Evaluation and management of pediatric febrile seizures in the emergency department.

Febrile seizures are common in children, who are often brought to the nearest emergency department (ED). Patients who meet the case definition of simple febrile seizure are not at higher risk for serious bacterial illness than clinically similar febrile children who have not experienced a convulsion. Children who have had complex febrile seizures must be evaluated on a case-by-case basis, and treated with diagnostic and therapeutic measures based on the differential diagnosis.

Mass transfer of pediatric tertiary care hospital inpatients to a new location in under 12 hours: lessons learned and implications for disaster preparedness.

Objective: To report an experience with large-scale rapid transportation of hospitalized children, highlighting elements applicable to a disaster event.

Study Design: This was a retrospective study of the relocation of an entire pediatric inpatient population. Mitigation steps included postponement of elective procedures, implementation of planned discharges, and transfer of selected patients to satellite hospitals.

Interpreters: telephonic, in-person interpretation and bilingual providers.

Context: Language barriers affect health care interactions. Large, randomized studies of the relative efficacy of interpreter modalities have not been conducted.

Objective: To compare the efficacy of telephonic and in-person medical interpretation to visits with verified bilingual physicians.

Job market survey of recent pediatric emergency medicine fellowship graduates.

Objectives: The American Academy of Pediatrics Section of Emergency Medicine's Subcommittee on Administration developed a survey tool targeting recent pediatric emergency medicine (PEM) fellowship graduates to assess the current PEM job market in a variety of areas including (1) the new positions accepted, (2) perspectives of fellowship training, and (3) the relationship between PEM and general emergency medicine practice.

Methods: The 40-question internet-based survey was developed through www.surveymonkey.

Febrile seizure: measuring adherence to AAP guidelines among community ED physicians.

Objective: In 1996, the American Academy of Pediatrics published practice parameters for the acute management of febrile seizure. These guidelines emphasize the typically benign nature of the condition and discourage aggressive neurodiagnostic evaluation. The extent to which these suggestions have been adopted by general emergency medicine practitioners is unknown.

A Medicaid eHealth program: an analysis of benefits to users and nonusers.

Objective: To describe parental use of an Internet-based educational and emotional support system, in a regional NICU program.

Methods: Baby CareLink was installed in NICUs in 4 Denver area hospitals in 2003. Parents were offered access from hospital terminals and from any other Internet access point.

Correction of factitious hyperkalemia in hemolyzed specimens.

Background: Hemolysis in pediatric specimens is common due to difficult blood draws and small-bore intravenous catheters. Values of serum K+ become falsely elevated secondary to release of intracellular contents. If a reliable correction factor existed for this factitious elevation, repeat K+ measurements might be avoided.

Performance of a decision rule for radiographs of pediatric knee injuries.

Although decision rules for radiographs of pediatric knee injuries have been suggested from retrospective studies, prospective evaluations of such rules have been limited. We sought to prospectively assess the performance of a rule in children presenting with acute knee injuries. Eligible participants were children aged 3-18 years with an acute knee injury.

Cecal retention of a swallowed penny mimicking appendicitis in a healthy 2 year old.

Toddlers commonly ingest coins. Studies of the evaluation and management of such ingestions have focused on the risk of complications from impaction in the esophagus. It is commonly assumed that coins that have passed through the esophagus present little or no risk for distal complications.

Physician variation in test ordering in the management of gastroenteritis in children.

Objectives: To describe the variation among physicians in test ordering when caring for children with gastroenteritis and to explore the effect of hospital charge information on such variation.

Design: Prospective, nonmasked, observational study and controlled trial of price information.

Setting: Urban, university-affiliated pediatric emergency department.

The truth about language barriers: one residency program's experience.

Objective: To describe perceptions of how a lack of house staff Spanish proficiency adversely affects communication with Spanish-speaking families with limited English proficiency (LEP).

Methods: An anonymous, structured questionnaire was administered to the house staff an of urban, university-affiliated children's hospital that serves a population in which 10%-20% have LEP.

Results: Ninety-four percent (59 of 63) completed the questionnaire.

Regional after-hours urgent care provided by a tertiary children's hospital.

Background: Ambulatory presentation to a tertiary pediatric emergency department (ED) is not convenient for many families. Yet many primary care pediatricians (PCPs) desire after-hours urgent care for their patients as an alternative to extended office hours or care by general emergency medicine providers at community hospitals.

Objective: To describe a regional, community-based pediatric urgent care network (PUCN).

Professional interpreters and bilingual physicians in a pediatric emergency department: effect on resource utilization.

Objective: To determine the impact of interpreters and bilingual physicians on emergency department (ED) resource utilization.

Design: Cohorts defined by language concordance and interpreter use were prospectively studied preceding and following the availability of dedicated, professional medical interpreters.

Setting: Pediatric ED in Chicago, Ill.

Teaching Spanish to pediatric emergency physicians: effects on patient satisfaction.

Background: Language barriers are known to negatively affect patient satisfaction.

Objective: To determine whether a course of instruction in medical Spanish for pediatric emergency department (ED) physicians is associated with an increase in satisfaction for Spanish-speaking-only families.

Design, Setting, Participants, And Intervention: Nine pediatric ED physicians completed a 10-week medical Spanish course.

Practice variation in the emergency management of croup.

Objective: To explore the effect of physician training background on the emergency management of croup.

Methods: Two community hospitals with a general emergency department (ED) staffed by board-certified emergency medicine (EM) practitioners were the setting for this study. At both sites, pediatricians (PED) or pediatric emergency medicine specialists (PEM) managed acute pediatric visits during evening and weekend hours.