Child Life Reduces Distress and Pain and Improves Family Satisfaction in the Pediatric Emergency Department

2018 ◽  
Vol 57 (13) ◽  
pp. 1567-1575 ◽  
Author(s):  
Natasha Sanchez Cristal ◽  
Jennifer Staab ◽  
Rachel Chatham ◽  
Sarah Ryan ◽  
Brian Mcnair ◽  
...  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Pediatric Trauma ◽  
Family Satisfaction ◽  
Pediatric Emergency ◽  
Child Life ◽  
Convenience Sample ◽  
Patient Cooperation ◽  
To Receive ◽  
Pain Rating Scale

This study evaluated the effects of Certified Child Life Specialist (CCLS) intervention on pediatric distress and pain and family satisfaction during routine peripheral intravenous (PIV) line placement in the emergency department (ED). A convenience sample of 78 children (3-13 years) requiring PIV placement for their treatment at a regional level 1 pediatric trauma center ED with 70 000 annual visits were selected to receive either standard nursing care or CCLS intervention for PIV placement. CCLS involvement was associated with fewer negative emotional behaviors as indicated by a lower score on the Children’s Emotional Manifestation Scale (−3.37 ± 1.49, P = .027), a reduction in self-reported pain on the Wong-Baker Faces pain rating scale (−1.107 ± 0.445, P = .017), an increase in parent-reported patient cooperation during PIV placement, and greater satisfaction with the ED visit. This study demonstrates that Child Life can have an impact on important outcomes in the pediatric ED such as distress, pain, and visit satisfaction.

scholarly journals Validation of the Wong-Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients

2010 ◽  
Vol 17 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Gregory Garra ◽  
Adam J. Singer ◽  
Breena R. Taira ◽  
Jasmin Chohan ◽  
Hiran Cardoz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Pain Rating ◽  
Emergency Department Patients ◽  
Pain Rating Scale

scholarly journals Evaluation of the Efficacy of a Onetime Injectable Dexamethasone Administered Orally in the Pediatric Emergency Department for Asthma Exacerbation

2017 ◽  
Vol 22 (5) ◽  
pp. 326-331
Author(s):  
Ashley McCallister ◽  
Tsz-Yin So ◽  
Josh Stewart
Keyword(s):  
Emergency Department ◽  
Asthma Exacerbation ◽  
Pediatric Patients ◽  
Pediatric Emergency ◽  
Average Weight ◽  
Pediatric Emergency Department ◽  
Routes Of Administration ◽  
Efficacious Treatment ◽  
Randomized Control ◽  
To Receive

OBJECTIVE This study assessed the efficacy of injectable dexamethasone administered orally in pediatric patients who presented to the emergency department with asthma exacerbation. METHODS This was a retrospective study of patients 0 to 18 years of age who presented to and who were directly discharged from the emergency department at Moses H. Cone Memorial Hospital between September 1, 2012, and September 30, 2015, for the diagnosis of asthma or asthma exacerbation. Patients had to receive a onetime dose of injectable dexamethasone orally prior to discharge. Patients were followed for a 30-day period to identify the number of asthma relapses. RESULTS Ninety-nine patients were included in this study. The average weight-based dose ± SD of dexamethasone was 0.35 ± 0.18 mg/kg (range, 0.08–0.62 mg/kg) and the actual dose ± SD was 10.58 ± 1.92 mg (range, 5–16 mg). Over a 30-day period, 6 patients (6%) had one repeated emergency department visit, 6 patients (6%) were admitted to the hospital, and 3 patients (3%) presented to an outpatient clinic for asthma-related symptoms. CONCLUSIONS Injectable dexamethasone administered orally may be an efficacious treatment for asthma exacerbation in pediatric patients. A randomized control trial comparing injectable dexamethasone administered orally to other dexamethasone formulations/routes of administration should be performed to adequately assess the bioequivalence and effectiveness of the former formulation.

