The use of an institutional pediatric abdominal trauma protocol improves resource use.

Background: A novel protocol to standardize the emergency center (EC) management of abdominal trauma in children was developed and implemented at our trauma center. The purpose of this study was to evaluate whether this protocol improved patient safety by decreasing unnecessary computed tomography (CT) radiation and improved quality of care by decreasing EC length of stay (LOS) and laboratory costs.

Methods: We performed a prospective, longitudinal study of children who presented to the EC with a mechanism for abdominal trauma and received an abdominal CT scan from January 2011 to September 2014.

Trauma surgeon becomes consultant: evaluation of a protocol for management of intermediate-level trauma patients.

Purpose: At our level 1 pediatric trauma center, 9-54 intermediate-level ("level 2") trauma activations are received per month. Previously, the surgery team was required to respond to and assume responsibility for all patients who had "level 2" trauma activations. In 8/2011, we implemented a protocol where the emergency room (ER) physician primarily manages these patients with trauma consultation for surgical evaluation or admission.

Application of superposition with nonlinear head-dependent fluxes.

While superposition is commonly used to address linear ground water problems, it can also be used to address certain nonlinear problems. In particular, it can be used to address problems with nonlinear head-dependent fluxes, where the problem can be separated conveniently into steady-state and transient-state components. Superposition can be used to simulate the transient-state head changes independently from the steady-state heads.

Adaptive underrelaxation of Picard iterations in ground water models.

This methods note examines the use of adaptive underrelaxation of Picard iterations to accelerate the solution convergence for nonlinear ground water flow problems. Ground water problems are nonlinear when drains, phreatophytes, stream aquifer, and similar features are simulated. Typically, simple Picard iterations are used to address such nonlinear problems.

Cervical necrotizing fasciitis caused by Serratia marcescens in a 2 year old.

We report an unusual, life-threatening complication of producing fulminant cervical necrotizing fasciitis in a previously healthy 2-year-old girl. We reviewed the literature for necrotizing fasciitis in children and its morbidity, mortality, and treatment. This case illustrates the necessity of prompt recognition and aggressive management in patients presenting with cervical necrotizing fasciitis.