Using an Online Vaccination Registry to Confirm Tetanus Status in Children with Tetanus-prone Wounds

Zeretzke-Bien, C.

Tetanus vaccination status is an important consideration for emergency physicians managing patients with tetanus-prone wounds. Physicians must identify at-risk patients, but vaccination histories are often unknown and commonly lack documentation. The study objective was to determine the potential impact of an online immunization registry (Florida SHOTS – State Health Online Tracking System) on the appropriate administration of tetanus prophylaxis for pediatric patients managed in the emergency department (ED).

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Food Insecurity in a Pediatric Emergency Department and the Feasibility of Universal Screening

Gonzalez, JV.

Children with food insecurity (FI) experience adverse health outcomes due to inadequate quantity or quality of food. Food insecurity may be high among families seeking emergency care. The Hunger Vital Sign (HVS) is a two-question validated tool used to screen families for FI. Our goal in this study was to assess prevalence of FI among emergency department (ED) patients, patient-level risk factors for FI, and the feasibility of screening.

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A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department

Donaldson, CD.

Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

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Suffocation Injuries in the United States: Patient Characteristics and Factors Associated with Mortality

Sasso, MD, et al.

Asphyxiation or suffocation injuries can result in multi-organ damage and are a major cause of morbidity and mortality among different age groups. This study aims to describe characteristics of patients presenting with suffocation injuries to emergency departments (EDs) in the United States (U.S.) and to identify factors associated with mortality in this population.

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Computed Tomography Risk Disclosure in the Emergency Department: A Survey of Pediatric Emergency Medicine Fellowship Program Leaders

Marin, MD, MSc, et al.

We conducted a cross-sectional survey study of the United States and Canadian PEM fellowship directors and associate/assistant directors. We developed a web-based survey using a modified Dillman technique. Primary outcome was the proportion who “almost always” or “most of the time” discussed potential malignancy risks from CT prior to ordering this test.

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English-based Pediatric Emergency Medicine Software Improves Physician Test Performance on Common Pediatric Emergencies: A Multicenter Study in Vietnam

Author Affiliation Michelle Lin, MD  University of California, San Francisco, Department of Emergency Medicine, San Francisco, California KidsCareEverywhere – Vietnam, Berkeley, California Trevor N. Brooks, BS  University of California, San Francisco, Department of Emergency Medicine, San Francisco, California Alex C. Miller, BA  KidsCareEverywhere – Vietnam, Berkeley, California Jamie L. Sharp, BA  KidsCareEverywhere – Vietnam, Berkeley, […]

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Tension Gastrothorax in a Child Presenting with Abdominal Pain

A 4-year-old girl was brought to our hospital by her parents because of abdominal pain. She had suffered minor trauma after rolling from her standard-height bed 2 days prior. Vital signs were appropriate for age. Physical examination was remarkable for decreased breath sounds to the left side of the chest. A chest radiograph (Figure) demonstrated a large gas-filled structure in the left side of the chest with mediastinal shift.

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Ovarian Teratoma with Torsion Masquerading as Intussusception in 4-Year-Old Child

We present the case of a four-year-old female who presented to the emergency department (ED) with a five-day history of intermittent abdominal pain and emesis. Initial diagnosis was suspicious for intussusception; however, on operative exploration, she was found to have a right adnexal torsion secondary to an ovarian teratoma. A right salpingo-oophorectomy was performed.

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Acute Ischemic Stroke in a Pediatric Patient

Acute ischemic stroke in a pediatric patient is a complex disease with a variety of etiologies that differ from adults. Though rare, they are a real phenomenon with potentially devastating consequences. Some treating institutions are using anti-thrombotic drug therapy with unclear benefits. Available literature, which is limited to case reports and retrospective reviews of databases, clouds this topic with both positive and negative outcomes. Emergency department management should focus on stabilization and resuscitation with immediate involvement of a pediatric neurologist and intensivist. The decision to use anti-thrombotic drug therapy, including anti-platelet drugs and thrombolytics, should be in consult with the specialists involved until randomized controlled trials determine their safety and efficacy in the pediatric population.

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Ultrasound-Assisted Peripheral Venous Access in Young Children: A Randomized Controlled Trial and Pilot Feasibility Study

Intravenous (IV) access in children treated in the emergency department (ED) is frequently required and often difficult to obtain. While it has been shown that ultrasound can be useful in adults for both central and peripheral venous access, research regarding children has been limited. We sought to determine if the use of a static ultrasound technique could, a) allow clinicians to visualize peripheral veins and b) improve success rates of peripheral venous cannulation in young children in the ED.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389


ISSN: 1936-900X
e-ISSN: 1936-9018

ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.