scholarly journals Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres

CJEM ◽  
2012 ◽  
Vol 14 (01) ◽  
pp. 14-19 ◽  
Author(s):  
Robin Cardamore ◽  
Joe Nemeth ◽  
Christine Meyers
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Positive Impact ◽  
Pediatric Trauma ◽  
Great Majority ◽  
Pediatric Emergency ◽  
Perceived Barriers ◽  
Emergency Physicians ◽  
The Future

ABSTRACT Objectives: To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. Methods: An electronic survey was sent to 162 pediatric emergency physicians and 12 site directors from the 12 pediatric emergency departments across Canada. Results: Ninety-two percent (11 of 12) of centres completed the survey. The individual physician response rate was 65% (106 of 162), with 100% of site directors responding. Ultrasound machines were available in 45% (5 of 11) of centres. Forty-two percent (32 of 77) of emergency physicians working in equipped pediatric centres used bedside EDUS to evaluate blunt abdominal trauma (BAT). In the subgroup of staff who also worked at adults sites, the frequency of ultrasonography use for the evaluation of pediatric BAT was 75%. In the 55% (6 of 11) of centres without ultrasonography, 88% of staff intend to incorporate its use in the future and 81% indicated that they believed the incorporation of ultrasonography would have a positive impact on patient care. The main perceived barriers to the use of ultrasonography in the evaluation of BAT were a lack of training (41%) and a lack of equipment (26%). Conclusion: Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.

scholarly journals GAMBARAN TINGKAT KECEMASAN PASIEN DI INSTALASI GAWAT DARURAT

2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Serenity Prayer Amiman ◽  
Mario Katuuk ◽  
Reginus Malara
Keyword(s):  
Emergency Department ◽  
Emergency Treatment ◽  
Rating Scale ◽  
To Receive ◽  
Hamilton Rating Scale

might be dangerous is called anxious. Fear and anxious is an emotion that appears in healthfacility. Anxiety appears with a dim without a clear cause that made an indiviual feltuncomfotable with the environment around. Anxiety can also became a signal to prepare anindividual to cope with a problem that might came. People with anxiety seems to be tense,worried and affraid, also there are change in physiological. Emergency treatment can makepatient to feel fear dan anxious to receive a treatment. An intervention to save lives can be thecause of anxiety since the treatment might cause change on a persons integrity. Anxious is aform of unspesific objek that cause uncomfortable and or might cause death. The purpose ofthis study is to see the levels of anxiety that might appears on patients at EmergencyDepartment in Bhayangkara Hospital Manado. Design of descriptive to collect data from therespondent using HARS anxiety questionair to measure the levels of anxiety. Samples are 69respondents that are the patients in Emergency Department in Bhayangkara Hospital. Theresult indicate that from 69 responden there are 47 responden (68,1%) are having severeanxiety.Keyword : Anxiety, Emergency DepartmentAbstrak: Cemas merupakan suatu perasaan yang muncul saat seseorang berada dalamkeadaan yang dapat mengancam keadaan jiwa. Takut dan cemas sebagai emosi yangdirasakan oleh pasien di sarana kesehatan. Kecemasan muncul secara samar tanpa penyebabyang jelas dan dapat membuat seseorang merasa tidak nyaman terhadap keadaan lingkungansekitarnya. Kecemasan juga dapat menjadi sinyal kepada seseorang untuk mempersiapkandirinya dalam menghadapi suatu keadaan. Kecemasan ditandai dengan adannya perasaantegang, khawatir dan ketakutan, serta dapat terjadi perubahan fisiologis. Perawatan gawatdarurat membuat pasien takut dan cemas dalam menghadapi tindakan perawatan. Memberikantindakan penyelamatan jiwa dapat menyebabkan kecemasan karena dapat mengancamintegritas jiwa. Cemas merupakan bentuk reaksi yang tidak spesifik yang menimbulkan rasatidak nyaman dan mengancam jiwa. Tujuan penelitian ini untuk melihat tingkat kecemasanyang dapat muncul atau dirasakan oleh pasien yang mendapat perawatan di IGD RSBhayangkara. Metode penelitian ini menggunakan desain penelitian deskriptif denganmenggunakan kuisioner HARS (Hamilton Rating Scale for Anxiety) sebagai alat ukur untukmengetahui tingkat kecemasan. Tingkat kecemasan dibagi menjadi 5 tingkatan, yaitu tidakada kecemasan, kecemasan ringan, kecemasan sedang, kecemasan berat dan kecemasan beratsekali. Sampel yang digunakan yaitu pasien yang berkunjung di IGD RS BhayangkaraManado yakni berjumlah 69 responden. Kesimpulan hasil penelitian didapatkan bahwa dari69 responden yang diteliti, sebanyak 47 responden (68,1%) mengalami kecemasan berat.Kata kunci: Kecemasan, Instalasi Gawat Darurat

