Pediatric Observation Units

Pediatrics, 2018

BACKGROUND: Management of pediatric emergencies is challenging for ambulatory providers because these rare events require preparation and planning tailored to the expected emergencies. The current recommendations for pediatric emergencies in ambulatory settings are based on 20-year-old survey data. We aimed to objectively identify the frequency and etiology of pediatric emergencies in ambulatory practices. METHODS: We examined pediatric emergency medical services (EMS) runs originating from ambulatory practices in the greater Indianapolis metropolitan area between January 1, 2012, and December 31, 2014. Probabilistic matching of pickup location addresses and practice location data from the Indiana Professional Licensing Agency were used to identify EMS runs from ambulatory settings. A manual review of EMS records was conducted to validate the matching, categorize illnesses types, and categorize interventions performed by EMS. Demographic data related to both patients who required tr...

European Journal of Pediatrics, 2012

The objectives of this study are to describe the number and nature of adverse events occurring in general pediatric practice, to describe factors contributing to the occurrence of these adverse events, and to report on the experience of pediatricians with reporting adverse events. It is a prospective study on 11 pediatric units in a 3-month period; adverse events were registered for all newly admitted patients. Ninety-four adverse events were registered in 88 of 5,669 patients, amounting to a 1.6 per 100 admissions rate and a 0.4 per 100 patient days rate. Ninety percent of the adverse events did not cause serious harm. Failed diagnostic procedures were most common. Conclusion: Adverse event registration in general pediatric practice is a first step in assessing quality and safety of care. It yields a considerable number of adverse events. Compliance to adverse event registration in daily practice is difficult but also key to optimal monitoring of quality of care.

The American Journal of Medicine, 2001

Pediatric Clinics of North America, 1987

In 1986, the pediatric intensive care unit (PleU) is a busy place. The child is exposed to constant visual, auditory, and tactile stimuli that are not part of his or her normal routine and are often emotionally and physically painful. It is a place where the child's autonomy and sense of self are often lost and the traditional roles of the family severely disrupted. It is a place where the common objective is to monitor patients closely in an environment where physiologic changes can be recognized and acted on rapidly. The Pleu has come to rely on doctors, nurses, social workers, and occupational, physical, and respiratory therapists with specific training in the care of critically ill children. It also relies heavily on invasive and noninvasive monitoring devices, invasive procedures, and constant manipulation and assessment of the child's condition. This degree of monitoring and observation, although playing a vital part in therapy and eventual outcome, carries with it inherent risks to the child. In some areas of medicine and even critical care, the risks and adverse occurrences have been clearly described and often quantified. 1, 21, 103, 120, 124 In contrast, and despite the burgeoning of pediatric critical care as a subspeciality, there is very little information addressing adverse occurrences in the realm of pediatric critical care. At present, therefore, we are often left to extract data gathered from the adult and neonatal literature and then translate and apply this information to the care of the young child-not a very satisfactory long-term approach! It is the aim of this article to review the literature describing adverse occurrences affecting children in the Pleu. By necessity, data from studies in adult patients will be cited when similar information in children is lacking and when these data are applicable. It will not be prudent to document all reported adverse occurrences referenced to children; there

