Medical Student Documentation in the Emergency Department in the Electronic Health Record Era-A National Survey.

Objectives: Implementation of electronic health record (EHR) has generated a new challenge in the practice of medical student documentation in the emergency department (ED). This study discerns both the current practices and consensus opinions of pediatric ED directors and Association of American Medical Colleges (AAMC) student representatives regarding best practices for documentation by medical students in the ED EHR nationwide.

Methods: The authors conducted a cross-sectional Web-based survey of the directors of academic pediatric EDs and AAMC student representatives using Qualtric survey engine.

The usefulness of procalcitonin in the diagnosis of appendicitis in children: a pilot study.

Objective. To assess the predictive value of procalcitonin in detecting acute appendicitis (AP) in children, and to determine a cutoff value of procalcitonin which can safely include/exclude the diagnosis of acute appendicitis in children with acute abdominal pain. Methods.

Substituting whole blood for urine in a bedside pregnancy test.

Background: Point-of-care testing for rapid detection of pregnancy in women of reproductive age is common practice in the emergency department. Commercially available rapid human chorionic gonadotropin (hCG) immunoassays are validated for use with urine and serum, but not whole blood.

Study Objectives: We assessed the validity of using whole blood to detect pregnancy using a point-of-care hCG assay by comparing it to a laboratory quantitative serum hCG assay as the criterion standard.

Current trends in the management of common painful conditions of preschool children in United States pediatric emergency departments.

Trends in pain management practice by Pediatric Emergency Medicine fellows in the United States were described and analyzed. Self-administered surveys on pain management practices conducted among Pediatric Emergency Medicine fellows at the national Pediatric Emergency Medicine fellows' annual conference in 1996 and 2004 were compared. In comparison to the 1996 survey, the 2004 survey noted a significant increase in narcotics use for headache (6% versus 12%; P = .

Utilization of personal digital assistants (PDAS) by pediatric and emergency medicine residents.

The objective of the present study was to investigate the current personal digital assistant (PDA) usage patterns of the residents and their interest in future PDA-based applications. A cross-sectional survey was conducted among the Pediatrics (Peds) and Emergency Medicine (EM) residents in an urban teaching hospital. Data points included level of training, specialty of training, experience of use of different PDA devices, use of current software applications, and interest in future applications.

Challenges of electronic medical record implementation in the emergency department.

Target Audience: Physicians, nurse practitioners and physician assistants who care for infants and children in the emergency department or in other ambulatory and acute care settings. In particular, physicians with administrative responsibilities will find this information useful.

Objectives: 1.

Where's the beef? The promise and the reality of clinical documentation.

Physician-generated emergency department clinical documentation (information obtained from clinician observations and summarized decision processes inclusive of all manner of electronic systems capturing, storing, and presenting clinical documentation) serves four purposes: recording of medical care and communication among providers; payment for hospital and physician; legal defense from medical negligence allegations; and symptom/disease surveillance, public health, and research functions. In the consensus development process described by Handler, these objectives were balanced with the consideration of efficiency, often evaluated as physician time and clinical documentation system costs, in recording the information necessary for their accomplishment. The consensus panel session participants and authors recommend that 1) clinical documentation be electronically retrievable; 2) selection and implementation be evidence-based and grounded on valid metrics (research is needed to identify these metrics); 3) the user interface be crafted to promote clinical excellence through high-quality information collection and efficient charting techniques; 4) the priorities for integration of clinical information be standardized and implemented within enterprises and across health and information systems; 5) systems use accepted standards for bidirectional, real-time clinical data exchange, without limiting the location or number of simultaneous users; 6) systems fully utilize existing electronic sources of specific patient information and general medical knowledge; 7) systems automatically and reliably capture appropriate data that support electronic billing for emergency department services; and 8) systems promote bedside documentation and mobile access.

International pediatric emergency care: establishment of a new specialty in a developing country.

Background: Emergency medicine is being established as a unique and independent specialty throughout the world. Pediatric emergency medicine, however, is a relatively new subspecialty in the United States and a newer subspecialty in the rest of the world. In most of Europe and Asia, this specialty has yet to be developed.

Cosmetic outcome of scalp wound closure with staples in the pediatric emergency department: a prospective, randomized trial.

Objective: The purpose of this study is to compare the cosmetic outcome of scalp wound closure with staples to traditional skin sutures.

Methods: A prospective, randomized trial was conducted using a convenience sample of children (aged 1-16 y) with simple scalp lacerations admitted to the pediatric emergency department. After parental consent was obtained, patients were randomly assigned to either a stapling or suturing procedure.