The Effect of Price Information on Test-ordering Behavior and Patient Outcomes in a Pediatric Emergency Department

PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_1) ◽  
pp. 877-882 ◽  
Author(s):  
Louis C. Hampers ◽  
Susie Cha ◽  
David J. Gutglass ◽  
Steven E. Krug ◽  
Helen J. Binns
Keyword(s):  
Emergency Department ◽  
Control Period ◽  
Family Satisfaction ◽  
Pediatric Emergency ◽  
Hospital Charges ◽  
Pediatric Emergency Department ◽  
Intervention Period ◽  
Price Information ◽  
Test Ordering

Objective. We sought to determine whether information on hospital charges (prices) would affect test-ordering and quality of patient care in a pediatric emergency department (ED). Design. Prospective, nonblind, controlled trial of price information. Setting. Urban, university-affiliated pediatric ED. Methods. We prospectively assessed patients 2 months to 10 years of age with a presenting temperature ≥38.5°C or complaint of vomiting, diarrhea, or decreased oral intake. The assessments were done during three periods: September 1997 through December 1997 (control), January 1998 through March 1998 (intervention), and April 1998 (washout). In the control and washout periods, physicians noted tests ordered on a list attached to each chart. In the intervention period, physicians noted tests ordered on a similar list that included standard hospital charges for each test. Records of each visit were reviewed to determine clinical and demographic information as well as patient disposition. In the control and intervention periods, families of nonadmitted patients were interviewed by telephone 7 days after the visit. Results. When controlled for triage level, vital signs, and admission rates, in a multivariate model, charges for tests in the intervention period were 27% less than charges in the control period. The greatest decrease was seen among low-acuity, nonadmitted patients (43%). In telephone follow-up, patients in the intervention period were slightly more likely to have made an unscheduled follow-up visit to a health care provider (24.4% vs 17.8%), but did not differ on improved condition (86.7% vs 83.4%) or family satisfaction (93.8% vs 93.0%). Adjusted charges in the washout period were 15% lower than in the control period and 15% higher than in the intervention period. Conclusion. Providing price information was associated with a significant reduction in charges for tests ordered on pediatric ED patients with acute illness not requiring admission. This decrease was associated with a slightly higher rate of unscheduled follow-up, but no difference in subjective outcomes or family satisfaction.

Trauma Visits to a Pediatric Emergency Department During the COVID-19 Quarantine and “Stay at Home” Period

2021 ◽  
pp. 000313482110474
Author(s):  
Usha Sethuraman ◽  
Nirupama Kannikeswaran ◽  
Adam Singer ◽  
Carolyn B Krouse ◽  
Dawn Cloutier ◽  
...  
Keyword(s):  
Emergency Department ◽  
Physical Abuse ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Pediatric Emergency ◽  
Child Physical Abuse ◽  
Emergency Department Visits ◽  
Pediatric Emergency Department ◽  
Dog Bites ◽  
At Home

