Humor in the Pediatric Emergency Department: A 20-Year Retrospective

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1089-1090
Author(s):  
Douglas S. Nelson
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Medical Training ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Children's Hospital ◽  
Chief Complaints ◽  
Children’S Hospital

Humorous events often take place in pediatric emergency departments without being recorded. A written account of amusing situations occurring in an emergency department has been compiled over 20 years by personnel at a large urban children's hospital. Data from this reference were analyzed for humorous content and presented in the following categories: most interesting chief complaints, suspicious sounding chief complaints, favorite telephone inquiries, and illustrative cases. This study demonstrates that an emergency department may be a fertile source of medical humor. Recognition of these statements and events helps to relieve the stress of medical training and emergency department work.

scholarly journals Mental health-related visits in a pediatric emergency department during the COVID-19 pandemic

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Arnaud Fernandez ◽  
Morgane Gindt ◽  
Phillipe Babe ◽  
Florence Askenazy
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
Pediatric Emergency Department ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Health Related ◽  
The University

AbstractWe aimed to describe the epidemiology of all pediatric emergency department visits (focusing on mental health-related visits versus total visits) at the University Children’s Hospital of Nice (France) from 1 January to 31 December 2020 (year of the COVID-19 pandemic) and to compare it with the earlier 3-year period. The increase in mental health-related visits (44.2%) that we observed, while total visits decreased (30.0%), suggests an impact of the pandemic on children’s and adolescents’ mental health.

scholarly journals 215. Appropriateness and Accuracy of Antimicrobial Prescriptions at Pediatric Emergency Department Discharge

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S109-S110
Author(s):  
Jackelyn lau ◽  
Shamim Islam ◽  
Emily Polischuk
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
Medical Society ◽  
Pediatric Emergency Department ◽  
Children's Hospital ◽  
Common Diagnosis ◽  
Children’S Hospital ◽  
Dosing Accuracy ◽  
Antimicrobial Prescription

Abstract Background Up to 20% of pediatric emergency department visits result in an antimicrobial prescription. The objective of this study was to evaluate the appropriateness and dosing accuracy of antimicrobial prescriptions given at discharge from an ED of a freestanding children’s hospital. Methods Electronic medical records of patients seen in the ED at Oishei Children’s Hospital from 12 dates (3 in each of 4 seasons) were screened. All patients discharged from the ED with a prescription for an antimicrobial were included. Diagnosis, provider type, antibiotic dose per weight, duration and frequency were recorded. Appropriateness of antibiotic choice and dosing accuracy were assessed using major medical society guidelines, pharmacy references and hospital antibiograms. Antibiotic doses were considered inaccurate if >10% outside of recommended weight-based dose ranges. Results Of a total of 1733 screened patients, 12% (207) were discharged with a systemic antimicrobial prescription. The percentage of visits resulting in an antimicrobial prescription varied by season, and was highest during the winter at 19%. Amoxicillin (33% of all) and oseltamivir (15%) were most frequently prescribed. Overall, 98% of patients were prescribed the appropriate antimicrobial, but only 65% of systemic antimicrobial prescriptions had accurate dosing. Amoxicillin was dosed incorrectly in 32% of prescriptions, Figure 1, specifically being below the high-dose recommended range in 28% of otitis media (OM) and 29% of pneumonia cases. Despite being the most common diagnosis, OM was treated with accurate dosing only 57% of the time, Figure 2. Also, more than 40% of patients with UTI or pneumonia had inaccurate drug dosing. Nurse practitioners (NP) prescribed the most antibiotics. Appropriate prescribing did not vary by provider, but accuracy of dosing did; for example, NP dosing accuracy was 58%, vs. 73% for residents (p < 0.04), Figure 3. Dosing Accuracy of Antimicrobials Dosing Accuracy by Diagnosis Appropriateness and Accuracy by Prescriber Group Conclusion An eighth of pediatric ED visits resulted in an antimicrobial prescription. Inaccurate dosing occurred regularly for common infections; most notably underdosing of amoxicillin for OM and pneumonia. Education and audit related to specific drugs and providers promises to be of high stewardship impact in pediatric EDs. Disclosures All Authors: No reported disclosures

scholarly journals Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

2020 ◽  
Vol 11 ◽  
pp. 215013272092627
Author(s):  
Julia Ellbrant ◽  
Jonas Åkeson ◽  
Helena Sletten ◽  
Jenny Eckner ◽  
Pia Karlsland Åkeson
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Cross Sectional ◽  
Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

