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Pediatric Emergency Care

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https://www.readbyqxmd.com/read/29596286/acute-terminal-ileitis-in-children-a-retrospective-study-in-pediatric-emergency-department
#1
Miguel Angel Molina Gutiérrez, Eva Martínez-Ojinaga Nodal, Julia Piñán Díez, Pedro María Rubio Aparicio, Alida Alcolea Sánchez, Agustín Remesal Camba, Ana Pérez Vigara
OBJECTIVES: This study aims to describe the clinical presentation and outcome of patients diagnosed with acute ileitis in our pediatric emergency department. METHODS: We performed a retrospective study of all patients diagnosed with terminal ileitis by abdominal ultrasonography findings in our pediatric emergency department, over the years 2013 and 2014. Patients with previous diagnosis of inflammatory bowel disease (IBD) were excluded. Data collected were clinical, radiological, and laboratory data at diagnosis; outcome including hospitalization care; and outpatient follow-up in pediatric gastroenterology and/or primary care...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596285/rising-clinical-burden-of-psychiatric-visits-on-the-pediatric-emergency-department
#2
Ariella Nadler, Deena Avner, Hnin Khine, Jeffrey R Avner, Daniel M Fein
OBJECTIVE: The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period. METHODS: A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2)...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596284/a-case-of-wernicke-encephalopathy-developing-after-ileal-bypass-surgery
#3
Tülay Kamaşak, Sibel Kul, Mustafa Tuşat, Nezir Ozgun, Ali Cansu
Wernicke encephalopathy is an acute neurological problem resulting from thiamine deficiency and manifesting with mental confusion, oculomotor dysfunction, and ataxia. It is associated with alcohol dependence in adults. Preparatory factors include hyperemesis gravidarum, prolonged diarrhea, prolonged parental nutrition without vitamin support, absorption disorders, anorexia, cancer, and chemotherapy. Failure to consider the clinical findings and preparatory factors of this disease, which is rare in children, can delay diagnosis...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596283/pediatric-sigmoid-volvulus
#4
Bennett Lee, Andrea Wu
Sigmoid volvulus is an extremely rare cause of abdominal pain in children. More commonly seen in older adults, an SV occurs when a redundant loop of sigmoid wraps around its elongated, narrow mesentery causing obstruction and ischemia to the affected bowel segment. Children usually present with abdominal pain, nausea, and abdominal distension. Presentations may be acute or chronic with a history of episodic constipation or abdominal distension. The treatment plan includes an initial reduction of the volvulus via sigmoidoscopy with rectal biopsy to rule out Hirschsprung disease; however, operative management to remove the dilated sigmoid colon may be required in the setting of recurrence or confirmed Hirschsprung disease...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596282/intimate-partner-violence-educational-materials-in-the-acute-care-setting-acceptability-and-impact-on-female-caregiver-attitudes-toward-screening
#5
Kimberly A Randell, Ashley Sherman, Irene Walsh, Donna OʼMalley, Mary Denise Dowd
OBJECTIVES: This study aimed to determine acceptability of intimate partner violence (IPV) materials and effect of the materials on caregiver attitudes toward IPV screening. METHODS: We used an anonymous computerized survey to assess approval of IPV materials and screening, and willingness to disclose IPV in response to screening among mothers bringing a child to an urban pediatric emergency department or 2 suburban pediatric urgent care centers affiliated with a free-standing academic children's hospital...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596281/chikungunya-in-a-pediatric-traveler
#6
Vanessa A Thomas, Kristy O Murray, Heather L Crouse
Chikungunya is a mosquito-transmitted virus found primarily in Africa and Asia. In late 2013, chikungunya virus emerged in the Western hemisphere, spreading from the Caribbean to South, Central, and North America (MMWR Morb Mortal Wkly Rep. 2014;63:1121-1128). Symptoms can be similar to nonspecific viral presentations including fever, joint pain, joint swelling, and rash. The diagnosis of infectious tropical diseases in the emergency department often requires a high index of suspicion, given the nonspecific early findings that characterize many of these tropical diseases...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596280/adolescent-sexual-behavior-and-emergency-department-use
#7
Julie Weisman, Alyse Chase, Gia M Badolato, Stephen J Teach, Maria E Trent, James M Chamberlain, Monika K Goyal
