Impact of a Disaster Drill on Waiting Times in a Pediatric Emergency Department

Abstract Objective: Emergency departments should improve their preparedness for mass casualty incidents (MCIs) through periodic drills. These exercises are conducted while maintaining regular care. The aim of this study was to determine the impact of a disaster drill in a pediatric emergency department (PED) on real patients’ waiting times. Methods: On September 10, 2019, a 4-h disaster drill was conducted in the PED of a tertiary pediatric hospital, with minimal staff reinforcement (2 nurses). Cases were real patients that came to the PED during the drill. The patients that visited the PED the day before were the control group. Variables analyzed were: age, sex, destination, triage level, time-to-triage, time-to-physician, length of PED stay, and percentage of patients visited within the optimal time according to triage level. Results: Sixty-eight patients (case group) and 63 patients (control group) were analyzed; both groups were comparable except for the median age. There were no differences in time-to-triage, time-to-physician, and length of PED stay between the 2 groups. The percentage of patients visited within optimal time according to triage level was higher in the case group. Conclusions: Conducting an MCI drill in the PED, with minimal staff reinforcement, was not detrimental to real patients’ waiting times.

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An Analysis of Waiting Times in a Pediatric Emergency Department

Clinical Pediatrics ◽

10.1177/000992288502400405 ◽

1985 ◽

Vol 24 (4) ◽

pp. 202-209 ◽

Cited By ~ 10

Author(s):

Gregory S. Liptak ◽

Dennis M. Super ◽

Nancy Baker ◽

Klaus J. Roghmann

Keyword(s):

Emergency Department ◽

Waiting Times ◽

Pediatric Emergency ◽

Pediatric Emergency Department

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Tertiary Pediatric Emergency Department Admission Rates Fall as Waiting Times Increase

Pediatric Emergency Care ◽

10.1097/pec.0b013e3181666f44 ◽

2008 ◽

Vol 24 (3) ◽

pp. 125-129 ◽

Cited By ~ 2

Author(s):

Damian Roland ◽

Gary Geelhoed

Keyword(s):

Emergency Department ◽

Waiting Times ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Emergency Department Admission ◽

Admission Rates

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Left-handedness as a Risk Factor for Unintentional Injury in Children

PEDIATRICS ◽

10.1542/peds.92.6.823 ◽

1993 ◽

Vol 92 (6) ◽

pp. 823-826

Author(s):

Charles J. Graham ◽

Rhonda Dick ◽

Vaughn I. Rickert ◽

Robert Glenn

Keyword(s):

Emergency Department ◽

Risk Factor ◽

Confidence Interval ◽

Children And Adolescents ◽

Odds Ratio ◽

Unintentional Injury ◽

Pediatric Emergency ◽

Control Group ◽

Pediatric Emergency Department ◽

Left Handedness

Objective. To determine whether left-handedness is a risk factor for unintentional injury among children and adolescents. Design. Case-control study. Setting. Pediatric emergency department of Arkansas Children's Hospital. Patients. 265 patients sustaining unintentional trauma aged 6 to 18 years and 494 control patients who did not have trauma were given a questionnaire to determine handedness, past unintentional injury, and parental perception of injury proneness. Results. The frequency of left-handedness in the trauma group (18.1%) was significantly greater than frequency of 10.5% in the control group (P < .003, odds ratio = 1.80, 95% confidence interval 1.20 to 2.72). Multivariate analysis revealed handedness as the only significant vanable between trauma and control (P < .04). The proportion of left-handers who had been hospitalized previously for injury treatment (20.0%) was larger than the proportion of right-handers, (12.0%) (P < .026, odds ratio = 1.84, 95% confidence interval 1.03 to 3.27). More parents of left-handens rated their child as "more clumsy than average' than parents of right-handens (26.0% vs 15.2%, P < .007). Conclusions. Left-handedness appears to be a risk factor for unintentional injury in children and adolescents in a pediatric emergency department population.

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Reduction of Waiting Times and Patients Leaving Without Being Seen in the Tertiary Pediatric Emergency Department

Pediatric Emergency Care ◽

10.1097/pec.0000000000002605 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Luca Adriani ◽

Immacolata Dall'Oglio ◽

Carla Brusco ◽

Orsola Gawronski ◽

Simone Piga ◽

...

