Missed intracranial injuries are rare in emergency departments using the PECARN head injury decision rules.

Purpose: The PECARN head trauma (HT) prediction rules have been developed to guide computed tomography-related decision-making for children with minor HT (mHT). There are currently limited data on the rate of unscheduled revisits to emergency departments (EDs), and initially missed intracranial injuries, in children with mHT initially assessed using the PECARN rules. This study aimed to fill this gap in knowledge.

The effect of in situ simulation training on the performance of tasks related to patient safety during sedation.

In many countries, procedural sedation outside of the operating room is performed by pediatricians. We examined if in situ sedation simulation training (SST) of pediatricians improves the performance of tasks related to patient safety during sedation in the Emergency Department (ED). We performed a single-center, quasi-experimental, study evaluating the performance of sedation, before-and-after SST.

Emergency Department Pain Management in Pediatric Patients With Fracture or Dislocation in a Bi-Ethnic Population.

Study Objective: We determine whether ethnicity in a bi-ethnic population of northern Israel is associated with disparities in pediatric emergency department (ED) opioid analgesia in patients with fracture or dislocation.

Methods: A retrospective cohort study was conducted. All records of patients aged 3 to 15 years and receiving a diagnosis of a limb fracture or dislocation were extracted.

Prehospital pain management of injured children: a systematic review of current evidence.

Objectives: Injury is a common cause of acute pain in children. The objective of this study was to analyze the available evidence in prehospital pain management of injured children.

Methods: The Patient/Population, Intervention, Comparator, and Outcome question was as follows: "In pediatric patients requiring prehospital analgesia for traumatic injuries, what is the level of evidence (LOE) available for the safety and efficacy of pharmacologic interventions?" The electronic databases MEDLINE/PUBMED, EMBASE, and Google Scholar were searched to identify all the relevant articles published in electronic journals, books, and scientific Web sites over the last 20 years.

Sedation for children with intraoral injuries in the emergency department: a case-control study.

Objective: Intraoral procedures (IOPs) are performed within the oral cavity of a spontaneously breathing, deeply sedated child. The objective of this study was to retrospectively evaluate the safety of sedation for IOP in a pediatric emergency department.

Methods: An unmatched, case-control study was conducted.

The Pediatric Emergency Care Applied Research Network intermediate-risk predictors were not associated with scanning decisions for minor head injuries.

Aim: This study determined the predictors associated with the decision to perform a computed tomography (CT) scan in children with a minor head injury (MHI). We focused on those facing an intermediate risk of clinically important traumatic brain injury (ciTBI), according to the Pediatric Emergency Care Applied Research Network (PECARN) prediction rule.

Methods: A 1-year, cross-sectional study was performed in an Italian paediatric emergency department, focusing on children presenting within 24 h of an MHI and meeting the PECARN intermediate-risk criteria.

The use of handheld near-infrared device (Infrascanner)for detecting intracranial haemorrhages in children with minor head injury.

Objective: A handheld device using near-infrared technology(Infrascanner) has shown good accuracy for detection of traumatic intracranial haemorrhages in adults. This study aims to determine the feasibility of use of Infrascanner in children with minor head injury (MHI) in the Emergency Department(ED). Secondary aim was to assess its potential usefulness to reduce CT scan rate.

The use of handheld near-infrared device (Infrascanner) for detecting intracranial haemorrhages in children with minor head injury.

Objective: A handheld device using near-infrared technology (Infrascanner) has shown good accuracy for detection of traumatic intracranial haemorrhages in adults. This study aims to determine the feasibility of use of Infrascanner in children with minor head injury (MHI) in the Emergency Department (ED). Secondary aim was to assess its potential usefulness to reduce CT scan rate.

Emergency department diagnosis and treatment of traumatic hip dislocations in children under the age of 7 years: a 10-year review.

Background And Aims: Traumatic hip dislocations (THD) are uncommon in children. They constitute true emergencies because unrecognised THD leads to avascular necrosis (AVN) of the femoral head. This review presents the evidence for best practice for the diagnosis and treatment of THD in the emergency department (ED) of children under the age of 7 years.

Prehospital injury severity of children evacuated by helicopters from combat zones: a retrospective report.

Background: In Israel, the Airborne Rescue and Evacuation Unit (AREU) provides prehospital trauma care in times of peace and during times of armed conflict. In peacetime, the AREU transports children who were involved in motor vehicle collisions (MVC) and those who fall off cliffs (FOC). During armed conflict, the AREU evacuates children who sustain firearm injuries (FI) from the fighting zones.

Carbon monoxide poisoning in narghile (water pipe) tobacco smokers.

Narghile (water pipe, hookah, shisha, goza, hubble bubble, argeela) is a traditional method of tobacco use. In recent years, its use has increased worldwide, especially among young people. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide (CO).

Competency-based achievement system: using formative feedback to teach and assess family medicine residents' skills.

Problem Addressed: Family medicine residency programs require innovative means to assess residents' competence in "soft" skills (eg, patient-centred care, communication, and professionalism) and to identify residents who are having difficulty early enough in their residency to provide remedial training.

