Pediatric emergency care最新文献

{"title":"Cannabis Use Patterns and Blood Profiles in Adolescent Cannabinoid Hyperemesis Syndrome.","authors":"Joshua Bloom, Francesca L Beaudoin, Timmy R Lin, Ashley Gaipo, Carolyn Ortega, Rachel S Wightman","doi":"10.1097/PEC.0000000000003495","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003495","url":null,"abstract":"<p><strong>Objective: </strong>Adolescent use of cannabis in the United States is on the rise. Multiple toxicities and negative outcomes are possible with chronic or heavy cannabis use, including cannabinoid hyperemesis syndrome (CHS). This study analyzes a population of adolescent emergency department patients with cyclic vomiting onset after cannabis use, with a hypothesis that use patterns or biomarkers may offer insights into diagnostics, pathophysiology, or management of this disease.</p><p><strong>Methods: </strong>This pilot prospective observational cohort study recruited pediatric emergency department patients aged 14 to 21 years with symptomatic cyclic vomiting onset after chronic cannabis use, and reassessed them at an asymptomatic follow-up visit. Cannabis use patterns were assessed with validated questionnaires, and blood profiles of cannabinoid metabolites and essential minerals and B vitamins were quantified and compared.</p><p><strong>Results: </strong>We screened 869 adolescent ED patients and enrolled ten participants. All participants (n=10) had cannabis use disorder (n=9) or hazardous cannabis use (n=1) by the Cannabis Use Disorders Identification Test-Revised, and participants reported withdrawal symptoms when attempting to discontinue cannabis. There were significant differences in 11-hydroxy-delta-9-tetrahydrocannabinol between index [median 0.6 ng/mL (IQR: 0, 2.6)] and asymptomatic follow-up visits [median 4.2 ng/mL (IQR: 1.2, 10.1)]. Median vitamin and mineral concentrations were within reference ranges.</p><p><strong>Conclusions: </strong>Symptomatic adolescent patients with suspected CHS had evidence of cannabis use disorder and had significantly lower blood concentrations of 11-hydroxy-delta-9-tetrahydrocannabinol when symptomatic. Further research is needed to better explore the pathophysiology and diagnostics in adolescent CHS, and exploration and treatment of cannabis use disorder should be considered in these patients.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of Discharge Instructions by Age for Children Presenting to the ED With Mild Traumatic Brain Injury: A Quality Improvement Project.","authors":"Niralee K Rana, Nicole L Gerber, Snezana Nena Osorio, Michael J Alfonzo, Sean C Rose, Miriam H Beauchamp, Deborah A Levine","doi":"10.1097/PEC.0000000000003493","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003493","url":null,"abstract":"<p><strong>Introduction: </strong>Mild traumatic brain injuries (mTBI) are common in pediatric emergency departments (EDs), but inconsistent use of diagnostic labels leads to variable discharge instructions, especially with regard to concussion. Lack of age-appropriate guidance can increase parental anxiety and ED revisits and hinder recovery.</p><p><strong>Objective: </strong>This quality improvement (QI) initiative aimed to increase the proportion of mTBI patients receiving age-appropriate discharge instructions to 50% over 13 months in an urban pediatric ED.</p><p><strong>Methods: </strong>An interdisciplinary QI team conducted an observational time series study with sequential experimentation at a quaternary academic medical center over 13 months. Using a key driver diagram, they created SMART aim, measures, and designed interventions which were tested through 5 Plan-Do-Study-Act (PDSA) cycles. Interventions included an educational curriculum, e-reminders, workspace materials, and pre-written electronic medical record (EMR) templates (smart phrases) for age-specific discharge instructions (0 to 5 y, ≥6 y), and parent surveys were used on a subset of sample families to assess knowledge, behavior, and anxiety post-discharge. Outcome measures included the percentage of age-appropriate discharge instructions provided and use of the new EMR smart phrase. Balancing measures tracked head computed tomography (CT) utilization, ED revisits within 14 days of discharge, and neurology referrals. Process control charts and rules to detect special cause variation were used to analyze data. We use descriptive statistics to analyze survey data.</p><p><strong>Results: </strong>Among 1263 patients, age-appropriate discharge instruction rates improved from 36% to 56%. Smart phrases were used in 58% of relevant cases (n=628). No changes were observed in CT orders, ED revisits, or neurology referrals. Among 37 surveyed parents (28% response rate), 95% (n=35) found instructions helpful, and 68% (n=25) reported reduced anxiety.</p><p><strong>Conclusions: </strong>Implementing EMR smart phrases in a pediatric ED increased standardized, age-appropriate discharge instructions for children with mTBI. These low-cost interventions are scalable for broader ED use and other settings.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of Nonstandard Inflammatory and Cardiac Biomarker Levels in Children With Fever and Viral or Nonspecific Illness.","authors":"Danielle N Steinberg, Son H McLaren, Katherine Aschheim, Peter S Dayan, Tamar R Lubell","doi":"10.1097/PEC.0000000000003489","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003489","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the distribution of laboratory values for nonstandard inflammatory and cardiac biomarkers in otherwise healthy children presenting to the pediatric emergency department (PED) with fever and viral or nonspecific illness.