Improving Quality and Efficiency in Pediatric Emergency Department Behavioral Health Care.

Introduction: Many children with behavioral health concerns increasingly utilize the emergency department for assessment and care. These visits are increasing in frequency, length, and cost, further stressing already limited resources. To improve the quality of care in this population, we developed a multidisciplinary improvement initiative to decrease the length of stay by 10% (from 5.

Reliability of Telemedicine in the Assessment of Seriously Ill Children.

Background And Objective: Data are limited that establish the clinical reliability of telemedicine in evaluating children who are seriously ill. Evaluation of a seriously ill child poses a challenge in that telemedicine is primarily visual, without the ability to perform a "hands-on" physical examination. Previous studies evaluating observation in assessing febrile children and children in respiratory distress have validated observation as both predictive and reliable in detecting underlying illness.

Respiratory failure caused by a suspicious white powder: a case report of intentional methadone poisoning in an infant.

Methadone exposures in children have increased as the drug has gained more prevalence in the treatment of adult narcotic dependency. Previous literature concerning pediatric methadone ingestion has focused primarily on unintentional ingestions. We describe a 2-month-old male infant presenting with respiratory failure from suspected intentional methadone administration.

Assessment of pediatric residents' communication and interpersonal skills during family-centered rounds.

Objectives: Residency training programs are required to assess and document residents' competency in communication. Multisource evaluations that include direct resident observations are preferred. Previous studies have often used methods of asking faculty members to evaluate residents on behaviors they did not witness.

Arm pain and fever as an unusual presentation of lobar pneumonia in a 3-year-old girl: case report.

Children with pneumonia presenting with extrathoracic pain, such as abdominal pain, have been previously described. In this report, we describe a 3-year-old girl with fever and right arm pain who was found to have an apical lobar pneumonia.