scholarly journals Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospital: Association With Environmental Factors

2019 ◽  
Vol 29 (5) ◽  
pp. 365-370 ◽  
Author(s):  
MA Marques-Mejías ◽  
M Tomás-Pérez ◽  
I Hernández ◽  
I López ◽  
S Quirce
Keyword(s):  
Emergency Department ◽  
Environmental Factors ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Asthma Exacerbations

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 Understanding the environmental factors related to the decrease in Pediatric Emergency Department referrals for acute asthma during the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Arianna Dondi ◽  
Ludovica Betti ◽  
Claudio Carbone ◽  
Ada Dormi ◽  
Marco Paglione ◽  
...  
Keyword(s):  
Emergency Department ◽  
Air Pollution ◽  
Urban Areas ◽  
Acute Asthma ◽  
Pediatric Emergency ◽  
Anthropogenic Sources ◽  
Pediatric Emergency Department ◽  
Respiratory Pathogens ◽  
Specific Chemical ◽  
Asthma Exacerbations

Background: Asthma exacerbations, a common reason for Pediatric Emergency Department (PED) referral, can be triggered by multiple factors, including infections, air pollution and allergens. Lockdown measures and other public health interventions during the SARS-CoV-2 pandemic determined radical changes to behavioral and social habits, that were reflected by a reduction in the transmission of all respiratory pathogens and in the emissions of relevant air pollution anthropogenic sources. Objective: This study aims to describe how restrictions during SARS-CoV-2 pandemic impacted the PED referral for asthma exacerbations and their potentially associated environmental triggers in densely populated urban areas. Methods: PED referrals for acute asthma from 2015 to 2020 were compared to air pollution and pollen data. To this purpose, historical daily concentration records of PM2.5, PM10 (including specific chemical tracers), as well as NO2, C6H6, tree, grass and weed pollen were analyzed. Results: In 2020, asthma-related PED referrals decreased up to 85%, compared to the average referral rate of the previous 5 years (P<0.01). The drastic drop in PED referrals was associated with a reduction of high-priority cases by 50-60%, unlike PED referrals for overall diagnoses, showing a larger contribution for severe outcomes. A concomitant diminished contribution of traffic-related air pollution was shown. Conclusions: The lower rate of asthma exacerbations in childhood can be related to synergic interactions of the multiple effects of lockdown measures which induced lower viral infection rates and decreased exposure to outdoor allergens. The reduction of traffic-related air pollution determined a weakening of inflammatory properties of urban PM.

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