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Pediatric Emergency Care

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https://www.readbyqxmd.com/read/28632578/acute-abdominal-pain-recognition-and-management-of-constipation-in-the-emergency-department
#1
Stefania Norbedo, Giulia Bassanese, Francesca Barbieri, Egidio Barbi
OBJECTIVE: The main aim of the study was to investigate the incidence and the clinically relevant features of functional constipation in patients evaluated for acute abdominal pain in a tertiary care pediatric emergency department. METHODS: This is a retrospective study. We analyzed 4394 medical records and recorded the information (demographics, triage code, symptoms, medical history, physical evaluation, laboratory tests, radiological studies, procedures, and treatments) of all patients admitted for acute abdominal pain to the emergency department of the IRCCS Burlo Garofolo, Trieste, during 2010 to 2013...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632577/outcome-of-pediatric-forearm-fracture-reductions-performed-by-pediatric-emergency-medicine-providers-compared-with-reductions-performed-by-orthopedic-surgeons-a-retrospective-cohort-study
#2
Donna Milner, Ernest Krause, Karen Hamre, Andrew Flood
OBJECTIVE: The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions. METHODS: We performed an analysis of patients between 1 and 14 years of age who presented to the emergency department (ED) with a forearm fracture requiring reduction. Data collected included reducing provider (PEM or orthopedist) and prereduction, postreduction, and follow-up fracture angles and displacements of both radius and ulna...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#3
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632575/clinical-profile-etiology-and-outcome-of-infantile-ocular-trauma-a-developing-country-perspective
#4
Vedang D Shah, Madhu Uddaraju, Amitabh Singh, Rashmi Ranjan Das
OBJECTIVE: The aim of this article was to study the clinical profile, etiology, and outcome of infantile ocular trauma in a developing country setting. METHODS: A retrospective study on corneal trauma in infants (≤12 months old) was undertaken in a tertiary care hospital during a 2-year period. An analysis of clinical profile, etiology, microbiological profile, clinical course, and outcome was studied. RESULTS: Seventy-six infants were included...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28617713/gastric-emphysema-a-cannot-miss-emergency-medicine-diagnosis
#5
Sean D Murnan, Jill Miller, Anne Kuhn
The radiographic finding of gastric emphysema with portal venous gas is classically an ominous finding, associated with a high rate of mortality. Although classically the case, this imaging finding must be quickly correlated with the overall clinical picture, allowing for the essential differentiation between the highly lethal emphysematous gastritis and the much more benign gastric emphysema, each of which has drastically different management strategies. We report a case of gastric emphysema with portal venous gas likely attributable to a gastric outlet obstruction and gastric mucosal defect in a 17-year-old girl with a chief complaint of syncope that was diagnosed in the emergency department and treated conservatively...
June 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28614102/intracranial-complications-of-pediatric-sinusitis
#6
Alexandria J Wiersma, Tien Vu
"Headache and fever" is a common presentation to the urgent care and emergency department setting and can have many etiologies. We present a case of a 10-year-old girl who presented with headache and fever and was found to have intracranial extension of sinusitis despite lack of typical sinus or chronic upper respiratory tract infection symptoms. This case illustrates the need in the emergency department or urgent care to keep a broad differential diagnosis for pediatric headache, especially when initial interventions are unsuccessful...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28614101/clinical-characteristics-of-allergy-to-hymenoptera-stings
#7
Nualanong Visitsunthorn, Teera Kijmassuwan, Kittipos Visitsunthorn, Panchama Pacharn, Orathai Jirapongsananuruk
OBJECTIVE: The purpose of this study was to evaluate the clinical characteristics of allergy to stings from the Hymenoptera order of insects in a hospital in Thailand. METHODS: A descriptive retrospective analytical study was carried out in inpatients and outpatients suffering from Hymenoptera stings from 2009 to 2013 in Siriraj Hospital. RESULTS: Medical records of 386 patients with an allergy to Hymenoptera stings were evaluated. Anaphylaxis was more common in patients younger than 15 years, who comprised 22...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28614100/acuity-prediction-using-emergency-medical-services-prenotifications-in-a-pediatric-emergency-department
#8
Kristy Williamson, Robert Gochman, Francesca Bullaro, Bradley Kaufman, William Krief
