Abstract:
OBJECTIVES:Describe the usage of observation status (OS) beds on a pediatric inpatient unit and identify diagnoses likely to be successfully discharged compared to those requiring formal inpatient admission. METHODS:Retrospective chart review of all patients (0-18 years) transferred to pediatric OS beds from the emergency department (ED) between April 1, 1997 and April 30, 1999. Outcome measures consisted of time interval between ED triage and arrival to an OS bed, total hours in observation, and need for admission or transfer. Using relative risk (RR), we compared admission rates for the 4 most common diagnoses. RESULTS:We studied 800 transfers to pediatric OS beds. Asthma (27%), gastroenteritis/dehydration (16%), infectious disease (12%), and bronchiolitis (9%) were the 4 most common diagnoses. There were 597 patients (75%) successfully discharged from observation and 174 (22%) required inpatient admission. Seventeen patients (2%) were transferred to a psychiatric facility and 12 patients (1%) were transferred to a tertiary care center for further evaluation and treatment. Compared to gastroenteritis/dehydration, patients with asthma were just as likely to be admitted/transferred (RR 1.05, 95% CI, 0.87-1.27), those with an infectious disease were 1.3 times more likely to be admitted/transferred (RR 1.35, 95% CI, 1.0-1.83), and those with bronchiolitis were 2 times more likely to be admitted/transferred (RR 1.92, 95% CI, 1.34-2.74). CONCLUSIONS:We describe the usage of OS beds in a community hospital that we believe can be a successful model for the care of pediatric patients. Future studies are needed to delineate the clinical characteristics of patients that would benefit from this care delivery model.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Crocetti MT,Barone MA,Amin DD,Walker ARdoi
10.1097/01.pec.0000106238.72265.5fsubject
Has Abstractpub_date
2004-01-01 00:00:00pages
17-21issue
1eissn
0749-5161issn
1535-1815pii
00006565-200401000-00005journal_volume
20pub_type
杂志文章,评审abstract::Musculoskeletal pain is a common symptom among active adolescent in the emergency department. The etiologic list is broad and range from benign to potential life-threatening conditions. Deep vein thrombosis is a rare cause of lower extremity pain in children. We report an adolescent who presented with lower extremity ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31818c2856
更新日期:2008-11-01 00:00:00
abstract::Bone and joint infection complicating tuberculosis is most likely to involve vertebrae. Pott disease, or tuberculous spondylitis, represents a small proportion of tuberculosis cases, but it can be associated with significant morbidity and mortality. Our case report details Pott disease in a teenage girl, which present...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181fb0e38
更新日期:2010-11-01 00:00:00
abstract::When an emergency medicine physician evaluates a child with abdominal pain and a history of appendectomy, appendicitis is often excluded from the differential. We present a case of a 16-year-old boy who developed stump appendicitis 3 years after laparoscopic appendectomy. Knowledge of this rare phenomenon in children ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31827b54db
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Obtaining intravascular access can be challenging or even impossible in several clinical situations. As an alternative, medications and fluids can be administered via the intraosseous (IO) route, which is a well-tolerated and established alternative, especially in the emergency setting. METHODS:Seventy-five...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001587
更新日期:2020-10-01 00:00:00
abstract::Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubat...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000093
更新日期:2014-03-01 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:OBJECTIVES:Prolonged excessive endotracheal cuff pressure greater than 30 cmH2O is thought to cause ischemic airway injury. Excessive cuff pressure with altitude gain during air medical transport has been previously described in adult patients. It is poorly understood how pediatric-sized endotracheal tube (ETT) cuffs b...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000755
更新日期:2018-08-01 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::Concentrated liquid detergent pods are an emerging public health hazard, especially in pediatric patients. Ingestion is a more common route of exposure for liquid detergent pods compared with non-pod detergents and it tends to be associated with more severe adverse effects. We present 3 cases that demonstrate the vari...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000292
更新日期:2014-12-01 00:00:00
abstract::As the field of pediatric procedural sedation continues to expand, so does the exploration of medications that have a role in such invasive and noninvasive procedures. One such medication that has emerged during the last decade is dexmedetomidine, a drug approved for use in the adult intensive care setting. Its role i...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e3182495e1b
更新日期:2012-03-01 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::Acute pediatric elbow trauma is commonly seen in the emergency department (ED). Reports confirm that, compared to other fractures, children's elbow fractures are commonly misdiagnosed in the ED. In addition, missed orthopedic injuries are one of the leading causes of malpractice claims in emergency medicine. Radiologi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199712000-00021
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:The prevalence of pneumonia in infants with high fever without source (FWS; temperature, > or =39.0 degrees C) and a white blood cell (WBC) count greater than 20 x 10(9)/L (occult pneumonia) has been reported to be 20% before the introduction of the 7-valent pneumococcal conjugated vaccine (PCV7). This is th...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181e582e4