A Am ma aç ç: : S›k görülen çocukluk ça¤› hastal›klar› için yatakl› servisler d›fl›nda bir seçenek olan acil gözlem birimlerinin nas›l kullan›ld›¤›n› de¤erlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em m: : Gazi Üniversitesi T›p Fakültesi Çocuk Acil Servis'inde yer alan Çocuk Acil Gözlem Birimi'ne 1 Ocak-31 Aral›k 2006 tarihleri aras›nda yatan olgular›n demografik özellikleri, tan›lar›, hastanede kal›fl süreleri acil servis hasta kay›t defterinden ve hasta dosyala-r›ndan elde edilen veriler do¤rultusunda geriye dönük olarak incelendi. B Bu ul lg gu ul la ar r: : Bir y›l içinde Çocuk Acil Poliklini¤i'ne baflvuran 22,286 olgudan, 919'u (%4,1) yatakl› servislerde; yafllar› 1-228 ay aras›nda de¤iflen 243'ü k›z, 292'si erkek 535 (%2,4) hasta ise Acil Gözlem Birimi'nde izlendi. Acil Gözlem Birimi'ne yatan hastalar›n yat›fl tan›lar› s›ras›yla travma (164/535), zehirlenme (111/535), solunum sistemi hastal›klar› (65/535) ve nörolojik hastal›klar (61/535) idi. Tüm olgular›n 494'ü yirmidört saatten k›sa , 41'i yirmidört saatten daha uzun süre Acil Gözlem Birimi'nde izlendi. Olgular›n 439'u (%82) Çocuk Acil Gözlem Birimi'nden taburcu edilirken, 96 olgu izlem ve tedavilerin devam› için ilgili servislere devredildi. Ç Ç› ›k ka ar r› ›m ml la ar r: : Bir y›l içinde Acil Servis'ten yatakl› servislere ve Acil Gözlem odalar›na yatan hasta say›lar› göz önüne al›nd›¤›nda, Acil Gözlem Birimi'nde izlenen 535 olgunun %82'sinin Acil Gözlem Birimi'nden taburcu edilmifl olmas›, yatakl› servislere gereksiz hasta yat›r›lmas› ve gereksiz tetkik yap›lmas›n› engellemede, hastanede kal›fl süresini azaltmada, klinik bulgular› flüpheli olan olgular›n tan› ve tedavilerinin gecikmesini önlemede, hastan›n daha çabuk taburcu edilerek hasta memnuniyetini artt›rmada önemlidir. Bu nedenlerle, acil gözlem birimleri, çocuk hastalar›n belli durumlarda daha iyi de¤erlendirilmesini ve tedavilerinin yap›labilmesini sa¤lamak için çocuk acil servisleri içinde hastanelerin olanaklar›na göre bulundurulmas› gereken alanlard›r. (Türk Ped Arfl 2007; 42: 61-4) A An na ah ht ta ar r k ke el li im me el le er r: : Acil servis, çocuk, gözlem birimi Summary A Ai im m: : The evaluation of pediatric emergency department observation unit for the hospitalization of patients with frequently seen childhood disorders, as an alternative to hospital wards. M Ma at te er ri ia al l a an nd d M Me et th ho od d: : Demographic features, diagnoses, hospital stay intervals of patients hospitalized in Gazi University Faculty of Medicine Pediatric Emergency Department Observation Unit between January 1 st and November 31 st 2006 were collected from the Pediatric Emergency Department records and patient files. R Re es su ul lt ts s: : Within one year, 22286 patients were admitted. Among them, 535 patients were hospitalized in The Pediatric Observation Unit while 919 patients were hospitalized in wards. A total of 535 patients (243 girls, 292 boys) aged between 1-228 months were hospitalized in the Pediatric Emergency Unit. Their diagnoses were trauma (164/535), intoxications (111/535), respiratory diseases (65/535) and neurologic diseases (61/535). Four-hundred-ninenty-four of all cases were hospitalized for less than 24 hours, 41 of them stayed more than 24 hours at the Observation Unit. 439 (82%) of all cases were discharged from the pediatric observation unit. 96 of all cases were transferred from the observation unit to the ward for continuation of medical treatment. C Co on nc cl lu us si io on n: : 535 subjects were hospitalized in the Emergency Pediatric Observation Unit and 82% of these subjects were discharged from the Emergency Pediatric Observation Unit. This reality shows the benefits of this unit as prevention of unnecessary and over-hospitalizations, decreament in hospital stay intervals, early diagnosis of clinically suspicious subjects, prevention of delay in their treatment and increasing patient satisfaction by early discharge. Pediatric emergency observation units are a must for the pediatric emergency services for the better evaluation and treatment of children.