Perspectives on preparedness for pediatric emergencies after residency: A needs assessment.

Background: General emergency physicians provide most pediatric emergency care in the United States yet report more challenges managing emergencies in children than adults. Recommendations for standardized pediatric emergency medicine (PEM) curricula to address educational gaps due to variations in pediatric exposure during emergency medicine (EM) training lack learner input. This study surveyed senior EM residents and recent graduates about their perceived preparedness to manage pediatric emergencies to better inform PEM curricula design.

Resident perspectives on professionalism lack common consensus.

Study Objective: We sought to characterize and understand the residents' perspective on how professionalism develops through pediatric emergency medicine experiences.

Methods: Qualitative methods (freelisting--listing words associated with professionalism--and semistructured interviews) were conducted with senior emergency medicine and pediatric residents about their experiences rotating in the emergency department of a large, urban, tertiary care, freestanding children's hospital. All senior residents were eligible, with purposive sampling to maximize demographic variability.

Predictive value of weight-for-age to identify overweight children.

Objective: The objective was to assess the predictive value of weight-for-age to identify overweight children and adolescents in the unusual research or public health situations where height is not available to calculate BMI.

Research Methods And Procedures: Data from the National Health and Nutrition Examination Survey 1999 to 2004 were used to calculate the sensitivity, specificity, and positive and negative predictive values of selected weight-for-age cut-off points to identify overweight children and adolescents (as defined by BMI >or=95th percentile). Positive and negative predictive values are dependent on prevalence and are reported here for this study population only.

Early detection of imperforate hymen prevents morbidity from delays in diagnosis.

Objective: Although it is detectable at all ages through inspection of the external genitalia, imperforate hymen (IH) is a diagnosis that is missed commonly. We hypothesized that children with late diagnoses (predefined as > or =8 years of age, chosen to reflect the timing of normal menarche) would be more likely to be symptomatic, undergo more diagnostic testing, and lack appropriate documentation in their medical records, compared with children with earlier diagnoses (ie, <8 years of age).

Methods: All patients with IH were identified through searches of 3 hospital databases with International Classification of Diseases, Ninth Revision, codes.

A randomized, clinical trial of a home safety intervention based in an emergency department setting.

Objective: To assess the effectiveness of an emergency department (ED)-based home safety intervention on caregivers' behaviors and practices related to home safety.

Methods: We conducted a randomized, clinical trial of 96 consecutive caregivers of children who were younger than 5 years and presented to an urban pediatric ED for evaluation of an acute unintentional injury sustained in the home. After completing a structured home safety questionnaire via face-to-face interview, caregivers were randomly assigned to receive either comprehensive home safety education and free safety devices or focused, injury-specific ED discharge instructions.

Poisoning prevention education during emergency department visits for childhood poisoning.

Objective: Childhood poisoning represents a major public health problem that can be prevented through educational efforts. Commonly, young children experiencing a first poisoning episode will have a second occurrence. The aim of this study is to assess whether caretakers of children evaluated in an emergency department for acute poisoning exposure recall receiving poisoning prevention education as part of the medical encounter.

Mild traumatic brain injury in children: practice guidelines for emergency department and hospitalized patients. The Trauma Program, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine.

Mild traumatic brain injury (MTBI) is a frequent occurrence in children. Current practice in treating such injuries varies in terms of evaluative studies, length of observation, need for inpatient hospitalization, sports restrictions, and follow-up. A multidisciplinary panel of experts from a level I pediatric trauma center was convened to develop and implement a clinical pathway to improve the quality and consistency of care provided to children after MTBI.