Poisoning Prevention Education During Emergency Department Visits for Childhood Poisoning

Demorest, Rebecca A.; Posner, Jill C.; Osterhoudt, Kevin C.; Henretig, Fred M.

doi:10.1097/01.pec.0000125654.20443.33

Cited by 47 publications

(29 citation statements)

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“…1 Anybody in vehicle was injured 58. 8 Air bags deployed 87. 6 Visible damage to car seat *While this is the minimum age and weight to have an infant forward-facing, the current AAP recommendation is that children remain rear-facing to keep infants facing backward as long as possible, up to the weight limit for convertible car seat.…”

Section: Resultsmentioning

confidence: 99%

“…2 In addition to providing standard instructions, many authors promote using the ''teachable moment'' in the ED, when patients and families may be more receptive to specific disease-or injury prevention information. [3][4][5][6][7] While there is evidence that the pediatric ED can be successfully used as a venue to disseminate information about home safety [8][9][10][11] and motor vehicle safety, 12,13 the majority of injured patients do not receive injury prevention information as part of their postcare instructions. 14 The American Academy of Pediatrics (AAP) is an important source of injury prevention information and guidance and has published extensive recommendations regarding child passenger safety (CPS).…”

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confidence: 99%

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Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

Zonfrillo

Nelson

Durbin

2011

Academic Emergency Medicine

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Objectives: While physicians provide discharge instructions to patients and families following emergency department (ED) visits, injury prevention information may not be routinely included in these instructions. This study assessed emergency physicians' knowledge and provision of child passenger safety (CPS) information to patients following motor vehicle crashes (MVCs).Methods: This study was both a survey of emergency physician knowledge and provision of CPS information and an examination of frequency of CPS information in discharge instructions at a single institution. Members of the American Academy of Pediatrics (AAP) Section on Emergency Medicine were invited to participate in the survey. Respondents were asked about their provision of CPS information to patients and knowledge of national AAP CPS recommendations. The institutional ED medical record chart review assessed the frequency of written CPS information for patients of MVC-related visits who were discharged home.Results: There were 317 survey respondents from 1,024 eligible physicians, of whom 43 began but did not complete the survey. The data analyzed are from the 274 who completed the survey. While 85% (95% confidence interval [CI] = 81% to 89%) of physicians believed that CPS information should be included in discharge instructions, only 36% (95% CI = 31% to 42%) correctly answered all knowledge questions. Of the 51 self-identified division ⁄ department chiefs, 15 (29.4%; 95% CI = 16.9% to 41.9%) reported that their EDs routinely provide CPS information in discharge instructions for pediatric passengers in MVCs. For the medical record review, of the 152 randomly selected MVC visits, 13 (8.6%; 95% CI = 4.1% to 13.0%) had documented CPS information in the discharge instructions. Patients with documented CPS information were younger, but there were no significant differences in race, sex, or maximum abbreviated injury scale score between patients with versus without CPS information. Conclusions:While emergency physicians value the use of CPS information in discharge instructions following MVCs, they do not have adequate knowledge of, nor do they regularly disseminate, this information.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

Zonfrillo

Nelson

Durbin

2011

Academic Emergency Medicine

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“…[19] We did not fi nd records indicating that the children received any post exposure counseling and that there was no follow-up description. Though there is limited evidence suggesting that nasogastric lavage is an effective treatment for patients with poisoning, a signifi cant number of patients who received such treatment should be evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…[9,10] Other epidemiological studies of pediatric poisoning have demonstrated that the most common risk factors for poison exposure are young age and female gender, which are in agreement with our fi ndings. [11][12][13][14][15][16][17] Poisoning incidents can be categorized into intentional or unintentional types based on how they happened, but most of childhood poisonings are accidental in nature. In the current study, most episodes were unintentional similar to those reported by Paudyal et al [18] (unintentional poisoning 98.4%) and by authors from Taiwan province (77.7%).…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional study of children with acute poisoning: A three-year retrospective analysis

Bacha¹,

Tilahun²

2015

World Journal of Emergency Medicine

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BACKGROUND:There is a lack of evidence on description of burden and cases of childhood poisoning in developing countries. This study aimed to assess the characteristics of children with acute poisoning, and factors for time of presentation to health facility and nature of poisoning. METHODS:A cross-sectional study was conducted at three major pediatric referral hospitals in Addis Ababa, Ethiopia. Description of demographics of children with acute poisoning and factors associated with time to presentation and nature of poisoning were analyzed. Data were entered to Epi info 3.5.3 and analyzed with SPSS version 20. RESULTS:Over three years, we retrieved records of a total of 128 children admitted for acute poisoning. The mean age of victims was 5.46 (SD, standard deviation=4.48) years. The majority (29.7%) were poisoned by prescribed drugs. Most poisoning incidents (73.5%) were unintentional in nature. The median time to health facility visit was 15.5 hours. Age less than 2 years was related to earlier presentation to health facility (P=0.010, OR=0.28, 95%CI=0.10-0.74). Children with age more than 5 years was more likely to have intentional poisoning (χ 2 =25.06, P<0.0001). None of the victims was provided psychosocial evaluation and counseling.CONCLUSION: Most poisoning incidents are unintentional. Prescribed drugs are the commonest causes. Psychosocial counseling and care for the affected children is lacking. Family and community education should be given on prevention of poisoning. We recommend that caregivers take the required action in keeping prescribed drugs at home. Psychosocial support should be part of care and treatment of children with poisoning.

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“…Unfortunately, health promotion and injury prevention discussions rarely occur in the ED. 12,13 Even when ED physicians do provide health promotion information or counselling upon discharge these interactions are usually brief. 14 When counselling and health promotion opportunities are prioritized, an ED visit can serve as a "teachable moment"-a time when the patient, having just suffered an injury, will be most likely to understand advice and consider behaviour change.…”

Section: Introductionmentioning

confidence: 99%

Emergency physicians as human billboards for injury prevention: a randomized controlled trial

Sullivan

Fuller

Paterson

et al. 2016

CJEM

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Objectives The objective of this study was to evaluate the impact of a novel injury prevention intervention designed to prompt patients to initiate an injury prevention discussion with the ED physician, thus enabling injury prevention counselling and increasing bicycle helmet use among patients. Methods A repeated measures 2 x 3 randomized controlled trial design was used. Fourteen emergency physicians were observed for two shifts each between June and August 2013. Each pair of shifts was randomized to either an injury prevention shift, during which the emergency physician would wear a customized scrub top, or a control shift. The outcomes of interest were physician time spent discussing injury prevention, current helmet use, and self-reported change in helmet use rates at one year. Logistic regression analyses were used to examine the impact of the intervention. Results The average time spent on injury prevention for all patients was 3.3 seconds. For those patients who actually received counselling, the average time spent was 17.0 seconds. The scrub top intervention did not significantly change helmet use rates at one year. The intervention also had no significant impact on patient decisions to change or reinforcement of helmet use. Conclusions Our study showed that the intervention did not increase physician injury prevention counselling or self-reported bicycle helmet use rates among patients. Given the study limitations, replication and extension of the intervention is warranted.

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Poisoning Prevention Education During Emergency Department Visits for Childhood Poisoning

Abstract: Emergency department personnel are missing a potentially important opportunity to provide poisoning prevention education to families of children at high risk for repeat occurrence.

Cited by 47 publications

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Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

A cross-sectional study of children with acute poisoning: A three-year retrospective analysis

Emergency physicians as human billboards for injury prevention: a randomized controlled trial

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