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https://www.readbyqxmd.com/read/29452747/accuracy-of-clinician-practice-compared-with-three-head-injury-decision-rules-in-children-a-prospective-cohort-study
#1
Franz E Babl, Ed Oakley, Stuart R Dalziel, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Susan Donath, Stephen Hearps, Charlotte Molesworth, Louise Crowe, Silvia Bressan, Mark D Lyttle
STUDY OBJECTIVE: Three clinical decision rules for head injuries in children (Pediatric Emergency Care Applied Research Network [PECARN], Canadian Assessment of Tomography for Childhood Head Injury [CATCH], and Children's Head Injury Algorithm for the Prediction of Important Clinical Events [CHALICE]) have been shown to have high performance accuracy. The utility of any of these in a particular setting depends on preexisting clinician accuracy. We therefore assess the accuracy of clinician practice in detecting clinically important traumatic brain injury...
February 13, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29446796/posttraumatic-headache
#2
Raquel Langdon, Sharief Taraman
After sustaining a concussion or mild traumatic brain injury, headaches are one of the most common complaints. The pathophysiologic changes that occur in the setting of injury likely contribute to or cause posttraumatic headaches. Posttraumatic headaches often present as migraine or tension-type headaches. Unlike pain from other types of injuries, headaches following mild traumatic brain injury are more likely to persist. Preexisting conditions such as migraine and mood disorders may influence posttraumatic headache and complicate management...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29443859/over-resuscitation-with-plasma-is-associated-with-sustained-fibrinolysis-shutdown-and-death-in-pediatric-traumatic-brain-injury
#3
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29433912/factors-influencing-emergency-department-care-of-young-children-at-risk-for-clinically-important-traumatic-brain-injury
#4
Tara Rhine, Shari L Wade, Nanhua Zhang, Huaiyu Zang, Stephanie Kennebeck, Lynn Babcock
OBJECTIVES: Care decisions for young children presenting to the emergency department (ED) with head injury are often challenging (e.g. whether to obtain neuroimaging). We sought to identify factors associated with acute management of children at-risk for clinically important traumatic brain injury (ciTBI) and describe symptom management. METHODS: Observational evaluation of children, ages 0-4years, presenting to a pediatric ED following minor head injury. Children with ≥1 risk element per the Pediatric Emergency Care Academic Research Network's decision rule were deemed "at-risk" for ciTBI...
January 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29432249/pediatric-traumatic-brain-injury-and-concussion
#5
Meeryo Choe, Karen M Barlow
PURPOSE OF REVIEW: This article summarizes the impact and complications of mild traumatic brain injury and concussion in children and outlines the recent evidence for its assessment and early management. Useful evidence-based management strategies are provided for children who have a typical recovery following concussion as well as for those who have persistent postconcussion syndrome. Cases are used to demonstrate the commonly encountered pathologies of headache, cognitive issues, and mood disturbances following injury...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#6
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29429778/hydrocephalus-in-pediatric-traumatic-brain-injury-national-incidence-risk-factors-and-outcomes-in-124-444-hospitalized-patients
#7
Kavelin Rumalla, Vijay Letchuman, Kyle A Smith, Paul M Arnold
BACKGROUND: Hydrocephalus is a life-threatening sequela of traumatic brain injury (TBI) with poorly defined epidemiology in children. Here, we report the national incidence, risk factors, and outcomes associated with post-traumatic hydrocephalus (PTH). METHODS: The Kids Inpatient Database (2003, 2006, 2009, 2012) was queried using the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes to identify all patients (age 0 to 20) with TBI (850...
