Relation Between Pediatric Emergency Department Activity and Patient Complexity.

OBJECTIVES: Potentially projecting pediatric emergency department (ED) volume trends is a matter that has been researched extensively. It is vital to understand the relation between patient complexity and department volumes to properly staff and allocate resources within the ED. Multiple studies have analyzed ED volumes based on disease severity; however, the degree of illness was determined by triage classification. This study proposed a novel method of evaluating the relation between pediatric ED patient complexity, centered on Current Procedural Terminology (CPT) code, and day of the week. METHODS: This was a retrospective study of pediatric patients presenting to the ED between January 1, 2010 and December 31, 2015. This study looked at the relation between individuals with CPT codes who were evaluated in the pediatric ED on a particular day of the week and evaluated in the pediatric ED either the day before, the day of, and the day after a legal holiday. RESULTS: A total of 81,698 (54%) male and 70,002 (46%) female patients were analyzed. No relation was noted between ED patient complexity, based on their CPT code, and the day of the week (P = 0.41). Individual, nonstatistically significant differences between the day of the week and pediatric ED volumes were identified, however. CONCLUSIONS: We identified no relation between pediatric ED patient complexity, assessed by CPT code, and the day of the week. Furthermore, a more multifactorial and granular analysis may be necessary to model resource constraints by type and time of day to more effectively manage ED resources. CPT-based modeling may benefit superimposed financial analyses of demand-capacity management.

Is There Benefit in Identifying Asthma Triggers During an Exacerbation?

Introduction. Allergen-specific IgE (sIgE) testing provides an objective assessment of sensitization to an allergen. Goal. To identify the time when serum measurements of sIgE would be most sensitive. Methods. This was a prospective study conducted between September 1, 2015, and February 25, 2019. Subjects ≥5 and ≤18 years of age, seen in the ED or admitted with an asthma exacerbation, were tested for total IgE and 8 perennial sIgE levels. Subjects with elevated sIgE were tested again after symptom resolution. Results. A total of 104 subjects were enrolled; 50 subjects were eligible for inclusion in the analysis. There were statistically significant differences between the visits for all sIgE, except Alternaria alternatum. Conclusions. In pediatric patients, serum sIgE levels measured during an asthma exacerbation were elevated compared with when their asthma was in better control. sIgE testing during an asthma exacerbation may help identify asthma triggers, mitigate exposure, and hence improve asthma control.