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Glass mercury thermometers were once used as the criterion standard for measuring core body temperature. Once broken, however, there is the dual hazard of broken glass and exposure to mercury. Previous studies have focused only on the mercury hazard rather than injuries related to thermometer glass. OBJECTI...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/pec.0b013e3181b920cc
更新日期:2009-10-01 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:OBJECTIVES:This study examined whether utilization of the Florida State Health Online Tracking System (SHOTS) immunization registry to determine Haemophilus influenzae type B and heptavalent pneumococcal conjugate (PCV7) vaccine status impacts the protocolized decision to perform a screening blood draw for occult bacte...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825cfd3e
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:This study examined how much parents are willing to pay and/or willing to stay to make their child's intravenous (IV) catheter placement painless. METHODS:A prospective survey was conducted using a questionnaire administered to a consecutive sample of parents presenting to an emergency department (ED). Elig...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000238743.96606.69
更新日期:2006-11-01 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::This case provides the first report of a young healthy child presenting in septic shock from Clostridium difficile colitis. This child had no identifiable risk factors for C. difficile, raising the suspicion for a hypervirulent strain. Once infection was recognized and treated appropriately, the child made a full reco...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000496
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Venipuncture is a frequent source of painful procedures for infants. It has been well documented that infants react to pain with a combination of physiologic and behavioral responses. Infants are unable to describe pain and at particularly high risk for inadequate pain management. The Vibration Anesthesia Dev...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0000000000000228
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:This study aimed to compare clinical manifestations, physical examination findings, laboratory, and radiographic dates in pediatric patients with different pathological diagnoses of acute scrotum as well as to accurately establish the true incidence of various pathological diagnoses of acute scrotum. METHODS:T...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318213144e
更新日期:2011-04-01 00:00:00
abstract::The unlikely event of long-term complications in some pediatric fractures, such as midclavicular fractures, has allowed for management of these injuries with interventions that support the injured extremity rather than immobilize it while healing occurs. However, there is currently a growing body of evidence that advo...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e3181ce310c
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES AND METHODS:The aim of the present retrospective, cross-sectional, descriptive study was to determine the characteristics of febrile 3- to 36-month-old children who were admitted to the emergency department (ED) with the chief complaint of fever and returned with the same complaint within 72 hours (returning...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823a3e86
更新日期:2011-12-01 00:00:00
abstract::We report the case of an unrestrained driver with achondroplastic dwarfism who suffered a fatal anterior neck injury when her airbag deployed as she rear-ended another vehicle at 30-40 mph. Her short stature and short limbs required her to sit within a handbreadth of the steering wheel, which probably allowed the airb...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1999-08-01 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:UNLABELLED:Clavicle fractures are a common injury among pediatric patients. Few data exist regarding specific etiologies and their management in the preadolescent patient. Our objective was to determine the specific source of injury and treatment techniques used in the youngest patient population. METHODS:Study Design...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181bec7fc
更新日期:2009-11-01 00:00:00
abstract::Clinical signs of hypophosphatemia, even when severe, are rare in diabetic ketoacidosis despite their high frequency in this condition. This article presents a patient with rhabdomyolysis due to severe hypophosphatemia, where the level of serum phosphorus was observed to be as low as 0.42 mg/dL on the 16th hour of ket...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31821dc68a
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to describe the demographics, epidemiology, and characteristics associated with survival of children younger than 18 years who had an out-of-hospital respiratory arrest (OOHRA) during a 1-year period in a large urban area. METHODS:A prospective observational cohort of consecut...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182675b61
更新日期:2012-09-01 00:00:00
abstract::A case history of a young girl who sustained a small posterior laceration of her cervical trachea after blunt trauma is presented. She was brought to the emergency department (ED) by her parents roughly two hours after the incident with only minor symptoms. While in the ED, she developed significant airway compromise ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199110000-00008
更新日期:1991-10-01 00:00:00
abstract::Spontaneous pneumothorax is an uncommon complication of bronchiolitis due to respiratory syncytial virus. Bilateral spontaneous pneumothorax in an infant with respiratory syncytial virus bronchiolitis has not been previously reported. We report the case of a four-month-old infant who presented in respiratory distress ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198703000-00010
更新日期:1987-03-01 00:00:00