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Pediatric Emergency Medicine Practice

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https://www.readbyqxmd.com/read/30383347/points-pearls-pediatric-bacterial-meningitis-an-update-on-early-identification-and-management
#1
Emerson Posadas, Jay Fisher, Kathryn Pade
The presentation of bacterial meningitis can overlap with viral meningitis and other conditions, and emergency clinicians must remain vigilant to avoid delaying treatment for a child with bacterial meningitis. Inflammatory markers, such as procalcitonin, in the serum and cerebrospinal fluid may help distinguish between bacterial meningitis and viral meningitis. Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Although debated, corticosteroids should be considered in certain cases...
November 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30383346/calculated-decisions-bacterial-meningitis-score-for-children
#2
Cullen Clark
The bacterial meningitis score for children rules out bacterial meningitis in pediatric patients with suspected meningitis.
November 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30358380/pediatric-bacterial-meningitis-an-update-on-early-identification-and-management
#3
Emerson Posadas, Jay Fisher
The presentation of bacterial meningitis can overlap with viral meningitis and other conditions, and emergency clinicians must remain vigilant to avoid delaying treatment for a child with bacterial meningitis. Inflammatory markers, such as procalcitonin, in the serum and cerebrospinal fluid may help distinguish between bacterial meningitis and viral meningitis. Appropriate early antibiotic treatment and management for bacterial meningitis is critical for optimal outcomes. Although debated, corticosteroids should be considered in certain cases...
November 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30280870/points-pearls-diagnosing-and-managing-common-genital-emergencies-in-pediatric-girls
#4
Michelle K. Arzubi-Hughes, Laila A. Salts, Melanie A. Weller, Bryan Wilson
The presentation of genital injuries and emergencies in pediatric girls can sometimes be misleading. A traumatic injury with excessive bleeding may be a straddle injury that requires only conservative management, while a penetrating injury may have no recognizable signs or symptoms but require extensive surgery. This issue reviews the most common traumatic genital injuries in girls presenting to the emergency department, including straddle injuries, hematomas, and impalement injuries. Nontraumatic emergencies, including hematocolpos and urethral prolapse, are also discussed...
October 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30251816/diagnosing-and-managing-common-genital-emergencies-in-pediatric-girls
#5
Michelle K Arzubi-Hughes, Laila A Salts, Melanie A Weller
The presentation of genital injuries and emergencies in pediatric girls can sometimes be misleading. A traumatic injury with excessive bleeding may be a straddle injury that requires only conservative management, while a penetrating injury may have no recognizable signs or symptoms but require extensive surgery. This issue reviews the most common traumatic genital injuries in girls presenting to the emergency department, including straddle injuries, hematomas, and impalement injuries. Nontraumatic emergencies, including hematocolpos and urethral prolapse, are also discussed...
October 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183415/calculated-decisions-wound-closure-classification
#6
Jennie Kim, Ronald Simon
The Wound Closure Classification stratifies types of wounds to help guide strategies for closure.
September 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183241/calculated-decisions-ottawa-knee-rule
#7
Calvin Hwang
The Ottawa Knee Rule describes criteria for knee trauma patients who are at low risk for clinically significant fracture and do not warrant knee imaging.
September 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183240/calculated-decisions-ottawa-ankle-rule
#8
Calvin Hwang
The Ottawa Ankle Rule shows the areas of tenderness to be evaluated in ankle trauma patients to determine the need for imaging.
September 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30179415/points-pearls-tick-borne-illnesses-identification-and-management-in-the-emergency-department
#9
Jennifer Bellis, Ee Tein Tay, Bryan Wilson
Tick-borne illnesses are increasing in prevalence and geographic reach. Because the presentation of these illnesses is sometimes nonspecific, they can often be misdiagnosed, especially in the early stages of illness. A detailed history with questions involving recent activities and travel and a thorough physical examination will help narrow the diagnosis. While some illnesses can be diagnosed on clinical findings alone, others require confirmatory testing, which may take days to weeks to result. This issue reviews the emergency department presentation of 9 common tick-borne illnesses and evidence-based recommendations for identification, testing, and treatment...
September 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30179409/calculated-decisions-rule-of-7s-for-lyme-meningitis
#10
REVIEW
Matthew Lecuyer
The Rule of 7s for Lyme Meningitis is a validated clinical prediction rule to distinguish Lyme meningitis from aseptic meningitis.
