scholarly journals Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres

CJEM ◽  
2012 ◽  
Vol 14 (01) ◽  
pp. 14-19 ◽  
Author(s):  
Robin Cardamore ◽  
Joe Nemeth ◽  
Christine Meyers
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Positive Impact ◽  
Pediatric Trauma ◽  
Great Majority ◽  
Pediatric Emergency ◽  
Perceived Barriers ◽  
Emergency Physicians ◽  
The Future

ABSTRACT Objectives: To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. Methods: An electronic survey was sent to 162 pediatric emergency physicians and 12 site directors from the 12 pediatric emergency departments across Canada. Results: Ninety-two percent (11 of 12) of centres completed the survey. The individual physician response rate was 65% (106 of 162), with 100% of site directors responding. Ultrasound machines were available in 45% (5 of 11) of centres. Forty-two percent (32 of 77) of emergency physicians working in equipped pediatric centres used bedside EDUS to evaluate blunt abdominal trauma (BAT). In the subgroup of staff who also worked at adults sites, the frequency of ultrasonography use for the evaluation of pediatric BAT was 75%. In the 55% (6 of 11) of centres without ultrasonography, 88% of staff intend to incorporate its use in the future and 81% indicated that they believed the incorporation of ultrasonography would have a positive impact on patient care. The main perceived barriers to the use of ultrasonography in the evaluation of BAT were a lack of training (41%) and a lack of equipment (26%). Conclusion: Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.

scholarly journals Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Agron Dogjani ◽  
Kastriot Haxhirexha ◽  
Edvin Selmani ◽  
Hysni Bendo ◽  
Amarildo Blloshmi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Injury Severity Score ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Pediatric Age ◽  
Predictive Tool ◽  
Trauma Score

Background: Trauma is the leading cause of morbidity and mortality in pediatric age. Abdominal trauma is the third most frequent cause of trauma injuries in children. The purpose of our study is to discuss BATp epidemiology and its relationship with polytrauma, , to recognize and describe the mechanisms of blunt abdominal trauma in pediatric age and to identify the signs and symptoms that associate it. Material and methods: In this retrospective study we reviewed all patients with blunt abdominal trauma in pediatric age who presented in Emergency Department at the University Hospital of Trauma in Tirana, Albania in the period between December 1-st 2017 and June 24-th 2018. The sample in the study was taken randomly. The Injury Severity Score, Revised Trauma Score were used as important points to evaluate gravity of injuries, and method of treatment. The data was introduced in absolute and percentage values and Kendal's tau b correlation coefficient and the regression analysis was used to analyze and to find out any association among the dependent versus independent variable. The type of study is case control with two components; descriptive and analytical. Results: In the time period that we studied, about 25200 patients were presented in Emergency department and 6.68% of these cases were hospitalized. Most frequent causes were motor vehicle accidents (35.4%) and abdominal trauma comprised 25.8% of cases, whereas in children it comprised 13.7% of total pediatric trauma. We have found correlation between the injury severity score and complications rate (r = 0.254, n = 49, p <0.001), and injury severity score with length of hospital stay (r = 0279, n = 49, p <0.001). Conclusions: Blunt Abdominal Trauma in pediatric age is a serious threat to the health of the children. Their treatment should be carried out not only in tertiary trauma centers but in every regional hospital. The trauma score is very valuable to determine the gravity of the injury, method of treatment and is a predictive tool in trauma outcomes.

Is FAST  Too FAST?

2020 ◽  
pp. 75-80
Author(s):  
Laurie Malia ◽  
Joni E. Rabiner
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Point Of Care ◽  
Pediatric Trauma ◽  
Abdominal Injury ◽  
Reliable Information ◽  
Highly Sensitive ◽  
Fast Exam

Blunt abdominal trauma is common in pediatric trauma. This chapter discusses a child who presents to the emergency department with left upper quadrant pain after being struck by a motor vehicle. The point-of-care focused assessment with sonography for trauma (FAST) examination provides quick, reliable information on bleeding into the peritoneal, pericardial, and pleural spaces in the setting of trauma. The FAST exam is highly sensitive for identification of hemoperitoneum but is less accurate for ruling out hemoperitoneum and intra-abdominal injury. Discussion of the trauma evaluation and utility of the FAST examination in the context of pediatric blunt abdominal trauma is presented.

