This study suggests that children with VMD visits contribute a substantial resource burden in the ED, and focused interventions such as the child guidance model in the ED can significantly decrease LOS and reduce ED costs.
Patient and family–centred care (PFCC) is an approach to health care that recognizes the integral role of the family and encourages mutually beneficial collaboration between the patient, family and health care professionals. Specific to the pediatric population, the literature indicates that the majority of families wish to be present for all aspects of their child's care and be involved in medical decision-making. Families who are provided with PFCC are more satisfied with their care. Integration of these processes is an essential component of quality care. This article reviews the principles of PFCC and their applicability to the pediatric patient in the emergency department; and it discusses a model for integrating PFCC that is modifiable based on existing resources.
Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients.
In this system, the majority of pediatric patients are not severely ill, and a large number are not transported. Non-transports are more likely to be young adolescents, have been involved in assaults, and have a longer on-scene time.
Caregivers with limited English proficiency are less aware of and are less likely to utilize EMS for their children. Barriers to utilization include concerns of cost and communication with the operator.
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