OBJECTIVES: The objective of this study was to determine whether adolescents in emergency departments (EDs) who report engaging in high-risk sexual behaviors are less likely to identify a primary care provider (PCP) and more likely to access the ED than their sexually inexperienced peers. METHODS: This was a secondary analysis of adolescents presenting to a pediatric ED with non-sexually transmitted infection (STI)-related complaints who completed surveys to assess sexual behavior risk and health care access...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29596279/electronic-medical-record-in-the-ed-a-cross-sectional-survey-of-resuscitation-documentation-practices-and-perceptions-among-emergency-department-clinicians
#8
Marleny Franco, Janette Baird, Linda L Brown, Frank L Overly
OBJECTIVES: The aims of this study were to describe current practices in nursing documentation of trauma and medical resuscitations across emergency departments (EDs) and explore physicians' and nurses' perceptions of electronic medical record (EMR) use for nursing documentation of resuscitations. METHODS: An anonymous Web-based survey was developed and distributed to a convenience sample of ED physicians and nurses in the United States. RESULTS: Of 438 respondents, 154 were nurses; 97...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538269/erythema-ab-igne-in-an-adolescent-with-chronic-pain-an-alarming-cutaneous-eruption-from-heat-exposure
#9
Sabrina Gmuca, JiaDe Yu, Pamela F Weiss, James R Treat, David D Sherry
Erythema ab igne (EAI) is a cutaneous finding caused by prolonged heat exposure and is characterized by a reticular, brownish-pigmented, often telangiectatic dermatosis. The eruption is reminiscent of livedo reticularis, which is typically seen in the setting of a number of rheumatologic conditions, most prominently vasculitis. Identification of key features distinguishing EAI from livedo reticularis can aid in the diagnosis of EAI and correct elucidation of the underlying etiology. Our patient presented with heating pad-induced EAI in the setting of chronic pain...
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538268/scaphoid-fractures-in-children-do-we-need-to-x-ray-a-retrospective-chart-review-of-144-wrists
#10
Jonathan Porter, Robert Porter, Kevin Joseph Chan
OBJECTIVES: The purpose of this study is to determine the predictive value of clinical suspicion for scaphoid fracture in children aged 4 to 11 years, to look at the efficiency and practicality of current management of children presenting to the emergency department, and to help quantify the burden of the treatment strategy of immobilization for 10 to 14 days on clinical grounds despite negative or equivocal x-rays on presentation. METHODS: We performed a retrospective chart review study of a consecutive sample of all children aged 4 to 11 years old who presented to a tertiary pediatric emergency department from January 1, 2009, to December 31, 2013, within 24 hours of a wrist injury, with a clinical suspicion sufficient to order a scaphoid x-ray...
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538267/assessment-of-emergency-department-antibiotic-discharge-prescription-dosing-errors-for-pediatric-patients-in-a-community-hospital-health-system
#11
Linda Barstow, Erika Herman, Heidi Phillips, Patrick Maloney
OBJECTIVES: We quantify and describe emergency department antibiotic discharge prescription dosing errors for pediatric patients in a community hospital health system. METHODS: This was a retrospective chart review evaluating emergency department discharge prescriptions written between July 1, 2014, and June 30, 2015. Pediatric patients who received a prescription for an oral antibiotic were included in error analysis if they had a weight updated in the electronic medical record during the encounter...
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538266/synthetic-cannabinoid-exposure-in-adolescents-presenting-for-emergency-care
#12
Meghan Gilley, Jeffrey Brent, Diane P Calello, Paul Wax, Yaron Finkelstein
OBJECTIVE: The objective of this study was to characterize the clinical picture and management of synthetic cannabinoid exposure in a cohort of adolescents. METHODS: Using the 45 participating sites of the Toxicology Investigators Consortium Registry, a North American database, we conducted an observational study of a prospectively collected cohort. We identified all adolescent (12-19 years) cases of synthetic cannabinoid exposure who have received medical toxicology consultation between January 2012 and December 2016...
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538265/late-onset-vitamin-k-deficiency-presenting-as-scrotal-bruising-and-mediastinal-mass
#13
Lauren A Bruns, Sarah Isbey, Melisa Tanverdi, Ian Kane
Although there are several reports of intracranial hemorrhage associated with vitamin K deficient bleeding, there are few reported cases of extracranial manifestations, specifically involving the thymus. Here, we discuss the unique case of a 4-week-old infant presenting with scrotal discoloration, respiratory distress, and widened mediastinum, found to have thymic hemorrhage related to confirmed coagulopathy secondary to late-onset vitamin K deficiency bleeding of the newborn.
