Children's Hospital Los Angeles

THURSDAY, Nov. 21, 2024 -- A sprain on the soccer field. A tumble to the floor at home. Kids get injured, but as a parent, when's the right time to bring them to a doctor or ER? Pediatric sports medicine and orthopedic physician Dr. Bianca Edison , of Children's Hospital Los Angeles, offers up guidance for worried moms and dads. First of all, she said, don't assume that childhood injuries are seldom severe: Edison pointed to U.S. Centers for Disease Control and Prevention statistics, showing that nearly half (45%) of playground injuries involve fractures, dislocations, concussions and other harms serious enough to need urgent medical attention. She broke down child injuries into four types: head injuries, mouth/tooth injuries, fractures and eye injuries. Head injuries A knock to the noggin isn't an uncommon event for rambunctious kids. But certain symptoms may signal that more than a hug is needed to help your child. “They include severe crankiness above and beyond what the child normally displays, multiple vomiting episodes, slurred speech, different pupil sizes and a sudden change in the way the child walks,” according to Edison. “These symptoms are of significant concern and need immediate medical attention.” There are certain metrics that can also help, especially when it comes to head injuries linked to falls. If the child is less than 2 years old and falls more than 3 feet, or is over age 2 and falls more than 5 feet, a trip to the emergency room is in order, the Los Angeles physician said. Certainly, if you feel any dent or depression on your's child's head, take them to immediate medical care, Edison added. That could point to a skull fracture. Any bruising in or around the eyes is another red flag, as is blood draining from the nose or ears. Once you're at the hospital, a CT scan may be required if any of these symptoms or events are involved: “These symptoms or situations indicate or may produce increased pressure in the brain, swelling of the brain or actual bleeding in the brain,” Edison explained. Eye injuries There are clear warning signs that emergency care is needed whenever a child's eye is injured: “Ask the child to follow your finger,” Edison instructed. “If one eye follows it and the other eye stays straight, or if there’s pain with the movement of one of the eyes, there may be more significant trauma to the injured eye, or there might be an infection brewing within it.” Injuries to the mouth or teeth Very young children who are still mastering walking can sometime tumble and damage the mouth or teeth. If that means a child loses a primary ("baby") tooth, that's typically not an emergency, Edison said, although having the child see a dentist over the next 24 hours is warranted. For older children, however, any injury to a permanent tooth is a dental emergency, she said. If the child loses a tooth, be sure to retrieve it, wash it with saline or warm water, being sure to hold the tooth by its crown, not its root. After the tooth is properly rinsed, you can actually re-implant it yourself, making sure you have correctly positioned in your child's mouth, Edison said. Hold the tooth in place with a moist napkin or paper towel. “You should do this within five to 20 minutes of the tooth falling out so the roots of the tooth don’t die,” she added. An adult should always hold the tooth in place with a moist napkin or paper towel. Don't let your child do this themselves, because they may not hold the tooth still, or the tooth could loosen away from the jaw and pose a choking hazard. If re-implanting the tooth is tough, or there are multiple missing teeth, seek out emergency dental care. “All missing teeth should be accounted for,” Edison said, “and follow up with your child’s dentist to ensure there’s not an underlying injury.” Fractures Skateboarding, football, climbing trees: Kids find many different way to fracture a bone. But the most common cause of fractures is a simple tumble from a bed, changing table or sofa by a baby or toddler, Edison noted. “All it takes is the right angle and the right force to the bone for a fracture to occur,” she said. For infants and toddlers, the most common fracture sites are the elbow, wrist, collar bone, lower leg and finger. Fractures typically show key characteristics, such as immediate swelling at the site of the injury, deformity and reluctance by your child to use the injured body part. They might keep the fractured arm close to their body, for example, or "favor" a leg or foot and not put weight on it. Any fracture requires a doctor's immediate attention. Look for one of these "5 Ps," each of which warrant taking a child to the ER: Make sure your child is taken to a facility with scanning technologies such as X-rays. Knowing the above tips can help moms and dads react quickly and effectively when injuries occur. “Kids are active and curious and injuries will occur, no matter how many safety precautions are put in place,” Edison said in a hospital news release. “That’s why it’s important to know what to do when something happens.” SOURCE: Children's Hospital Los Angeles, news release, Nov. 4, 2024 Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

