Under Prescription of Epinephrine to Medicaid Patients in the Pediatric Emergency Department

Objective. To describe pediatric Medicaid patients with pediatric emergency department (PED) visits for anaphylaxis who received epinephrine auto-injector (EAI) prescriptions in the ED versus those who did not; and to compare patients who filled their prescriptions versus those who did not. Methods. We conducted a cross-sectional study of Medicaid patients aged 0 to 21 years presenting to 2 PEDs, with symptoms meeting the National Institute of Allergy and Infectious Diseases criteria for anaphylaxis, between July 2012 and July 2014. Results. We identified 86 patients across the 2 hospitals with a confirmed diagnosis of anaphylaxis in the PED. Of these, 55 (64%, 95% confidence interval [CI] = 53% to 74%) received a prescription for an EAI during their ED visit. Forty-two (68%; 95% CI = 56% to 80%) received a prescription for EAI in Hospital 1 versus 13 (54%; 95% CI = 33% to 74%) in Hospital 2. Medicaid prescription fill rates were available for Hospital 1. Of the 42 who received an EAI prescription, 36 (86%; 95% CI = 75% to 96%) filled these prescriptions with Medicaid. Of the 20 (32%) out of 62 patients with anaphylaxis who did not receive prescriptions for an EAI, only 5 had previously filled prescriptions for epinephrine. Conclusion. Previous Medicaid patient prescription adherence data suggested that these patients would have a low EAI prescription fill rate. We found Medicaid patients who received prescriptions for an EAI after the ED visit for anaphylaxis filled them; however, a considerable proportion of anaphylaxis visits had no EAI prescription provided at discharge.

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Improving pediatric emergency department physicians’ adherence to clinical practice guidelines on the diagnosis and management of group A beta-hemolytic streptococcal pharyngitis—a cross-sectional study

International Journal of Emergency Medicine ◽

10.1186/s12245-018-0209-4 ◽

2018 ◽

Vol 11 (1) ◽

Cited By ~ 3

Author(s):

Ahmed A. Alkhazi ◽

Khalid M. Alessa ◽

Ahmed M. Almutairi ◽

Hamad A. Almadi ◽

Abdullah Akkam ◽

...

Keyword(s):

Emergency Department ◽

Clinical Practice ◽

Practice Guidelines ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Streptococcal Pharyngitis ◽

Pediatric Emergency Department ◽

Sectional Study ◽

Cross Sectional ◽

Group A

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Pediatric Emergency Department Resource Utilization among Children with Primary Care Clinic Contact in the Preceding 2 Days: A Cross-Sectional Study

The Journal of Pediatrics ◽

10.1016/j.jpeds.2017.06.007 ◽

2017 ◽

Vol 188 ◽

pp. 245-251.e2

Author(s):

Christina K. Grech ◽

Molly A. Laux ◽

Heather L. Burrows ◽

Michelle L. Macy ◽

Elaine S. Pomeranz

Keyword(s):

Primary Care ◽

Emergency Department ◽

Resource Utilization ◽

Primary Care Clinic ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Pediatric Emergency Department ◽

Sectional Study ◽

Cross Sectional ◽

Care Clinic

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A cross-sectional study of screening for coronavirus disease 2019 (COVID-19) at the pediatric emergency department in Vilnius during the first wave of the pandemic

European Journal of Pediatrics ◽

10.1007/s00431-021-03999-z ◽

2021 ◽

Author(s):

Indrė Stacevičienė ◽

Sigita Burokienė ◽

Aušra Steponavičienė ◽

Daiva Vaičiūnienė ◽

Augustina Jankauskienė

Keyword(s):

Emergency Department ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Pediatric Emergency Department ◽

Sectional Study ◽

Cross Sectional

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Clinical profile & management of children with seizures presenting to pediatric emergency department: A cross-sectional study

International Journal of Surgery Open ◽

10.1016/j.ijso.2020.11.017 ◽

2020 ◽

Vol 27 ◽

pp. 188-191

Author(s):

Ayesha Abbasi ◽

Ghazala Kazi ◽

Saman Siddiqui ◽

Yumna Siddiqi

Keyword(s):

Emergency Department ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Clinical Profile ◽

Pediatric Emergency Department ◽

Sectional Study ◽

Cross Sectional ◽

Profile Management

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The Effect of the COVID-19 Pandemic on the Pediatric Emergency Department Flow

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.355 ◽

2021 ◽

pp. 1-25

Author(s):

Andrea Rivera-Sepulveda ◽

Timothy Maul ◽

Katherine Dong ◽

Kylee Crate ◽

Talia Helman ◽

...