</p><p><strong>Methods: </strong>Single-center retrospective study of otherwise healthy children 3 months to 20 years presenting to the PED with fever and had a laboratory evaluation for multisystem inflammatory syndrome in children (MIS-C) between April 15, 2020 and January 24, 2022. All patients had NT-pro-b-natriuretic peptide (NT-proBNP) or troponin obtained (as part of an institutional pathway for MIS-C evaluation) during this period. Children with comorbidities, MIS-C, Kawasaki disease, myocarditis, or definitive non-viral illness were excluded. We summarized d-dimer, ferritin, troponin, and NT-proBNP distributions using descriptive statistics. One-way analysis of variance tested for differences among 3 disease categories: non-SARS-CoV-2 viral illness, fever not otherwise specified (NOS), and SARS-CoV-2 infection. Outlier values were identified as three times the interquartile range above the third quartile on box-and-whisker plots.</p><p><strong>Results: </strong>Of 134 eligible patients, 50, 65, and 19 were categorized as non-SARS-CoV-2 viral illness, fever NOS, and SARS-CoV-2 positive illness, respectively. Median age was 2 years. Median fever duration was 4 days, with 124/134 (93%) described as well-appearing and 112/134 (84%) discharged home. The median values for all biomarkers were within institutional laboratory reference ranges, with all distributions skewed to lower values, and without statistically significant differences between disease categories (P > 0.05). D-dimer values were above the institutional reference range in 43/97 (44%), ferritin was above the reference range in 24/114 (21%), NT-proBNP was above the reference range in 26/123 (21%), and troponin levels were outside the range in 4/123 (3%). Thirteen patients had extreme outlier values.</p><p><strong>Conclusions: </strong>Otherwise healthy children presenting to the PED with a fever and viral or nonspecific illnesses may frequently have elevated serum d-dimer, ferritin, and NT-proBNP above institutional reference ranges. Troponin elevation was infrequent.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Pediatric Trauma Team Performance Through Interdisciplinary Trauma Simulation and Feedback From Trauma Code Video Analysis.","authors":"Lea C Dikranian, Katherine Oag, Lisa Vitale, Mariah Malaniak, Ronald Thomas, Kelly Levasseur","doi":"10.1097/PEC.0000000000003492","DOIUrl":"10.1097/PEC.0000000000003492","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma is a leading cause of pediatric emergency visits, yet training often underemphasizes nontechnical skills (NOTECHS). Simulation-based training can improve these skills, and targeted video review (TVR) may further enhance debriefings by enabling precise, case-based feedback. This study evaluated the combined impact of multidisciplinary, simulation-based training and TVR on technical performance and NOTECHS during pediatric trauma resuscitations.</p><p><strong>Methods: </strong>This prospective educational quality improvement study was conducted at a level 1 pediatric trauma center from February 2023 to July 2023. Multidisciplinary teams participated in in situ pediatric trauma simulations followed by structured debriefings incorporating TVR. Video reviews of preintervention and postintervention trauma activations (n = 76) assessed changes in team behavior and clinical metrics, including time-to-vitals, imaging, emergency department (ED) length of stay (LOS), and time-to-operating room (OR). Trauma performance was evaluated using the Trauma Team Evaluation Tool and T-NOTECHS.</p><p><strong>Results: </strong>Seventy-six trauma activations (21 preintervention, 55 postintervention) were reviewed. Postintervention, the proportion of cases without an identified team leader decreased (33% to 9.1%), and those with a defined disposition plan increased (66.7% to 100%). Overall team performance improved (6.52 to 7.60/10; P < 0.001), with significant gains in communication and situational awareness ( P = 0.012 and P = 0.033, respectively). Time-to-vitals decreased significantly ( P = 0.027); while imaging, ED LOS, and time-to-OR showed nonsignificant changes.</p><p><strong>Conclusions: </strong>Simulation-based interdisciplinary training, paired with TVR improved teamwork, communication, and decision-making in pediatric trauma resuscitations. This approach reinforced protocol adherence and supported quality improvement. While effects on patient outcomes remain uncertain, these findings support simulation and TVR as strategies to enhance performance in high-acuity settings.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Shock Index and Pediatric Age-Adjusted Shock Index in Predicting Severe Sepsis and Septic Shock.","authors":"Raziye Merve Yaradilmiş, Aytaç Göktuğ, İlknur Bodur, Betül Öztürk, Orkun Aydin, Muhammed M Güneylioğlu, Bilge Akkaya, Fatma Şule Erdem, Ahmet S Özcan, Ali Güngör, Can Demir Karacan, Nilden Tuygun","doi":"10.1097/PEC.0000000000003494","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003494","url":null,"abstract":"<p><strong>Introduction: </strong>Early recognition of severe sepsis and septic shock in the pediatric emergency department (PED) is crucial for the success of early targeted therapy. The shock index (SI) and pediatric age-adjusted shock index (SIPA) are promising noninvasive tools for early risk stratification. This study aimed to evaluate the predictive performance of SI, SIPA, and modified indexes in severe outcomes.