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Festekjian A, Hall JE, Zipkin R, Schiff J, Pham PK, Mesropyan L, Araradian C, Nager AL, Chang TP. A checklist intervention for pediatric emergency department transfer of care sign-outs. Am J Emerg Med 2024; 77:215-219. [PMID: 38216365 DOI: 10.1016/j.ajem.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/01/2024] [Accepted: 01/01/2024] [Indexed: 01/14/2024] Open
Affiliation(s)
- Ara Festekjian
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
| | - Jeanine E Hall
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
| | - Ronen Zipkin
- Department of Pediatrics, Division of Hospital Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 94, Los Angeles, CA 90027, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
| | - Jared Schiff
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
| | - Phung K Pham
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027, United States of America
| | - Levon Mesropyan
- University of California Los Angeles, Burbank Pediatrics, 2625 W. Alameda, Suite 300, Burbank, CA 9150, United States of America.
| | - Cynthia Araradian
- Oregon Health Sciences University*, 3181 S.W. Jackson Park Road, Portland, OR 97239, United States of America.
| | - Alan L Nager
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
| | - Todd P Chang
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027, United States of America; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
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Abstract
Innocent heart murmurs are quite common in children and adolescents. These murmurs are physiologic in nature and are not associated with any structural heart disease. Not only does the idea of having a child with a murmur bring unnecessary unrest to families, but the child also often goes through numerous tests that could be avoided. It is critical to obtain a detailed history and perform a thorough physical examination to diagnose these innocent murmurs. This article reviews the different types of innocent murmurs, their characteristics, how they can be differentiated on the physical examination, and most importantly, how they can be differentiated from pathologic murmurs, which require referral to a pediatric cardiologist and additional testing. [Pediatr Ann. 2016;45(8):e306-e309.].
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