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Pediatric Emergency Care

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https://www.readbyqxmd.com/read/29438126/sonographic-evaluation-and-monitoring-of-pneumoperitoneum-after-air-enema-reduction-for-intussusception
#1
Amy Z Zhou, Amy Toporowski, James W Tsung
Abdominal radiography and computed tomography scans are standard tests to diagnose pneumoperitoneum. With the growing availability of point-of-care ultrasound, pneumoperitoneum may be diagnosed in settings without easy access to radiography or computed tomography, such as in overcrowded emergency departments or resource-poor environments. The use of point-of-care ultrasound to diagnose or monitor pneumoperitoneum has been described in adult but not pediatric patients. We present a case of point-of-care ultrasound detection of pneumoperitoneum and monitoring for tension pneumoperitoneum, after failed air enema reduction for intussusception in an infant...
February 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29438125/presumed-systemic-inflammatory-response-syndrome-in-the-pediatric-emergency-department
#2
Cheryl P Z Foo, Jamie A Seabrook, Gurinder Sangha, Jennifer Ruth Foster
OBJECTIVE: The aim of this study was to examine the incidence and outcomes of patients presenting with systemic inflammatory response syndrome (SIRS) in the pediatric emergency department (PED). METHODS: This was a descriptive, retrospective cohort study of all patients from birth to 18 years presenting to the PED of a single center on 16 days distributed over 1 year. The presence of presumed SIRS (pSIRS, defined as noncore temperature measurement and cell count when clinically indicated) and sepsis was determined for all study patients...
February 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29438124/friendly-faces-characteristics-of-children-and-adolescents-with-repeat-visits-to-a-specialized-child-psychiatric-emergency-program
#3
Mollie Marr, Sarah M Horwitz, Ruth Gerson, Amy Storfer-Isser, Jennifer F Havens
OBJECTIVES: Pediatric mental health emergency department (ED) visits continue to rise with 19% to 62% of youth presenting to the ED ultimately returning for a mental health-related complaint. To better understand the needs of children returning to the ED, this study examines the clinical, demographic, and environmental factors associated with revisits to a dedicated child psychiatric ED. METHODS: Clinical factors, home environment, and mental health service utilization of 885 children presenting to a dedicated child psychiatric ED over a 1-year period were abstracted by retrospective chart review...
February 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406480/evaluation-of-predictors-of-mortality-associated-with-childhood-heart-failure-in-nigeria-a-2-center-study
#4
Wilson E Sadoh, Blessing Okperi, Paul Ikhurionan, Promise Monday, Ayebo E Sadoh
OBJECTIVE: The aim of this study was to evaluate the predictors of mortality in childhood heart failure (HF) in 2 tertiary hospitals. METHODS: A 51-month retrospective review of case notes of children with HF admitted into children's emergency rooms of 2 tertiary centers in Southern Nigeria was done. Bio-data and certain sociodemographic variables including mortality were abstracted. Bivariate and multivariate analyses were done to evaluate the predictors of mortality in HF...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406479/application-of-the-rochester-criteria-to-identify-febrile-infants-with-bacteremia-and-meningitis
#5
Paul L Aronson, Russell J McCulloh, Joel S Tieder, Lise E Nigrovic, Rianna C Leazer, Elizabeth R Alpern, Elana A Feldman, Fran Balamuth, Whitney L Browning, Mark I Neuman
OBJECTIVES: The Rochester criteria were developed to identify febrile infants aged 60 days or younger at low-risk of bacterial infection and do not include cerebrospinal fluid (CSF) testing. Prior studies have not specifically assessed criteria performance for bacteremia and bacterial meningitis (invasive bacterial infection). Our objective was to determine the sensitivity of the Rochester criteria for detection of invasive bacterial infection. METHODS: Retrospective cohort study of febrile infants aged 60 days or younger with invasive bacterial infections evaluated at 8 pediatric emergency departments from July 1, 2012, to June 30, 2014...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406478/the-use-of-chest-computed-tomographic-angiography-in-blunt-trauma-pediatric-population
#6
Rabea Hasadia, Joseph DuBose, Kobi Peleg, Jacob Stephenson, Adi Givon, Boris Kessel
INTRODUCTION: Blunt chest trauma in children is common. Although rare, associated major thoracic vascular injuries (TVIs) are lethal potential sequelae of these mechanisms. The preferred study for definitive diagnosis of TVI in stable patients is computed tomographic angiography imaging of the chest. This imaging modality is, however, associated with high doses of ionizing radiation that represent significant carcinogenic risk for pediatric patients. The aim of the present investigation was to define the incidence of TVI among blunt pediatric trauma patients in an effort to better elucidate the usefulness of computed tomographic angiography use in this population...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406477/intoxication-from-accidental-marijuana-ingestion-in-pediatric-patients-what-may-lie-ahead
