Left-handedness as a Risk Factor for Unintentional Injury in Children

PEDIATRICS ◽  
1993 ◽  
Vol 92 (6) ◽  
pp. 823-826
Author(s):  
Charles J. Graham ◽  
Rhonda Dick ◽  
Vaughn I. Rickert ◽  
Robert Glenn
Keyword(s):  
Emergency Department ◽  
Risk Factor ◽  
Confidence Interval ◽  
Children And Adolescents ◽  
Odds Ratio ◽  
Unintentional Injury ◽  
Pediatric Emergency ◽  
Control Group ◽  
Pediatric Emergency Department ◽  
Left Handedness

Objective. To determine whether left-handedness is a risk factor for unintentional injury among children and adolescents. Design. Case-control study. Setting. Pediatric emergency department of Arkansas Children's Hospital. Patients. 265 patients sustaining unintentional trauma aged 6 to 18 years and 494 control patients who did not have trauma were given a questionnaire to determine handedness, past unintentional injury, and parental perception of injury proneness. Results. The frequency of left-handedness in the trauma group (18.1%) was significantly greater than frequency of 10.5% in the control group (P < .003, odds ratio = 1.80, 95% confidence interval 1.20 to 2.72). Multivariate analysis revealed handedness as the only significant vanable between trauma and control (P < .04). The proportion of left-handers who had been hospitalized previously for injury treatment (20.0%) was larger than the proportion of right-handers, (12.0%) (P < .026, odds ratio = 1.84, 95% confidence interval 1.03 to 3.27). More parents of left-handens rated their child as "more clumsy than average' than parents of right-handens (26.0% vs 15.2%, P < .007). Conclusions. Left-handedness appears to be a risk factor for unintentional injury in children and adolescents in a pediatric emergency department population.

Factors associated with difficult intravenous access in the pediatric emergency department

2019 ◽  
Vol 21 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Se Uk Lee ◽  
Jae Yun Jung ◽  
Eun Mi Ham ◽  
Sang Won Wang ◽  
Joong Wan Park ◽  
...  
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Pediatric Emergency ◽  
Catheter Placement ◽  
Pediatric Emergency Department ◽  
Intravenous Catheter ◽  
Related Factors ◽  
Intravenous Access ◽  
Factors Associated

Background: Successful intravenous catheter placement plays a vital role in the pediatric emergency department. We assessed pediatric emergency department–related factors associated with difficult intravenous catheter placement. Method: We retrospectively reviewed the electronic medical records of patients younger than 18 years who had an intravenous catheter placement attempt during their pediatric emergency department stay. Difficult intravenous access was defined as intravenous catheter placement requiring more than one attempt. The demographic-, clinical- and procedure-related factors were collected, and a logistic regression analysis was used to evaluate the factors associated with difficult intravenous access. Result: In total, 925 patients were enrolled, and 77 (8.32%) cases had difficult intravenous access. The median age of the patients was 3.0 (interquartile range = 1–9) years, and 496 (53.6%) patients were male. After adjustment, we found that age (odds ratio = 0.91, 95% confidence interval = (0.85–0.98), p = 0.01); a history of prematurity (odds ratio = 2.31, 95% confidence interval (1.08–4.98), p = 0.03); the intravenous catheter insertion site (foot versus hand odds ratio = 5.65, 95% confidence interval = (2.97–10.75); p < 0.001); and the experience of the provider (<6 months versus ⩾12 months odds ratio = 4.59, 95% confidence interval = (1.92–11.01), p = 0.01) were associated with difficult intravenous access. However, the acuity of disease, crowdedness at the pediatric emergency department, sex, vein visibility, vein palpability, intravenous catheter size, patients’ experience with intravenous access, and time of day were not significantly correlated with difficult intravenous access. Conclusion: The success rate of intravenous catheter placement at the pediatric emergency department could be improved by experienced providers. The acuity of disease and crowdedness at the pediatric emergency department were not significantly associated factors.

scholarly journals Low Rate of SARS-CoV-2 Infections in Symptomatic Patients Attending a Pediatric Emergency Department

2021 ◽  
Vol 9 ◽  
Author(s):  
Christoph Zurl ◽  
Ernst Eber ◽  
Anna Siegl ◽  
Sabine Loeffler ◽  
Evelyn Stelzl ◽  
...  
Keyword(s):  
Emergency Department ◽  
Nucleic Acid ◽  
Children And Adolescents ◽  
Clinical Symptoms ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Measured Temperature ◽  
Nucleic Acid Testing ◽  
Case Definitions ◽  
Outpatient Visits

