Abstract:
OBJECTIVE:To describe pediatric advanced life support (PALS) in a single urban environment and clarify educational priorities for ALS pre-hospital providers and pediatric medical control physicians. METHODS:Retrospective observational review of all pediatric pre-hospital PALS transport and medical control records of the two-tiered, unified, municipal emergency medical service of the City of Boston (catchment area 590,000) over a 1-year period. RESULTS:Of the 555 pediatric patients receiving ALS transport, 38% were for respiratory emergencies, 24% for nonrespiratory medical emergencies, 19% for traffic-related blunt trauma, and 10% for penetrating trauma. Two percent involved cardiac arrests. The most frequent procedures performed were intravenous (IV) cannulation (n = 184, 33%), bag-mask ventilation (n = 28, 5%) and intubation (n = 15, 3%). Intraosseous access was only performed in three patients (0.5%). Fifty ALS providers in the EMS system averaged pediatric IV cannulation 3.7 times, intubation 0.3 times, and intraosseous access 0.06 times per provider per year. On-line medical control was requested in 28 % of PALS transports. The chief complaints managed by medical control closely mirrored the distribution of all ALS transports. The most frequent medication ordered by on-line medical control was additional nebulized albuterol after standing orders (off-line medical control) had been exhausted. CONCLUSIONS:A limited number of chief complaints make up the majority of PALS transports. Initial and continuing education for ALS providers needs to reflect the importance of these critical entities. Education for urban pre-hospital providers should reflect that certain procedures will be only executed every few years (eg, pediatric intubation) or once in the career of an ALS pre-hospital provider (eg, intraosseous access). With a limited amount of pediatric teaching time, paramedic education will have to strike a careful balance between teaching about the chief complaints most frequently encountered and teaching rare, high-risk procedures that could provide maximal support for the uncommon critically ill child. On-line medical control physicians need to be prepared to direct and support the management by ALS pre-hospital providers for the chief complaints most frequently seen in pediatric patients.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Babl FE,Vinci RJ,Bauchner H,Mottley Ldoi
10.1097/00006565-200102000-00002subject
Has Abstractpub_date
2001-02-01 00:00:00pages
5-9issue
1eissn
0749-5161issn
1535-1815journal_volume
17pub_type
杂志文章abstract::Malignant hypertension due to autonomic dysfunction is a known complication of Guillain-Barré syndrome. We describe a child who presented with status epilepticus secondary to hypertensive encephalopathy who, in recovery, was found to be areflexic. Nerve conduction studies confirmed the clinical diagnosis of Guillain-B...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31814b2ddd
更新日期:2007-09-01 00:00:00
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 hour...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820943e4
更新日期:2011-02-01 00:00:00
abstract::We report an extremely rare case of homicidal lithium battery ingestion in a neonate hitherto unreported in the medical literature. Although a definitive diagnosis was initially missed in the baby, the patient survived with no complications whatsoever even after retention of the said foreign body for 10 days. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825d23df
更新日期:2012-07-01 00:00:00
abstract::Inflammatory causes of bloody diarrhea during infancy include necrotizing enterocolitis and allergic colitis, often due to cow's milk protein. We report this case of cow's milk protein allergy, managed successfully with elimination of dietary antigen, to highlight the unusual finding of pneumatosis intestinalis on abd...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001369
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:To evaluate changes in imaging practices for pediatric head trauma after publication of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines, explore areas for quality improvement regarding neuroradiology referrals. We also sought to determine the prevalence of incidental findings discov...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002124
更新日期:2020-06-12 00:00:00
abstract:OBJECTIVES:Extrapyramidal symptoms (EPS) induced by pharmacologic agents can cause patient discomfort and lead to emergency department visits. Analyzing these cases at a pediatric emergency department may help to elucidate the characteristic features of extrapyramidal syndrome in children. METHODS:This retrospective s...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001954
更新日期:2020-10-01 00:00:00
abstract::The recent popularity of elastic bands on the wrist may put children at risk for acute compartment syndrome. Acute compartment syndrome is a limb-threatening condition characterized by elevated interstitial pressure in a confined fascial compartment. If left untreated, it may result in tissue necrosis, irreversible ne...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318217b5a7
更新日期:2011-05-01 00:00:00
abstract::A 17-year-old adolescent girl with no past medical history presented to the emergency department with a chief complaint of lower back pain after sustaining a minor fall several hours earlier. Physical examination revealed mild to moderate back tenderness, and the result of review of systems was negative. Laboratory ev...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181bec953
更新日期:2009-11-01 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::Pyogenic liver abscess (PLA) is a rare pediatric disease. Typically, PLA is found in adults with biliary disease. There are no typical physical findings or symptoms. Often, pathogenic organisms are not recovered for identification. This case illustrates a teenager presenting with prolonged episodes of fever and vomiti...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318196fa9b
更新日期:2009-02-01 00:00:00