#7
Osei Boadu, Grace Y Gombolay, Verne S Caviness, Chadi M El Saleeby
Marijuana is the most commonly used illicit drug. In young children, there are relatively few reports in the literature of acute marijuana intoxication. Here, we describe the case of a previously healthy 2-year-old girl who presented with clinical seizures. A urine toxicology screen showed elevated levels of tetrahydrocannabinol. The source of the drug was not identified. After a short stay in the hospital, the patient fully recovered with only supportive measures. In this report, we also summarize all domestic and international cases of marijuana intoxication in children younger than 6 years, in conjunction with the number of exposures in children of similar age identified by the US National Poison Data System...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406476/intravenous-thrombolysis-at-3-5-hours-from-onset-of-pediatric-acute-ischemic-stroke
#8
Elizabeth D Waring, Truman J Milling, Steven Warach
Acute thrombolysis has a proven benefit for adults presenting with acute ischemic stroke, but data within the pediatric population are extremely limited. We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406475/pediatric-emergency-provider-sexually-transmitted-infection-screening-practices-in-adolescents-with-oropharyngeal-or-anorectal-chief-complaints
#9
Courtney Gallagher, Susan S Lee, Frances S Shofer, Cynthia J Mollen, Monika K Goyal, Nadia L Dowshen
OBJECTIVES: Sexually transmitted infections (STIs) may present with oropharyngeal or anorectal symptoms. Little is known about the evaluation of adolescents with these complaints in the pediatric emergency department (PED). This study aimed to determine the frequency of and factors associated with STI consideration and testing in this population. METHODS: Retrospective chart review of patients aged 13 to 18 years who presented to an urban PED with oropharyngeal or anorectal chief complaints between June 2014 and May 2015...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406474/childhood-drowning-review-of-patients-presenting-to-the-emergency-departments-of-2-large-tertiary-care-pediatric-hospitals-near-and-distant-from-the-sea-coast
#10
Neta Cohen, Dennis Scolnik, Ayelet Rimon, Uri Balla, Miguel Glatstein
OBJECTIVE: Drowning is a leading cause of death among infants and toddlers. Unique physiological and behavioral factors contribute to high mortality rates. Drowning incidents predominantly occur during warmer months and holidays. The aim of this study was to describe the characteristics of pediatric drowning victims who attended 2 different emergency departments (EDs), 1 near and 1 distant from the sea coast, to recognize risk factors, complications, causes of death, and the educational needs of families and caregivers...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406473/characteristics-of-pediatric-patient-transferred-from-hospital-based-general-emergency-departments-to-acute-care-facilities-an-analysis-of-the-healthcare-cost-and-utilization-project-nationwide-emergency-department-sample
#11
Isabel Araujo Barata, Meredith Akerman, Zayan Mahmooth, Kathryn Bradburn, John DʼAngelo
STUDY OBJECTIVE: The objective of this study was to analyze the characteristics of pediatric patients transferred from a hospital-based general emergency department (ED) to an acute care facility. METHODS: Study data were abstracted from the 2010 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database. A multivariate logistic regression was constructed for pediatric patients (<18 years old) who require a transfer to an acute care facility from a general ED...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406472/novel-approach-to-emergency-departments-pediatric-readiness-across-a-health-system
#12
Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406471/life-threatening-accidental-intravenous-epinephrine-overdose-in-a-12-year-old-boy
#13
Maya Caroline André, Jürg Hammer
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). He reacted with acute loss of consciousness and acute cardiorespiratory failure due to arterial hypotension, ischemic heart failure, and severe pulmonary edema...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29369266/pain-intensity-and-risk-of-bone-fracture-in-children-with-minor-extremity-injuries
#14
Chiara Zanchi, Manuela Giangreco, Luca Ronfani, Claudio Germani, Rita Giorgi, Lorenzo Calligaris, Stefania Norbedo, Giulio Liccari, Giorgio Cozzi, Egidio Barbi
OBJECTIVES: Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture. METHODS: We conducted a retrospective study, considering all patients presenting to the ED of a children's hospital in Italy, with an accidental extremity injury, between May and December 2015...
