• Optimizing Critical Care Documentation in a Pediatric Emergency Department

    5 days ago - By Pediatric Emergency Care

    Objective
    Emergency department physicians frequently provide critical care but document inconsistently. Variability in documentation can result in underbilling and is inconsistent with financial stewardship. We used admissions to the intensive care unit as a proxy for CC provision. At baseline, CC notes were correctly documented for 20% of eligible visits, with potential missed charges of $1.8 million per year.
    Our objective was to increase CC note placement for eligible patients from 20% to 60% over 2 years. Additionally, we measured CC notes and the number of ICU admissions per 1000 ED...
    Read more ...

     

  • Pediatric Emergency Department Management of C1 Inhibitor Deficiency

    5 days ago - By Pediatric Emergency Care

    Introduction
    C1 inhibitor deficiency is a rare, potentially life-threatening syndrome. Acute attacks of angioedema may occur at any time, so the emergency department constitutes an indispensable component of its care.
    Aim
    To describe the reasons for consultation by children with C1 inhibitor deficiency at the ED, as well as its management and complications.
    Patients and Methods
    This is a longitudinal retrospective study conducted in a pediatric ED of a tertiary care hospital in Madrid. The study includes children with C1 inhibitor deficiency, aged 0 to 16 years, who had consulted the ED...
    Read more ...

     

  • Incidence of Bradycardia and the Use of Atropine in Pediatric Rapid Sequence Intubation in the Emergency Department

    5 days ago - By Pediatric Emergency Care

    Objective
    Bradycardia during rapid sequence intubation is an uncommon but serious adverse effect encountered in pediatric intubations. Atropine has historically been used in the pediatric population as RSI premedication to prevent bradycardia, especially when using succinylcholine as an induction agent. The objective of this analysis was to identify the incidence of bradycardia with or without atropine use.
    Methods
    This single-center, retrospective, observational case series reviewed pediatric patients up to 18 years old requiring intubation from January 1, 2015, to December 31, 2018...
    Read more ...

     

  • Racial and Language Disparities in Pediatric Emergency Department Triage

    5 days ago - By Pediatric Emergency Care

    Objective
    The aim of this study was to assess the impact race and language have on emergency department triage scores while accounting for illness severity. We hypothesized that non-White and non-English-speaking patients were assigned lower-acuity triage scores compared with White and English-speaking patients, respectively.
    Methods
    We used a chart review-based retrospective cohort study design, examining patients aged 0 to 17 years at our pediatric ED from July 2015 through June 2016. Illness severity was measured using a truncated Modified Pediatric Early Warning Score calculated from...
    Read more ...