Missed Fractures in Infants Presenting to the Emergency Department With Fussiness

Kondis, Jamie S.; Muenzer, Jared T.; Luhmann, Janet D.

doi:10.1097/pec.0000000000001106

Cited by 16 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nineteen (26%) studies focused specifically on injury patterns of abused children, and the likelihood of child abuse among patients presenting with fractures, head trauma, and oral injuries. 71 , 75 , 81 , 82 , 86 , 91 , 95 , 97 , 99 , 101 , 107 , 109 – 111 , 113 , 115 , 117 , 119 , 127 About 22 (31%) studies focused specifically on child sexual assault cases, 70 , 79 , 80 , 96 , 98 , 106 , 112 , 116 , 118 , 120 , 123 , 125 , 130 , 132 , 133 , 141 with six of these studies looking at sexually transmitted infection (STI) and pregnancy testing, STI prophylaxis, and the use of sexual assault nurse examiners. 77 , 78 , 121 , 122 , 140 , 150 Two of three review publications focused on screening, 154 , 155 with one publication focusing on improving the ED workflow for suspected or confirmed child abuse cases.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

View full text Add to dashboard Cite

Introduction: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. Methods: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. Results: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. Conclusion: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

show abstract

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

View full text Add to dashboard Cite

show abstract

“…Without these surveillance mechanisms and regular pediatric checkups, more children are presenting to emergency departments (ED) with signs of maltreatment (Sidpra et al, 2020). This requires ED providers to recognize abuse within their differential diagnosis in order for child abuse reports and referrals to be made, even when patients are presenting with nonspecific chief complaints (Jenny et al, 1999;Kondis et al, 2017;Sheets et al, 2013). EDs and other acute care settings have been identified as sources of missed child maltreatment-related presentations due to failure to consider abuse within the differential diagnosis, lack of training, fear of losing clientele, and aversion to involvement in legal processes (Gunn et al, 2005;Jenny et al, 1999;Keshavarz et al, 2002;Pierce et al, 2017;Sheets et al, 2013).…”

Section: Covid-19's Impact On Child Maltreatment and Medical Settingsmentioning

confidence: 99%

Deviations in criminal filings of child abuse and neglect during COVID-19 from forecasted models: An analysis of the state of Oklahoma, USA

Whelan

Hartwell

Chesher

et al. 2021

Child Abuse & Neglect

View full text Add to dashboard Cite

“…There were 27 studies that reported on the specific keywords that were present within the narratives [ 38 - 41 , 43 , 79 , 81 , 83 , 86 , 89 - 93 , 95 , 99 , 101 , 102 , 104 , 107 - 111 , 117 , 118 , 125 , 126 , 131 ]. The number of keywords ranged from 1 [ 101 ] to >160 [ 39 ], with a median number of 11 (IQR 3-24.5) keywords reported ( Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…However, 11% (3/27) of studies did not report the exact number of keywords used [ 38 - 40 ]. The authors reported the use of express keywords with correct spellings [ 86 , 93 , 101 , 107 , 109 - 111 ] as well as intentional variations such as misspellings, abbreviations, or truncations [ 39 , 40 , 81 , 92 , 108 ]. One of the studies searched for terms using keywords in 2 languages (English and French) [ 95 ].…”

Section: Resultsmentioning

confidence: 99%

The Use and Structure of Emergency Nurses’ Triage Narrative Data: Scoping Review

Picard¹,

Kleib²,

Norris³

et al. 2023

JMIR Nursing

View full text Add to dashboard Cite

Background Emergency departments use triage to ensure that patients with the highest level of acuity receive care quickly and safely. Triage is typically a nursing process that is documented as structured and unstructured (free text) data. Free-text triage narratives have been studied for specific conditions but never reviewed in a comprehensive manner. Objective The objective of this paper was to identify and map the academic literature that examines triage narratives. The paper described the types of research conducted, identified gaps in the research, and determined where additional review may be warranted. Methods We conducted a scoping review of unstructured triage narratives. We mapped the literature, described the use of triage narrative data, examined the information available on the form and structure of narratives, highlighted similarities among publications, and identified opportunities for future research. Results We screened 18,074 studies published between 1990 and 2022 in CINAHL, MEDLINE, Embase, Cochrane, and ProQuest Central. We identified 0.53% (96/18,074) of studies that directly examined the use of triage nurses’ narratives. More than 12 million visits were made to 2438 emergency departments included in the review. In total, 82% (79/96) of these studies were conducted in the United States (43/96, 45%), Australia (31/96, 32%), or Canada (5/96, 5%). Triage narratives were used for research and case identification, as input variables for predictive modeling, and for quality improvement. Overall, 31% (30/96) of the studies offered a description of the triage narrative, including a list of the keywords used (27/96, 28%) or more fulsome descriptions (such as word counts, character counts, abbreviation, etc; 7/96, 7%). We found limited use of reporting guidelines (8/96, 8%). Conclusions The breadth of the identified studies suggests that there is widespread routine collection and research use of triage narrative data. Despite the use of triage narratives as a source of data in studies, the narratives and nurses who generate them are poorly described in the literature, and data reporting is inconsistent. Additional research is needed to describe the structure of triage narratives, determine the best use of triage narratives, and improve the consistent use of triage-specific data reporting guidelines. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2021-055132

show abstract

Missed Fractures in Infants Presenting to the Emergency Department With Fussiness

Abstract: Fractures concerning for child abuse are an important cause of unexplained fussiness in infants presenting to the pediatric ED. A high index of suspicion is essential for prompt diagnosis and likely prevention of other abuse.

Cited by 16 publications

References 14 publications

A Scoping Review of Current Social Emergency Medicine Research

A Scoping Review of Current Social Emergency Medicine Research

Deviations in criminal filings of child abuse and neglect during COVID-19 from forecasted models: An analysis of the state of Oklahoma, USA

The Use and Structure of Emergency Nurses’ Triage Narrative Data: Scoping Review

Contact Info

Product

Resources

About