December 11, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29429559/epo-improved-neurologic-outcome-in-rat-pups-late-after-traumatic-brain-injury
#8
Michelle E Schober, Daniela F Requena, Christopher K Rodesch
In adult rats, erythropoietin improved outcomes early and late after traumatic brain injury, associated with increased levels of Brain Derived Neurotrophic Factor. Using our model of pediatric traumatic brain injury, controlled cortical impact in 17-day old rats, we previously showed that erythropoietin increased hippocampal neuronal fraction in the first two days after injury. Erythropoietin also decreased activation of caspase3, an apoptotic enzyme modulated by Brain Derived Neurotrophic Factor, and improved Novel Object Recognition testing 14 days after injury...
February 8, 2018: Brain & Development
https://www.readbyqxmd.com/read/29427544/pediatric-nurses-perceived-knowledge-and-beliefs-of-evidence-based-practice-in-the-care-of-children-and-adolescents-with-moderate-to-severe-traumatic-brain-injury
#9
Tolu O Oyesanya, Traci R Snedden
PURPOSE: Pediatric nurses play a significant role in all phases of traumatic brain injury (TBI) recovery, particularly during the hospital stay. Although evidence-based nursing practice is known to improve patient outcomes, limited research exists on nurses' evidence-based perceived knowledge and beliefs specific to TBI care. As nurses' perceived knowledge and beliefs are known to guide their practice behaviors, this assessment is important to overall TBI outcomes. The purpose of this study was to evaluate pediatric nurses' evidence-based perceived knowledge and beliefs in providing care for children and adolescents with moderate-to-severe TBI...
February 10, 2018: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/29419604/assessment-of-recovery-following-pediatric-traumatic-brain-injury
#10
Julia C Slovis, Nachi Gupta, Natasha Y Li, Steven G Kernie, Darryl K Miles
OBJECTIVES: We analyzed a prospective database of pediatric traumatic brain injury patients to identify predictors of outcome and describe the change in function over time. We hypothesized that neurologic status at hospital discharge would not reflect the long-term neurologic recovery state. DESIGN: This is a descriptive cohort analysis of a single-center prospective database of pediatric traumatic brain injury patients from 2001 to 2012. Functional outcome was assessed at hospital discharge, and the Glasgow Outcome Scale Extended Pediatrics or Glasgow Outcome Scale was assessed on average at 15...
February 6, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29413725/current-practices-and-safety-of-medication-use-during-rapid-sequence-intubation
#11
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
January 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29394483/nurse-perceptions-of-pain-in-pediatric-traumatic-brain-injury-a-pilot-study
#12
Robin McCaa
Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study...
March 2017: Pediatric Nursing
https://www.readbyqxmd.com/read/29385015/the-effect-of-admission-functional-independence-on-early-recovery-in-pediatric-traumatic-and-nontraumatic-brain-injury
#13
Cherylynn Marino, Amanda Botticello, Julia H Coyne, Michael Dribbon, John DeLuca
OBJECTIVE: To examine functional independence at admission as a predictor of outcomes during an initial inpatient hospitalization for a pediatric brain injury. PARTICIPANTS: A total of 531 pediatric inpatients with traumatic (n = 298) or nontraumatic (n = 233) brain injuries. DESIGN: Retrospective analysis of data extracted from the Uniform Data System for Medical Rehabilitation. MAIN MEASURE: The Functional Independence Measure for Children, a measure of self-care, mobility, and cognitive independence...
January 30, 2018: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29385009/evidence-and-consensus-based-guidelines-for-the-management-of-communication-and-swallowing-disorders-following-pediatric-traumatic-brain-injury
#14
Cristina Mei, Vicki Anderson, Mary-Clare Waugh, Louise Cahill, Angela T Morgan
OBJECTIVE: Evidence-based management guidelines for communication and swallowing disorders following pediatric traumatic brain injury (TBI) are scarcely available, potentially resulting in suboptimal outcomes. To improve clinical care of this population, a multidisciplinary guideline development committee was formed to develop evidence-based recommendation (EBR) and consensus-based recommendation (CBR) for the management of speech, language, and swallowing disorders during the first year of recovery...