abstract::Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication of the use of certain medications. It is being seen more often in the pediatric population because of the increasing use of both typical and atypical antipsychotics in children. Rapid recognition of NMS is important to emergency physicia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001000
更新日期:2017-01-01 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::We describe the case of an 18-month-old child with recurrent apneic episodes, often requiring resuscitation, who was admitted to an academic pediatric medical center after previous evaluations had been unrevealing. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180ff44
更新日期:2008-08-01 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:OBJECTIVES:The Internet may be the first source of information used by parents during a suspected poisoning of their children. Our primary aim was to assess the reliability of the Internet as a resource for information for parents to initially manage a suspected poisoning involving their child without outside consultat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000022
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:Emergency medical services (EMS) prenotifications are critical, although they oftentimes inaccurately convey the arriving patient's true acuity, resulting in inappropriate preparation in the emergency department. The objectives of this study were (1) to determine interrater reliability of acuity prediction b...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001015
更新日期:2018-04-01 00:00:00
abstract::Superior ophthalmic vein thrombosis (SOVT) usually results from inflammatory, infectious, or malignant causes. This case describes a 2-year-old boy with severe prolapsing chemosis and proptosis due to thrombosis of the right superior ophthalmic vein resulting from midfacial and right orbital fractures 1 week after the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000066
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of a single dose of oral dexamethasone (Dex) versus 5 days of twice-daily prednisolone (Pred) in the management of mild to moderate asthma exacerbations in children. STUDY DESIGN:A prospective, randomized, double-blinded trial of children 2 to 16 years of age who presented to the emer...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.pec.0000248683.09895.08
更新日期:2006-12-01 00:00:00
abstract::The object of this study was to review and delineate the presenting complaints, signs, symptoms, and Emergency Department (ED) management of pediatric heart transplant recipients who presented to Loma Linda University Medical Center's (LLUMC) Emergency Department. A retrospective chart review was made of all of the pe...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199512000-00006
更新日期:1995-12-01 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::Neonatal seizures are a potentially life-threatening pediatric problem with a variety of causes, such as birth trauma, asphyxia, congenital anomalies, metabolic disturbances, infections, and drug withdrawal or intoxication. Thorough and timely evaluations of such patients are necessary to identify and treat the underl...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a62fd6
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:Methamphetamine (meth) abuse in the rural South has increased greatly in the last decade. This addiction harms meth abusers and producers and endangers children who live with them. Appropriate medical evaluation and treatment of these exposed children are largely undefined. The objective of this research was...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181558d72
更新日期:2007-10-01 00:00:00
abstract::Chlamydia trachomatis is a common cause of subacute, afebrile pneumonia with onset from 1 to 3 months of age. On physical examination, crepitant inspiratory rales are commonly heard. Infiltration is usually bilateral and interstitial; reticulonodular pattern and atelectasis have also been described, which distinct the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181b922e3
更新日期:2009-09-01 00:00:00
abstract::Two children who presented with fever, rash, and hypotension were found to have group A beta hemolytic streptococcal toxic shock syndrome. These cases are reported to remind physicians who care for acutely ill children that exotoxin-producing streptococci can produce clinical features and multisystem failure similar t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199208000-00008
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:To assess the effect of adding a shared research nurse on patient enrollment in an ongoing clinical study. DESIGN:Before/after comparison of recruitment rates and consent rates involving patients eligible for a study of blood culture collection strategies for methods on the detection of bacteremia and deter...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199610000-00004
更新日期:1996-10-01 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::A 4-year-old boy, who had no prior history of convulsions, presented with inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation) following the instillation of 1% cyclopentolate, a commonly used mydriatic in pediatric practice. This case demonstrates the uncommon, alt...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182417a63
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Major studies (PECARN [Pediatric Emergency Care Applied Research Network], CATCH [Canadian Assessment of Childhood Head Injury]) that regulate the use of computed tomography (CT) algorithms in children with minor head trauma (MHT) have been conducted among children presenting in 24 hours after injury. In this...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002011
更新日期:2020-01-10 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::We present the case of a 9-year-old female who presented after minor blunt abdominal trauma during a sporting event. On focused assessment with sonography for trauma, she was found to have an incidental renal mass, which was ultimately diagnosed as a renal cell carcinoma. In this report, we focus on the use of bedside...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000242
更新日期:2014-10-01 00:00:00