Objective: Rotavirus has an important role in viral childhood gastroenteritis all over the world. Acute gastroenteritis constitutes an important part of pediatric emergency department admissions. We aimed to evaluate the burden of rotavirus gastroenteritis in the pediatric emergency department. Material and Methods: Patients who were admitted to Ankara University Faculty of Medicine Pediatric Emergency Department between August 1, 2011 and July 31, 2012 with a diagnosis of acute gastroenteritis were included in this study. Clinical characteristics and the data of patients with a positive rotavirus antigen test in stool were analyzed retrospectively. Stool samples were examined by using an immunochromatographic test (CerTest Rota Kart BIOTEC, Zaragoza, Spain). Results: In the study period, 3046 stool samples for rotavirus antigen were evaluated, and 552 patients (284 boys, 268 girls) were found to have positive test results. The ages of the patients ranged from 36 days to 14.59 years, with a median of 1.70 years; 58.1% of the patients were under 2 years. The patient admissions were more frequent in winter and less frequent summer months. It was determined that 46% of the patients were followed up in the pediatric emergency department or pediatric infection disease services; 66.8% of these patients were under 2 years, and no patients were hospitalized over the age of 5. Conclusion: As a result, rotavirus gastroenteritis had a higher frequency under 2 years of age and in winter; also, hospitalizations were more frequent in this age group. Most of the patients were followed up in the pediatric emergency department and discharged after the treatment; thus, the burden of hospital inpatient services was reduced. Pediatric emergency departments have an important role in the treatment of rotavirus gastroenteritis.
Objective The aims of the present study were to investigate the reasons parents prefer the pediatric emergency department for nonurgent admissions and to evaluate the effect of parental age and educational level on nonurgent admissions and the relationship between the reasons for nonurgent admissions and child age. Methods We conducted a cross-sectional survey at an emergency department of a tertiary care pediatric referral center. A questionnaire that was prepared to understand the reasons underlying nonurgent admissions was administered to the parents of 1033 children who were classified as nonurgent cases using the Pediatric Canadian Triage and Acuity Scale (4–5). Results The most common reasons for nonurgent admissions were the concern for progression in child's complaints, the complaints with an onset outside working hours, and the parental perception that more cautious and better care is provided in the emergency department. The most urgent complaints from the parental perspective included fever (23.1%), vomiting (11.0%), and diarrhea (10.5%), respectively. The mean age of the mothers was 31.1 ± 5.9 years (17–51 years), and the mean age of the fathers was 34.94 ± 6.1 years (20–60 years). Parents younger than 30 years were more likely to prefer the emergency department due to convenience and economic reasons. Nonurgent admissions due to confidence in the emergency department were more frequent among parents who were primary school graduate. Conclusions It is critically important to examine why parents prefer the emergency department for nonurgent conditions of their children and to develop solution offers in this regard. The improvements to be made in the emergency department would both prioritize patients requiring urgent care and increase the productivity of emergency department staff.
Catatonia is a syndrome characterized by symptoms such as perseveration, passive obedience, mutism, immobility, negativism, stereotypes, mannerisms, and echo phenomenon. It is usually seen with psychiatric disorders. A nine-year-old girl was admitted to the emergency unit with symptoms of unresponsiveness and tonic contractions after using an unknown drug. Mutism and rigidity were detected in the conscious state with waxy flexibility. Catatonia symptoms resolved after intravenous midazolam treatment. In this paper, we aimed to discuss catatonia, which is rarely observed in pediatric practice.
Background. The most underdeveloped area in the care of critically-ill-children (CIC) is the prehospital period. Appropriate prehospital assessment and life-saving-interventions (LSI) of this population are challenging and require dedicated resources to ensure the best outcomes. We aimed to determine the characteristics and outcomes of CIC transported to the Turkish Pediatric Emergency Departments (EDs). The frequency and distribution of LSI administered by prehospital providers on route and in the EDs were also investigated. Methods. This prospective study was conducted at 4 metropolitan cities and 9 tertiary pediatric EDs between August 2014-August 2015. A survey based study evaluated all CIC who were brought by ambulance to the participant EDs. CIC were defined as a patient who requires LSI or needs intensive care admission for any reason. Patient demographics, clinical features, reason for transport, performed procedures in the ambulance or ED were sought. Finally, the short-term outcomes of transported CIC and transport-associated risks were analyzed. Results. During the study period, a total 2094 children were brought by ambulance to all participant EDs. Only 227 (10.8%) of them were critically-ill. Emergency Medical Services (EMS) providers were less likely to perform procedures in CIC if they were staffed with paramedics (p<0.001). Most procedures were performed on children aged one or older (p<0.001). No procedure was performed in the ambulance for nearly one fourth of patients who received LSI in the EDs. If the EMS did not have a physician, prehospital providers were less likely to provide immediate LSIs (p<0.001). CIC were more likely referred from secondary/tertiary care hospitals. The short-term mortality rate was higher if the ambulance was staffed by only paramedics. Conclusion. This study demonstrated that Turkish prehospital pediatric emergency care is deficient. We offer a clinical overview of pediatric emergencies to aid EMS directors, policymakers, and ED directors in planning the care of CIC.
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