An Evidence-Based Review of Hyperbilirubinemia in the Late Preterm Infant, with Implications for Practice: Management, Follow-Up, and Breastfeeding Support

2007 ◽  
Vol 26 (6) ◽  
pp. 395-405 ◽  
Author(s):  
Joan Renaud Smith ◽  
Ann Donze ◽  
Lisa Schuller
Keyword(s):  
Emergency Department ◽  
Bowel Movement ◽  
Pediatric Emergency ◽  
Evidence Based ◽  
Pediatric Emergency Department ◽  
Late Preterm Infant ◽  
Breastfeeding Support ◽  
The Past ◽  
Chief Complaints

SIX-DAY-OLD BABY DANNY WAS brought to the pediatric Emergency Department (ED) by his parents with chief complaints of persistent sleeping, difficulty arousing for feedings, and a lack of interest in breastfeeding. Danny’s parents reported that he had had only two wet and very yellow diapers within the past 12 hours. Danny’s mother was concerned because he had not had a bowel movement for more than 48 hours.

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

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.

scholarly journals Designers Drugs—A New Challenge to Emergency Departments—An Observational Study in Poland

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 354
Author(s):  
Rakesh Jalali ◽  
Paula Dmochowska ◽  
Izabela Godlewska ◽  
Justyna Balmas ◽  
Katarzyna Młynarska ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Therapeutic Process ◽  
Symptomatic Treatment ◽  
Pediatric Emergency ◽  
Designer Drugs ◽  
New Psychoactive Substances ◽  
Pediatric Emergency Department ◽  
Psychoactive Substances ◽  
Number Of Patients

Background and Objective: In the last decade, the phenomenon of using new psychoactive substances (NPS), called designer drugs, has been on rise. Though their production and marketing in Poland is prohibited, reports of the Supreme Audit Office noted that young people are increasingly reaching for new intoxication agents in the form of designer drugs. There is a significant increase in the number of patients with NPS abuse admitted to the emergency departments. As NPS cannot be detected by standard tests for the presence of psychoactive substances, it is difficult to choose the appropriate therapeutic intervention. Therefore, the aim of the present study was to evaluate the patient characteristics in the population of adults and children suspected of using NPS and formulate the protocol for diagnosis and treatment. Materials and Method: The paper is based on a retrospective analysis of medical records of hospitalized patients in the Clinical Emergency Department of The Regional Specialist Hospital in Olsztyn (SKOR WSS, emergency department (ED)) and the Pediatric Emergency Department of the Provincial Specialist Children′s Hospital in Olsztyn (SORD WSSD, pediatric emergency department (PED)) between years 2013 to 2018. The patient records related to their general symptoms at admission, mental state and laboratory diagnostic tests were evaluated. Results: The majority of patients hospitalized due to the suspected use of NPS were adolescents in 2013–2016 and a reversal of this trend was observed in 2017–2018 when number of adults admitted to the emergency department (ED) due to NPS use was higher. The NPS abuse was significantly higher among male patients, alcoholics, people using other psychoactive substances, patients suffering from mental disorders and teenagers in difficult socio-economic family situations. Whereas, the most common symptoms among pediatric patients were co-ordination disorder and aggression, in adults mainly tachycardia and aggression was observed. The laboratory tests in significant number of adult patients showed leukocytosis and ketonuria. Conclusions: In the present study, no unambiguous toxidrome or biochemical pattern characteristic for using NPS was observed. However, evaluation of blood morphology, coagulation parameters, liver and kidney function can be helpful in the diagnostic and therapeutic process. Symptomatic treatment of patients, fluid therapy and sedation was sufficient in most cases to resolve the patient symptoms in 48 h.

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