The treatment of pediatric XXXX : a comparative analysis of pediatric emergency physicians' practice patterns.

@entity1 @entity697 @entity2700 @entity3974 @entity341 @entity391 @entity1902
OBJECTIVES: @entity697 is a very common @entity341 ( @entity341 ) diagnosis accounting for greater than 1.5 million outpatient visits and 200,000 hospitalizations annually among @entity1 in the United States. Although guidelines exist to assist clinicians, they do not clearly address topics for which evidence is new or limited, including the use of antiemetic agents, probiotics, and intravenous (IV) fluid rehydration regimens. This study sought to describe the @entity341 treatments administered to @entity1 with @entity697 and to compare management between Canadian and U.S. physicians practicing pediatric emergency medicine (PEM). METHODS: Members of PEM research networks located in Canada and the United States were invited to participate in a cross-sectional, Internet-based survey. @entity1 were included if they are attending physicians and provide care to @entity1 <18 years of age in an @entity341 . RESULTS: In total, 235 of 339 (73%) eligible individuals responded. A total of 103 of 136 Canadian physicians (76%) report initiating oral rehydration therapy (ORT) in @entity1 with moderate @entity2700 , compared with 44 of 94 (47%) of their U.S. colleagues (p<0.001). The latter more often administer antiemetic agents to @entity1 with @entity391 (67% vs. 45%; p=0.001). American physicians administer larger IV fluid bolus volumes (p<0.001) and over shorter time periods (p=0.001) and repeat the fluid boluses more frequently (p<0.001). Probiotics are routinely recommended by only 35 of 230 respondents (15%). CONCLUSIONS: The treatment of pediatric @entity1902 varies by geographic location and differs significantly between Canadian and American PEM physicians. Oral rehydration continues to be underused, particularly in the United States. Probiotic use remains uncommon, while @entity3974 administration has become routine. @entity1 frequently receive IV rehydration, with the rate and volume administered being greater in the United States.
