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Pediatric Emergency Care

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https://www.readbyqxmd.com/read/28538609/critical-care-interventions-for-asthmatic-patients-admitted-from-the-emergency-department-to-the-pediatric-intensive-care-unit
#1
Kristen Michelle Cundiff, James M Gerard, Robert G Flood
OBJECTIVES: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital. METHODS: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538608/assessing-dehydration-employing-end-tidal-carbon-dioxide-in-children-with-vomiting-and-diarrhea
#2
Stephen B Freedman, David W Johnson, Alberto Nettel-Aguirre, Angelo Mikrogianakis, Sarah Williamson-Urquhart, Nicholas Monfries, Adam Cheng
OBJECTIVE: Serum bicarbonate reflects dehydration severity in children with gastroenteritis. Previous work in children receiving intravenous rehydration has correlated end-tidal carbon dioxide (EtCO2) with serum bicarbonate. We evaluated whether EtCO2 predicts weight change in children with vomiting and/or diarrhea. METHODS: A prospective cohort study was conducted. Eligible children were 3 months to 10 years old and presented for emergency department (ED) care because of vomiting and/or diarrhea...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538607/evaluation-of-highest-level-pediatric-trauma-activation-criteria
#3
Jessica A Zagory, Minna M Wieck, Brooke E Lerner, Suzanne Moody, Richard A Falcone, Rita V Burke
BACKGROUND: Despite the presence of a tiered in-hospital trauma triage system for the past decade, trauma centers still struggle with a definitive list of highest level activation criteria. In 2002, the American College of Surgeons (ACS) mandated 6 criteria for highest level activation. However, it is unknown if pediatric trauma centers follow these criteria. The purpose of this study is to identify and categorize the highest level pediatric trauma criteria used by pediatric trauma centers in the United States...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538606/assessing-severity-in-pediatric-pneumonia-predictors-of-the-need-for-major-medical-interventions
#4
Are Stuwitz Berg, Christopher Stephen Inchley, Hans Olav Fjaerli, Truls Michael Leegaard, Britt Nakstad
OBJECTIVE: The aim of this study was to determine potential predictors of the need for major medical interventions in the context of assessing severity in pediatric pneumonia. METHODS: This was a prospective, cohort study of previously healthy children and adolescents younger than 18 years presenting to the pediatric emergency room with clinically suspected pneumonia and examining both the full cohort and those with radiologically confirmed pneumonia. The presence of hypoxemia (peripheral oxygen saturation ≤92%), age-specific tachypnea, high temperature (≥38...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538605/the-heads-ed-evaluating-the-clinical-use-of-a-brief-action-oriented-pediatric-mental-health-screening-tool
#5
Mario Cappelli, Roger Zemek, Christine Polihronis, Nathalie R Thibedeau, Allison Kennedy, Clare Gray, Mona Jabbour, Sarah Reid, Paula Cloutier
OBJECTIVES: This effectiveness study aimed to evaluate the clinical use of the HEADS-ED tool for patients presenting to a pediatric emergency department (PED) for mental health (MH) care. METHODS: In this pragmatic trial, PED physicians used the HEADS-ED to guide their assessment and identify areas of MH need in 639 patients (mean [SD], 15.16 [1.40] years; female, 72.6%) who presented to the emergency department with MH concerns between May 2013 and March 2014. RESULTS: The HEADS-ED guided consultation to psychiatry/crisis, with 86% receiving a recommended consult...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538604/acute-gastric-volvulus-successfully-treated-by-endoscopic-reduction-in-a-6-year-old-girl-and-a-review-of-the-japanese-literature
#6
Mitsuhiro Haga, Nobuyuki Sano, Takamichi Kamiyama, Naohiro Dairaku, Mari Ishii, Teruko Nemoto, Hoshiro Suzuki, Hiromi Fujie, Jun Suzuki
A previously healthy 6-year-old girl suddenly developed severe abdominal pain and nausea. She was diagnosed with acute gastric volvulus, and a nasogastric tube was inserted to decompress the stomach. The volvulus did not reduce spontaneously; therefore, we performed endoscopic reduction on day 3 and were able to treat her successfully. We reviewed the Japanese literature on endoscopic reduction for gastric volvulus in children. Fifteen cases have been reported since 1994. There are no reports of perforation during the procedure...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28509687/trust-in-the-medical-profession-among-adolescents-in-an-emergency-department
#7
Kelstan Lynch Ellis, Kimberly Randell, John Lantos, Melissa K Miller
OBJECTIVE: The aims of this study were to assess trust in the medical profession among adolescents in an urban pediatric emergency department (ED) and explore factors associated with trust. METHODS: We used a computerized survey to assess personal trust, perceived trust among family/friends, health care use, general and genital examination preferences, health behaviors, and demographics among youth aged 14 to 19 years. The primary outcome was the mean composite score of a validated 5-item scale...
