Safety Audits in the Emergency Department: Applying the Threat and Error Model to the Management of Pediatric Diabetic Ketoacidosis.

Objectives: This study aims to better understand factors that impact management of patients with diabetic ketoacidosis (DKA) in the pediatric emergency department (ED) by novel application of the threat-and-error model, commonly used in the aviation industry.

Methods: This study was a retrospective chart review of all patients diagnosed with DKA and managed in our pediatric ED during a 1-year period. A "flight plan" was created for each patient's ED visit, from triage to final disposition.

Ethics consultation in paediatric and adult emergency departments: an assessment of clinical, ethical, learning and resource needs.

Objective: We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments (EDs) in order to build ethics capacity and provide a foundation for the development of an ethics education programme.

Methods: This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity.

An Interesting Case of Viral Pericarditis.

A previously healthy 14-year-old girl presented to the emergency department with a 3-day history of upper respiratory symptoms and 2 syncopal episodes. She was initially febrile, tachycardic, and tachypneic; the initial electrocardiogram showed diffuse T-wave inversions and right atrial enlargement. There was no pericardial effusion on bedside and formal echocardiography; the latter, however, revealed a hyperechogenic pericardium.