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Biomedical subjects

Ilene Claudius

Publications and source records attributed to Ilene Claudius.

5 recordsLinked to original sources
PubMed2006

Decrease in emergency department length of stay as a result of triage pulse oximetry.

OBJECTIVES: Many emergency departments do not perform pulse oximetry in triage, in spite of its potential for altering management decisions. We attempted to quantify the decrease in patient throughput time in a pediatric emergency department following the introduction of triage pulse oximetry. METHODS: One hundred fifty-nine bronchiolitis patients from 2004 served as the preintervention group, and were evaluated against 89 severity-matched postintervention bronchiolitis patients from 2005. Their mean lengths of ED stay were compared by a t test. RESULTS: The preintervention group had a mean length of stay of 4 hours and 59 minutes, and the postintervention group had a mean length of stay of 4 hours and 9 minutes, which was significantly different (P = 0.03). The sensitivity of respiratory distress on the triage exam for predicting hypoxia was fair (74%). CONCLUSIONS: Institution of triage pulse oximetry significantly decreases ED throughput times. Clinical exam alone is not a replacement for measurement of oxygen saturation.

Bronchiolitis↗
PubMed2006

Poststabilization care for pediatric fractures: a follow-up survey.

OBJECTIVES: Compliance with emergency department instructions regarding patient follow-up is generally poor. Children with Medicaid have been previously shown to have less access to orthopedic care than those with private insurance. Our objectives were to quantify the compliance of pediatric fracture patients with recommended emergency department follow-up and to identify barriers for patients who do not follow-up. METHODS: Telephone survey of pediatric fracture patients seen and splinted between July and September of 2004 in a level 1 pediatric trauma center emergency department serving primarily a Medicaid-insured population. Those patients instructed to obtain an orthopedics consultation for definitive care of their fracture were included. RESULTS: Eighty-two patients were identified and met inclusion criteria. Of these, 66 families completed a telephone interview; 34.7% of patients did not receive follow-up with an orthopedist. Eleven patients elected not to follow-up with their PCP, mostly secondary to perceived lack of need. Twelve patients followed up with their PCP but were not referred to an orthopedist. CONCLUSION: Over one third of children with nonemergent fractures treated in our emergency department did not receive recommended follow-up. Although our data cannot comment on the outcomes of these specific patients, the orthopedic literature suggests that these children are at higher risk of a poor outcome than those receiving timely follow-up.

Child↗
PubMed2005

The emergency department approach to newborn and childhood metabolic crisis.

For most emergency medicine physicians, the phrases "newborn workup" and "metabolic disease" are, at best, uncomfortable. This article, however, provides a simple approach to the recognition,evaluation, and treatment of infants with all manners of metabolic issues, including hypoglycemia, inborn errors of metabolism, jaundice, and electrolyte abnormalities. The disorders are grouped based on symptomatology, and have simple guidelines for work-up and management, with an emergency department practitioner perspective in mind.

Acid-Base Equilibrium↗
PubMed2003

Usefulness of B-type natriuretic peptide as a noninvasive screening tool for cardiac allograft pathology in pediatric heart transplant recipients.

We examined the utility of B-type natriuretic peptide (BNP) in the evaluation of pediatric orthotopic heart transplant recipients for allograft pathology by measuring the serum BNP levels at the time of either screening echocardiography and biopsy, or at the time of clinical rejection. There was a significant difference (p <0.0001) in the BNP levels in 37 patients in the group with evidence of pathology compared with those without evidence. There was also 100% sensitivity and 100% negative predictive value of BNP levels >100 pg/ml for identifying graft pathology.

Adolescent↗