January 23, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29369265/a-provider-focused-intervention-to-promote-optimal-care-of-pediatric-patients-with-suspected-elbow-fracture
#15
Maria Carmen G Diaz, Lloyd N Werk, James H Crutchfield, Lori K Handy, James P Franciosi, Joanne Dent, Raymond Villanueva, Eileen Antico, Alex Taylor, Tim Wysocki
OBJECTIVE: Emergency department (ED) and urgent care (UC) physicians' accurate assessment of the neurovascular and musculoskeletal (NV/MSK) examination in pediatric patients with suspected elbow fracture is crucial to the early recognition of neurovascular compromise. Our objective was to determine the impact of computer-based simulation (CBS) and computerized clinical decision support systems (CCDSS) on ED and UC physicians' assessment of the NV/MSK examination of pediatric patients with elbow fracture as noted in their documentation...
January 23, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29369264/endoscopic-findings-associated-with-button-battery-ingestion-in-children-do-we-need-to-change-the-protocol-for-managing-gastric-location
#16
Gloria Ríos, Lorena Rodríguez, Yalda Lucero, Isabel Miquel, María Eugenia Arancibia, Francisco Alliende
BACKGROUND: Ingested button batteries (BB) can cause corrosive damage of digestive mucosa within minutes. Immediate endoscopic removal of esophageal BB has been clearly established, but the management of BB located in the stomach is still controversial. AIM: To describe demographic, clinical, radiologic, and endoscopic characteristics of a series of pediatric patients evaluated for BB ingestion. METHODS: Retrospective analysis of clinical charts belonging to children younger than 15 years, who underwent endoscopic removal of BB at Clínica Alemana of Santiago, between November 2007 and November 2011...
January 23, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29369263/do-you-c-what-i-c-emergency-department-evaluation-and-diagnosis-of-pediatric-scurvy-in-an-autistic-child-with-a-restricted-diet
#17
James Burhop, Jennifer Gibson, Justin de Boer, Cyrus Heydarian
Scurvy in modern times may not be as rare as previously thought. The link between adequate intake of vitamin C and scurvy has been known since ancient times and is recorded in Ebers Papyrus. Recent reports indicate that, with restricted diets, vitamin C deficiency is being seen in infants exclusively fed plant-based formula and children with oral aversion, autism, restricted diets, and cerebral palsy. Additional at-risk groups include the older adults and patients having alcoholism. Often costly, emergency department visits and elaborate diagnostic studies lead to fruitless results when a simple diet history is often overlooked...
January 23, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29369262/analysis-of-complications-after-button-battery-ingestion-in-children
#18
Ágnes Varga, Tamás Kovács, Amulya K Saxena
AIM: Button battery ingestion (BBI) in children may cause severe complications. This analysis is a literature review of complications after pediatric BBI. METHODS: Literature was searched on PubMed (1995-2015) using the terms "button battery," "ingestion," and "children." End points were age, type and diameter of battery, complications, affected organ, and fatality. RESULTS: A total of 31 publications were analyzed. Patients from 4 months to 19 years old were included (n = 136,191, with n = 102,143 or 75% aged <6 y)...
January 23, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29369261/screening-of-pediatric-facial-fractures-by-brain-computed-tomography-diagnostic-performance-comparison-with-facial-computed-tomography
#19
JongChan Ryu, Seong Jong Yun, Sun Hwa Lee, Yoon Hee Choi
OBJECTIVES: Facial bone fractures secondary to head trauma are more common in children than in adults. Recently, multidetector row computed tomography (CT) has been considered superior to conventional radiography. Some studies have reported that facial soft tissue injuries require both facial and brain CT and that brain CT is helpful in screening facial bone fractures. However, these studies included only adult patients. The aim of this study was to evaluate the diagnostic performance of brain CT and the need for additional facial CT to detect facial bone fractures in emergency pediatrics...
January 23, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346238/trends-in-severe-pediatric-emergency-conditions-in-a-national-cohort-2008-to-2014
#20
Kenneth A Michelson, Joel D Hudgins, Laura G Burke, Todd W Lyons, Michael C Monuteaux, Richard G Bachur, Jonathan A Finkelstein
OBJECTIVE: The objective of this study was to determine the incidence and recent trends in serious pediatric emergency conditions. METHODS: We conducted a cross-sectional study of the Nationwide Emergency Department Sample from 2008 through 2014, and included patients with age below 18 years with a serious condition, defined as each diagnosis group in the diagnosis grouping system with a severity classification system score of 5. We calculated national incidences for each serious condition using annualized weighted condition counts divided by annual United States census child population counts...
January 16, 2018: Pediatric Emergency Care
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