OBJECTIVES: Emergency medical services (EMS) prenotifications are critical, although they oftentimes inaccurately convey the arriving patient's true acuity, resulting in inappropriate preparation in the emergency department. The objectives of this study were (1) to determine interrater reliability of acuity prediction based on prenotifications among physicians and (2) to compare predicted versus actual patient acuity based on prenotifications. METHODS: A panel of physicians reviewed recordings of EMS prenotifications and then predicted the patient's acuity using the Emergency Severity Index (ESI)...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28609333/feasibility-of-the-digital-retinography-system-camera-in-the-pediatric-emergency-department
#9
Yaron Ivan, Sriram Ramgopal, Margarita Cardenas-Villa, Daniel G Winger, Li Wang, Melissa A Vitale, Richard A Saladino
PURPOSE: Direct ophthalmoscopy may be difficult without pupillary dilation and patient cooperation. Nonmydriatic ocular fundus photography (NMOFP) has been shown to be easily and efficiently accomplished by medical providers and improve the detection of abnormalities in adult emergency department (ED) patients. Nonmydriatic ocular fundus photography for pediatric ED patients has not been studied. The purpose of this study was to assess the ease of use of the Digital Retinography System (DRS) camera for NMOFP in ED patients aged 5 to 12 years and the quality of retinal images obtained with the DRS...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28609332/the-use-of-intranasal-dexmedetomidine-and-midazolam-for-sedated-magnetic-resonance-imaging-in-children-a-report-from-the-pediatric-sedation-research-consortium
#10
Carmen Sulton, Pradip Kamat, Michael Mallory, Jason Reynolds
OBJECTIVE: The objective of this study was to describe the use of intranasal dexmedetomidine (IN DEX) for sedated magnetic resonance imaging (MRI) examinations in children. The use of IN DEX for MRI in children has not been well described in the literature. MATERIALS AND METHODS: The Pediatric Sedation Research Consortium (PSRC) is a collaborative and multidisciplinary group of sedation practitioners dedicated to understanding and improving the process of pediatric sedation...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28609331/evaluation-and-impact-of-the-advanced-pediatric-life-support-course-in-the-care-of-pediatric-emergencies-in-spain
#11
Javier Benito, Carlos Luaces-Cubells, Santiago Mintegi, Ignacio Manrique Martínez, Mercedes De la Torre Espí, Concepción Miguez Navarro, Paula Vazquez López, Carmen Campos Calleja, Francesc Ferres Serrat, María Teresa Alonso Salas, Javier González Del Rey
INTRODUCTION: The Advanced Pediatric Life Support (APLS) course was introduced in the training of professionals who care for pediatric emergencies in Spain in 2005. OBJECTIVE: To analyze the impact of the APLS course in the current clinical practice in Spanish PEDs. METHODS: The directors of APLS courses were asked about information regarding the courses given to date, especially on the results of the satisfaction survey completed by students at the end of the course...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28562463/an-ethical-justification-for-termination-of-resuscitation-protocols-for-pediatric-patients
#12
Michael G Muñoz, David H Beyda
OBJECTIVE: The aim of this article was to compare specific characteristics and outcomes among adult and pediatric out-of-hospital cardiac arrest (OHCA) patients to show that the existing literature warrants the design and implementation of pediatric studies that would specifically evaluate termination of resuscitation protocols. We also address the emotional and practical concerns associated with ceasing resuscitation efforts on scene when treating pediatric patients. METHODS: Relevant prospective and retrospective studies were used to compare characteristics and outcomes between adult and pediatric OHCA patients...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590998/a-comparison-of-direct-laryngoscopy-and-videolaryngoscopy-for-endotracheal-intubation-by-inexperienced-users-a-pediatric-manikin-study
#13
Onur Balaban, Mumin Hakim, Hina Walia, Dmitry Tumin, Meredith Lind, Joseph D Tobias
OBJECTIVE: Direct laryngoscopy (DL) is the most common technique for endotracheal intubation, whereas videolaryngoscopy provides an indirect view of the glottis without the need to align the oral, pharyngeal, and tracheal axes. The current study compares videolaryngoscopy with DL among experienced and inexperienced users for endotracheal intubation using a pediatric manikin. METHODS: Participants performed DL using Miller and Macintosh laryngoscopes and videolaryngoscopy using CMAC and GlideScope devices on a manikin (SimBaby; Laerdel, Wappingers Falls, NY)...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590997/is-radiography-necessary-for-pediatric-emergency-department-clinicians-to-safely-manage-ankle-injuries
