Adverse events and risk factors during emergency intubation in a tertiary paediatric emergency department

2018 ◽  
Vol 25 (3) ◽  
pp. 209-215 ◽  
Author(s):  
Ruth M.C. Löllgen ◽  
Jennifer Pontin ◽  
Matthew Gow ◽  
Mary E. McCaskill
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Adverse Events ◽  
Emergency Intubation ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

scholarly journals Evaluation of compliance with early postbirth follow-up and unnecessary visits to the paediatric emergency department: a prospective observational study at the Lenval Children’s Hospital in Nice

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e056476
Author(s):  
Antoine Tran ◽  
Anne-Laure Hérissé ◽  
Marion Isoardo ◽  
Petri Valo ◽  
Anne-Marie Maillotte ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Care Pathway ◽  
Emergency Department Visits ◽  
Secondary Outcome ◽  
Medical Visit ◽  
Paediatric Emergency Department ◽  
Factors Associated ◽  
Paediatric Emergency

ObjectiveTo evaluate compliance with the French National Authority for Health’s (Haute Autorité de Santé, HAS) postbirth follow-up recommendations for newborns attending our paediatric emergency department (PED) and identify risk factors associated with non-compliance and unnecessary emergency department utilisation.DesignProspective, single centre.SettingFourth biggest PED in France in terms of attendance (CHU-Lenval).Patients280 patients of whom 249 were included in the statistical analysis.Main outcome measuresThe primary outcome of this study was the evaluation of compliance of the care pathway for newborns consulting at the PED with respect to the French postbirth follow-up recommendations. Secondary outcome was the assessment of whether the visit to the PED was justified by means of PED reception software and two postconsultation interviewsResults77.5% (193) of the newborns had non-compliant care pathways and 43% (107) of PED visits were unnecessary. Risk factors associated with a non-compliance regarding the HAS’s postbirth follow-up recommendations were: unnecessary visit to the PED (OR 2.0, 95% CI 1.1 to 3.9), precariousness (OR 2.8, 95% CI 1.4 to 6.2), birth in a public maternity hospital (OR 2.5, 95% CI 1.3 to 4.8) and no information about HAS’s postbirth follow-up recommendations on discharge from maternity ward (OR 11.4, 95% CI 5.8 to 23.3). Risk factors for unnecessary PED visits were: non-compliant care pathway (OR 2.0, 95% CI 1.1 to 3.9) and a first medical visit at a PED (OR 1.8, 95% CI 1.1 to 3.1).ConclusionPostbirth follow-up may lead to decrease unnecessary emergency department visits unnecessary emergency department visits.Trial registration numberThe study bears the clinical trial number NCT02863627.

scholarly journals Third-generation cephalosporin-resistant urinary tract infections in children presenting to the paediatric emergency department

2019 ◽  
Vol 25 (3) ◽  
pp. 166-172
Author(s):  
Kristopher T Kang ◽  
Karen Ng ◽  
Jennifer Kendrick ◽  
Peter Tilley ◽  
Joseph Ting ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Urinary Tract Infections ◽  
Generation Cephalosporin ◽  
Third Generation ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Tract Infections

Abstract Background The incidence of antibiotic-resistant urinary tract infections (UTIs) in children is increasing. The purpose of this study was to describe the incidence, clinical characteristics, and risk factors for third-generation cephalosporin-resistant UTIs presenting to the paediatric emergency department (ED). Methods This was a retrospective cohort study conducted at British Columbia Children’s Hospital. Children aged 0 to 18 years old presenting to the ED between July 1, 2013 and June 30, 2014 and were found to have UTI due to Enterobacteriaceae and Pseudomonas species were included. Patient demographics, clinical features, laboratory findings, and outcomes were compared using standard statistical analyses. Risk factors for resistant UTIs were analyzed using multiple logistic regression analysis. Results There were 294 eligible patients. The median age was 27.4 months. A third-generation cephalosporin-resistant organism was identified in 36 patients (12%). Patients with resistant UTI had lower rates of appropriate empiric antibiotic therapy (25% versus 95.3%, P<0.05), higher rates of hospitalization (38.9% versus 21.3%, P<0.05), higher rates of undergoing a voiding cystourethrogram (19.4% versus 5.0%, P<0.05), and higher rates of UTI recurrence within 30 days (13.9% versus 4.7%, P<0.05). In multivariate analysis, recent hospitalization (odds ratio [OR] 4.3, confidence interval [CI] 1.2 to 16) and antibiotic therapy (OR 3.5, CI 1.5 to 8.5) within the previous 30 days were risk factors for resistant UTI. Conclusions Third-generation cephalosporin-resistant organisms account for a significant proportion of community-acquired paediatric UTIs. Recent hospitalization and antibiotic use are associated with increased risk of resistant UTI.

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

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