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pediatrics fast trauma

John R Richards, John P McGahan
Focused assessment with sonography in trauma (FAST) has been extensively utilized and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly utilized to diagnose intraabdominal injury. Today the FAST examination has evolved into a more comprehensive study of the abdomen, heart, chest, and inferior vena cava, and many variations in technique, protocols, and interpretation exist. Trauma management strategies such as laparotomy, laparoscopy, endoscopy, computed tomographic angiography, angiographic intervention, serial imaging, and clinical observation have also changed over the years...
April 2017: Radiology
Hakan Aylanç, Filiz Tütüncüler, Necdet Süt
BACKGROUND: This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma. MATERIALS AND METHODS: In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined...
October 2016: Journal of Neurosciences in Rural Practice
Shannon N Acker, Brianne Hall, Lauren Hill, David A Partrick, Denis D Bensard
Introduction In the adult population, assessment of blood consumption (ABC) score [penetrating mechanism, positive focused assessment sonography for trauma (FAST), systolic blood pressure < 90, and heart rate (HR) > 120] ≥2 identifies trauma patients who require massive transfusion (MT) with sensitivity and specificity of 75 and 86%. We hypothesized that the adult criteria cannot be applied to children, as the vital sign cut-offs are not age-adjusted. We aimed to determine if the use of a shock index, pediatric age-adjusted (SIPA) would improve the discriminate ability of the ABC score in children...
February 2017: European Journal of Pediatric Surgery
Gunjan Kamdar Tiyyagura, Marcie Gawel, Aimee Alphonso, Jeannette Koziel, Kyle Bilodeau, Kirsten Bechtel
BACKGROUND: Prehospital care providers are in a unique position to provide initial unadulterated information about the scene where a child is abusively injured or neglected. However, they receive minimal training with respect to detection of Child Abuse and Neglect (CAN) and make few reports of suspected CAN to child protective services. AIMS: To explore barriers and facilitators to the recognition and reporting of CAN by prehospital care providers. DESIGN/METHODS: Twenty-eight prehospital care providers participated in a simulated case of infant abusive head trauma prior to participating in one-on-one semi-structured qualitative debriefs...
January 2017: Prehospital Emergency Care
Aikaterini Kanavaki, Christophe Draenert, Dimitri Ceroni, Sylviane Hanquinet
BACKGROUND/AIM: Management of scaphoid trauma includes imaging with repeated X-rays whose interpretation is difficult and often ambivalent. The aim of the study was to propose a fast magnetic resonance imaging (MRI) protocol permitting exclusion of traumatic lesions of the scaphoid bone in children, which would avoid unnecessary immobilization and irradiation in negative cases. PATIENTS AND METHODS: Two pediatric radiologists retrospectively reviewed the X-rays and MRIs of 45 children with clinical suspicion of scaphoid trauma...
July 2016: In Vivo
Maura E Ryan, Alok Jaju, Jody D Ciolino, Tord Alden
INTRODUCTION: Rapid MRI with ultrafast T2 sequences can be performed without sedation and is often used in place of computed tomography (CT) to evaluate pediatric patients for indications such as hydrocephalus. This study investigated the sensitivity of rapid magnetic resonance imaging (MRI) for detection and follow-up of acute intracranial hemorrhage in comparison to CT, which is commonly the first-line imaging. METHODS: Patients presenting to a pediatric hospital with acute intracranial hemorrhage on CT and follow-up rapid MRI within 48 h were included...
August 2016: Neuroradiology
Julia Hoeffe, Marie Pier Desjardins, Jason Fischer, Benoit Carriere, Jocelyn Gravel
BACKGROUND: Adult and pediatric emergency physicians have been using point-of-care ultrasound (POCUS) for many years. It is a fast, usually painless, noninvasive diagnostic tool that does not expose the patient to radiation. Information about its current implementation in pediatric emergency medicine (PEM) fellowship programs in Canada is lacking. OBJECTIVE: The main goal of our study was to investigate current integration and future direction of POCUS training in Canadian PEM programs...