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 238 pediatric patients aged 1 month to 18 years who met systemic inflammatory response syndrome criteria. Clinical findings and vital signs were collected at presentation. SI, SIPA, and modified indices were calculated using heart rate and systolic blood pressure. Biomarkers, including lactate and immature granulocyte percentage (IG%), were also recorded.</p><p><strong>Results: </strong>Of 238 patients, 49 (20.6%) had severe sepsis or septic shock. SI ≥1.81 showed an AUC of 0.815, sensitivity of 81.6%, and specificity of 67.7%. SIPA had a sensitivity of 91.8% but a lower specificity (45.0%). Pediatric Shock Index and Temperature-adjusted and Age-adjusted Mean Shock Index had AUCs of 0.443 and 0.734, respectively. Age-specific SI cutoffs improved predictive performance, particularly in younger children. Combining SI with IG% or lactate enhances diagnostic accuracy.</p><p><strong>Conclusions: </strong>SI and SIPA are practical tools for early recognition of severe sepsis in children. Age-adjusted SI cutoffs improve accuracy. Diagnostic performance was further enhanced when combined with IG% and lactate, supporting their integration in PED clinical decision-making.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resources Utilization May Not Accurately Reflect the Validity of Triage Scales.","authors":"Amir Mirhaghi","doi":"10.1097/PEC.0000000000003437","DOIUrl":"https://doi.org/10.1097/PEC.0000000000003437","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"41 10","pages":"e163-e164"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating a Triage Screen in a Pediatric Emergency Department to Improve Appropriate Identification of Immigrant Populations.","authors":"Leen Bakdash, Amy Zeidan, Anna Q Yaffee","doi":"10.1097/PEC.0000000000003428","DOIUrl":"10.1097/PEC.0000000000003428","url":null,"abstract":"<p><strong>Objectives: </strong>One in 4 children in the United States is part of an immigrant family. Children in immigrant families (CIFs) experience significant disparities in health care quality and access in the pediatric emergency department (PED). Insufficient utilization of interpreters for those with non-English language preference contributes to these disparities. CIFs are often excluded from clinical research studies, impairing efforts to improve their health care access. We evaluated an immigration and language triage screen in a PED to better identify CIF.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of attitudes toward a triage screen identifying country of origin and language preference. Caregivers who entered the assessment/triage room of an urban PED were asked about the caregiver's and child's country of birth, year of arrival to the US, and preferred language. Patients who were born outside the United States or had a caregiver born outside the United States were identified as CIF. Caregivers of CIF were asked to participate in a survey to understand their attitudes toward the screen. Demographics and attitudes toward the triage screen were then analyzed using basic descriptive statistics.</p><p><strong>Results: </strong>CIF were identified in 252 or 21.9% of screened encounters. In 51.2% (n=129) of these encounters, caregivers completed a survey. Ninety-two percent of surveyed families were comfortable with the triage screen. In contrast, almost one third of families endorsed that they would have felt uncomfortable had they been asked their immigration status directly. Eighteen percent of families who needed an interpreter did not have this need identified until after the triage screen.</p><p><strong>Conclusions: </strong>Our findings suggest that a language and immigration triage screen in a PED is feasible and acceptable to improve the identification of CIF and their language needs in electronic medical records with the goal of improving the quality of health care and research for this population.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"766-771"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Facial Petechiae in Infants Evaluated for Excessive Crying.","authors":"Heather L Edward, Jessica Moore, Phinnara Has, Stephanie M Ruest, Amy P Goldberg, Jessica Bagley, Pamela High, Cynthia L Loncar, Christine E Barron","doi":"10.1097/PEC.0000000000003434","DOIUrl":"10.1097/PEC.0000000000003434","url":null,"abstract":"<p><strong>Objectives: </strong>Petechiae on the face in infants are known to be caused by trauma; however, they are also sometimes attributed to infant crying. This study aims to determine the prevalence of facial petechiae in infants with excessive crying.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective record review of 138 infants (under 1 y old) evaluated at a specialized outpatient clinic for crying and fussiness between January 2015 and March 2020. Medical records were reviewed for caregiver-reported crying by clinical history and behavior diaries, and the presence of facial petechiae on physical exam (specifically documented with a checkbox on the exam form). Descriptive statistics were used to describe the average time spent crying, medical history, and prevalence of facial petechiae.