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Pediatric Emergency Care

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https://www.readbyqxmd.com/read/28099296/a-reexamination-of-the-accuracy-of-the-broselow-tape-as-an-instrument-for-weight-estimation
#1
Muhammad Waseem, Justin Chen, Mark Leber, Ashley E Giambrone, Linda M Gerber
BACKGROUND: Accurate weight estimation is important for calculating appropriate medication dosages, determining rates of fluid replacement, and selecting correct equipment sizes in critically ill children requiring resuscitation. The actual measurement of the weight of a critically ill or injured child is often not possible. The Broselow Pediatric Emergency Tape (BT) is an important tool for predicting a child's weight based on his/her height. Although BT has previously been validated, given the increasing prevalence of obesity in today's society, it behooves clinicians relying on this resuscitation aid to revisit the issue...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28099295/comparison-of-resource-utilization-and-length-of-hospitalization-between-overweight-and-healthy-weight-pediatric-trauma-patients-presenting-to-a-pediatric-emergency-department-with-moderate-to-severe-injury-a-prospective-study
#2
Theresa Romano, Ioannis Koutroulis, Evan Weiner, Anthony Little, Sabina Singh
OBJECTIVES: Our study aimed to compare overweight and healthy-weight pediatric trauma patient outcomes, specifically with respect to hospital length of stay and resource utilization. We hypothesized that overweight pediatric trauma patients would have increased hospital length of stay and radiographic study use compared with their healthy-weight counterparts. METHODS: This was a prospective, observational, cohort study of pediatric trauma patients aged 2 to 19 years presenting to an urban pediatric emergency department over a period of 1 year...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28099294/examination-of-pediatric-radiation-dose-delivered-after-cervical-spine-trauma
#3
Laura K Somppi, Kristin A Frenn, Anupam B Kharbanda
OBJECTIVES: Pediatric cervical spine injuries (CSIs) are rare but potentially fatal injuries. Plain radiographs (x-rays) and computed tomography (CT) are used to diagnose CSIs. Given concerns related to radiation exposure, the utility of x-rays in diagnosing CSIs compared with other forms of imaging must be examined. METHODS: Patients younger than 19 years presenting with possible CSI to an urban tertiary care hospital who received imaging for possible CSI between January 1, 2011, and December 31, 2013, were included...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28099293/validating-a-clinical-prediction-rule-for-ventricular-shunt-malfunction
#4
Tehnaz P Boyle, Amir A Kimia, Lise E Nigrovic
OBJECTIVE: This study aims to validate a published ventricular shunt clinical prediction rule for the identification of children at low risk for ventricular shunt malfunction based on the absence of 3 high-risk clinical predictors (irritability, nausea or vomiting, and headache). METHODS: We identified children aged 21 years and younger with a ventricular shunt who presented between 2010 and 2013 to a single pediatric emergency department (ED) for evaluation of potential shunt malfunction...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28099292/evaluating-the-necessity-of-antibiotics-in-the-treatment-of-acute-epididymitis-in-pediatric-patients-a-literature-review-of-retrospective-studies-and-data-analysis
#5
Thomas A Cristoforo
OBJECTIVES: This literature review and data analysis aims to evaluate the percentage of pediatric patients with acute epididymitis found to have bacterial etiology and the percentage of patients in these studies that were treated with antibiotic therapy versus conservative therapy. METHODS: A search of EBSCO through January 13, 2016, using the key words epididymitis or epididymo-orchitis and child, children, or pediatric, identified 542 potential studies.Twenty-seven retrospective studies met the inclusion criteria, containing patients aged 21 years or younger with acute epididymitis or epididymo-orchitis...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072673/the-use-of-ultrasound-measured-optic-nerve-sheath-diameter-to-predict-ventriculoperitoneal-shunt-failure-in-children
#6
Sophia D Lin, Kimberly R Kahne, Amira El Sherif, Kevin Mennitt, David Kessler, Mary J Ward, Shari L Platt
OBJECTIVE: The goal of this study was to assess the accuracy of ultrasound-measured optic nerve sheath diameter (ONSD) as a screen for ventriculoperitoneal shunt failure. METHODS: We prospectively enrolled a convenience sample of children presenting to the ED with suspected shunt failure. The ONSD was measured by ultrasound and compared with computed tomography/magnetic resonance imaging (CT/MRI) and neurosurgical impression. We defined shunt failure on ultrasound as an ONSD greater than 4...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072672/a-simplified-electroencephalogram-monitoring-system-in-the-emergency-room