January 30, 2018: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29370008/initiating-nutritional-support-before-72-hours-is-associated-with-favorable-outcome-after-severe-traumatic-brain-injury-in-children-a-secondary-analysis-of-a-randomized-controlled-trial-of-therapeutic-hypothermia
#15
Elizabeth Meinert, Michael J Bell, Sandra Buttram, Patrick M Kochanek, Goundappa K Balasubramani, Stephen R Wisniewski, P David Adelson
OBJECTIVES: To understand the relationship between the timing of initiation of nutritional support in children with severe traumatic brain injury and outcomes. DESIGN: Secondary analysis of a randomized, controlled trial of therapeutic hypothermia (Pediatric Traumatic Brain Injury Consortium: Hypothermia, also known as "the Cool Kids Trial" (NCT 00222742). SETTINGS: Fifteen clinical sites in the United States, Australia, and New Zealand. SUBJECTS: Inclusion criteria included 1) age less than 18 years, 2) postresuscitation Glasgow Coma Scale less than or equal to 8, 3) Glasgow Coma Scale motor score less than 6, and 4) available to be randomized within 6 hours after injury...
January 24, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29350373/pediatric-dural-venous-sinus-thrombosis-following-closed-head-injury-an-easily-overlooked-diagnosis-with-devastating-consequences
#16
Joe M Das, Rashmi Sapkota, Binjura Shrestha
Dural venous sinus thrombosis (DVST) is an uncommon finding after traumatic brain injury. The diagnosis can often be initially missed, particularly if not associated with an overlying fracture. Pediatric DVST following closed head injury and without an overlying fracture is very rare, with only 20 cases reported in the literature to date. Here we present the case of a 19-month-old boy who presented with a history of trivial fall and an episode of fever. On presentation, the pediatric Glasgow Coma Scale (pGCS) score was E3V4M6, and initial brain computed tomography (CT) was normal...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29346233/video-recordings-to-analyze-preventable-management-errors-in-pediatric-resuscitation-bay
#17
Julia Borns, Jörg Ersch, Milana Dobrovoljac, Georg Staubli, Barbara Brotschi
OBJECTIVE: In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. METHODS: Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29336197/neurosensory-deficits-vary-as-a-function-of-point-of-care-in-pediatric-mild-traumatic-brain-injury
#18
Andrew Mayer, Chris Wertz, Sephira Ryman, Eileen Storey, Grace Park, John Phillips, Andrew Burke Dodd, Scott Oglesbee, Richard Campbell, Ron Yeo, Ben Wasserott, Nicholas Shaff, John J Leddy, Rebekah Mannix, Kristy B Arbogast, Timothy Meier, Matthew Grady, Christina Master
Neurosensory abnormalities are frequently observed following pediatric mild traumatic brain injury (pmTBI) and may underlie the expression of several common concussion symptoms and delay recovery. Importantly, active evaluation of neurosensory functioning more closely approximates real-world (e.g., physical and academic) environments that provoke symptom-worsening. The current study determined whether symptom provocation (i.e., during neurosensory exam) improved classification accuracy relative to pre-exam symptom levels and whether symptoms varied as a function of point of care...
January 16, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29334996/italian-guidelines-on-the-assessment-and-management-of-pediatric-head-injury-in-the-emergency-department
#19
REVIEW
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29333742/parvalbumin-fast-spiking-interneurons-are-selectively-altered-by-pediatric-traumatic-brain-injury
#20
Joshua Nichols, George Reed Bjorklund, Jason Newbern, Trent Anderson
Pediatric traumatic brain injury (TBI) is a leading cause of death and disability in children. Traditionally, ongoing neurodevelopment and neuroplasticity have thought to confer children with an advantage following TBI. However, recent findings indicate that the pediatric brain may be more sensitive to brain injury. Inhibitory interneurons are essential for proper cortical function and implicated in the pathophysiology of TBI, yet few studies have directly examined for TBI induced changes to interneurons themselves...
January 15, 2018: Journal of Physiology
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