</p><p><strong>Results: </strong>There were 138 infants (mean age 2 mo) evaluated by a pediatrician for facial petechiae (N=187 physical exams). Colic was diagnosed in 74% of the infants. Infants were excessive criers with no statistically significant difference between the time that infants were reported to cry and/or fuss per day by caregivers' clinical history (median 4 h/d) and by caregiver-completed home behavior diaries (median 3.8 h/d). No infants had facial petechiae on physical exam.</p><p><strong>Conclusions: </strong>While facial petechiae is believed to be due to excessive crying, this study supports that facial petechiae in infants is rare and that there is no association between crying and facial petechiae. In the absence of medical causes, facial petechiae in infants should be evaluated as a potential traumatic injury and practitioners should consider possible physical abuse.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"796-800"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Ultrasound-Guided Brachial Plexus Blocks Performed by Pediatric Emergency Physicians for the Reduction of Forearm Fractures: A Retrospective Cohort Study.","authors":"Albano de Juan Plaza, Karol Gawelovicz, Emma Edner, Yair Katzir, Fredrik Granath, Johan von Heideken, Aron Kerenyi","doi":"10.1097/PEC.0000000000003444","DOIUrl":"10.1097/PEC.0000000000003444","url":null,"abstract":"<p><strong>Objectives: </strong>Ultrasound-guided nerve blocks are commonly used in pediatric anesthesia and have excellent safety profiles. This study aims to compare outcomes of forearm fracture reductions that were performed using regional anesthesia with ultrasound-guided brachial plexus nerve blocks (UBPB) versus those performed using nitrous oxide (N 2 O) sedation with hematoma block or sedation with ketamine or propofol.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients under 15 years of age who underwent closed forearm fracture reduction in a tertiary care pediatric emergency department from 2019 to 2024. Data were extracted from electronic health records and analyzed for demographic, clinical, and radiographic variables. The primary outcome was the association between sedation method and the likelihood of an unacceptable fracture reduction, adjusted for confounder variables.</p><p><strong>Results: </strong>Three hundred forty-one patients were included in the analysis, and 89 (26.1%) received UBPBs. Unacceptable fracture reduction occurred in 14.8% of cases using N 2 O, 7.9% using UBPB, and 8.5% using ketamine/propofol sedation. Relative to N 2 O, UBPB and ketamine/propofol were associated with adjusted odds ratios of 0.3 (95% CI: 0.1-0.9) and 0.4 (95% CI: 0.1-1.6), respectively, for unacceptable reduction.</p><p><strong>Conclusions: </strong>Our findings indicate that UBPB performed by pediatric emergency physicians is associated with a reduced risk of unacceptable reductions relative to standard methods of sedation. However, prospective studies are necessary to confirm these results.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e150-e155"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Evaluation of Pediatric Emergency Department Visits of Children With Medical Complexity in a Tertiary Care Center in Italy.","authors":"Anna Zanin, Chiara La Piana, Gloria Brigiari, Dario Gregori, Antuan Divisic, Silvia Bressan, Tiziana Zangardi, Susanna Masiero, Franca Benini","doi":"10.1097/PEC.0000000000003463","DOIUrl":"10.1097/PEC.0000000000003463","url":null,"abstract":"<p><strong>Objective: </strong>Children with medical complexity are a growing population with multiple conditions, medical device dependency and frequent need for emergency department (ED) visits; their care and management in an emergency setting may be challenging. The pediatric palliative care (PPC) network aims to address the needs of these children and their families to improve their quality of life.The purpose of this retrospective single-center study was to determine the prevalence and reasons for visiting the ED, the management, outcome, and quality of care received in a Tertiary Care Pediatric Hospital, where the PPC facility is strongly integrated and cooperating with the ED.</p><p><strong>Methods: </strong>We collected data on the 775 pediatric ED visits performed in Padua Pediatric ED between 2006 and 2023 by 85 children under the care of the regional center for PPC in Veneto, Italy.</p><p><strong>Results: </strong>Median number of visits per patient was 2.0 per year, 33.4% resulting in hospital admissions. Most frequent reasons for ED visits were respiratory conditions (28.9%), followed by medical device malfunctions (18.3%). Other data included PPC specialist involvement, ED referral, time of arrival, color code, and type of assistance required. Over the years, there has been an increased number of ED visits, admissions, medical device malfunctions, hours spent in the ED, and involvement of PPC specialists. No significant influences were noted during the COVID-19 pandemic period.</p><p><strong>Conclusion: </strong>These data highlight potential areas of intervention to enhance emergency care management for CMC, such as early PPC specialist involvement with the home care network activation, a specific training of ED providers, and a dedicated service for the management of device malfunctions.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}