November 2016: CJEM
Kristin Berona, Tarina Kang, Emily Rose
BACKGROUND: With focused assessment with sonography in trauma (FAST) examinations being performed more commonly on pediatric trauma patients, emergency providers will encounter a positive FAST examination in patients with benign abdominal examinations. This poses a diagnostic dilemma for the provider when deciding whether to obtain a computed tomography (CT) scan of the abdomen/pelvis, observe the patient, or admit the patient. CASE REPORT: We report a series of pediatric patients involved in blunt abdominal trauma who had small pelvic free fluid on FAST but a benign abdominal examination...
May 2016: Journal of Emergency Medicine
Offir Ben-Ishay, Mai Daoud, Zvi Peled, Eran Brauner, Hany Bahouth, Yoram Kluger
INTRODUCTION: In pediatric care, the role of focused abdominal sonography in trauma (FAST) remains ill defined. The objective of this study was to assess the sensitivity and specificity of FAST for detecting free peritoneal fluid in children. METHODS: The trauma registry of a single level I pediatric trauma center was queried for the results of FAST examination of consecutive pediatric (<18 years) blunt trauma patients over a period of 36 months, from January 2010 to December 2012...
2015: World Journal of Emergency Surgery: WJES
Roger Chen Zhu, Vadim Kurbatov, Patricia Leung, Gainosuke Sugiyama, Valery Roudnitsky
INTRODUCTION: Splenic pseudoaneurysms (SPA) are a rare but serious sequela of blunt traumatic injury to the spleen. Management of adult blunt splenic trauma is well-studied, however, in children, the management is much less well-defined. PRESENTATION OF CASE: A 15 year-old male presented with severe abdominal pain of acute onset after sustaining injury to his left side while playing football. FAST was positive for free fluid in the abdomen. Initial abdomen CT demonstrated a grade III/IV left splenic laceration with moderate to large hemoperitoneum with no active extravasation or injury to the splenic vessels noted...
2015: International Journal of Surgery Case Reports
Gunes Orman, Kevin Yuqi Wang, Ximin Li, Carol Thompson, Thierry A G M Huisman, Izlem Izbudak
PURPOSE: Obtaining fast, reliable, high-resolution diffusion tensor imaging (DTI) of the pediatric cervical spinal cord (CSC) is challenging, given the multitude of technical limitations involved. Overcoming these limitations may further potentiate DTI as a valuable quantitative tool in evaluating the pediatric CSC. METHODS: Sixteen patients (9 girls and 7 boys) with hypoxic brain injury, craniocervical junction malformations, and head trauma were included in this retrospective study...
August 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Isabelle Imamedjian, Robert Baird, Alexander Sasha Dubrovsky
We report a case of a false-positive focused abdominal sonography in trauma (FAST) examination in a persistently hypotensive pediatric trauma patient, performed 12 hours after the trauma, suspected to be caused by massive fluid resuscitation leading to ascites. While a positive FAST in a hypotensive trauma patient usually indicates hemoperitoneum, this case illustrates that the timing of the FAST examination relative to the injury, as well as clinical evolution including the volume of fluid resuscitation, need to be considered when interpreting the results of serial and/or late FAST examinations...
June 2015: Pediatric Emergency Care
Ellen M Dean, Kenneth Rogers, Mihir M Thacker, Richard W Kruse
OBJECTIVE: The aim of our study was to determine the inter-observer reliability of the ankle-brachial index (ABI) in the pediatric population. This was done to determine if this simple diagnostic test could be utilized in lieu of CT angiograms to reduce radiation exposure to children sustaining trauma, particularly physeal fractures about the knee. DESIGN: Diagnostic study of consecutive patients with no applied "gold-standard" test. SETTING: Level I pediatric hospital...
March 2015: Delaware Medical Journal
P Hilbert-Carius, G O Hofmann, R Lefering, R Stuttmann, M Bucher, P Goebel, G H Gronwald
BACKGROUND: A fast and comprehensive diagnostic by means of whole-body CT has been shown to reduce mortality in the adult trauma population. Therefore whole-body CT seems to be the standard in adult trauma-patients. Due to the higher radiation exposure of whole-body CT the use of this diagnostic toll in pediatric trauma patients is still under debate. It is not yet clear if whole-body CT in children can increase the probability of survival. METHOD: In a retrospective, multicenter study, we used the data recorded in the TraumaRegister DGU(®) to calculate the probability of survival according to the revised injury severity classification (RISC) and standardized mortality ratio (SMR)...