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538264/ingestion-of-fireworks-rare-cause-of-poisoning-in-children
#14
Hasan Yuksekkaya, Meltem Gumus, Aylin Yucel, Meltem Energin, Serafettin Demirci
BACKGROUND: Mistaken ingestion of all manner of toxic matter is common in childhood, but poisoning with fireworks and matchsticks is rare. Fireworks usually contain 10% yellow phosphorus and 50% potassium chlorate. Potassium chlorate is an extremely reactive and toxic agent that is used in fireworks and matchstick heads. METHODS: Eleven cases (7 females and 5 males; median age, 36 months [ranging from 24 to 48 months]) of poisoning after ingestion of fireworks and matchstick(s), between February 2008 and June 2014, were reviewed...
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29538263/emergency-medicine-providers-knowledge-and-management-of-pediatric-tropical-diseases-a-needs-assessment
#15
Vanessa A Thomas, Heather L Crouse, Kristy O Murray, Deborah C Hsu, Elizabeth A Camp, Andrea T Cruz
OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations...
March 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29509648/c-reactive-protein-concentration-can-help-to-identify-bacteremia-in-children-visiting-the-emergency-department-a-single-medical-center-experience
#16
I-Min Chiu, Ying-Hsien Huang, Chih-Min Su, Chia-Te Kung, Chao-Jui Li, Chih-Ho Chen, Kuo-Su Tang, Kuang-Che Kuo
BACKGROUND: For febrile children who are evaluated in a pediatric emergency department (PED), blood culture can be considered the laboratory criterion standard to detect bacteremia. However, high rates of negative, false-positive, or contaminated blood cultures in children often result in this testing being noncontributory. This study determined the factors associated with true-positive blood cultures in children. METHODS: This retrospective study was conducted at a tertiary medical center's PED...
March 6, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29509651/hydronephrosis-from-ureteropelvic-junction-obstruction-discovered-on-point-of-care-ultrasound-in-patients-with-trauma
#17
Jennifer E Melvin, Michael C Ost, Jennifer R Marin
We present 2 cases of patients with abdominal trauma who were found to have hydronephrosis on point-of-care ultrasound secondary to previously undiagnosed ureteropelvic junction obstructions. We review the ultrasound findings, technique, and relevant literature regarding renal point-of-care ultrasound and ureteropelvic junction obstruction.
March 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29509650/chlamydia-conjunctivitis-in-2-prepubertal-children-an-uncommon-presentation-of-child-sexual-abuse
#18
Amanda D Brownell, Virginia Miraldi Utz, Kathi L Makoroff, Robert A Shapiro, Joel E Mortensen
Sexually transmitted infection as the result of child sexual abuse in prepubertal children is uncommon. Chlamydia trachomatis conjunctivitis is an even less common entity in prepubertal children outside the newborn period. This report details the presentation of 2 children with conjunctivitis who were subsequently diagnosed as having C. trachomatis conjunctivitis. One child was also diagnosed as having rectal and pharyngeal C. trachomatis infection, and the other also had genital C. trachomatis infection. Even with multisite C...
March 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29509649/presentation-and-investigation-of-pediatric-bone-and-joint-infections-in-the-pediatric-emergency-department
#19
Olugbenga Akinkugbe, Charles Stewart, Caoimhe McKenna
OBJECTIVE: The objective of this study was to evaluate the presenting features of bone and joint infections with a view to identify distinguishing trends that will be useful for pediatric emergency departments. METHODS: We performed a retrospective review of patient records over a 12-year period in the pediatric emergency department of a large regional pediatric teaching center serving a diverse population. RESULTS: There were 88 cases of osteoarticular infections during the study period...
March 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29489611/oculocardiac-reflex-in-a-pediatric-trauma-patient
#20
Angelica W DesPain, Jennifer Chapman, Haroon Shaukat
We describe the case of a 6-year-old boy who presented to a tertiary care emergency department after a motor vehicle accident with facial trauma and bradycardia. The patient was found to have an orbital floor fracture and inferior rectus muscle entrapment with resulting bradycardia secondary to the oculocardiac reflex. The oculocardiac reflex is an uncommon cause of bradycardia in the setting of trauma but should be considered because it can necessitate surgical intervention.
February 28, 2018: Pediatric Emergency Care
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