May 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28509686/accuracy-of-point-of-care-ultrasonography-for-pediatric-ankle-sprain-injuries
#8
Sarah Jones, Keith Colaco, Jason Fischer, Jennifer Stimec, Charisse Kwan, Kathy Boutis
OBJECTIVES: In children with radiograph fracture-negative lateral ankle injuries, the main objective of this pilot study was to explore the accuracy, sensitivity, and specificity of point-of-care ultrasound (POCUS) performed by a pediatric emergency physician in diagnosing anterior talofibular ligament injuries, radiographically occult distal fibular fractures, and effusions compared with reference standard magnetic resonance imaging (MRI). METHODS: This was a prospective cohort pilot study...
May 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486267/evaluation-of-patients-with-febrile-seizure-risk-factors-reccurence-treatment-and-prognosis
#9
Rahime Renda, Deniz Yüksel, Y K Yavuz Gürer
INTRODUCTION: Febrile convulsion (FC) is the most common neurological disorder in childhood. The aim of this study was to determine the risk factors for recurrence and the development of epilepsy from the demographic data of these patients. METHODS: A retrospective study was made of 680 patients with FC who presented to our hospital. Patients with only FC were defined as group 1 and those who developed epilepsy after FC as group 2. Comparisons were made between the 2 groups of the demographic parameters, parental consanguinity, familial history of FCs or epilepsy, criteria for starting prophylactic treatment, response to treatment, risk factors for recurrence, and results of electroencephalogram...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486266/pediatric-drowning-a-standard-operating-procedure-to-aid-the-prehospital-management-of-pediatric-cardiac-arrest-resulting-from-submersion
#10
Rebecca R Best, Benjamin H L Harris, Jason L Walsh, Timothy Manfield
OBJECTIVES: Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. METHODS: A literature review on the management of pediatric drowning was conducted...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486265/effect-of-family-presence-on-advanced-trauma-life-support-task-performance-during-pediatric-trauma-team-evaluation
#11
Karen J OʼConnell, Elizabeth A Carter, Jennifer L Fritzeen, Lauren J Waterhouse, Randall S Burd
IMPORTANCE: In many hospitals, family members are separated from their children during the early phases of trauma care. Including family members during this phase of trauma care varies by institution and is limited by concerns for adverse effects on clinical care. OBJECTIVE: The aim of this study is to evaluate the effect of family presence (FP) on advanced trauma life support primary and secondary survey task performance by pediatric trauma teams. We hypothesized that trauma care with FP would be noninferior to care when families were absent...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486264/temporary-seizure-in-an-infant-who-had-been-exposed-to-g-amino-butyric-acid-receptor-antagonist-thiocolchicoside
#12
Cengiz Havali, Kivilcim Gucuyener, Esra Gurkas, Ercan Demir
Seizure is the most common presentation of neurological disorder in the pediatric emergency care setting. In evaluating the child after a first seizure, the first consideration should be determining if the seizure was provoked or unprovoked. Investigation listing the causes of the first seizure is considerably long, and adverse drug reactions must be in mind. Epileptic seizures after using thiocolchicoside (TCC) have been reported in several adult patients with epilepsy and acute brain injury. We present a previously healthy 3-month-old female infant who was admitted to the emergency department with a generalized seizure after exposure to TCC...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486263/predicting-thoracic-injury-in-children-with-multitrauma
#13
Kirstin D Weerdenburg, Paul W Wales, Derek Stephens, Suzanne Beno, Jessica Gantz, Jessie Alsop, Suzanne Schuh
OBJECTIVES: Previous pediatric trauma studies focused on predictors of abnormal chest radiographs or included patients with low injury severity. This study identified predictors of thoracic injury (TI) diagnoses in a high-risk population and determined TI rate without predictors. METHODS: This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486262/an-adolescent-presenting-with-seizures-as-a-symptom-of-gliomatosis-cerebri
#14
Elena Blanco-Iglesias, Beatriz Cabeza, Elena Garcia Esparza, Inmaculada de Prada, Alvaro Lassaletta, Marcelo Budke, Ana Serrano
