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Pediatric ems

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https://www.readbyqxmd.com/read/29209919/association-between-cyp2c19-extensive-metabolizer-phenotype-and-childhood-anti-reflux-surgery-following-failed-proton-pump-inhibitor-medication-treatment
#1
James P Franciosi, Edward B Mougey, Andre Williams, Roberto A Gomez Suarez, Cameron Thomas, Christa L Creech, Katherine George, Diana Corao, John J Lima
When pediatric gastroesophageal reflux disease (GERD) that is refractory to proton pump inhibitor (PPI) medication treatment is identified in clinical practice and anti-reflux surgery (ARS) is being considered, genetic factors related to PPI metabolism by the CYP2C19 enzyme are currently not part of the clinical decision-making process. Our objective was to test the hypothesis that the distribution of the extensive metabolizer (EM) phenotypes among children undergoing ARS after failing PPI therapy would differ compared to controls (children with no history of ARS)...
December 6, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29189593/association-of-insurance-with-use-of-emergency-medical-services-among-children
#2
Parul Dayal, Timothy K Ruttan, Jamie L Kissee, Ilana S Sigal, James P Marcin
OBJECTIVE: The use of emergency medical services (EMS) can be lifesaving for critically ill children and should be defined by the child's clinical need. Our objective was to determine whether nonclinical demographic factors and insurance status are associated with EMS use among children presenting to the emergency department (ED). METHODS: In this cross-sectional study using the National Hospital Ambulatory Medical Care Survey, we included children presenting to EDs from 2009 to 2014...
November 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29185783/comparison-of-recidivism-rates-for-a-teenage-trauma-prevention-program-after-the-addition-of-high-fidelity-patient-simulation
#3
Marjorie Lee White, J Lynn Zinkan, Geni Smith, Dawn Taylor Peterson, Amber Q Youngblood, Ashley Dodd, Walter Parker, Samuel Strachan, Peter Sloane, Nancy Tofil
OBJECTIVES: We evaluated benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps towards safe driving. METHODS: A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the Emergency Medical Services (EMS) handoff to complete trauma care...
November 29, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29136270/60-seconds-to-survival-a-pilot-study-of-a-disaster-triage-video-game-for-prehospital-providers
#4
Mark X Cicero, Travis Whitfill, Kevin Munjal, Manu Madhok, Maria Carmen G Diaz, Daniel J Scherzer, Barbara M Walsh, Angela Bowen, Michael Redlener, Scott A Goldberg, Nadine Symons, James Burkett, Joseph C Santos, David Kessler, Ryan N Barnicle, Geno Paesano, Marc A Auerbach
INTRODUCTION: Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. METHODS: Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls...
April 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29023218/out-of-hospital-pediatric-patient-safety-events-results-of-the-csi-chart-review
#5
Garth Meckler, Matthew Hansen, William Lambert, Kerth O'Brien, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. METHODS: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28985969/modifiable-factors-associated-with-survival-after-out-of-hospital-cardiac-arrest-in-the-pan-asian-resuscitation-outcomes-study
#6
Hideharu Tanaka, Marcus E H Ong, Fahad J Siddiqui, Matthew H M Ma, Hiroshi Kaneko, Kyung Won Lee, Kentaro Kajino, Chih-Hao Lin, Han Nee Gan, Pairoj Khruekarnchana, Omer Alsakaf, Nik H Rahman, Nausheen E Doctor, Pryseley Assam, Sang Do Shin
STUDY OBJECTIVE: The study aims to identify modifiable factors associated with improved out-of-hospital cardiac arrest survival among communities in the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network: Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and the United Arab Emirates (Dubai). METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis...
October 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28956669/prehospital-pain-management-disparity-by-age-and-race
#7
Hilary A Hewes, Mengtao Dai, N Clay Mann, Tanya Baca, Peter Taillac
IMPORTANCE: Historically, pain management in the prehospital setting, specifically pediatric pain management, has been inadequate despite many EMS (emergency medical services) transports related to traumatic injury with pain noted as a symptom. The National Emergency Services Information System (NEMSIS) database offers the largest national repository of prehospital data, and can be used to assess current patterns of EMS pain management across the country. OBJECTIVES: To analyze prehospital management of pain using NEMSIS data, and to assess if variables such as patient age and/or race/ethnicity are associated with disparity in pain treatment...
