema is a disorder characterized by decreased levels or function of complement C1 esterase inhibitor. Symptoms in children generally consist of recurrent episodes of soft tissue swelling. On rare occasion, it can cause airway edema which may lead to airway obstruction. A case is presented of a child p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000150985.81109.0d
更新日期:2005-01-01 00:00:00
abstract::Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an underdiagnosed disease that has been described thus far only in case series. Patients, the majority of which are females, develop neuropsychiatric symptoms that can often be misdiagnosed as purely psychiatric illness. Although teratomas are nearly pathognom...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001853
更新日期:2019-09-01 00:00:00
abstract::Adolescents infected with the human immunodeficiency virus (HIV) often confront the clinician with difficult medical problems. Besides the host of opportunistic infections, which can affect these patients, side effects from medications can be frequent and, at times, life-threatening. We report a case of aseptic mening...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199706000-00010
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:The objectives of this study were: 1) to determine whether obtaining intraosseous (IO) blood samples was practical during cardiopulmonary resuscitation (CPR), and 2) to compare the acid-base status (pH and partial pressure of CO2 (PCO2) of venous and IO blood during CPR. DESIGN:A prospective repeated measure...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199708000-00002
更新日期:1997-08-01 00:00:00
abstract::We present an instructive case of a 5-week-old infant seen in the emergency department with acute inspiratory stridor and depressed level of consciousness. His emergency department course identified an acute opiate intoxication. The child also developed chest wall rigidity, a rare complication of narcotic use. We disc...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000144921.85747.e0
更新日期:2004-11-01 00:00:00
abstract::During a 12-month period ending on 11/30/88, data were collected on 143 pediatric patients visiting a pediatric emergency department with burns. Sixty-four percent were males. Common causes of the burns included hot water (17%), hot food (23%), hot appliances (18%), and charcoal and grills (9%). Sixty-six percent of t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199104000-00004
更新日期:1991-04-01 00:00:00
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
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To validate a previously published clinical decision rule to predict risk of urinary tract infection in febrile young girls. METHODS:We performed a retrospective case-control study at a children's hospital emergency department in a different city than that in which the original derivation study took place. G...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000081238.98249.40
更新日期:2003-06-01 00:00:00
abstract::We report a case of a patient presenting with fever, right lower leg swelling, and pain who was found to have a fluid collection between muscle planes noted on point-of-care ultrasound. Point-of-care ultrasound raised the clinician's concern for deep musculoskeletal infection, leading to prompt initiation of antibioti...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001711
更新日期:2019-01-01 00:00:00
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
更新日期:2019-12-01 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:BACKGROUND:Acute appendicitis is the most common surgical emergency during childhood. Accurate early diagnosis is important to avoid complications and unnecessary interventions. In 2002, Samuel developed the Pediatric Appendicitis Score (PAS) based on a series of data obtained from anamnesis, physical examination, and ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182586d34
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Optimizing patient/family caregiver satisfaction with emergency department (ED) encounters has advantages for improving patient health outcomes, adherence with medical plans, patient rights, and shared participation in care, provider satisfaction, improved health economics, institutional market share, and li...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318235be06
更新日期:2011-11-01 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:In 1997, a Canadian task force published evidence-based guidelines for diagnosing pediatric pneumonia, concluding that the absence of each of four signs (ie, respiratory distress, tachypnea, crackles, and decreased breath sounds) accurately excludes pneumonia. The study was performed to evaluate the accuracy...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00003
更新日期:2001-08-01 00:00:00