Related Experiment Videos

Factors associated with prolonged emergency department length of stay for admitted children

Arpi Bekmezian1, Paul J Chung, Michael D Cabana

  • 1Department of Pediatrics, University of California, San Francisco, CA, USA. bekmeziana@peds.ucsf.edu

Pediatric Emergency Care
|January 22, 2011
PubMed

Insights

Prolonged emergency department length-of-stay (ED-LOS) affects 13% of admitted children, particularly those arriving overnight or during winter. Strategies like better staffing and interpreter services can reduce pediatric ED-LOS.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Operations Research

Background:

  • Prolonged emergency department length-of-stay (ED-LOS) is a significant concern in pediatric care.
  • Understanding factors contributing to extended ED-LOS is crucial for improving patient flow and care quality.

Purpose of the Study:

  • To determine the prevalence of prolonged ED-LOS in admitted children.
  • To identify patient, physician, and system-level factors associated with prolonged ED-LOS for pediatric patients.

Main Methods:

  • Analysis of the 2001-2006 National Hospital Ambulatory Medical Care Survey data.
  • Definition of prolonged ED-LOS as total ED time exceeding 8 hours for admitted children.
  • Multivariable logistic regression to identify independent predictors of prolonged ED-LOS.

Main Results:

  • Thirteen percent of admitted pediatric patients experienced prolonged ED-LOS (median 3.7 hours).
  • Factors associated with prolonged ED-LOS included Hispanic ethnicity, arrival between midnight and 8 a.m., and winter season.
  • Diagnostic imaging (CT/MRI) and intravenous treatments increased the odds of prolonged ED-LOS, while ICU admission and pulse oximetry decreased it.

Conclusions:

  • Prolonged ED-LOS is common in admitted pediatric patients.
  • Hispanic ethnicity, winter season, and early morning arrival are key associated factors.
  • Improving interpreter services, staffing, and inpatient bed availability during peak times may reduce pediatric ED-LOS.
Abstract

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Attention-Deficit/Hyperactivity Disorder01:30

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Methods of Documentation II: POMR01:26

Methods of Documentation II: POMR

The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.