A Specialized Pediatric Emergency Medicine Track Decreases Computed Tomography in Head Injured Patients.

Background: There is an increased emphasis on reducing exposure to ionizing radiation in pediatric patients. Guidelines from the Pediatric Emergency Care Applied Research Network help practitioners identify patients at low risk for clinically important traumatic brain injury after head injury.

Objectives: We seek to determine whether the institution of a pediatric track staffed by pediatric emergency medicine physicians (PEMs) within a community emergency department (ED) impacts the overall utilization of head computed tomography (CT) on children younger than 15 years with head injury.

A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department.

Objectives: An increasing number of pediatric patients with psychiatric chief complaints present to emergency departments (EDs) nationwide. Many of these patients require treatment with antipsychotic medications to treat agitation. We sought to examine the use of antipsychotic medications in pediatric patients presenting to a tertiary care pediatric ED.

The Impact of Behavioral Health Patients on a Pediatric Emergency Department's Length of Stay and Left Without Being Seen.

Objective: Emergency department (ED) boarding of admitted patients negatively impacts ED length of stay (LOS). Behavioral health (BH) patients are often challenging to safely discharge. We examined the association between daily BH census and non-BH LOS and left without being seen (LWBS) rates.

Oxygen saturation is not clinically useful in the exclusion of bacterial pneumonia in febrile infants.

Background: Acute respiratory infection remains a common presentation to Emergency Departments. Oxygen saturations (Sao(2)) may be useful in determining which febrile infants require chest x-rays (CXR) in investigation for bacterial pneumonia (PNA). This study aimed to determine whether Sao(2) is clinically useful in excluding bacterial PNA in febrile infants <24 months.

Urinalysis is not reliable to detect a urinary tract infection in febrile infants presenting to the ED.

Objective: Urinary tract infections are a common source of serious bacterial infections in febrile infants younger than 2 years. Our objective was to compare urinalysis with urine culture in the emergency department evaluation of febrile infants.

Methods: A febrile infant registry was instituted at a tertiary care hospital treating an average of 55000 patients annually (27% children), from December 2002 to December 2003.

Serious bacterial infections in febrile infants in the post-pneumococcal conjugate vaccine era.

Objectives: The objective was to identify the epidemiology of serious bacterial infections (SBI) and the current utility of obtaining routine complete blood counts (CBC) and blood cultures to stratify infants at risk of SBI, in the study population of febrile infants in the post-heptavalent pneumococcal conjugate vaccine (PCV7) era.

Methods: A cohort study with nested case-controls was undertaken at a tertiary care military hospital emergency department (ED) from December 2002 through December 2003. Irrespective of clinical findings at the initial encounter, patients were included if they were under 3 months of age and had a home or ED temperature of >or=100.

Emergency department presentation of acute disseminated encephalomyelitis.

Acute disseminated encephalomyelitis is an acute demyelinating disorder of the central nervous system that usually occurs in children and young adults. We report the case of an 8-year-old girl who presented to the emergency department with acutely altered mental status. Standard workup including head computed tomography, lumbar puncture, and routine chemistries was unrevealing.

Pneumococcal bacteremia in febrile infants presenting to the emergency department before and after the introduction of the heptavalent pneumococcal vaccine.

Study Objective: Fever is among the most common presenting complaints of infants and children younger than 3 years who present to the emergency department (ED). The evaluation and management of the febrile child is evolving rapidly. We compare the proportion of pneumococcal bacteremia between febrile infants and children younger than 3 years who had and had not received the heptavalent pneumococcal vaccine and who had received blood culture tests in our ED.