Abstract:
BACKGROUND:The use of observational units (OUs) in pediatric emergency departments (EDs) has become an important adjunct to emergency care. An extended observation period (4 to 23 hours) in the ED has decreased both the number of admissions and prolonged use of acute ED beds. This serves to increase patient satisfaction as well as optimizing care. The use of OUs allows for the most appropriate allocation of resources. These units are typically located within the ED or immediately adjacent to it. The ED physicians are the gatekeepers of the unit and serve as the medical supervision for these patients. The Children's Hospital of Philadelphia developed an OU known in the hospital as the Emergency Department Extended Care Unit (EDECU) approximately 5 years ago. In order for the EDECU to function at its fullest potential, the ED at The Children's Hospital of Philadelphia has opted to use the ED nurse practitioners (NPs) to enhance the care for these patients. OBJECTIVE:The NP has been an integral member of the ED for the past 10 years with primary roles in urgent care and in the follow-up program. As the ED expanded to include the EDECU, the role of the NP also developed to meet the needs of these patients. A review of the role development of the ED NP in observation medicine and the impact on patient and staff satisfaction as well as contributing to fiscally responsible care will be addressed. METHODS:A retrospective review of the NP's role development in the evolution of the EDEDU. RESULTS:Incorporation of the NP in the treatment team has provided efficient use of professional staff, comprehensive patient care, and increased patient satisfaction. CONCLUSIONS:The use of the EDECU has become an important part of the services offered in the ED at The Children's Hospital of Philadelphia. The integration of the NP in a pivotal role allows for optimal use of human resources, and provides efficient, cost-effective patient care in the ED.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Silvestri A,McDaniel-Yakscoe N,O'Neill K,Bradley D,Hawkins H,Holleran R,Burke P,Hohenhaus S,Howard PKsubject
Has Abstractpub_date
2005-03-01 00:00:00pages
199-202issue
3eissn
0749-5161issn
1535-1815pii
00006565-200503000-00011journal_volume
21pub_type
杂志文章abstract:OBJECTIVE:To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries. DESIGN:A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006. SETTING:The C...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181cd7f3f
更新日期:2010-01-01 00:00:00
abstract::We present a case of a 4-month-old girl referred to the emergency department with a provisional diagnosis of acute life-threatening event with a recent episode of heart block and a history of long-lasting fever. Soon after admission, the child suddenly deteriorated rapidly; she became pulseless with complete heart blo...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000195757.74328.68
更新日期:2006-01-01 00:00:00
abstract::We present a case of a six-week-old infant who developed life-threatening complications after unintentional sodium bicarbonate intoxication. Baking soda was being used by the mother as a home remedy to "help the baby burp." A review of the literature regarding the use (or misuse) of baking soda follows. Our patient, a...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:
更新日期:1995-04-01 00:00:00
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::Young female patients with gynecologic complaints, including vaginal discharge, commonly seek care in the emergency department. Prepubertal vaginal discharges have various potential etiologies including nonspecific vulvovaginitis, infections, inflammatory or dermatologic processes, precocious puberty, malignancy, anat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/pec.0b013e31815c9dd2
更新日期:2007-12-01 00:00:00
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
更新日期:1985-12-01 00:00:00
abstract::Deep vein thrombosis (DVT) and pulmonary embolism (PE) are relatively rare occurrences in the pediatric population. However, DVT and PE are associated with significant morbidity and mortality to the patient if not promptly diagnosed and treated. We describe the case of a 5-year-old boy that was diagnosed in our emerge...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318267ea4e
更新日期:2012-09-01 00:00:00
abstract:STUDY OBJECTIVE:To document the current epidemiology of pediatric injury-related deaths in a rural state and evaluate changes over time. DESIGN:Retrospective review of injury-related deaths in children less than 15 years of age. Data were obtained from death certificates and coroner, autopsy, prehospital, and hospital...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199812000-00002
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVES:Pediatric refusal of medical assistance (RMA) is a potentially high-risk event with implications for both individual patient outcomes and greater emergency medical services system efficiency. The purpose of this study was to describe characteristics of pediatric RMA calls and outcomes. METHODS:Single emerge...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002018
更新日期:2020-01-01 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:OBJECTIVES:The objective of this study was to describe the characteristics of pediatric palliative care (PPC) patients presenting to a pediatric emergency department (ED) and these patients' ED visits. METHODS:This retrospective chart review was conducted from April 1, 2007, to March 31, 2012, in a tertiary care pedia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001620
更新日期:2018-09-25 00:00:00
abstract:PURPOSE:This study aimed to determine the prevalence of and risk factors for postpartum depression (PPD) in mothers of young infants presenting to the pediatric emergency department (PED). METHODS:This was a prospective, observational study to evaluate the prevalence of PPD in a sample of mothers of young infants pres...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000260