Keyword(s):

Emergency Department ◽

Patient Flow ◽

Admission Rate ◽

Severity Index ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

P Value ◽

Pediatric Emergency Department ◽

Cross Sectional ◽

Chief Complaints

ABSTRACT Objective: To determine how the early stages of the COVID-19 pandemic affected the utilization of the Pediatric Emergency Department (PED). Methods: Cross-sectional study of PED visits during January through April, 2016-2020. Data included: total PED visits, emergency severity index (ESI), disposition, chief complaint, age (months), time from first Provider to Disposition (PTD), and PED length of stay (PED-LOS). P-value <0.01 was statistically significant. Results: In total, 67,499 visits were reported. There was a significant decrease in PED visits of 24-71% from March to April 2020. Chief complaints for fever and cough were highest in March 2020; while April 2020 had a shorter mean PED-LOS (from 158 to 123 minutes), an increase of admissions (from 8% to 14%), a decrease in ESI 4 (10%), and an increase in ESI 3 (8%) (p<0.001). There was no difference in mean monthly PTD time. Conclusions: Patient flow in the PED was negatively affected by a decrease in PED visits and increase in admission rate that may be related to higher acuity. By understanding the interaction between hospital processes on PEDs and patient factors during a pandemic, we are able to anticipate and better allocate future resources.

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Pediatric emergency department utilisation during Ramadan: a retrospective cross-sectional study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-319173 ◽

2020 ◽

pp. archdischild-2020-319173

Author(s):

Rasha D Sawaya ◽

Cynthia Wakil ◽

Sami Shayya ◽

Moustafa Al Hariri ◽

Alik Dakessian ◽

...

Keyword(s):

Emergency Department ◽

Tertiary Care ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Peak Time ◽

Work Efficiency ◽

Sectional Study ◽

Tertiary Care Centre ◽

Cross Sectional ◽

The Impact

ObjectiveTo investigate the impact of Ramadan on patient characteristics, diagnoses and metrics in the paediatric emergency department (PED).DesignRetrospective cross-sectional study.SettingPED of a tertiary care centre in Lebanon.PatientsAll paediatric patients.ExposureRamadan (June 2016 and 2017) versus the months before and after Ramadan (non-Ramadan).Main outcome measuresPatient and illness characteristics and PED metrics including peak patient load; presentation timings; length of stay; and times to order tests, receive samples and report results.ResultsWe included 5711 patients with mean age of 6.1±5.3 years and 55.4% males. The number of daily visits was 28.3±6.5 during Ramadan versus 31.5±7.3 during non-Ramadan (p=0.004). The peak time of visits ranged from 18:00 to 22:00 during non-Ramadan versus from 22:00 to 02:00 during Ramadan. During Ramadan, there were significantly more gastrointestinal (GI) and trauma-related complaints (39.0% vs 35.4%, p=0.01 and 2.9% vs 1.8%, p=0.005). The Ramadan group had faster work efficiency measures such as times to order tests (21.1±21.3 vs 24.3±28.1 min, p<0.0001) and to collect samples (50.7±44.5 vs 54.8±42.6 min, p=0.03).ConclusionsRamadan changes presentation patterns, with fewer daily visits and a later peak time of visits. Ramadan also affects illness presentation patterns with more GI and trauma cases. Fasting times during Ramadan did not affect staff work efficiency. These findings could help EDs structure their staffing to optimise resource allocation during Ramadan.