Background Impact of social distancing on pediatric injuries is unknown. Methods We retrospectively compared injury visits to a pediatric emergency department by individuals ≤21 years during “Stay at Home” (SHO) period to the same period in 2019 (non-SHO). Demographics, types, and outcomes of injuries were noted. Results Although, there was a 35.6% reduction in trauma-related emergency department visits during SHO period (1226 vs 1904), the proportion of injury visits increased (15.5% vs 8.1%, P < .001) and mean age was lower (5.8 yrs ±4.5 vs 8.4 yrs ± 5.2, P < .001). There were significant increases in visits related to child physical abuse (CPA), firearms, and dog bites. Further, significant increases in trauma alerts ( P < .01), injury severity ( P < .01), critical care admissions ( P < .001), and deaths ( P < .01) occurred during the SHO period. Conclusions Although overall trauma-related visits decreased during SHO, the proportion of these visits and their severity increased. Trauma visits related to child physical abuse, dog bites, and firearms increased. Further studies are required to assess the long-term impact of pandemic on pediatric trauma epidemiology.

scholarly journals Pediatric Trauma Boot Camp: A Simulation Curriculum and Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ahmad Khobrani ◽  
Nirali H. Patel ◽  
Richard L. George ◽  
Neil L. McNinch ◽  
Rami A. Ahmed
Keyword(s):  
Emergency Medicine ◽  
Pilot Study ◽  
Survey Methodology ◽  
Pediatric Trauma ◽  
Boot Camp ◽  
Pediatric Emergency ◽  
Basic Knowledge ◽  
Convenience Sample ◽  
Simulation Based ◽  
Trauma Curriculum

Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees’ basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern’s curricular conceptual framework. This was a pilot, prospective, single cohort, exploratory, observational study utilizing survey methodology and a convenience sample. The curriculum consisted of a two-day experience that included confidence surveys, a cognitive multiple-choice questionnaire, and formative and summative simulation scenarios. At the conclusion of this intensive simulation-based trauma boot camp participants reported increased confidence and demonstrated significant improvement in the basic knowledge and performance of the management of pediatric trauma cases in a simulated environment.

scholarly journals Pharmacologic Management of Agitation and Aggression in a Pediatric Emergency Department – A Retrospective Cohort Study

2018 ◽  
Vol 23 (6) ◽  
pp. 455-459 ◽  
Author(s):  
Jennifer G. Kendrick ◽  
Ran D. Goldman ◽  
Roxane R. Carr
Keyword(s):  
Emergency Department ◽  
Adverse Events ◽  
Single Agent ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Inclusion Criteria ◽  
Medication Utilization ◽  
Pharmacologic Management ◽  
Acute Agitation ◽  
To Receive

BACKGROUND Benzodiazepine and antipsychotic use for acute management of agitation and aggression in the pediatric emergency department (ED) setting has not been well described. OBJECTIVES To describe medication utilization in the management of agitation and aggression in a pediatric ED and to assess the safety of their use. METHODS This was a retrospective observational study. Patients less than 20 years of age who presented to our pediatric ED and had agitation or aggression as part of their chief complaint were included if they received at least 1 dose of benzodiazepine or antipsychotic. Outcomes included frequency of benzodiazepine and antipsychotic use, dosing of medications, and reported adverse events. RESULTS During the 5-year study period, there were 128 visits of 120 patients who met the inclusion criteria. Lorazepam was most commonly given (70%), followed by chlorpromazine (20%). Most patients (82%) required a single dose of medication. Intoxication was associated with needing more than 1 dose of medication. Patients with autism or Asperger syndrome were more likely to receive an antipsychotic medication compared to not having these conditions (75% vs. 28%, respectively). Adverse events were documented in 6 visits: oxygen desaturation (n = 1), dizziness and nausea (n = 2), dizziness (n = 1), and paradoxical excitation (n = 2). The Naranjo Score indicated a probable adverse drug reaction for the cases of paradoxical excitation. CONCLUSIONS Benzodiazepine and antipsychotic drug therapy for acute agitation and aggression in children appears to be safe and well tolerated when used as a single agent and at the recommended doses in this setting.

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