optimal care for children in the emergency department

Did you know that of the approximately 119 million visits to an emergency department (ED) each year, nearly 20% are made by children? That means that nearly 24 million children are seen in EDs each year. There are nearly 4000 EDs in the US, and only a minority of those are in children's hospitals, or hospitals with pediatric training programs, or clearly identified pediatric ED's. Emergency care for children was identified by the institute of medicine (IOM) in 2003 as woefully in need of improvement. The IOM found that EDs often lack the expertise and equipment needed to provide appropriate care for childre during emergencies.

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what do you expect from your physician?

On Monday night I watched the latest episode of the medical series "House" on Fox. I watch this program for amusement, and to some extent because it annoys my twenty-somethng daughter to hear me discount many of the thought processes the "team" is supposedly engaging in to demonstrate how smart they are. This week, for example they tried to "rule out lead poisoning" by sending someone out to the patient's home to look for something she might have been exposed to. I know this is good TV, but it is VERY BAD medicine.

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a family member is not a visitor

On Friday I wrote about issues in patient safety, and I will continue in that vein today

. One big focus of the Children's hospital over the last two years, has been the introduction and development of patient and family centered care (PFCC). There are many aspects to health care that make it patient and family centered. One major aspect is acknowledging the role that families play in the lives  of patients, and recognizing that respect for families is an important part of how we care for patients.

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confessions about patient harm

A couple of days ago, Nancy Agee, president of Carilion Clinic's hospital division, distributed a sobering article from the Reader's Digest about the importance of patient safety It is moving, because it consists of a number of "confessions" of doctors, nurses, and pharmacists who inadvertently caused harm to patients, and have lived with the knowledge of this harm for the rest of their careers. Such experiences happen to EVERY HEALTH CARE PROVIDER at some time in their careers, and are responsible for unnecessary harm to patients and unnecessary cost to our health care system.

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...and home again

Apologies for not writing last night after a busy day of listening to new information about resuscitation, and meeting with old friends and new acquaintances. Lots of walking around the San Francisco Embarcadero area, and the need to go to sleep early so I could rise at 4am to catch my plane home, lead me to  postpone the post I promised on the soon-to-be released new approaches to CPR in children.

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a day of learning new things...learning about learning

Today at the AAP NCE I attended the scientific abstract and poster presentations, followed by an afternoon of presentations and discussions about challenges in teaching medical students, residents and fellows.

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at the AAP NCE meeting

Yesterday was a day of uneventful travel from Roanoke to San Francisco.

Today I started performing the "work" of attending this meeting.  At 7:30 am I was among a small group of  pediatric subspecialists that met with the leadership of the American Board of Pediatrics to discuss issues related to maintenance of certification in the pediatric subspecialties.

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the value of travel

Dr. Ackerman discusses her upcoming trip to San Francisco, and notes the value of medical travel for continuing medical education.

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