Gliomatosis cerebri is a diffuse infiltrating glioma of neuroepithelial origin that affects more than 2 cerebral lobes. This is rarely seen in pediatric patients. The clinical presentation and imaging are very unspecific, and a biopsy is typically needed for the diagnosis. Given the widespread nature of the disease, surgical treatment is not possible and has a poor overall prognosis. A pediatric patient presented with elevated intracranial pressure. All initial studies were negative, and the imaging showed a symmetrical affection involving the supratentorial and infratentorial regions...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28463948/emergency-management-of-the-ingested-magnet-an-algorithmic-approach
#15
Brent Bauman, Kendall McEachron, Deborah Goldman, Amanda Louiselle, Eugene Zheng, David Mills, Jeffrey Louie, Bradley Segura
INTRODUCTION: Accidental ingestion of foreign bodies is an increasing problem in the pediatric population. Symptoms are often nonspecific and may lead to a missed diagnosis because the ingestion event often goes unwitnessed. CASE: We present a case of a missed diagnosis of a multiple magnet ingestion event in a pediatric patient leading to operative management. A 2-year-old boy with a 4-week history of nonspecific abdominal pain presented to the emergency department (ED) with vomiting and worsening abdominal pain...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28463947/impact-of-interfacility-transport-method-and-specialty-teams-on-outcomes-of-pediatric-trauma-patients
#16
Shetal C Patel, Stephen Murphy, Scott Penfil, Debra Romeo, James H Hertzog
OBJECTIVE: The aim of the study was to evaluate the impact of ground versus air transport and use of pediatric specialty versus generalist transport teams on outcomes of pediatric trauma victims requiring interfacility transport. METHODS: A retrospective review of our hospital's trauma registry database was performed. Children with traumatic injuries who were transported from a referring hospital by either our pediatric specialty transport team or an outside generalist transport team were included in the analysis...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28463946/a-rare-cause-of-shock-in-an-infant-cor-triatriatum
#17
Tatyana Vayngortin, Howard Rosenfeld, Karim Mansour
Congenital heart disease can be difficult to diagnose in infants because they often present with nonspecific symptoms. Their clinical presentation can resemble that of respiratory infections or sepsis, yet typical treatments for these conditions such as fluid resuscitation may worsen their course. We report a case of an 8-week-old boy who had several weeks of viral symptoms and eventually presented to the emergency department in shock. An echocardiogram revealed the diagnosis of cor triatriatum, a rare congenital heart disease that requires urgent surgical repair...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28463945/epidemiology-of-fractures-in-children-younger-than-12-months
#18
Diana Rodà, Victoria Trenchs, Ana Isabel Curcoy, Anibal Dolores Martínez, Jordi Pou, Carles Luaces
OBJECTIVES: The aim of this study is to determine the prevalence and characteristics of fractures in young infants attended at the pediatric emergency department (PED). METHODS: This is a retrospective study for 2 years (2011-2012) of children younger than 12 months attended with a fracture at the PED. Age, sex, site and type of fracture, mechanism of injury, time interval before seeking medical attention, and management were analyzed. RESULTS: One hundred one patients were included...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28463944/oral-mucosal-envenomation-of-an-infant-by-a-puss-caterpillar
#19
Dante Allen Pappano, Rebecca Trout Fryxell, Molly Warren
The term "puss caterpillar" describes the larva of at least two Megalopygidae species common to North America. Accidental contact with the hairs (setae) is intensely painful, and serious systemic effects have been reported. We describe the envenomation of an infant through the face and oral mucosa, resulting in severe discomfort, limited oral intake, and vomiting, but no other untoward effects.
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28463943/diaper-slit-perineal-bag-urine-sampling
#20
Sody A Naimer
OBJECTIVE: Many indications justifiably drive the pediatrician to request a urine sample in order to assess the health status of the incontinent baby or infant. Urine collection by means of an adhesive perineal bag is the most widely used in children who do not control urine emission, despite its inaccurate reflection of bacteriuria. We suggest a novel technique to immediately visualize the micturition event upon occurrence, in attempt to shorten waiting times and exhausting checking and rechecking opaque diapers in order to determine whether the desired sample has finally been delivered...
May 1, 2017: Pediatric Emergency Care
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