The spectrum and frequency of illness presenting to a pediatric emergency department

Krauss, Baruch; Harakal, Thomas; Fleisher, Gary

doi:10.1097/00006565-199104000-00001

Cited by 128 publications

(65 citation statements)

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“…1 Trauma also comprises up to one-third of all emergency department visits for children under 15 years of age. 2 Various scoring systems have been developed to predict the severity of trauma and to organize the medical resources. Basically, a trauma patient can be scored in three different ways: the body regions affected by trauma, the mechanism of trauma, and the severity of the trauma.…”

Section: Introductionmentioning

confidence: 99%

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

Anıl¹,

Sarıtaş²,

Bıcılıoğlu³

et al. 2017

cayd

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Introduction:The aim of this study was to assess the efficacy of the Pediatric Trauma Score (PTS) in predicting significant trauma in patients presenting with blunt trauma to a high-level pediatric emergency department. Methods: Patients younger than 15 years of age presenting to the pediatric emergency department of the Tepecik Training and Research Hospital with acute high-energy blunt trauma were analyzed prospectively. The PTS was calculated on arrival at the pediatric emergency department. The patients were classified into two groups as follows: patients with a PTS of ≤8 comprised the significant trauma group, while patients with a PTS of >8 made up the non-significant trauma group. Results: Two-hundred-thirteen children with a mean age of 6.1±3.9 years (range: 10 days-15 years) were included in the study. The frequency of coagulation testing and thorax computed tomography in the pediatric emergency department, need for critical interventions and therapies in the pediatric emergency department, rate of hospitalization, need for transfer to the pediatric intensive care unit, mechanical ventilation, operation, blood transfusion, and mortality rate were statistically higher in the significant trauma group (p<0.05). PTS ≤8 exhibited a sensitivity of 56.2% and a specificity of 90.8% for hospitalization (AUROC: 0.682; 95% confidence interval: 0.610-0.755). The PTS was significantly correlated with length of hospital stay (r=-0.493; p<0.001) and length of observation in the pediatric emergency department (r=-0.442; p<0.01). Conclusion: PTS on arrival at a high-level pediatric emergency department is a good predictor of the need for critical interventions/ therapies and mortality in children with high-energy blunt trauma. However, its accuracy is moderate for the prediction of hospitalization. Keywords: Pediatric Trauma Score, high-energy trauma, mortality, hospitalization Amaç: Çalışmanın amacı, üst düzey bir çocuk acil servisine künt yüksek enerjili travma nedeniyle başvuran çocuklardaki ciddi travmayı öngörmede, Pediyatrik Travma Skoru'nun (PTS) etkin olup olmadığının araştırılmasıdır. Yöntemler: Akut künt yüksek enerjili travma nedeniyle Tepecik Eğitim ve Araştırma Hastanesi'ne başvuran 15 yaşından küçük çocuklar ileriye yönelik olarak incelendi. PTS yaralı acil servise geldiği anda hesaplandı. Hastalar iki gruba ayrıldı: PTS ≤8 (ciddi travma) ve PTS >8 (ciddi olmayan travma). Bulgular: İki yüz on üç çocuk (ortalama yaş: 6,1±3,9 yıl; en küçük: 10 gün -en büyük: 15 yıl) çalışmaya alındı. Acil serviste koagülasyon testi ve toraks tomografisi sıklığı, acil serviste kritik girişim ve tedavi gereksinimi, hastaneye yatış oranı, yoğun bakım gereksinimi, mekanik ventilatör gereksinimi, ameliyat, kan transfüzyonu, ölüm sıklığı PTS ≤8 grubunda daha fazlaydı (p<0,05). PTS ≤8'in duyarlılığı %56,2; özgüllüğü %90,8 (AUROC: 0,682; %95 CI: 0,610-0,755) olarak hesaplandı. PTS hastanede yatış süresi (r=-0,493; p<0,001) ve acil serviste izlenme süresi (r=-0,442; p<0,01) ile anlamlı korelasyon göstermekteydi. Sonuç: Künt yüksek en...