Children and adolescents seem to be at lower risk of developing clinical symptoms of COVID-19. We analyzed the rate of SARS-CoV-2 infections among 3,605 symptomatic children and adolescents at 4,402 outpatient visits presenting to a pediatric emergency department. In a total of 1,105 (32.6%) episodes, the patients fulfilled clinical case definitions for SARS-CoV-2 infection and were tested by nucleic acid testing. A SARS-CoV-2 infection was diagnosed in 10/1,100 episodes (0.3% of analyzed episodes, 0.91% of validly tested patients). Symptoms at presentation did not differ between patients with and without SARS-CoV-2 infection, apart from the frequency of measured temperature ≥37.5°C at presentation. Three percent of analyzed children reported disturbances of olfactory or gustatory senses, but none of them was infected with SARS-CoV-2. The rate of SARS-CoV-2 infections among symptomatic children and adolescents was low and SARS-CoV-2 infections could not reliably be differentiated from other infections without nucleic acid testing.

scholarly journals Decreased Incidence of Pediatric Intussusception during COVID-19

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1072
Author(s):  
Jun Sung Park ◽  
Young-Hoon Byun ◽  
Seung Jun Choi ◽  
Jong Seung Lee ◽  
Jeong-Min Ryu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Linear Regression ◽  
Odds Ratio ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Communicable Diseases ◽  
Pediatric Emergency Department ◽  
Lower Base ◽  
Log Linear ◽  
Clinical Changes

Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020–January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases—defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08–4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (−4.8 mmol/L vs. −3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic.

Pediatric Emergency Room Visits: A Risk Factor for Acquiring Measles

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 74-79
Author(s):  
Karen M. Farizo ◽  
Paul A. Stehr-Green ◽  
Diane M. Simpson ◽  
Lauri E. Markowitz
Keyword(s):  
Risk Factor ◽  
Los Angeles ◽  
Confidence Interval ◽  
Emergency Room ◽  
Odds Ratio ◽  
The United States ◽  
Pediatric Emergency ◽  
Emergency Room Visits ◽  
Emergency Rooms ◽  
Case Control Studies

In recent years, measles outbreaks have occurred among unimmunized children in inner cities in the United States. From May 1988 through June 1989, 1214 measles cases were reported in Los Angeles, and from October 1988 through June 1989, 1730 cases were reported in Houston. More than half of cases were in children younger than 5 years of age, most of whom were unvaccinated. Of cases of measles in preschool-aged children, nearly one fourth in Los Angeles and more than one third in Houston were reported by one inner-city emergency room. To evaluate whether emergency room visits were a risk factor for acquiring measles, in Los Angeles, 35 measles patients and 109 control patients with illnesses other than measles, and in Houston, 49 measles patients and 128 control patients, who visited these emergency rooms, were enrolled in case-control studies. Control patients were matched to case patients for ethnicity, age, and week of visit. Records were reviewed to determine whether case patients had visited the emergency room during the period of potential measles exposure, which was defined as 10 to 18 days before rash onset, and whether control patients had visited 10 to 18 days before their enrollment visit. In Los Angeles, 23% of case patients and 5% of control patients (odds ratio = 5.2, 95% confidence interval = 1.7, 15.9; P &lt; .01), and in Houston, 41% of case patients and 6% of control patients (odds ratio = 8.4, 95% confidence interval = 3.3, 21.2; P &lt; .01), visited the emergency room during these periods. These data suggest that measles transmission in pediatric emergency rooms played a prominent role in perpetuating these outbreaks. Measles transmission in emergency rooms can be reduced by triage and isolation of suspected cases and by vaccination of eligible patients. Vaccination in emergency rooms provides postexposure prophylaxis and may increase vaccination coverage in the community.

scholarly journals Use of Audiobooks as an Environmental Distractor to Decrease State Anxiety in Children Waiting in the Pediatric Emergency Department: A Pilot and Feasibility Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Leah I. Stein Duker ◽  
Anita R. Schmidt ◽  
Phung K. Pham ◽  
Sofronia M. Ringold ◽  
Alan L. Nager
Keyword(s):  
Emergency Department ◽  
State Anxiety ◽  
Low Cost ◽  
Pediatric Emergency ◽  
Control Group ◽  
Pediatric Emergency Department ◽  
Post Intervention ◽  
Paired Samples ◽  
Before And After ◽  
The Impact

