Driving Time to Trauma Centers for Children Living in Wisconsin.

Introduction: Trauma is the number 1 cause of death among children. Shorter distance to definitive trauma care has been correlated with better clinical outcomes. There are only a small number of pediatric trauma centers (PTC) designated by the American College of Surgeons, and the resources available to treat injured children at non-PTCs are limited.

Factors Affecting Family Presence During Fracture Reduction in the Pediatric Emergency Department.

Introduction: Asking family members to leave during invasive procedures has historically been common practice; however, evidence-based recommendations have altered the trend of family presence during pediatric procedures. The aim of this study was to determine factors related to family members' choice to be present or absent during fracture reductions in a pediatric emergency department (ED), and their satisfaction with that choice.

Methods: We administered role-specific, anonymous surveys to a convenience sample of patients' family members in the ED of a Level I pediatric trauma center.

Secure Provider-to-Provider Communication With Electronic Health Record Messaging: An Educational Outreach Study.

Introduction: With increasing electronic health record (EHR) use, providers are talking less with one another. Now, many rely on EHRs, informal emails, or texts, introducing fragmentation and new data security challenges with new communication strategies. We aimed to examine the impact of a physician champion educational outreach intervention to promote electronic provider-to-provider communication in a large academic multispecialty group.

Using Chief Complaint in Addition to Diagnosis Codes to Identify Falls in the Emergency Department.

Objectives: To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme.

Design: Retrospective electronic record review.

Setting: Academic medical center ED.

A rare case of posterior interosseous nerve palsy associated with radial head fracture.

Background: Radial head fractures are the most common fractures occurring about the elbow in adults, but there have been few reported cases of associated nerve injury. The little-known posterior interosseous nerve travels in close proximity to the radial head and is particularly susceptible to injury.

Objectives: The objectives of this case report include raising awareness of the possibility of posterior interosseous nerve palsy after radial head fracture and reviewing the clinical assessment of the posterior interosseous nerve to exclude occult injury.

A randomized clinical trial of ibuprofen versus acetaminophen with codeine for acute pediatric arm fracture pain.

Study Objective: We compare the treatment of pain in children with arm fractures by ibuprofen 10 mg/kg versus acetaminophen with codeine 1 mg/kg/dose (codeine component).

Methods: This was a randomized, double-blind, clinical trial of children during the first 3 days after discharge from the emergency department (ED). The primary outcome was failure of the oral study medication, defined as use of the rescue medication.

Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy.

Objective: The aim of this study was to measure the change of cerebral and somatic regional oxygen saturation (rSO2) using near-infrared spectroscopic (NIRS) monitoring during volume resuscitation of dehydrated children.

Methods: This prospective, observational study enrolled 17 moderately dehydrated children presenting to the emergency department in a tertiary care pediatric hospital. Pulse oximetry and 2-site rSO2 using forehead and flank NIRS probes were monitored continuously during intravenous rehydration.

Vomiting of liquid corticosteroids in children with asthma.

Background: Oral corticosteroids are an essential part of the management of children with acute asthma exacerbations. Vomiting is a frequently cited problem attributed to oral corticosteroids. A new formulation of prednisolone, Orapred, claims to have improved palatability that may decrease the incidence of vomiting.

Outpatient pediatric pain management practices for fractures.

Objectives: Describe the pattern of utilization and effectiveness of outpatient fracture pain medication.

Methods: A cross-sectional survey of caregivers of children with an isolated extremity fracture at a hospital-based pediatric orthopedic clinic during initial follow-up.

Results: Surveys were completed by 98 (79.

Prehospital pain management: a comparison of providers' perceptions and practices.

Objective: To assess the knowledge of emergency medical technicians-paramedics (EMT-Ps) and compare their practice perceptions with actual pain management interventions in adults and pediatric patients (adolescents and children) with chest pain (CP), extremity injuries, or burns.

Methods: This study included a cross-sectional survey of EMT-Ps and review of the emergency medical services (EMS) system patient care database. EMT-Ps were surveyed for: 1) knowledge of pain treatment protocol; 2) estimated number of CP, extremity injury, or burn encounters and the frequency of morphine administration; and 3) barriers to providing morphine.

The anesthetic effectiveness of lidocaine-adrenaline-tetracaine gel on finger lacerations.

Objectives: To determine the effectiveness of lidocaine-adrenaline-tetracaine (LAT) in providing adequate anesthesia for the repair of finger lacerations and to monitor the risk of digital ischemia following application of LAT gel to finger lacerations.

Methods: A prospective case series. Children aged 5 to 18 years with a simple finger laceration-requiring repair were eligible for enrollment.

Morbidity following central compartment reoperation for recurrent or persistent thyroid cancer.

Objective: To determine the incidence of recurrent laryngeal nerve injury and hypoparathyroidism, we reviewed our experience with central compartment reoperation.

Design: Patients underwent preoperative ultrasonography and magnetic resonance imaging of the neck. Ultrasound-guided fine-needle aspiration biopsy was performed and demonstrated evidence of tumor in 15 patients.

Analgesia for children with acute abdominal pain: a survey of pediatric emergency physicians and pediatric surgeons.

Objective: To evaluate the current opinion and practice of pediatric emergency medicine physicians (PEM) and pediatric surgeons (PS) on the use of opioid analgesia in children with acute abdominal pain during their evaluation in the emergency department.

Methods: All members of the American Academy of Pediatrics in the Section of Emergency Medicine and the American Pediatric Surgeons Association were mailed a copy of the survey. Inclusion criteria were board-eligible or -certified PEM, or PS certified by American Board of Surgery or Royal College of Surgeons currently in practice whose patient population includes children.

A randomized clinical trial of analgesia in children with acute abdominal pain.

Objective: To evaluate the effects of intravenous morphine on pain reduction, physical examination, and diagnostic accuracy in children with acute abdominal pain.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted at an emergency department of a tertiary care children's hospital. Children aged 5-18 years with abdominal pain of < or =5 days' duration, pain score > or =5 on a 0-10 visual analog scale, and need for surgical evaluation were eligible.