Child Life Reduces Distress and Pain and Improves Family Satisfaction in the Pediatric Emergency Department

2018 ◽  
Vol 57 (13) ◽  
pp. 1567-1575 ◽  
Author(s):  
Natasha Sanchez Cristal ◽  
Jennifer Staab ◽  
Rachel Chatham ◽  
Sarah Ryan ◽  
Brian Mcnair ◽  
...  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Pediatric Trauma ◽  
Family Satisfaction ◽  
Pediatric Emergency ◽  
Child Life ◽  
Convenience Sample ◽  
Patient Cooperation ◽  
To Receive ◽  
Pain Rating Scale

This study evaluated the effects of Certified Child Life Specialist (CCLS) intervention on pediatric distress and pain and family satisfaction during routine peripheral intravenous (PIV) line placement in the emergency department (ED). A convenience sample of 78 children (3-13 years) requiring PIV placement for their treatment at a regional level 1 pediatric trauma center ED with 70 000 annual visits were selected to receive either standard nursing care or CCLS intervention for PIV placement. CCLS involvement was associated with fewer negative emotional behaviors as indicated by a lower score on the Children’s Emotional Manifestation Scale (−3.37 ± 1.49, P = .027), a reduction in self-reported pain on the Wong-Baker Faces pain rating scale (−1.107 ± 0.445, P = .017), an increase in parent-reported patient cooperation during PIV placement, and greater satisfaction with the ED visit. This study demonstrates that Child Life can have an impact on important outcomes in the pediatric ED such as distress, pain, and visit satisfaction.

Clinical Policy: Critical Issues in the Evaluation of Adult Patients Presenting to the Emergency Department With Acute Blunt Abdominal Trauma

2011 ◽  
Vol 57 (4) ◽  
pp. 387-404 ◽  
Author(s):  
Deborah B. Diercks ◽  
Abhishek Mehrotra ◽  
Devorah J. Nazarian ◽  
Susan B. Promes ◽  
Wyatt W. Decker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Adult Patients ◽  
Critical Issues

Group-facilitated audit and feedback to improve bronchiolitis care in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 678-686
Author(s):  
Shawn K. Dowling ◽  
Inelda Gjata ◽  
Nathan M. Solbak ◽  
Colin G.W. Weaver ◽  
Katharine Smart ◽  
...  
Keyword(s):  
Emergency Department ◽  
Control Charts ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Therapeutic Interventions ◽  
Audit And Feedback ◽  
Absolute Difference ◽  
Emergency Physicians ◽  
Feedback Session ◽  
Statistical Process

ABSTRACTObjectiveDespite strong evidence recommending supportive care as the mainstay of management for most infants with bronchiolitis, prior studies show that patients still receive low-value care (e.g., respiratory viral testing, salbutamol, chest radiography). Our objective was to decrease low-value care by delivering individual physician reports, in addition to group-facilitated feedback sessions to pediatric emergency physicians.MethodsOur cohort included 3,883 patients ≤ 12 months old who presented to pediatric emergency departments in Calgary, Alberta, with a diagnosis of bronchiolitis from April 1, 2013, to April 30, 2018. Using administrative data, we captured baseline characteristics and therapeutic interventions. Consenting pediatric emergency physicians received two audit and feedback reports, which included their individual data and peer comparators. A multidisciplinary group-facilitated feedback session presented data and identified barriers and enablers of reducing low-value care. The primary outcome was the proportion of patients who received any low-value intervention and was analysed using statistical process control charts.ResultsSeventy-eight percent of emergency physicians consented to receive their audit and feedback reports. Patient characteristics were similar in the baseline and intervention period. Following the baseline physician reports and the group feedback session, low-value care decreased from 42.6% to 27.1% (absolute difference: −15.5%; 95% CI: −19.8% to −11.2%) and 78.9% to 64.4% (absolute difference: −14.5%; 95% CI: −21.9% to −7.2%) in patients who were not admitted and admitted, respectively. Balancing measures, such as intensive care unit admission and emergency department revisit, were unchanged.ConclusionThe combination of audit and feedback and a group-facilitated feedback session reduced low-value care for patients with bronchiolitis.

Prehospital and Emergency Department Ultrasound in Blunt Abdominal Trauma

2009 ◽  
Vol 35 (4) ◽  
pp. 341-346 ◽  
Author(s):  
Miriam Ruesseler ◽  
Thomas Kirschning ◽  
Raoul Breitkreutz ◽  
Ingo Marzi ◽  
Felix Walcher
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma

scholarly journals Assessment of Patients with Blunt Abdominal Trauma Admitted to Emergency Department

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Dinesh Pratap Singh ◽  
◽  
Shwetank Agarwal ◽  
Shahnawaz Hussain Siddiqui ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma
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