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Pediatric Emergency Care

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https://www.readbyqxmd.com/read/28225379/the-presentation-of-a-fussy-infant-with-bruising-late-onset-vitamin-k-deficiency-bleeding
#1
Katherine Wolpert, Matthew Szadkowski, Michael Miescier, Hilary A Hewes
Vitamin K plays an integral role in the clotting cascade. Deficiency, specifically in vulnerable neonates with insufficient stores, can lead to spontaneous bleeding and devastating effects. In this case, we report a young infant with late-onset vitamin K deficiency bleeding who did not receive vitamin K prophylaxis after birth. Initially presenting with bruising and fussiness, the patient was later found to have intracerebral hemorrhage with midline shift and uncal herniation. The infant was not a surgical candidate and died shortly thereafter...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225378/traumatic-ventricular-septal-defect-in-a-1-year-old-boy-after-accidental-chest-compression-by-an-adult
#2
Huang-Wei Wu, Jen-Hung Chien, Ken-Pen Weng, Chu-Chuan Lin, Bo-Hau Chen, Shih-Ming Huang, Yu-Chi Hung
We report a 1-year-old boy with a delayed diagnosis of traumatic ventricular septal defect (VSD) related to chest compression. His cardiac function was stable after adequate medical treatment. Spontaneous closure of traumatic VSD occurred to this patient at the age of 4 years. This is a rare case of traumatic VSD associated with accidental chest compression, which is similar to rupture of the ventricular septum after blunt chest trauma. It should be kept in mind that traumatic VSD and concomitant thoracic injuries can develop during chest compression...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225377/inappropriate-shocks-and-power-delivery-using-adult-automatic-external-defibrillator-pads-in-a-pediatric-patient
#3
Shai Tejman-Yarden, Uriel Katz, Marina Rubinstein, Yehuda Attias, Reem Yahia, David Mishali, Michael Glikson
The use of automatic external defibrillators (AEDs) during pulseless resuscitations is considered safe and reliable, and was established as part of the guidelines in out-of-hospital events. Based on extensive studies, the use of the standard AED is now indicated in every age group with a preference of pediatric pad application for small children and babies. If unavailable, adult pads are recommended. We report a case of 2 inappropriate AED shocks that were delivered to a neonate during a pulseless resuscitation after application of adult pads...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#4
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225375/impact-of-a-child-life-and-music-therapy-procedural-support-intervention-on-parental-perception-of-their-child-s-distress-during-intravenous-placement
#5
Gabriela S Ortiz, Todd OʼConnor, Jessa Carey, Adam Vella, Audrey Paul, Diane Rode, Alan Weinberg
OBJECTIVES: Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225374/characterizing-the-toxicity-and-dose-effect-profile-of-tramadol-ingestions-in-children
#6
Gina L Stassinos, Lawrence Gonzales, Wendy Klein-Schwartz
OBJECTIVES: Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. METHODS: A retrospective evaluation of cases from the National Poison Center Data System between January 1, 2000, and December 31, 2013, was performed...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221282/characteristics-and-triage-of-children-presenting-in-mental-health-crisis-to-emergency-departments-at-detroit-regional-hospitals
#7
Kristen Williams, Amanda R Levine, David M Ledgerwood, Alireza Amirsadri, Leslie H Lundahl
OBJECTIVES: The number of children in the United States utilizing emergency department (ED) services for psychiatric crises is increasing, and psychiatric-related ED visits disproportionately burden hospital resources. Yet, there is limited available information on the epidemiology and outcomes of pediatric mental health emergencies. The present study sought to characterize pediatric mental health-related ED presentations in a large urban center and identify factors predictive of inpatient hospitalization...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221281/first-attempt-success-longevity-and-complication-rates-of-ultrasound-guided-peripheral-intravenous-catheters-in-children
#8
Alexandra M Vinograd, Joseph J Zorc, Anthony J Dean, Mary Kate F Abbadessa, Aaron E Chen
OBJECTIVE: The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department. METHODS: The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221280/the-elusive-diagnosis-of-adolescent-systemic-lupus-erythematosus
#9
Michelino Mancini
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple systems, and its various symptoms are often mistaken for other diseases. This case report describes a 15-year-old girl who presented to the emergency department with complaints of diffuse abdominal pain, facial swelling, joint pain, low-grade fever, and rash. An initial autoimmune process was suspected, and, with prompt referral, a diagnosis of SLE was confirmed. This case report and discussion review the difficulty of diagnosing SLE and the importance of maintaining autoimmune diseases, such as SLE, on an emergency physician's differential...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221279/risk-factors-for-recurrent-intussusception-after-fluoroscopy-guided-air-enema
#10
Jung Heon Kim, Jong Seung Lee, Jeong Min Ryu, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The aim of this study was to identify risk factors for recurrent intussusception after a successful reduction by fluoroscopy-guided air enema, the time required for recurrence, and the association between delayed reduction and the recurrence. METHODS: Medical records of 479 consecutive children with intussusception who underwent fluoroscopy-guided air enema between January 2004 and September 2014 were reviewed. Recurrent intussusception was defined as a recurrence within 48 hours of a reduction...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221278/meta-analysis-of-the-unintentional-death-of-children-aged-0-to-5-years-in-china-between-1995-and-2015
#11
Baoning Su, Jian'er Yu
OBJECTIVES: The aim of this study was to identify the primary cause of and a means by which to prevent the unintentional injury and death of children aged 0 to 5 years in China. METHODS: A systematic review of literature published in this area between 1995 and 2015, accessible via Chongqing VIP, Wanfang, CNKI, and PubMed databases, in addition to other electronic databases and related magazines and professional information, was conducted. The data were retrieved using Cochrane Systematic review methods...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#12
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28169981/carbon-monoxide-intoxication-of-childhood
#13
Leah K Middelberg, Neeraj Chhabra, Mark B Mycyk
No abstract text is available yet for this article.