The Associated Press reported recently that it has interviewed more than a dozen software engineers, developers and academic researchers who take issue with a claim by artificial intelligence developer OpenAI that one of its machine learning tools, which is used in clinical documentation at many U.S. health systems, has human-like accuracy. WHY IT MATTERS Researchers at the University of Michigan and others found that AI hallucinations resulted in erroneous transcripts – sometimes with racial and violent rhetoric, in addition to imagined medical treatments – according to the AP. Of concern is the widespread uptake of tools that use Whisper – available open source or as an API – that could lead to erroneous patient diagnoses or poor medical decision-making. Hint Health is one clinical technology vendor that added the Whisper API last year in order to give doctors the ability to record patient consultations within the vendor's app and transcribe them with OpenAI's large language models. Meanwhile, more than 30,000 clinicians and 40 health systems, such as Children’s Hospital Los Angeles, use ambient AI from Nabla that incorporates a Whisper-based tool. Nabla said Whisper has been used to transcribe approximately seven million medical visits, according to the report . A spokesperson for that company cited a blog posted on Monday that addresses the specific steps the company takes to ensure models are appropriately used and monitored in usage. "Nabla detects incorrectly generated content based on manual edits to the note and plain language feedback," the company said in the blog. "This provides a precise measure of real-world performance and gives us additional inputs to improve models over time." Of note, Whisper is also integrated into some versions of OpenAI’s flagship chatbot ChatGPT, and is a built-in offering in Oracle and Microsoft’s cloud computing platforms, according to the AP. Meanwhile, OpenAI warns users that the tool should not be used in "high-risk domains" and recommends in its online disclosures against using Whisper in "decision-making contexts, where flaws in accuracy can lead to pronounced flaws in outcomes." "Will the next model improve on the issue of large-v3 generating a significant amount of hallucinations?," one user asked on OpenAI's GitHub Whisper discussion board on Tuesday. A question that was unanswered at press time. "This seems solvable if the company is willing to prioritize it,” William Saunders, a San Francisco-based research engineer who left OpenAI earlier this year, told the AP. "It’s problematic if you put this out there and people are overconfident about what it can do and integrate it into all these other systems." Of note, OpenAI recently posted a job opening for a health AI research scientist, whose chief responsibilities would be to "design and apply practical and scalable methods to improve safety and reliability of our models" and "evaluate methods using health-related data, ensuring models provide accurate, reliable and trustworthy information." THE LARGER TREND In September, Texas Attorney General Ken Paxton announced a settlement with Dallas-based artificial intelligence developer Pieces Technologies over allegations that the company's generative AI tools had put patient safety at risk by overpromising accuracy. That company uses genAI to summarize real-time electronic health record data about patient conditions and treatments. And in a study looking at LLM accuracy in producing medical notes by the University of Massachusetts Amherst and Mendel, an AI company focused on AI hallucination detection, there were many errors. Researchers compared Open AI's GPT-4o and Meta's Llama-3 and found of 50 medical notes, GPT had 21 summaries with incorrect information and 50 with generalized information, while Llama had 19 errors and 47 generalizations. ON THE RECORD "We take this issue seriously and are continually working to improve the accuracy of our models, including reducing hallucinations," a spokesperson for OpenAI told Healthcare IT News by email Tuesday. "For Whisper use on our API platform, our usage policies prohibit use in certain high-stakes decision-making contexts, and our model card for open-source use includes recommendations against use in high-risk domains. We thank researchers for sharing their findings." Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS Media publication.

IRVING, Texas--( BUSINESS WIRE )-- Vizient, Inc. announced top performers in clinical quality, supplier diversity and environmental sustainability excellence. The awards recognize the achievements of participating hospitals and health systems in patient care quality and supply chain excellence and were announced at Vizient Connections Summit Sept. 17 in Las Vegas. “Top performers set a precedent in leadership and culture for other health systems and hospitals to follow," said Byron Jobe , Vizient president and CEO. "We celebrate each of these organizations for their efforts to deliver cost-effective, high-quality patient care in their communities." The Bernard A. Birnbaum, MD, Quality Leadership Award recognizes participating healthcare organizations in four cohorts through the Vizient Quality and Accountability Study, which measures performance on the quality of patient care in six domains: safety, mortality, effectiveness, efficiency, patient centeredness and equity. The study factors in measures from the Vizient Clinical Data Base and includes performance data from the HCAHPS survey and the CDC's National Healthcare Safety Network. Top performers in the comprehensive academic medical center cohort are: NYU Langone Health Rush University Medical Center UC Irvine Medical Center Houston Methodist Hospital Intermountain Medical Center Memorial Hermann - Texas Medical Center UCSF Medical Center Froedtert Health - Froedtert Hospital UC San Diego Health Northwestern Memorial Hospital Mayo Clinic Rochester The University of Kansas