September 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30130011/tick-borne-illnesses-identification-and-management-in-the-emergency-department
#11
REVIEW
Jennifer Bellis, Ee Tein Tay
Tick-borne illnesses are increasing in prevalence and geographic reach. Because the presentation of these illnesses is sometimes nonspecific, they can often be misdiagnosed, especially in the early stages of illness. A detailed history with questions involving recent activities and travel and a thorough physical examination will help narrow the diagnosis. While some illnesses can be diagnosed on clinical findings alone, others require confirmatory testing, which may take days to weeks to result. This issue reviews the emergency department presentation of 9 common tick-borne illnesses and evidence-based recommendations for identification, testing, and treatment...
September 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30070815/points-pearls-emergency-department-management-of-dental-trauma-recommendations-for-improved-outcomes-in-pediatric-patients
#12
Joyce Li, Kathryn Pade
Nearly 50% of children will experience dental trauma by the age of 4 years. Timely and effective care is important in the management of dental injuries, as several studies have shown poor outcomes with delayed treatment. The current evidence in the management of dental injuries is primarily from a dentist's perspective, with limited evidence specific to management in the emergency department. The goal of pediatric dental injury management is dictated largely by whether the dentition is primary or permanent...
August 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/30020737/emergency-department-management-of-dental-trauma-recommendations-for-improved-outcomes-in-pediatric-patients
#13
Joyce Li
Nearly 50% of children will experience dental trauma by the age of 4 years. Timely and effective care is important in the management of dental injuries, as several studies have shown poor outcomes with delayed treatment. The current evidence in the management of dental injuries is primarily from a dentist's perspective, with limited evidence specific to management in the emergency department. The goal of pediatric dental injury management is dictated largely by whether the dentition is primary or permanent...
August 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29993209/points-pearls-recognition-and-management-of-pediatric-thyroid-emergencies-in-the-emergency-department
#14
Troy W. S. Turner, Kathryn H. Pade
The wide range and vague nature of clinical presentations of thyroid emergencies make accurate and timely diagnosis challenging. Patients with a variety of thyroid conditions present to the emergency department, and appropriate suspicion can reduce unnecessary delay and expense in determining the correct diagnosis. This issue reviews the current evidence for presentation, evaluation, and treatment for emergencies of thyroid function and anatomy including hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid trauma...
July 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29949705/recognition-and-management-of-pediatric-thyroid-emergencies-in-the-emergency-department
#15
Troy W S Turner
The wide range and vague nature of clinical presentations of thyroid emergencies make accurate and timely diagnosis challenging. Patients with a variety of thyroid conditions present to the emergency department, and appropriate suspicion can reduce unnecessary delay and expense in determining the correct diagnosis. This issue reviews the current evidence for presentation, evaluation, and treatment for emergencies of thyroid function and anatomy including hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid trauma...
July 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29906381/points-pearls-management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#16
Andria Tatem, Rupa Kapoor, Bryan Wilson
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29893520/calculated-decisions-pecarn-pediatric-head-injury-trauma-algorithm
#17
Daniel Runde, Joshua Beiner
The PECARN Pediatric Head Injury Prediction Rule is a well-validated clinical decision aid that allows clinicians to safely rule out the presence of clinically important traumatic brain injuries.
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29893519/calculated-decisions-pediatric-glasgow-coma-scale
#18
Joyce Brown, Matthew Meigh
The Pediatric Glasgow Coma Scale allows clinicians to obtain, track, and communicate the mental status and level of consciousness in preverbal children aged ≤ 2 years.
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29771484/management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#19
Andria Tatem, Rupa Kapoor
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29718649/synthetic-drug-intoxication-in-children-recognition-and-management-in-the-emergency-department-digest
#20
Rahul Shah, Carl R Baum, Kathryn H Pade
When children and adolescents present to the emergency department with agitation or mental status changes, intoxication from synthetic drug use should be in the differential diagnosis. Identifying the responsible compound(s) may be difficult, so asking the patient broad questions and utilizing appropriate diagnostic studies, when indicated, will aid in making the diagnosis and help identify more-serious complications. This issue discusses the challenges presented by the changing chemical formulations of synthetic cannabinoids, cathinones, and phenethylamines; outlines common presentations of intoxication from these substances; and summarizes best practices for evaluating and managing patients who present with intoxication after consumption of these synthetic drugs of abuse...
May 1, 2018: Pediatric Emergency Medicine Practice
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