Objective Of Program: To develop a method to assess residents' competence in various skills and to identify residents who are having difficulty.

Program Description: The Competency-Based Achievement System (CBAS) was designed to measure competence using 3 main principles: formative feedback, guided self-assessment, and regular face-to-face meetings.

Comparison of outcomes of two skills-teaching methods on lay-rescuers' acquisition of infant basic life support skills.

Objectives: The objective was to determine if lay-rescuers' acquisition of infant basic life support (BLS) skills would be better when skills teaching consisted of videotaping practice and providing feedback on performances, compared to conventional skills-teaching and feedback methods.

Methods:   This pilot-exploratory, single-blind, prospective, controlled, randomized study was conducted on November 12, 2007, at the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. The population under study consisted of all first-year medical students enrolled in the 2007-2008 year.

Impact of a nurse practitioner on patient care in a Canadian emergency department.

Objective: Our objective was to determine whether the addition of a broad-scope nurse practitioner (NP) would improve emergency department (ED) wait times, ED lengths of stay (LOS) and left-without-treatment (LWOT) rates. We hypothesized that the addition of a broad-scope NP during weekday ED shifts would result in shorter patient wait times, reduced LOS and fewer patients leaving the ED without treatment.

Methods: This prospective observational study was conducted in a busy urban free-standing community ED.

Comparison of adverse events during procedural sedation between specially trained pediatric residents and pediatric emergency physicians in Israel.

Objectives: The aim was to compare the rate of procedural sedation-related adverse events of pediatric residents with specific training in "patient safety during sedation" and pediatric emergency physicians (PEPs) who completed the same course or were teaching faculty for it.

Methods: This prospective single-blinded, nonrandomized study was conducted in two university-affiliated pediatric emergency departments (PEDs) in Israel. Pediatric residents who were authorized to perform unsupervised sedations had previously completed a course in patient safety during sedation.

Introducing a nurse practitioner into an urban Canadian emergency department.

Objective: Our objective was to compare the emergency care provided by a nurse practitioner (NP) with that provided by emergency physicians (EPs), to identify emergency department (ED) patients appropriate for autonomous NP practice and to acquire data to facilitate the development of the clinical scope of practice recommendations for ED practice for NPs.

Methods: Using a comprehensive 3-part process, we selected and hired the best NP from 12 applicants. The NP was oriented to the operations of our free-standing community ED and incorporated in the care team, working in real time with EP preceptors during a 6-month, prospective clinical assessment comparing NP care with EP care.

Internal jugular venous thrombosis after in vitro fertilization.

Internal jugular vein thrombosis is an uncommon entity with high morbidity and an increased risk of mortality. Spontaneous clotting of the internal jugular vein without any known risk factors is virtually unheard of, and intravenous drug use is the most common cause for thrombosis. Assisted reproductive techniques alone or in conjunction with ovarian hyperstimulation syndrome seem to predispose patients for thrombosis of the internal jugular vein.

Enhancing patient safety during pediatric sedation: the impact of simulation-based training of nonanesthesiologists.

Objective: To evaluate the impact of simulation-based education on patient safety during pediatric procedural sedation.

Design: A prospective, observational, single-blind, controlled study of pediatric procedural sedation outside the operating room.

Setting: Two university teaching hospitals in Israel.

Analysis of factors influencing length of stay in the emergency department.

Objectives: Length of stay (LOS) is a key measure of emergency department (ED) throughput and a marker of overcrowding. Time studies that assess key ED processes will help clarify the causes of patient care delays and prolonged LOS. The objectives of this study were to identify and quantify the principal ED patient care time intervals, and to measure the impact of important service processes (laboratory testing, imaging and consultation) on LOS for patients in different triage levels.

Brugada syndrome in a young patient with palpitations.

Brugada syndrome is a potentially lethal and eminently treatable entity that may present with palpitations or syncope. This article presents the case of a young patient with Brugada syndrome and reviews key features in the epidemiology, pathophysiology, diagnosis, treatment and prognosis of this condition.

Educational intervention to reduce falls and fear of falling in patients after fragility fracture: results of a controlled pilot study.

Objectives: Falls and fear of falling are a major health problem. We sought to determine the effectiveness of an educational intervention in reducing fear of falling and preventing recurrent falls in community-dwelling patients after a fragility fracture.

Methods: One hundred two community-dwelling patients aged 50 years or older who fell and sustained a wrist fracture and were treated at Emergency Departments in Edmonton, Alberta, Canada (2001-2002) were allocated to either standardized educational leaflets and post-discharge telephone counseling regarding fall prevention strategies ("intervention") or attention-controls ("controls").

The influence of residents training level on their evaluation of clinical teaching faculty.

Background: Evaluations by learners are the most common sources of information on teaching. There is some debate about the role of these assessments, but the overall evaluation of faculty by learners was found to be valid and reliable.

Purpose: The purpose of this study was to examine the relationship between the level of training of family medicine residents and their evaluation of emergency medicine clinical teachers over time.