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[log in to unmask],Internet writes:
>From: Steven Mendes <[log in to unmask]>
>Subject: Pulm. Hemosiderosis
>Date: Wed, 27 Aug 1997 22:13:58 -0400
 
>I recently learned that a fairly well appearing child with known
>pulmonary
>hemosiderosis can deteriorate extremely fast.  Do you always admit these
>children to the PICU, or do they sometimes go to the floors?
 
 
>Thanks,
>Steve
>________________________________________
 
>Steven J. Mendes, MD, MPH
>Third Year Resident
>Department of Pediatrics
>Hasbro Children's Hospital
>Brown University School of Medicine
>Providence, RI
 
>e-mail address: [log in to unmask]
 
>For more information, send mail to [log in to unmask] with the
>message: info PED-EM-L
>The URL for the PED-EM-L Web Page is:
>  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
I am familiar with the level of care available in your PICU and on your
floor services given that I did my fellowship at Hasbro (Hi Ya'll).
However, I would pose the question from another point of view.  We are
not the accepting MD for any patient admitted from the ED to the floor
or PICU for any concern.  It should be based on the accepting MD's
available resources, level of monitoring, and confort level with each
patient at each particular institution that dictates the answer to this
question.  This may vary greatly.  For example, our group of MDs work
at two different children's hospitals but we admit to the same group of
PICU attendings. At one of our hospitals this child would probably go
to the floor with very close monitoring and transfer to the PICU at any
signs of worsening.  At our other institution we would probably not
hesitate putting the child in the PICU for closer monitoring than would
be available on the floor.
 
Hal Simon
 
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html