scholarly journals Early Newborn Discharge: Increasing Pediatric Emergency Room Utilization and Changing Follow-up Practices in a Geographically Defined Area† 1365

1998 ◽  
Vol 43 ◽  
pp. 233-233
Author(s):  
Cyril R Walker ◽  
Nicki Sims-Jones ◽  
Nancy Watters
Keyword(s):  
Emergency Room ◽  
Pediatric Emergency

Compliance with Follow-up Appointments Generated in a Pediatric Emergency Room

1985 ◽  
Vol 1 (3) ◽  
pp. 23-29 ◽  
Author(s):  
Patricia Fosarelli ◽  
Catherine DeAngelis ◽  
Anne Kaszuba
Keyword(s):  
Emergency Room ◽  
Pediatric Emergency

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

scholarly journals A78 THE IMPACT OFGASTROINTESTINAL FOLLOW UP CARE ON HEALTHCARE UTILIZATION IN PATIENTS WITH ESINOPHILICESOPHAGITID (EOE).

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 45-46
Author(s):  
K Alazemi ◽  
M Alkhattabi ◽  
J C Gregor
Keyword(s):  
Emergency Room ◽  
Healthcare Utilization ◽  
Attrition Rate ◽  
Quality Improvement Initiative ◽  
Food Impaction ◽  
Emergency Room Visits ◽  
True Rate ◽  
Funding Agencies ◽  
The Impact

Abstract Background EOE is an increasingly recognized gastrointestinal condition that causes significant morbidity ranging from dietary limitations to food impactions requiring emergency room visits. There are a variety of dietary, pharmacologic and endoscopic treatments available but most are more practically guided by a subspecialist familiar and experienced with the condition. There is a perception among some physicians that follow up is sporadic and may be related at least in part to patient compliance. Aims To assess the true rate of EOE patients follow up rate at Lodon Health Scince Center Methods We used a retrospective cohort of patients diagnosed with EoE between July 2011 and June 2014 who met the traditional diagnostic criteria. As part of a quality improvement initiative, local follow up over the ensuing 5–7 years was tracked. The impact of follow up on subsequent healthcare utilization was analyzed. Results 123 patients with biopsy confirmed EoE were analyzed. Follow up appointments were made for 114/123 (92%) patients. 55/123 (45%) had repeat elective endoscopy booked. Only 10/114 (8.7%) of initial appointments went unattended but 15/55 (27.2%) of the patients offered ongoing follow up failed to attend. There were no complications (ie. perforation or bleeding) attributable to any of the procedures. 5/123 (4%) patients required repeat emergency room endoscopy for food impaction. Two patients required this on multiple occasions. 4/5 patients requiring repeat emergency room endoscopy for food impaction had received some sort of follow up, although 4/5 of these had at least one missed appointment. 2/5 patients having emergency room endoscopy required overnight admission. There were no perforations in the cohort. Conclusions Patients with a confirmed diagnosis of EOE do have a risk of requiring subsequent emergency endoscopy for food impaction although it is not clear that scheduled follow up significantly reduces that risk. Contrary to the perception of some physicians, patients with EoE are very likely to attend their first follow up visit although the attrition rate for subsequent scheduled visits is not insignificant. Funding Agencies None

scholarly journals Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
T. Ahluwalia ◽  
S. Toy ◽  
C. Gutierrez ◽  
K. Boggs ◽  
K. Douglass
Keyword(s):  
Emergency Medicine ◽  
Self Efficacy ◽  
Pediatric Emergency ◽  
Pediatric Care ◽  
Procedural Skills ◽  
Knowledge And Skills ◽  
Post Graduate ◽  
Pediatric Emergencies ◽  
Simulation Based

Abstract Background Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees’ self-efficacy, knowledge, and skills in pediatric care. Methods We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. Results Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. Conclusions A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees’ self-efficacy, knowledge, and skills in pediatric emergency care.

Childhood Fever: Correlation of Diagnosis With Temperature Response to Acetaminophen

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 315-318
Author(s):  
M. Douglas Baker ◽  
Patricia D. Fosarelli ◽  
Richard O. Carpenter
Keyword(s):  
Patient Management ◽  
Temperature Response ◽  
Pediatric Emergency ◽  
Bacterial Disease ◽  
X Ray ◽  
Chest X Ray ◽  
Antipyretic Treatment ◽  
Fever Response ◽  
Childhood Fever

Many people believe that temperature response to antipyretics in febrile children varies according to diagnosis. To evaluate the validity of this premise, we prospectively studied the temperature response to acetaminophen of febrile children who came to an urban pediatric emergency and walk-in facility. The study group consisted of 1,559 patients between the ages of 8 weeks and 6 years whose temperatures when seen were greater than 38.4°C and who had not received antipyretic treatment within the previous four hours. Acetaminophen (15 mg/kg) was administered to each child and repeat temperatures were taken one and two hours later. Patient management was unaffected by the study, and physicians were unaware of the repeat temperature measurements. Telephone follow-up was conducted with the parents of each child within five days of the initial visit. Children with cultures positive for bacterial disease or chest x-ray films positive for pneumonia had slightly greater one- and two-hour temperature decreases compared with children with other diagnoses. Although statistically significant, we do not consider these differences in response to be clinically useful. We conclude that fever response to acetaminophen is not a clinically useful indicator by which to differentiate the causes of febrile illnesses in young children.

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