The Effect of Pediatric Early Warning Score Use on Emergency Response Calls After Admission From the Pediatric Emergency Department.

OBJECTIVES: Pediatric Early Warning Scores (PEWS) are an easy-to-use diagnostic tool for patient evaluation. The goal of this study was to determine if using PEWS in our pediatric emergency department (PED) at the time of admission to the hospital was associated with a decrease in the number of emergency response calls within 6 hours of admission. METHODS: A retrospective chart review of 6 months before (May 2013-October 2013) and after (December 2013-May 2014) initiation of PEWS upon inpatient admission from our urban, tertiary care PED was conducted to determine the number of patients who had emergency response calls within 6 hours of admission. RESULTS: The percentage of patients admitted from the PED who required an emergency response call within 6 hours of admission dropped from 1.77% in the 6 months before assigning PEWS to 0.79% in the 6 months after, a 55% reduction (P = 0.0070). CONCLUSIONS: Assigning PEWS to patients being admitted to our hospital from the PED was associated with a reduced number of emergency response calls in the period immediately after admission.

Assessing the knowledge of all-terrain vehicle safety for children among Alabama pediatricians.

BACKGROUND: Since 1987, the American Academy of Pediatrics (AAP) has had a policy regarding the use of all-terrain vehicles (ATVs) by children, which calls for pediatricians to educate families regarding the dangers of ATV use and to give recommendations for safety. Given the high incidence of ATV-related injuries in Alabama, our objective was to determine if pediatricians in our state are educating patients on ATV hazards and safety. METHODS: All general pediatricians in Alabama who are members of the AAP were asked to complete a survey distributed through e-mail using Survey Monkey® (Survey Monkey Palo Alto, Calif). Data were entered into Microsoft® Excel (Microsoft Corporation Redmond, Wash). RESULTS: Of the 353 general pediatricians in Alabama, 104 responded. Forty-one percent of the respondents were not aware that there is an AAP policy. Of the 59% who knew of the policy, 36% correctly identified the age limit recommendations. Forty-eight percent said that they routinely give anticipatory guidance regarding ATV use. Of them, 63% gave age recommendations younger than stated in the AAP policy. In addition, only 52% of them recommend helmet use, 5% recommend use of reflective clothing, 35% discourage passenger riding, and 8% encourage ATV training classes. Respondents who had patients treated for ATV-related injuries were more likely to give anticipatory guidance than those who had not had patients treated (χ² = 5.3; P = 0.02; odds ratio, 3.9 [95% confidence interval, 1.2-13.6]). Respondents who practice in rural areas were more likely not to give anticipatory guidance than those who practice in urban areas (χ² = 2.1; P = 0.14; odds ratio, 2.9 [95% confidence interval, 0.8-5.4]). CONCLUSIONS: Many general pediatricians in a state where ATV use is popular are not familiar with the current AAP policy and do not routinely follow its guidelines. Given the high incidence of ATV-related injuries and the complexities of general practice, exploring multiple methods to modify risk-taking ATV behavior is warranted.