#7
Masahiro Nozawa, Hiroshi Terashima, Satoshi Tsuji, Masaya Kubota
OBJECTIVES: The study aims to assess the clinical usefulness and related limitations of our simplified emergency electroencephalography (eEEG) as an assessment tool of lethal abnormal brain waves in the emergency room (ER). METHODS: Electrodes were placed on 4 places: bilateral frontal poles and parietal regions. The derivations to judge consisted of only 2 bipolar leads on the left and right. Abnormal wave was defined as either persistent rhythmic waves or persistent high-amplitude slow waves (<2 Hz)...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072671/evaluation-of-the-association-of-early-elevated-lactate-with-outcomes-in-children-with-severe-sepsis-or-septic-shock
#8
Noelle Gorgis, Jeannette M Asselin, Cynthia Fontana, R Scott Heidersbach, Heidi R Flori, Shan L Ward
OBJECTIVE: The aim of the study was to assess the association of initial lactate (L0) with mortality in children with severe sepsis. METHODS: This prospective cohort study included 74 patients younger than 18 years with severe sepsis admitted to the pediatric intensive care unit (PICU) of a tertiary, academic children's hospital with lactate measured within 3 hours of meeting severe sepsis or septic shock. The primary outcome was in-hospital mortality. The secondary outcomes included PICU and hospital length of stay...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072670/instruments-to-identify-commercially-sexually-exploited-children-feasibility-of-use-in-an-emergency-department-setting
#9
Stephanie Armstrong
OBJECTIVE: This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. METHODS: Four electronic databases were searched to identify screening instruments that assessed solely for commercial sexual exploitation. Search terms included "commercially sexually exploited children," "CSEC," "domestic minor sex trafficking," "DMST," "juvenile sex trafficking," and "JST...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072669/swimming-pool-electrical-injuries-steps-toward-prevention
#10
Jun Tashiro, Cathy A Burnweit
OBJECTIVE: Electrical injuries in swimming pools are an important pediatric public health concern. We sought to (1) improve our understanding of the clinical presentation and outcomes following and (2) describe the epidemiology of swimming pool electrical injuries in the United States. METHODS: We reviewed 4 cases of pediatric (<18 y old) electrical injury from a single, urban level 1 pediatric trauma center. We also queried the National Electronic Injury Surveillance System (NEISS) for emergency department visits due to electrical injury associated with swimming pools, occurring between 1991 and 2013...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072668/genital-and-extragenital-gonorrhea-and-chlamydia-in-children-and-adolescents-evaluated-for-sexual-abuse
#11
Nancy D Kellogg, John D Melville, James L Lukefahr, Shalon M Nienow, Edward L Russell
OBJECTIVE: The aim of this study was to describe the use of a nucleic acid amplification test in detecting genital and extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in children and adolescents assessed for sexual abuse/assault. METHODS: The charts of children aged 0 to 17 years, consecutively evaluated for sexual victimization, in emergency department and outpatient settings were reviewed. Data extracted included age, sex, type of sexual contact, anogenital findings, previous sexual contact, toxicology results, and sites tested for NG and CT...
January 9, 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
#12
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...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072666/outcomes-from-referrals-and-unscheduled-visits-from-community-emergency-departments-to-a-regional-pediatric-emergency-department-in-canada
#13
Ethan Reiner, Ardalan Ahmadi, Eric Grafstein, Quynh Doan
OBJECTIVES: Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. METHODS: We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072665/idiopathic-unilateral-paralysis-of-the-palate-in-a-youth
#14
Olcay Güngör, Serkan Kirik, Sedat Işikay, Gülay Güngör, Nagihan Bilal
Unilateral isolated paralysis of the soft palate is a rare clinical entity that is associated with rhinolalia and the flow of nasal fluids from the nostril on the affected side. We report a case of a 17-year-old boy admitted complaining of nasal speech and drinks flowing into his right nostril. Most cases of soft palate palsy are idiopathic, whereas a few cases are caused by viral infections or tumors. We describe an isolated case of soft palate palsy with spontaneous recovery within 1 month.
