Objectives: Ultrasound (US) may be a useful tool for rapidly diagnosing fractures. Our objective was to determine the accuracy of US as compared with radiographs in detection nonangulated distal forearm Methods: Distal performed and interpreted at bedside by pediatric emergency medicine physician before radiography prospective sample children possible A second extensive experience gave final interpretation images. This reviewer blinded both clinical radiographic findings. The primary outcome...

ACADEMIC EMERGENCY MEDICINE 2010; 17:687–693 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives: Clavicle fractures are among most common orthopedic injuries in children. Diagnosis typically involves radiographs, which expose children to radiation and may consume significant time resources. Our objective was determine if bedside emergency department (ED) ultrasound (US) is an accurate alternative radiography. Methods: This a prospective study of US diagnosing clavicle...

The purpose of this study was to prospectively determine the neurodevelopmental effects associated with single-suture, nonsyndromic craniosynostosis before and after surgery. Children diagnosed single-suture were evaluated by a psychologist using Bayley Scales Infant Development-Second Edition (BSID-II) within 2 months again 1 year surgical correction. BSID-II is widely used measure infant cognitive motor development. scale consists three parts, Mental Developmental Index (MDI), Psychomotor...

To investigate the demographic and clinical factors of children who present to pediatric emergency department (ED) with abdominal pain their outcomes.A review electronic medical record patients 1 18 years old, presented Children's Hospital Pittsburgh ED a complaint over course 2 years, was conducted. Demographic characteristics, as well visit outcomes, were reviewed. Subjects grouped by age, race, gender. Results evaluation, treatment, outcomes compared between groups using multivariate...

The objective of this study was to determine the predictive value Glasgow coma scale (GCS) and motor component (GMC) for overall mortality, death on arrival, major injury relationship between GCS length stay (LOS) in emergency department (ED) hospital.Records from American College Surgeons National Trauma Data Base 2007 2009 were extracted. Patients 0 18 years old transported a trauma scene with complete initial data included. Statistical analysis, including construction receiver-operator...

The objective of this study was to compare the duration analgesia, need for analgesic medications, and pain-related nursing interventions in patients who did not receive ultrasound-guided femoral nerve blocks femur fracture pain.This is a retrospective, preimplementation postimplementation cohort study. An emergency department log receiving pain compared with similar fractures blocks. primary outcome time from initial treatment until next dose analgesic. Data were analyzed using Kaplan-Meier...

Methods currently used to triage patients from mass casualty events have a sparse evidence basis. The objective of this project was assess gaps the widely Simple Triage and Rapid Transport (START) algorithm using large database when it is low-acuity patients. Subsequently, we developed tested evidenced-based improvements START.Using National Trauma Database (NTDB), set trauma victims were assigned START levels, which then compared recorded patient mortality outcomes area under...

Objective:Asthma is one of the most common childhood illnesses and accounts for a substantial amount pediatric emergency department visits. Historically, acute exacerbations are treated with beta agonist via nebulizer therapy (NEB). However, advent spacer, medication can be delivered metered dose inhaler (MDI + S) same efficacy mild-to-moderate asthma exacerbations. To date, no study has been done to evaluate (ED) length stay (LOS) opportunity cost between nebulized vs MDI S. The objective...

Recent studies reviewing immune mechanisms of thrombocytopenia (ITP) have suggested acute and chronic forms may represent distinct immunopathological disorders. This study evaluated absolute lymphocyte counts (ALCs) as predictors for ITP outcomes.CBCs with differential were ascertained at presentation, 3, 6, 12 months 204 patients. Receiver operating characteristic (ROC) curves used to determine cutoff values. Logistic regression models recursive partitioning evaluate which variables...

Influenza is a significant public health burden, causing morbidity and mortality in children, yet vaccination rates remain low. Vaccination the pediatric emergency department (PED) setting may be beneficial but, to date, has not been proven cost-effective.To compare cost-effectiveness of 4 strategies for PED-based influenza vaccine: offering vaccine all patients, only patients younger than 5 years, high-risk (all ages), or no patients.Using commercial decision analysis software, was...

Previous literature suggests that process-related factors (eg, time of day, patient volume) and patient-related acuity, socioeconomic status) are associated with premature departure from emergency departments. We sought to evaluate the relationship these other in a large, unselected cohort pediatric department patients.This study was retrospective analysis visits single tertiary site during 1-year period. Patients' zip codes determined assignment census-based metrics. Multivariate regression...

Currently, approximately 85% of children with significant congenital heart problems survive to adolescence and adulthood. This survival rate represents a dramatic improvement in the medical surgical care disease (CHD) during last 35 years. Nevertheless, these patients remain at increased risk for cardiac long after primary interventions are completed. They more likely than general population seek urgent care, often an emergency department setting. represent new growing specialized set not...

Though many mass-casualty triage methods have been proposed, few validated in an evidence-based manner. The Sacco Triage Method (STM) has shown to accurately stratify adult victims of blunt and penetrating trauma into groups increasing mortality risk. However, it not for pediatric victims.Evaluate the STM's performance victims.Records from United States' National Trauma Data Base, a registry developed by American College Surgeons, were extracted 2007-2009 reporting years. Patients ≤ 18 years...

Exertional heat stroke incidence is on the rise and has become third leading cause of death in high school athletes. It entirely preventable, yet this a case 15-year-old, 97-kg male football player who presented unresponsive hyperthermic after an August practice. His blood pressure was 80/30, his pulse 180. He had rectal temperature 107.3°F, upon entering emergency department, he rapidly cooled 40 minutes. As progressed, developed metabolic acidosis, elevated liver enzymes, prolapsed mitral...

Abstract Objectives: Approximately 2% to 5% of children presenting pediatric emergency departments (PEDs) leave prior a complete evaluation. This study assessed risk factors for premature departure (PD) from PED identify key metrics and cutoffs reducing the PD rate. Methods: A 3‐year cohort (June 2004–May 2007) was evaluated. Children were excluded if they presented psychiatric issues, held awaiting hospital admission in due lack inpatient beds, more than 21 years old, or died before...

Pediatric procedural sedation (PPS) is used to maintain children's safety, comfort, and cooperation during emergency department procedures. Our objective was gather data describing PPS practice across the United States highlight variations in adherence National Guidelines.We performed a nationwide survey of practitioners using secure web-based software program. A link sent all subscribers pediatric medicine listserv. We collected participant demographics, their approach for personnel,...