Diagnostic concordance between pediatric emergency department physicians and dermatologists in a tertiary hospital in Mexico

2020 ◽  
Vol 37 (6) ◽  
pp. 1113-1118
Author(s):  
Erika L. Alba‐Rojas ◽  
Edna Morán‐Villaseñor ◽  
Blanca L. Campos‐Cabrera ◽  
Iliana L. Aguirre‐Martínez ◽  
Rosa V. Vega‐Rangel ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Diagnostic Concordance

scholarly journals Validation of a Modified Triage Scale in a Norwegian Pediatric Emergency Department

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mette Engan ◽  
Asle Hirth ◽  
Håvard Trønnes
Keyword(s):  
Emergency Department ◽  
Negative Predictive Value ◽  
Resource Utilization ◽  
Predictive Value ◽  
Intraclass Correlation ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Interrater Agreement ◽  
Pediatric Emergency Department ◽  
Sensitivity Specificity

Objective. Triage is a tool developed to identify patients who need immediate care and those who can safely wait. The aim of this study was to assess the validity and interrater reliability of a modified version of the pediatric South African triage scale (pSATS) in a single-center tertiary pediatric emergency department in Norway. Methods. This prospective, observational study included all patients with medical conditions, referred to the pediatric emergency department of a tertiary hospital in Norway from September 1, 2015, to November 17, 2015. Their assigned triage priority was compared with rate of hospitalization and resource utilization. Validity parameters were sensitivity, specificity, positive and negative predictive value, and percentage of over- and undertriage. Interrater agreement and accuracy of the triage ratings were calculated from triage performed by nurses on written case scenarios. Results. During the study period, 1171 patients arrived at the hospital for emergency assessment. A total of 790 patients (67 %) were triaged and included in the study. The percentage of hospital admission increased with increasing level of urgency, from 30 % of the patients triaged to priority green to 81 % of those triaged to priority red. The sensitivity was 74 %, the specificity was 48 %, the positive predictive value was 52 %, and the negative predictive value was 70 % for predicting hospitalization. The level of over- and undertriage was 52 % and 26 %, respectively. Resource utilization correlated with higher triage priority. The interrater agreement had an intraclass correlation coefficient of 0.99 by Cronbach’s alpha, and the accuracy was 92 %. Conclusions. The modified pSATS had a moderate sensitivity and specificity but showed good correlation with resource utilization. The nurses demonstrated excellent interrater agreement and accuracy when triaging written case scenarios.

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.

scholarly journals Is a Laboratory Evaluations Required in Every Case Admitting to the Pediatric Emergency Department with Epistaxis?

2021 ◽  
Author(s):  
Songul Tomar Güneysu ◽  
Okşan Güleryüz ◽  
elif ceylan ◽  
AYLA AKÇA ÇAĞLAR ◽  
Özlem çolak
Keyword(s):  
Emergency Department ◽  
Chronic Disease ◽  
Laboratory Tests ◽  
Complete Blood Count ◽  
Systemic Disease ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Additional Treatment ◽  
Pediatric Emergency Department ◽  
Limiting Condition

ABSTRACT Background: Epistaxis is a mostly self-limiting condition common among children and is rarely severe. In this study, it was aimed to evaluate the incidence, demographic characteristics, causes of bleeding and treatment methods of patients who applied to the Pediatric Emergency Department (PED) with epistaxis, and to determine in which cases a laboratory test should be used. Method: Admitted to Gazi University Faculty of Medicine, PED which provides trauma care and is a tertiary hospital, between January 1, 2019 and December 31, 2019, 452 patients aged 0-18 years who presented with epistaxis to any reason or secondary to systemic disease were analyzed retrospectively. Results: The annual incidence was found 1.23%. The median age was 63 months, 258 of the cases (57.1%) were male. It was found that the cases most frequently applied to the hospital in the autumn months (37.6%). Sixty of the patients (13.3%) had a chronic disease and 54 (11.9%) had a history of drug use. Bleeding time was less than 5 minutes in 75.2% and 84.4% of the bleeding was unilateral. Nasal bleeding is local in 73.4%; 4.7% of them developed due to systemic reasons. The most common cause of epistaxis; while they were trauma at the first 10 years of age, they were idiopathic causes after the age of 10 years. In 434 (96%) of the patients, epistaxis spontaneously stopped and there was no need for additional treatment. Conclusion: As a result of this study, it was concluded that laboratory tests should be performed in cases with chronic disease history, bilateral bleeding, active bleeding and nontraumatic epistaxis. The situation that causes epistaxis in the childhood age group should be determined with a good history and physical examination, laboratory tests should not be used in every patient. Key Words: pediatric emergency, epistaxis, laboratory examinations, complete blood count

scholarly journals The status of drug wastage in the pediatric emergency department of a tertiary hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 10
Author(s):  
IbrahimHakan Bucak ◽  
Habip Almis ◽  
CaglaNur Dogan ◽  
Mehmet Turgut
Keyword(s):  
Emergency Department ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Drug Wastage ◽  
The Status

Assessing Somatization and Psychosocial Impairment in the Pediatric Emergency Department

2010 ◽  
Author(s):  
Zorash Montano ◽  
Neda Safvati ◽  
Angela Li ◽  
Ilene Claudius ◽  
Jeffrey I. Gold
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Psychosocial Impairment

Variation in Test Ordering for Low Acuity Patients By Pediatric Emergency Department Providers

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 276A-276A
Author(s):  
Kaynan Doctor ◽  
Kristen Breslin ◽  
Melissa M. Tavarez ◽  
Deena Berkowitz ◽  
James M. Chamberlain
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Test Ordering
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