#14
Rohan Angus Ramasubbu
OBJECTIVES: Ankle radiography in the pediatric emergency department exposes a radiosensitive population to harmful ionizing radiation and is costly to health care systems. This study aimed to determine if ankle injuries in children could be managed safely and effectively without radiography. METHODS: This prospective study enrolled 94 patients with ankle injuries between July 14, 2015, and December 16, 2015. Participating clinicians filled out a tick-box questionnaire describing their predicted diagnosis and management...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590996/helicopter-transport-from-the-scene-of-injury-are-there-improved-outcomes-for-pediatric-trauma-patients
#15
Sandra M Farach, Nebbie E Walford, Lindsey Bendure, Ernest K Amankwah, Paul D Danielson, Nicole M Chandler
BACKGROUND: There is conflicting data to support the routine use of helicopter transport (HT) for the transfer of trauma patients. The purpose of this study was to evaluate outcomes for trauma patients transported via helicopter from the scene of injury to a regional pediatric trauma center. METHODS: The institutional trauma registry was queried for trauma patients presenting from January 2000 through March 2012. Of 9119 patients, 1709 patients who presented from the scene were selected for further evaluation...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590995/mental-health-problems-in-children-and-adolescents-in-the-emergency-department-the-times-they-are-a-changin
#16
Giorgio Cozzi, Marta Minute, Giovanna Ventura, Egidio Barbi
No abstract text is available yet for this article.
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590994/a-collaborative-behavioral-model-for-psychiatric-visits-in-a-pediatric-emergency-department
#17
Kelsey Caffy, Tamekia L Jones, Barry G Gilmore
OBJECTIVES: Psychiatric pediatric emergency department (PED) visits are associated with extended length of stay (LOS) compared with nonpsychiatric visits. To address delays in definitive care, our PED incorporated a Collaborative Behavioral Model for patients with a psychiatric complaint. We evaluated LOS and 6-month readmission by comparing patients who received a psychiatric consultation through the model with a control group of nonpsychiatric patients. In addition, we assessed the utilization of laboratory tests and imaging and the impact of testing on final patient disposition...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590993/childhood-falls-with-occipital-impacts
#18
Norrell Atkinson, Rick R van Rijn, Suzanne P Starling
OBJECTIVES: Falls are commonly reported in children who present with both accidental and inflicted brain injuries. Short falls rarely result in serious or life-threatening injuries. Our purpose is to describe a series of cases of short falls with occipital impact leading to subdural hemorrhage (SDH). METHODS: We present a series of 8 witnessed accounts of young children diagnosed as having SDHs after striking the back of their heads during a short fall. Child-abuse physicians were surveyed to determine if they had evaluated a child younger than 24 months diagnosed as having SDH, with or without retinal hemorrhages, following a witnessed fall with occipital impact...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590992/montelukast-treatment-of-acute-asthma-exacerbations-in-children-aged-2-to-5-years-a-randomized-double-blind-placebo-controlled-trial
#19
Xiuping Wang, Jinfang Zhou, Xin Zhao, Xiongxiong Yi
BACKGROUND: Although montelukast has an established role in the management of chronic asthma in children, its efficacy in acute asthma exacerbations (AAEs) in children aged 2 to 5 years is not fully known. This study aimed to evaluate the effectiveness and safety of montelukast for treating AAE in children aged 2 to 5 years in China. METHODS: In total, 120 Chinese children with AAE, aged 2 to 5 years, were randomly divided into 2 groups, each with 60 patients. All patients received either montelukast or placebo along with standard therapy for acute asthma between January 2011 and December 2015...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590991/risk-factors-associated-with-emergency-department-return-visits-following-trauma-system-discharge
#20
Timothy Ruttan, Karla A Lawson, Karen Piper, Matthew Wilkinson
OBJECTIVES: Little evidence exists in the pediatric trauma literature regarding what factors are associated with re-presentation to the hospital for patients discharged from the emergency department (ED). METHODS: This was a retrospective cohort study of trauma system activations at a pediatric trauma center from June 30, 2007, through June 30, 2013, who were subsequently discharged from the ED or after a brief inpatient stay. Returns within 30 days were reviewed...
June 6, 2017: Pediatric Emergency Care
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