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072664/clinical-pathway-effectiveness-febrile-young-infant-clinical-pathway-in-a-pediatric-emergency-department
#15
Ashlee Lynn Murray, Elizabeth Alpern, Jane Lavelle, Cynthia Mollen
OBJECTIVE: Young infants are often treated in emergency departments (EDs) for febrile illnesses. Any delay in care or ineffective management could lead to increased patient morbidity and mortality. A standardized ED clinical pathway may improve care for these patients. The objective of this study is to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care. METHODS: This study used a before-and-after retrospective observational study design comparing 2 separate periods: prepathway from September 2007 through August 2008 and postpathway from September 2009 through August 2010...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28067687/a-case-of-toxic-breast-feeding
#16
Megan L Schultz, Mark Kostic, Sigmund Kharasch
Opiates are frequently prescribed postpartum for pain relief after cesarean delivery, episiotomies, and headaches. It is estimated that greater than 30% of breast-feeding mothers in the United States are prescribed opiates for pain relief associated with childbirth. Many opiates are readily transferred to human milk, although life-threatening events are rare. We report a 6-day-old breast-feeding infant whose mother was taking hydromorphone for pain relief from a cesarean delivery and whose clinical course was suggestive of opiate toxicity...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28067686/persistent-knee-pain-after-falling-off-of-a-bicycle
#17
Muhammad Waseem, Julissa Garrido-Joyce, Frances Quee, Soula Priovolos
We present the case of an 18-year-old young man with severe persistent knee pain secondary to a popliteal artery thrombosis. This occurred as a result of a fall from a bicycle. Acute compartment syndrome refers to the sequelae that can occur because of increased fascial compartment pressures, such as crush injuries, burns, traumatic or spontaneous hemorrhage, or constrictive casts. Increased pressures in nonelastic fascial compartments result in decreased perfusion distally, leading to ischemia of muscles and neurovascular tissue...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28067685/association-between-initial-emergency-department-lactate-and-use-of-vasoactive-medication-in-children-with-septic-shock
#18
Michael J Miescier, Roni D Lane, Xiaoming Sheng, Gitte Y Larsen
OBJECTIVES: Current guidelines emphasize early recognition of pediatric septic shock using clinical examination findings. Elevated serum lactate has been associated with increased mortality in adult patients with septic shock. Our objective was to determine the association between the initial serum lactate obtained in the pediatric emergency department (PED) from patients treated for septic shock and the use of vasoactive medication within 24 hours. METHODS: This was a retrospective study from 2008 through 2012 of PED patients at a tertiary care children's hospital...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28030520/parent-perceptions-on-transfers-to-pediatric-emergency-departments-and-the-role-of-telemedicine
#19
Cynthia J Mollen, Mira Henien, Lisa M Jacobs, Sage Myers
OBJECTIVE: Real-time audiovisual consultation (telemedicine) has been proven feasible and is a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternative to transfer. METHODS: Semistructured interviews of caregivers of patients transferred to a pediatric emergency department. Purposive sampling was used to recruit caregivers of patients who were transferred from varying distances and different times of the day...
December 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28030519/incorporating-a-computerized-cognitive-battery-into-the-emergency-department-care-of-pediatric-mild-traumatic-brain-injuries-is-it-feasible
#20
Aneesh M Khetani, Brian L Brooks, Angelo Mikrogianakis, Karen M Barlow
OBJECTIVES: The use of computers to test cognitive function acutely after a concussion is becoming increasingly popular, especially after sport-related concussion. Although commonly performed in the community, it is not yet performed routinely in the emergency department (ED), where most injured children present. The challenges of performing computerized cognitive testing (CCT) in a busy ED are considerable. The aim of this study was to evaluate the feasibility of CCT in the pediatric ED after concussion...
December 28, 2016: Pediatric Emergency Care
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