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Is caregiver refusal of analgesics a barrier to pediatric emergency pain management? A cross-sectional study in two Canadian centres

CJEM ◽

10.1017/cem.2018.11 ◽

2018 ◽

Vol 20 (6) ◽

pp. 892-902 ◽

Cited By ~ 3

Author(s):

Caroline Whiston ◽

Samina Ali ◽

Bruce Wright ◽

David Wonnacott ◽

Antonia S. Stang ◽

...

Keyword(s):

Emergency Department ◽

Pain Management ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Painful Condition ◽

Major Barrier ◽

Study Find ◽

Children's Pain

CLINICIAN’S CAPSULEWhat is known about the topic?Children’s pain in the emergency department (ED) continues to be under-recognized and sub-optimally managed.What did this study ask?We sought to evaluate the frequency of caregiver/child acceptance of analgesia offered in the ED.What did this study find?Of the 743 children who presented to the ED with a painful condition, 408 (54.9%) were offered analgesia. If offered in the ED, analgesia was accepted by 91% (373/408) of the caregivers/children.Why does this study matter to clinicians?This study suggests that caregiver/child refusal of analgesia is a not a major barrier to optimal pain management and highlights the importance of ED personnel in encouraging adequate analgesia.

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Pediatric somatization in the emergency department: assessing missed opportunities for early management

CJEM ◽

10.1017/cem.2019.477 ◽

2020 ◽

Vol 22 (3) ◽

pp. 331-337

Author(s):

Punit Virk ◽

Dzung X. Vo ◽

Jacob Ellis ◽

Quynh Doan

Keyword(s):

Mental Health ◽

Emergency Department ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Considerable Proportion ◽

Symptom Duration ◽

Cross Sectional ◽

Missed Opportunities ◽

Early Management ◽

Health Related

ABSTRACTObjectiveSomatization is a common phenomenon that can severely complicate youths’ functioning and health. The burden of somatization on pediatric acute care settings is currently unclear; better understanding it may address challenges clinicians experience in effectively caring for somatizing patients. In this study, we estimate the prevalence of somatization in a pediatric emergency department (ED).MethodsWe conducted a retrospective cross-sectional study of visits for non-critical, non-mental health-related concerns (n = 150) to a quaternary-level pediatric ED between July 2016 and August 2017. Demographic and clinical visit details were collected through chart review and used by two reviewing clinicians to classify whether each visit had a “probable,” “unclear” (possible), or “unlikely” somatizing component.ResultsApproximately 3.33% (n = 5) of youth displayed probable somatization, and an additional 13.33% (n = 20) possibly experienced a somatizing component but require additional psychosocial and visit documentation to be certain. Longer symptom duration and multiple negative diagnostic tests were associated with a higher likelihood of either probable or possible somatization.ConclusionsA considerable proportion of non-mental health-related visits may involve a somatizing component, indicating the burden of mental health concerns on the ED may be underestimated. A higher index of suspicion for the possibility of somatization may support clinicians in managing somatizing patients.

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What Determines The Migration Intentions Of University Students?

Balkan Region Conference on Engineering and Business Education ◽

10.2478/cplbu-2014-0042 ◽

2014 ◽

Vol 1 (1) ◽

pp. 193-198

Author(s):

Heiko Haase ◽

Arndt Lautenschläger

Keyword(s):

University Students ◽

Career Choice ◽

Cross Sectional Study ◽

Demographic Characteristics ◽

Migration Decision ◽

Considerable Proportion ◽

Sectional Study ◽

Intention To Stay ◽

Cross Sectional ◽

The University

AbstractThe paper aims at exploring determinants of the university students' intentions to stay within their university region. At this, we presume that students' career choice motivations are related to their professional intentions, which again, along with demographic characteristics, affect their migration decision. Our analysis is based on a cross-sectional study of 2,353 students from three different higher education institutions, two of them located in Germany and one in Namibia. Results indicate that in Germany migration matters because a considerable proportion of students intend to leave the university region after graduation. At this, we found that the students' geographical provenance exerts the most significant effect on the intention to stay. Moreover, certain professional intentions were directly and some career choice motivations were indirectly linked with the intention to remain at the university location. We present several conclusions and implications.

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