Objectives: Anxiety and anticipatory stressors are commonly experienced by children visiting the Pediatric Emergency Department (PED), but little research exists that addresses the efficacy of interventions to decrease this stress. This one-sample pretest-postest pilot study gathered preliminary data on the feasibility and effectiveness of utilizing audiobooks to reduce fear and state anxiety in children in the PED.Methods: Participants were 131 children in kindergarten through 8th grade (M = 9.4 years, 54% female), triaged urgent or emergent, presenting to the PED. Participants self-reported fear (Children's Fear Scale) and state anxiety (modified State-Trait Anxiety Inventory for Children; mSTAIC) before and after listening to an age-appropriate audiobook (two options). Data regarding patient experience were also collected. Paired samples t-test was used to examine pre–post intervention changes in fear and state anxiety.Results: Significant, albeit small, improvements in fear and the mSTAIC states of nervous, calm, happy, and relaxed were found after use of the audiobook (Cohen's dz = 0.22–0.35). Small, yet significant correlations were found between child age/grade level and improvements in fear and in the mSTAIC states of scared and relaxed, suggesting that the audiobook was more beneficial for older participants. Over 60% of participants liked the audiobook content “a lot” as well as enjoyed listening to the audiobook “a lot.” Without prompting, 15% of participants requested to listen to an additional audiobook.Conclusions: Listening to an audiobook is feasible and could be effective in decreasing fear and state anxiety for children during a waiting period in the PED. The technology is low-cost, simple, and portable. The results of this study should be interpreted with prudence due to the lack of a control group and results that, although significant, were modest based on effect size conventions; future studies should explore the impact of audiobooks on patient stress with an expanded sample size and control group.

Impact of a Disaster Drill on Waiting Times in a Pediatric Emergency Department

2021 ◽  
pp. 1-3
Author(s):  
Silvia Asenjo ◽  
Aitor López-González ◽  
David Muñoz-Santanach ◽  
Victoria Trenchs ◽  
Carles Luaces ◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Times ◽  
Pediatric Emergency ◽  
Optimal Time ◽  
Control Group ◽  
Case Group ◽  
Pediatric Emergency Department ◽  
Real Patients ◽  
Triage Level ◽  
Triage Time

Abstract Objective: Emergency departments should improve their preparedness for mass casualty incidents (MCIs) through periodic drills. These exercises are conducted while maintaining regular care. The aim of this study was to determine the impact of a disaster drill in a pediatric emergency department (PED) on real patients’ waiting times. Methods: On September 10, 2019, a 4-h disaster drill was conducted in the PED of a tertiary pediatric hospital, with minimal staff reinforcement (2 nurses). Cases were real patients that came to the PED during the drill. The patients that visited the PED the day before were the control group. Variables analyzed were: age, sex, destination, triage level, time-to-triage, time-to-physician, length of PED stay, and percentage of patients visited within the optimal time according to triage level. Results: Sixty-eight patients (case group) and 63 patients (control group) were analyzed; both groups were comparable except for the median age. There were no differences in time-to-triage, time-to-physician, and length of PED stay between the 2 groups. The percentage of patients visited within optimal time according to triage level was higher in the case group. Conclusions: Conducting an MCI drill in the PED, with minimal staff reinforcement, was not detrimental to real patients’ waiting times.

scholarly journals Length of stay in the emergency department and its associated factors among pediatrics patients attending at Wolaita Sodo University Teaching and Referral Hospital, Southern, Ethiopia, 2021.

2021 ◽  
Author(s):  
Nega Tezera ◽  
Kiberalem Bisete Negasi ◽  
Almaze Tefera ◽  
Migbaru Getachew
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Confidence Interval ◽  
Associated Factors ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Teaching ◽  
Southern Ethiopia ◽  
Pediatric Emergency Department ◽  
Wolaita Sodo

Abstract Background Pediatrics emergency department length of stay; is the time between emergency department arrival and discharge, admission, or referred. Globally, there is a rising in the need for emergency department visits, which is very high in pediatric patients causing a longer length of stay, which is a global challenge and the bottle neck of hospitals that increase the risk of patients, morbidity, mortality, and reduce satisfaction. Objective This study aimed to assess the length of stay and its associated factors in the pediatric emergency department, Wolaita Sodo University Hospital, 2021. Methods An institution-based cross-sectional study was conducted from March 15 to May 15/ 2021. A Systematic sampling technique was used to select 422 study participants. Semi-structured interviewer-administered questionnaires and chart reviews were used to collect the data. The data were entered in Epi Data version 4.6 and analyzed with SPSS version 26. Descriptive statistics were applied to describe the prevalence, pediatrics, emergency department length of stay with a 95% confidence interval. Bi-variable and multivariable logistic regression analysis were used to identify the factors associated with length of stay and the significant level was declared at p-value ≤ 0.05 on AOR and 95% confidence interval Results The proportion of prolonged pediatric emergency department length of stay was 79.70% (95% CI; 75.7, 83.6). Night time arrival [AOR = 3.19, 95% CI (1.14, 8.98)], weekend arrival [AOR=4.25 95% CI (1.63,11.12], ordered imaging study [AOR = 2.82 95% CI (1.49,5.35)], not got ordered medication in the hospital [AOR = 2.05 95% CI (1.04,4.03)] orange triage category [AOR = 4.01, 95% CI (1.60,10.05)], and duration of pain 13-24 hours[AOR = 0.29, 95% CI (0.89,0.98)], were significantly associated with length of stay Conclusion The proportion of prolonged pediatrics emergency department length of stay was high. To decrease the length of stay, it is better to support the investment of resources on solving these benchmarks.

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