Impact of Rapid Influenza Testing at Triage on Management of Febrile Infants and Young Children

Abanses, Juan Carlos; Dowd, M. Denise; Simon, Stephen D.; Sharma, Vidya

doi:10.1097/01.pec.0000202454.19237.b0

Cited by 91 publications

(71 citation statements)

References 26 publications

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“…While carefully considering the possibility of false-positive testing, rapid antigen testing of young febrile infants during influenza season may also assist with medical decision making. Definitive diagnosis also leads to decreased testing, decreased antibiotic use, and shorter stays in the emergency department, all of which help to decrease medical costs (1,6,7). This study compared the detection of influenza virus from secretions from the AN in a rapid antigen test when specimens were collected with polyurethane foam swabs to detection when specimens were collected with flocked nylon swabs.…”

Section: Rapid Antigen Detection For Influenza Virus Infection Continmentioning

confidence: 99%

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Comparison of Polyurethane Foam to Nylon Flocked Swabs for Collection of Secretions from the Anterior Nares in Performance of a Rapid Influenza Virus Antigen Test in a Pediatric Emergency Department

Scansen¹,

Bonsu²,

Stoner³

et al. 2010

J Clin Microbiol

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Rapid antigen testing of upper respiratory secretions collected with various swab types is often utilized for laboratory diagnoses of influenza virus infection. There are limited data on the effects of swab composition on test performance. This study compared the performance of the Quidel QuickVue Influenza A؉B test on secretions from the anterior nares when a polyurethane foam swab was used for collection to that when a nylon flocked swab was used for collection. One hundred subjects who presented to a pediatric emergency department with symptoms suggestive of an influenza virus infection were recruited for the study.

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Section: Rapid Antigen Detection For Influenza Virus Infection Continmentioning

confidence: 99%

“…Rapid diagnosis also aids clinical management by differentiating influenza from other viral illnesses and allows the option of timely antiviral therapy for maximum effectiveness (20,25). Previous research has also shown that a diagnosis of influenza not only decreases antibiotic use but also decreases testing and the length of stay in the ED (1,6,7).…”

mentioning

confidence: 99%

Comparison of Polyurethane Foam to Nylon Flocked Swabs for Collection of Secretions from the Anterior Nares in Performance of a Rapid Influenza Virus Antigen Test in a Pediatric Emergency Department

Scansen¹,

Bonsu²,

Stoner³

et al. 2010

J Clin Microbiol

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show abstract

“…25.2%) 5,22) . 신속 항원검사로 인플루엔자를 조기에 진단한 경우, 검사 및 치료 등에 따른 비용이 적었고 23) , 뇌척수액 장바이러스 양성 군에서 그렇지 않은 군보다 입원일수가 하는데 주의를 요한다 8,15) . …”

Section: 바이러스 검사와 세균 검사unclassified

Clinical Characteristics of Fever without Localizing Sign in Infants Younger than 100 Days of Age in a Single Center

Lee

2016

Pediatr Infect Vaccine

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Purpose: This study was done to define clinical characteristics of fever without localizing signs (FWLS) in infants younger than 100 days of age with a goal of providing baseline data to establish a new diagnostic paradigm in the future. Methods: We reviewed medical records of 183 patients who admitted to Daegu Catholic University Medical Center for FWLS younger than 100 days of age from January 2013 to September 2015 retrospectively. Demographic, clinical features and laboratory findings were analyzed. Patients were divided into serious bacterial infection (SBI) and non-SBI groups, and then were compared between two groups to find risk factors for SBI. Results: Among 183 patients, lumbar puncture was performed in 98.9% and CSF pleocytosis was present in 35.9%. Sterile CSF pleocytosis was found in 43% of urinary tract infection (UTI) patients. None had concomitant bacterial meningitis in patients with UTI. As final diagnosis, febrile syndrome without source (25.7%) was most common. Among SBI, UTI was most common (99%). Birth weight, ESR, and CRP were significantly higher in SBI group compared to non-SBI group. Male sex (OR 4.93,) and pyuria (OR 18.88,) were identified as risk factors for SBI. Presence of sibling (OR 0.30, 95% CI 0.11-0.83) was significantly lower in SBI group. Conclusions: Our results showed UTI was the most common SBI in young infants with FWLS. Though aseptic meningitis can be coexisting with UTI, lumbar puncture may not be necessary in all patients having UTI.

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“…However, some pediatric-specific pathways have been shown to have an effect on ED patient flow. [73][74][75] Developing emergency care pathways that adequately address pediatric issues and prioritize problems in accordance with those of adults is a priority. An increasing number and quality of pediatric-specific triage pathways are available, the most notable being the 5-level triage system.…”

Section: Emergency Care Pathwaysmentioning

confidence: 99%

Best Practices for Improving Flow and Care of Pediatric Patients in the Emergency Department

Barata¹,

Brown²,

Fitzmaurice³

et al. 2015

Pediatrics

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This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department. CURRENT STATUS AND NEEDS ED Use and ED Crowding in the United StatesApproximately 800 000 children seek care in the emergency department (ED) each day in the United States. Additionally, it is estimated that 3.4% of US children use EDs as their source for sick care. The vast majority (92%) of these children are seen in community EDs, with a smaller percentage seen in pediatric EDs. The increase in ED utilization has saturated the capacity of EDs and emergency medical services in many communities. Increases in patient volume and decreases in resources, including fragmentation of resources and shortage of critical subspecialists, have resulted in EDs facing crowding and ambulance diversion.The need for emergency medical services outstrips the available resources on a daily basis. This mismatch is reflected by the considerable increase in the number of patients visiting EDs. In 1993, 90.3 million patients visited EDs; in 2003 that number increased to 113.9 million patients. Approximately 21% of these patients were younger than 15 years. Despite the increase in ED visits, the number of hospitals decreased by 703, the number of hospital beds decreased by 198 000, and the number of EDs decreased by 425.

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Impact of Rapid Influenza Testing at Triage on Management of Febrile Infants and Young Children

Abstract: A triage protocol for rapid influenza testing for febrile infants and children appears to significantly decrease additional testing, time in the ED, and charges in children testing positive for influenza.

Cited by 91 publications

References 26 publications

Comparison of Polyurethane Foam to Nylon Flocked Swabs for Collection of Secretions from the Anterior Nares in Performance of a Rapid Influenza Virus Antigen Test in a Pediatric Emergency Department

Comparison of Polyurethane Foam to Nylon Flocked Swabs for Collection of Secretions from the Anterior Nares in Performance of a Rapid Influenza Virus Antigen Test in a Pediatric Emergency Department

Clinical Characteristics of Fever without Localizing Sign in Infants Younger than 100 Days of Age in a Single Center

Best Practices for Improving Flow and Care of Pediatric Patients in the Emergency Department

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