更新日期:2014-11-01 00:00:00
abstract:AIM:The objective of this study was to analyze the epidemiology, presentation, management, and complications of electrical burn injuries in urban children. METHODS:Data from records and clinical data were collected retrospectively and prospectively during 2008 to 2010. RESULTS:Of 41 children enrolled, the mean age of...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182852f71
更新日期:2013-03-01 00:00:00
abstract::Accessory spleen rupture may occur after blunt abdominal trauma or, more rarely, spontaneously. Although only few cases are described in adults, it is even more uncommon in children. We report the case of a 13-year-old boy with traumatic accessory spleen fracture. After a review of the literature, we discuss the diagn...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000001381
更新日期:2020-01-01 00:00:00
abstract::Unwind or incise has been the standard of management for removing hair tourniquets. The hair ends are usually difficult to hold and unwind as they break at the ends easily, and using scalpels or needles to get under the hair tourniquet is difficult when the involved appendage is swollen and leads to more trauma to the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820d65b7
更新日期:2011-03-01 00:00:00
abstract::Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall herni...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001222
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Stress may impair the success of procedures in emergency medicine. The aims were to assess residents' stress during simulated and clinical lumbar punctures (LPs) and to explore the correlation of stress and performance. METHODS:A prospective study (2013-2016) was carried out in a pediatric emergency departm...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001962
更新日期:2020-01-20 00:00:00
abstract::The Pediatric Assessment Triangle (PAT) has become the cornerstone for the Pediatric Education for Prehospital Professionals course, sponsored by the American Academy of Pediatrics. This concept for emergency assessment of children has been taught to more than 170,000 health care providers worldwide. It has been incor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181d6db37
更新日期:2010-04-01 00:00:00
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...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318248b431
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to determine whether adolescents in emergency departments (EDs) who report engaging in high-risk sexual behaviors are less likely to identify a primary care provider (PCP) and more likely to access the ED than their sexually inexperienced peers. METHODS:This was a secondary a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001456
更新日期:2020-07-01 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:OBJECTIVE:The duration of a specific event during an emergency and the duration of time from the event until medical evaluation are important components of a detailed history and may influence management decisions. We sought to determine whether a caregiver is accurate in their recollection of the passage of time relat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000278398.70870.4f
更新日期:2007-06-01 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:The aim of the study was to investigate the appropriate time of removal of button batteries (BB) from the esophagus and stomach in children. METHODS:This is a retrospective descriptive single-center study reviewing the medical records of all children with BB ingestion seen in the Royal Hospital between Janua...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001697
更新日期:2018-12-27 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:OBJECTIVES:This study aimed to assess the association between the appearance of intussusception in children and medication intake in the immediately preceding period (2-15 days). METHODS:A case-crossover design was used. We selected cases of children admitted with a diagnosis of intussusception (International Classifi...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/PEC.0000000000000397
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to delineate pediatric emergency medicine provider opinions regarding the importance of, and to ascertain existing processes by which practitioners maintain, the following critical procedural skills: oral endotracheal intubation, intraosseous line placement, pharmacologic and electri...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000991
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:Young children are highly vulnerable to elemental mercury toxicity, and elementary mercury exposure in young children in China unfortunately occurs regularly because of the wide use of fluorescent lamps, glass thermometers, and other mercury-contained items. This study aimed to summarize such recent cases in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000305
更新日期:2016-03-01 00:00:00
abstract::The expression of cardiac dysfunction in pediatric patients with myocarditis may not be conspicuous. While older children with myocarditis may abruptly present with pleuritic or angina-like pain, infants and toddlers with fulminant disease are unable to verbalize such complaints. Cardiac compromise in preverbal childr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199204000-00017
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:The utility of the Gram stain for the preliminary diagnosis of urinary tract infections (UTI) in infants journal_title:Pediatric emergency care pub_type: 杂志文章 doi:10.1097/00006565-200202000-00004 更新日期:2002-02-01 00:00:00