Hospital Keck Hospital of USC University of Utah Hospitals and Clinics Top performers in the large, specialized complex care medical center cohort are: St George Regional Hospital Houston Methodist Willowbrook Hospital NYU Langone Hospital - Long Island Cleveland Clinic - Fairview Hospital Baptist Memorial Hospital - North Mississippi ThedaCare Regional Medical Center-Neenah Novant Health Presbyterian Medical Center Memorial Hermann - The Woodlands Hospital Mayo Clinic Health System in Eau Claire NewYork-Presbyterian - Brooklyn Methodist Hospital Mayo Clinic Florida McKay-Dee Hospital Center NYU Langone Hospital - Brooklyn Utah Valley Regional Medical Center Fairview Southdale Hospital Endeavor Health - Evanston Hospital Northwestern Medicine Central DuPage Hospital AdventHealth Daytona Beach Top performers in the complex care medical center cohort are: Houston Methodist The Woodlands Hospital Houston Methodist West Houston Hospital Houston Methodist Baytown Hospital Houston Methodist Sugar Land Hospital Northwestern Medicine Delnor Hospital AdventHealth Fish Memorial AdventHealth Palm Coast Odessa Regional Medical Center Northwestern Medicine Lake Forest Hospital The Chester County Hospital and Health System Northwestern Medicine McHenry Hospital ThedaCare Regional Medical Center-Appleton Corewell Health Grosse Pointe Hospital AdventHealth New Smyrna Beach Greenwich Hospital St. Joseph Medical Center Prisma Health Baptist Hospital AdventHealth Celebration The Medical Center of Southeast Texas Saddleback Memorial Medical Center-Laguna Hills Campus UCHealth Highlands Ranch Hospital Stanford Tri-Valley Endeavor Health - Highland Park Hospital Top performers in the community hospital cohort are: Novant Health Mint Hill Medical Center Alta View Hospital Parkview Huntington Hospital Cedar City Hospital Mountain West Medical Center Lehigh Valley Hospital - Hecktown Oaks Parkview Noble Hospital University of Kansas Health Systems - Great Bend Campus Garrett Regional Medical Center Riverton Hospital Parkview Whitley Hospital Corewell Health Zeeland Hospital Fairview Northland Regional Hospital Houston Methodist Clear Lake Hospital Barnes-Jewish West County Hospital Mayo Clinic Health System in Fairmont Prisma Health Hillcrest Hospital Layton Hospital Prisma Health Greer Memorial Hospital OhioHealth O'Bleness Hospital Froedtert & the Medical College of Wisconsin Holy Family Memorial Southeast Georgia Health System-Camden Campus INTEGRIS Grove Hospital Sharon Hospital Baptist Medical Center - Nassau Fairview Lakes Medical Center Integris Miami CHRISTUS Spohn Hospital Beeville The Rising Star Award recognizes academic medical centers that made significant improvement in care quality, measured by a rise in at least 20 positions in the annual Vizient Quality and Accountability Study from the prior year and scoring in the top 25. Rising Stars are: Penn State Health Milton S Hershey Medical Center NewYork-Presbyterian Weill Cornell Medical Center University of Chicago Medicine The Vizient Ambulatory Quality and Accountability Award measures the quality of outpatient care in five domains: access to care, continuum of care, quality, efficiency, and equity. The composite scoring system uses patient-level data from the AAMC-Vizient Clinical Practice Solutions Center ® , Vizient Access and Throughput data, as well as data from the Vizient Clinical Data Base. Top performers are: UCLA Health Systems Clinics NYU Langone Health University of Utah Health UCI Health Rush University Medical Group The Vizient Supplier Diversity Excellence Award recognizes provider clients across five cohorts on how they champion inclusion in their supply chain and accelerate economic growth in their local community. Selection criteria is based on contract purchases of minority-, woman-, veteran-, LGBT- and disabled person-owned business enterprises as a percentage of a provider client’s Vizient spend. The top performers are: Comprehensive academic medical center: University of Maryland Medical System Large, specialized complex care medical center: Novant Health Complex care medical center: Memorial Hermann Health System Pediatric cohort: Children’s Hospital of Philadelphia The Environmental Sustainability Excellence Award ranks members across five cohorts on contributions to human and environmental health through responsible purchasing decisions. Ranking is based on the purchase of products that meet Vizient's Environmentally Preferred Purchasing Standard as well as those who commit to the White House-Health and Human Services Health Sector Climate Pledge. The top performers are: Comprehensive academic medical center: Stony Brook University Hospital Large, specialized complex care medical center: Memorial Health Complex care medical center cohort: Legacy Health Community hospitals: Buchanan General Hospital Pediatric: Children’s Hospital Los Angeles About Vizient, Inc. Vizient, Inc. , the nation’s largest provider-driven healthcare performance improvement company, serves more than 65% of the nation’s acute care providers, including 97% of the nation’s academic medical centers, and more than 35% of the non-acute market. The Vizient contract portfolio represents $140 billion in annual purchasing volume enabling the delivery of cost-effective, high-value care. With its acquisition of Kaufman Hall in 2024, Vizient expanded its advisory services to help providers achieve financial, strategic, clinical and operational excellence. Headquartered in Irving, Texas, Vizient has offices throughout the United States. Learn more at www.vizientinc.com .