Lead poisoning in children: emergency department recognition and management.

Millions of children continue to be at risk for lead exposure despite a dramatic decline over the past 4 decades, and hundreds present annually to emergency departments with lead poisoning. These patients can be challenging to identify due to their nonspecific presentation and frequent lack of known exposure. This issue will prepare the emergency clinician to identify and care for the lead-poisoned patient, focusing on: (1) identifying key historical features, signs, and symptoms at presentation; (2) the medical management of lead poisoning; and (3) formulation of a safe discharge plan.

Point-of-Care Ultrasonography for Ankle Injuries in Children.

Objectives: The aim of the study was to determine whether point-of-care ultrasound (US) can decrease x-rays in children with ankle injuries. Secondary objectives were to determine the test performance characteristics for ankle US, analyze diagnostic errors, and compare US with the Ottawa Ankle Rules (OAR).

Methods: This was a prospective study of children younger than 21 years presenting to an emergency department with an ankle injury requiring x-rays.

Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department.

Objective: The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period.

Methods: A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2).

Ordering Interruptions in a Tertiary Care Center: A Prospective Observational Study.

Objectives: By self-report, interruptions may contribute to up to 80% of ordering errors. A greater understanding of the frequency and context of interruptions during ordering is needed to identify targets for intervention. We sought to characterize the epidemiology of interruptions during order placement in the pediatric inpatient setting.

Natural history of experimental arterial chronic total occlusions.

Objectives: We sought to perform the first systematic study of the natural history of chronic total arterial occlusions (CTOs) in an experimental model.

Background: Angioplasty of CTOs has low success rates. The structural and perfusion changes during CTO maturation, which may adversely affect angioplasty outcome, have not been systematically studied.