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28169980/epidemiologic-characteristics-of-pediatric-trauma-patients-receiving-prehospital-care-in-kigali-rwanda
#14
Adam R Aluisio, Olivier Félix Umuhire, Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Jeanne DʼArc Nyinawankusi, Eric Uwitonze, Sam Enumah, John W Scott, Zeta Mutabazi, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Jean Claude Byiringiro, Adam C Levine
BACKGROUND: Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali by emergency medical services in Kigali, Rwanda. METHODS: This cohort study was conducted at the Centre Hospitalier Universitaire de Kigali from December 2012 to February 2015...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28169979/acute-focal-dystonia-after-a-single-dose-of-oral-cetirizine-in-a-9-year-old-boy
#15
Indar Kumar Sharawat, Lesa Dawman
Common cold is an acute illness affecting pediatric population in particular. The use of antihistamines is a common practice, with cetirizine being a frequently used drug with a good safety profile. However, adverse events due to the use of antihistamines have been rarely reported, such as drug-induced dystonia with the use of cetirizine. In our present case, dystonia due to the intake of cetirizine was observed, which the patient responded well to the use of benzodiazapines, namely, clonazepam. We report this case to highlight the occurrence of this adverse event with the use of cetirizine...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28169978/analysis-of-patient-visits-and-collections-after-opening-a-satellite-pediatric-emergency-department
#16
Katherine M Nichols, Kerry Caperell, Keith Cross, Scott Duncan, Ben Foster, Gil Liu, Hank Pritchard, Gary Southard, Ben Shinabery, Brad Sutton, In K Kim
OBJECTIVE: Satellite pediatric emergency departments (PEDs) have emerged as a strategy to increase patient capacity. We sought to determine the impact on patient visits, physician fee collections, and value of emergency department (ED) time at the primary PED after opening a nearby satellite PED. We also illustrate the spatial distribution of patient demographics and overlapping catchment areas for the primary and satellite PEDs using geographical information system. METHODS: A structured, financial retrospective review was conducted...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072667/does-the-use-of-a-vein-visualization-device-for-peripheral-venous-catheter-placement-increase-success-rate-in-pediatric-patients
#17
Duygu Demir, Sevil Inal
BACKGROUND: Peripheral intravenous catheterization is one of the most frequently encountered medical procedures for hospitalized children and is one that can often be painful. Pediatric nurses should therefore use techniques that increase the success rate or shorten the duration of peripheral intravenous catheterization. OBJECTIVES: This study was performed with the objective of determining the effect of using a vein visualization device on the success of the procedure...
February 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28146013/a-practice-guideline-for-postreduction-management-of-intussusception-of-children-in-the-emergency-department
#18
Hyuksool Kwon, Jin Hee Lee, Jin Hee Jeong, Hye Ran Yang, Young Ho Kwak, Do Kyun Kim, Kyuseok Kim
OBJECTIVES: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence. METHODS: We developed a practice guideline of postreduction management of intussusception in the PED. The practice guideline involved feeding 2 hours after reduction and discharge 2 hours after successful feeding...
January 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28146012/identification-of-optic-nerve-swelling-using-point-of-care-ocular-ultrasound-in-children
#19
Ronald F Marchese, Rakesh D Mistry, Gil Binenbaum, Grant T Liu, Richard J Scarfone, Ashley L Woodford, Aaron E Chen
OBJECTIVE: The aim of this study was to determine the feasibility and accuracy of point-of-care (POC) ocular ultrasound (US) when performed by a pediatric emergency medicine (PEM) physician to detect optic nerve abnormalities concerning for swelling, as compared with the fundus examination performed by an ophthalmologist. METHODS: This was a single-center, prospective cohort pilot study of children aged 12 months to 18 years who required optic disc evaluation by an ophthalmologist...
January 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28121978/a-vibrating-cold-device-to-reduce-pain-in-the-pediatric-emergency-department-a-randomized-clinical-trial
#20
Debra Ann Potts, Katherine Finn Davis, Okan U Elci, Joel A Fein
OBJECTIVE: Pain of intravenous (IV) catheter insertion can be mitigated with appropriate analgesia, thereby avoiding unnecessary distress. Our objective was to compare the self-reported pain of IV catheter insertion in children when using a vibrating cold device (VCD) versus standard of care 4% topical lidocaine cream (TL). METHODS: This was a 2-arm randomized controlled noninferiority trial with a convenience sample of 4- to 18-year-olds requiring nonemergent IV catheter insertion...
January 24, 2017: Pediatric Emergency Care
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