July 2015: Klinische Pädiatrie
Jay Menaker, Stephen Blumberg, David H Wisner, Peter S Dayan, Michael Tunik, Madelyn Garcia, Prashant Mahajan, Kent Page, David Monroe, Dominic Borgialli, Nathan Kuppermann, James F Holmes
BACKGROUND: The aim of this study was to evaluate the variability of clinician-performed Focused Assessment with Sonography for Trauma (FAST) examinations and its impact on abdominal computed tomography (AbCT) use in hemodynamically stable children with blunt torso trauma (BTT). The FAST is used with variable frequency in children with BTT. METHODS: We performed a planned secondary analysis of children (<18 years) with BTT. Patients with a Glasgow Coma Scale (GCS) score of less than 9, those with hypotension, and those taken directly to the operating suite were excluded...
September 2014: Journal of Trauma and Acute Care Surgery
J van Schuppen, D C Olthof, J C H Wilde, L F M Beenen, R R van Rijn, J C Goslings
INTRODUCTION: Blunt abdominal trauma (BAT) is an important but often unrecognized cause of death in children. Imaging plays a vital role in the early detection of abdominal trauma. The exact role of imaging in the management of BAT in children is still under research. The aim of this study was to assess diagnostic accuracy of a step-up imaging strategy, where the decision to observe or to perform an intervention depends on the vital parameters of the patient, in combination with the presence or absence of free fluid at Focused Assessment with Sonography for Trauma (FAST) and the findings on CT (performed selectively), for pediatric patients presenting to the ED with a blunt abdominal trauma...
January 2014: European Journal of Radiology
V Goldman, T H McCoy, M D Harbison, A T Fragomen, S R Rozbruch
INTRODUCTION/BACKGROUND: Russell-Silver syndrome (RSS) is the combination of intrauterine growth retardation, difficulty feeding, and postnatal growth retardation. Leg length discrepancy (LLD) is one of four major diagnostic criteria of RSS and is present in most cases. We aimed to ascertain whether pediatric RSS patients will adequately consolidate bony regenerate following leg lengthening. MATERIALS AND METHODS: We retrospectively reviewed pediatric RSS patients who underwent limb lengthening and compared them to a similar group of patients with LLD resulting from tumor, trauma, or congenital etiology...
March 2013: Journal of Children's Orthopaedics
Atilla Akbay, Burçak Bilginer, Nejat Akalan
PURPOSE: The purposes of this study were to characterize the clinical and radiological features of type 1 and type 2 atlantoaxial rotatory dislocations (AARD) and to evaluate the outcome of the manual reduction maneuver for these types of dislocations in pediatric patients. METHODS: This study considered 12 pediatric patients with AARD who were treated between January 2003 and March 2013. The diagnosis was established by clinical findings and 3D-CT. All of the patients were treated by closed manual reduction and then a cervical orthosis was performed...
June 2014: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Rieko Sumiyoshi
Preoperative fasting is principally intended to minimize the risk of pulmonary aspiration of gastric contents and facilitate the safe and efficient conduct of anesthesia. Liberalization of fasting guidelines has been implemented in most countries. In general, clear fluids are allowed up to 2h before anesthesia, and light meals up to 6h. In infants, most recommendations now allow breast milk feeding up to 4h and other kinds of milk up to 6h. Recently, the concept of preoperative oral rehydration using a carbohydrate-rich beverage up to 2h has also gained support...
September 2013: Masui. the Japanese Journal of Anesthesiology
Zhigang Li, Xiao Luo, Jinhuan Zhang
Drop is a frequent cause for infant head injury. To date, finite element (FE) modeling was gradually used to investigate child head dynamic response under drop impact conditions, however, two shortages still exist on this topic: (1) due to ethical reasons, none of developed 6-month-old (6MO) head FE model was found to be quantitatively validated against child cadaver tests at similar age group; (2) drop height and impact surface stiffness effects on infant head responses were not comprehensively investigated...
December 2013: Computer Methods and Programs in Biomedicine
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