Keyword(s):

Emergency Department ◽

Waiting Times ◽

Pediatric Emergency ◽

Pediatric Emergency Department

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Use of Audiobooks as an Environmental Distractor to Decrease State Anxiety in Children Waiting in the Pediatric Emergency Department: A Pilot and Feasibility Study

Frontiers in Pediatrics ◽

10.3389/fped.2020.556805 ◽

2021 ◽

Vol 8 ◽

Author(s):

Leah I. Stein Duker ◽

Anita R. Schmidt ◽

Phung K. Pham ◽

Sofronia M. Ringold ◽

Alan L. Nager

Keyword(s):

Emergency Department ◽

State Anxiety ◽

Low Cost ◽

Pediatric Emergency ◽

Control Group ◽

Pediatric Emergency Department ◽

Post Intervention ◽

Paired Samples ◽

Before And After ◽

The Impact

Objectives: Anxiety and anticipatory stressors are commonly experienced by children visiting the Pediatric Emergency Department (PED), but little research exists that addresses the efficacy of interventions to decrease this stress. This one-sample pretest-postest pilot study gathered preliminary data on the feasibility and effectiveness of utilizing audiobooks to reduce fear and state anxiety in children in the PED.Methods: Participants were 131 children in kindergarten through 8th grade (M = 9.4 years, 54% female), triaged urgent or emergent, presenting to the PED. Participants self-reported fear (Children's Fear Scale) and state anxiety (modified State-Trait Anxiety Inventory for Children; mSTAIC) before and after listening to an age-appropriate audiobook (two options). Data regarding patient experience were also collected. Paired samples t-test was used to examine pre–post intervention changes in fear and state anxiety.Results: Significant, albeit small, improvements in fear and the mSTAIC states of nervous, calm, happy, and relaxed were found after use of the audiobook (Cohen's dz = 0.22–0.35). Small, yet significant correlations were found between child age/grade level and improvements in fear and in the mSTAIC states of scared and relaxed, suggesting that the audiobook was more beneficial for older participants. Over 60% of participants liked the audiobook content “a lot” as well as enjoyed listening to the audiobook “a lot.” Without prompting, 15% of participants requested to listen to an additional audiobook.Conclusions: Listening to an audiobook is feasible and could be effective in decreasing fear and state anxiety for children during a waiting period in the PED. The technology is low-cost, simple, and portable. The results of this study should be interpreted with prudence due to the lack of a control group and results that, although significant, were modest based on effect size conventions; future studies should explore the impact of audiobooks on patient stress with an expanded sample size and control group.

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Utilization of Antipyretics for Nonurgent Fever in a Pediatric Emergency Department

Clinical Pediatrics ◽

10.1177/0009922817734356 ◽

2017 ◽

Vol 57 (6) ◽

pp. 722-726

Author(s):

Courtney E. Nelson ◽

Svetlana Ostapenko ◽

Joseph J. Zorc ◽

Fran Balamuth

Keyword(s):

Emergency Department ◽

Vital Signs ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Antibiotic Administration ◽

Continuous Variables ◽

Laboratory Studies ◽

Imaging Studies ◽

Confounding Variables ◽

Triage Level

This retrospective cohort study aimed to describe antipyretic use among healthy patients in a pediatric emergency department (ED) with nonurgent fever defined as: triage level 4 or 5, chief complaint fever or temperature 38°C to 39°C, and otherwise normal vital signs, and determine if antipyretic administration is associated with increased ED length of stay (LOS). We compared continuous variables using Kruskal-Wallis and Wilcoxon rank sum testing. We adjusted confounding variables using logistic regression modeling. A total of 22 169 patients were included. Of these, 52% received antipyretic: acetaminophen (38%), ibuprofen (19%), or both antipyretics (5%). ED LOS (median hours) varied by number of antipyretic types given (none, 2.2; ibuprofen, 2.7; acetaminophen, 2.7; and both 3.4, P < .001) and number of doses (0 doses, 2.2, 1 dose, 2.7; 2 doses, 3.4, P < .001). Patients who received antipyretic were more likely to have ED LOS greater than 2 hours (adjusted odds ratio 1.99, 95% CI 1.88-2.11) compared with those with no antipyretic, controlling for age, imaging studies, laboratory studies, antibiotic administration, and disposition.

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