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Section: Introductionmentioning

confidence: 99%

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

Anıl¹,

Sarıtaş²,

Bıcılıoğlu³

et al. 2017

cayd

View full text Add to dashboard Cite

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“…1 Nevertheless, treatment for seriously ill patients is time-sensitive and dependent on careful coordination of team performance to ensure efficient and effective patient care. It is impractical and unethical for PEM trainees to rely entirely on opportunities arising from clinical interactions with critically ill patients to develop and master the skills required to effectively manage patient resuscitation.…”

Section: Introductionmentioning

confidence: 99%

“…10,12 Although many SBE programs are well described in the literature, consensus-based learning objectives for simulation-based training have not been formally addressed at a national level in the United States or Canada. 1,33 Our research project was designed to identify the appropriate content required for a comprehensive simulation-based national curriculum for PEM training. We used the Delphi method 34 to build consensus among a national group of PEM and simulation experts.…”

Section: Introductionmentioning

confidence: 99%

Determining content for a simulation-based curriculum in pediatric emergency medicine: results from a national Delphi process

Bank

Cheng

McLeod

et al. 2015

CJEM

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Objectives: By the end of residency training, pediatric emergency medicine (PEM) residents are expected to have developed the confidence and abilities required to manage acutely ill children. Acquisition of competence requires exposure and/or supplemental formal education for critical and noncritical medical clinical presentations. Simulation can provide experiential learning and can improve trainees' knowledge, skills, and attitudes. The primary objective of this project was to identify the content for a simulation-based national curriculum for PEM training. Methods: We recruited participants for the Delphi study by contacting current PEM program directors and immediate past program directors as well as simulation experts at all of the Canadian PEM fellowship sites. We determined the appropriate core content for the Delphi study by combining the PEM core content requirements of the Royal College of Physicians and Surgeons of Canada (RCPSC) and the American Board of Pediatrics (ABP). Using the Delphi method, we achieved consensus amongst the national group of PEM and simulation experts. The participants completed a three-round Delphi (using a four-point Likert scale). Results: Response rates for the Delphi were 85% for the first round and 77% for second and third rounds. From the initial 224 topics, 53 were eliminated (scored <2). Eighty-five topics scored between 2 and 3, and 87 scored between 3 and 4. The 48 topics, which were scored between 3.5 and 4.0, were labeled as "key curriculum topics." Conclusion: We have iteratively identified a consensus for the content of a national simulation-based curriculum. RÉSUMÉObjectifs: Les résidents en médecine d'urgence pédiatrique (MUP) sont censés avoir acquis, à la fin de leur formation, la confiance et les compétences nécessaires pour traiter des enfants souffrant d'une maladie aiguë. L'acquisition des compétences exige une exposition à des tableaux cliniques médicaux extrêmement graves ou non, ou encore une formation supplémentaire en la matière. Les simulations peuvent, d'une part, fournir les acquis expérentiels et, d'autre part, améliorer les connaissances, les habiletés et les attitudes des stagiaires. L'étude décrite ici avait pour objectif principal d'établir le contenu d'un programme national, fondé sur la simulation en MUP. Méthode: Afin de trouver des participants à l'étude menée selon la méthode Delphi, les auteurs ont communiqué avec les directeurs actuels de programme en MUP et leurs prédécesseurs immédiats ainsi qu'avec des experts dans le domaine de la simulation, dans tous les établissements offrant une formation postdoctorale en MUP, au Canada. Le contenu de base pertinent en vue de l'étude a été élaboré à l'aide des exigences du Collège royal des médecins et chirurgiens du Canada et de celles de l'American Board of Pediatrics en la matière. Le recours à la méthode Delphi a permis d'établir un consensus au sein du groupe national d'experts en MUP et en simulation, et ce, après 3 tours de consultation (application de l'échelle de Likert à 4 poi...

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“…Fever without an apparent source is a common problem in children that may require medical evaluation. 1 Since implementation of immunization programs in the United States directed against Haemophilus influenzae type b and Streptococcus pneumoniae, systemic bacterial infection has become an uncommon cause, while localized bacterial infections, mostly urinary tract infections, account for ∼5% to 10% of cases. [2][3][4][5] Viral infections are believed to account for most of the remainder, but the specific viruses responsible have not been systematically delineated.…”

Section: Resultsmentioning

confidence: 99%

“…1 Currently in the United States, systemic bacterial infection accounts for ,1% of cases. [2][3][4]23 In contrast, we detected viruses in 76% of children with fever without an apparent source and identified adenovirus, HHV-6, enterovirus, and parechovirus as the predominant viruses detected in this patient group.…”

Section: Discussionmentioning

confidence: 99%

Detection of Viruses in Young Children With Fever Without an Apparent Source

2012

PEDIATRICS

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The spectrum and frequency of illness presenting to a pediatric emergency department

Cited by 128 publications

References 0 publications

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

Determining content for a simulation-based curriculum in pediatric emergency medicine: results from a national Delphi process

Detection of Viruses in Young Children With Fever Without an Apparent Source

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