September 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28921731/interobserver-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#8
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVES: The objective was to determine the interobserver agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28838781/a-comparison-of-pediatric-airway-management-techniques-during-out-of-hospital-cardiac-arrest-using-the-cares-database
#9
Matthew L Hansen, Amber Lin, Carl Eriksson, Mohamud Daya, Bryan McNally, Rongwei Fu, David Yanez, Dana Zive, Craig Newgard
OBJECTIVE: To compare odds of survival to hospital discharge among pediatric out-of-hospital cardiac arrest (OHCA) patients receiving either bag-valve-mask ventilation (BVM), supraglottic airway (SGA) or endotracheal intubation (ETI), after adjusting for the propensity to receive a given airway intervention. METHODS: Retrospective cohort study using the Cardiac Arrest Registry to Enhance Survival (CARES) database from January 1 201-December 31, 2015. The CARES registry includes data on cardiac arrests from 17 statewide registries and approximately 55 additional US cities...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28829652/pediatric-prehospital-refusal-of-medical-assistance-association-with-suspected-abuse-or-neglect
#10
Felicia Mix, Lucas A Myers, Anuradha Luke, Matthew D Sztajnkrycer
INTRODUCTION: Unlike adult refusal of medical assistance (RMA), pediatric refusal is not initiated by the patient. This lack of autonomy may permit neglect by the guardian through denial of necessary treatment. The purpose of the current study was to determine whether pediatric RMA was associated with suspected abuse or neglect (SAN). METHODS: This was a retrospective single EMS agency cross-sectional analysis of calls between January 1, 2011 and December 31, 2015 for patients <18 years of age resulting in RMA...
November 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28821366/safety-events-in-pediatric-out-of-hospital-cardiac-arrest
#11
Matt Hansen, Carl Eriksson, Barbara Skarica, Garth Meckler, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to explore the types of patient safety events that take place during pediatric out-of-hospital cardiac arrest resuscitation. METHODS: Retrospective medical record review from a single large urban EMS system of EMS-treated pediatric (<18years of age) out-of-hospital cardiac arrests (OHCA) occurring between 2008 and 2011. A chart review tool was developed for this project and each chart was reviewed by a multidisciplinary review panel...
August 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28812053/emergency-medical-service-personnel-recognize-pediatric-concussions
#12
Joshua N Speirs, Matthew I Lyons, Bert E Johansson
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#13
Timothy VanderKooy, Kelsey Spaur, Lina Brou, Sean Caffrey, Kathleen M Adelgais
INTRODUCTION: Prehospital intravenous (IV) access in children may be difficult and time-consuming. Emergency Medical Service (EMS) protocols often dictate IV placement; however, some IV catheters may not be needed. The scene and transport time associated with attempting IV access in children is unknown. The objective of this study is to examine differences in scene and transport times associated with prehospital IV catheter attempt and utilization patterns of these catheters during pediatric prehospital encounters...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28657816/retrospective-evaluation-of-risk-factors-for-pediatric-secondary-transport
#14
Jennifer N Fishe, Kevin J Psoter, Bruce L Klein, Jennifer F Anders
OBJECTIVE: Emergency medical services (EMS) typically transports patients to the nearest emergency department (ED). After initial presentation, children who require specialized care must undergo secondary transport, exposing them to additional risks and delaying definitive treatment. EMS direct transport protocols exist for major trauma and certain adult medical conditions, however the same cannot be said for pediatric medical conditions or injuries that do not meet trauma center criteria ('minor trauma')...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28614100/acuity-prediction-using-emergency-medical-services-prenotifications-in-a-pediatric-emergency-department
#15
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/28579715/combination-of-encephalo-myo-pial-synangiosis-and-encephalo-arterio-pial-synangiosis-procedure-in-pediatric-moya-moya-disease
#16
Prastiya Gunawan, Wihasto Suryaningtyas, Darto Saharso, Risky Prasetyo
BACKGROUND: Moya-moya disease in children is a cerebrovascular disorder that may cause cerebral ischemic or hemorrhage. CASE DETAILS: We report an 8-year-old boy that was admitted with the chief complaint of repeated sudden half left body paralyze. MRA showed acute thrombotic infarction in the right hemisphere and internal carotid artery stenosis in the form of puffs of smokes. Indirect revascularization surgical procedure with combination of Encephalo-myo-pial-synangiosis (EMS) and Encephalo-arterio-pial-synangiosis (EAS) was performed...
March 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28562463/an-ethical-justification-for-termination-of-resuscitation-protocols-for-pediatric-patients
#17
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...
July 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28558908/state-level-geographic-variation-in-prompt-access-to-care-for-children-after-motor-vehicle-crashes
#18
COMPARATIVE STUDY
Lindsey L Wolf, Ritam Chowdhury, Jefferson Tweed, Lori Vinson, Elena Losina, Adil H Haider, Faisal G Qureshi
BACKGROUND: Motor vehicle crashes (MVCs) are a principal cause of death in children; fatal MVCs and pediatric trauma resources vary by state. We sought to examine state-level variability in and predictors of prompt access to care for children in MVCs. MATERIALS AND METHODS: Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers aged <15 y involved in fatal MVCs (crashes on US public roads with ≥1 death, adult or pediatric, within 30 d)...
September 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28489471/effect-of-the-2011-revisions-to-the-field-triage-guidelines-on-under-and-over-triage-rates-for-pediatric-trauma-patients
#19
E Brooke Lerner, Jeremy T Cushman, Amy L Drendel, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) and the American College of Surgeons - Committee on Trauma (ACS-COT). It is unknown how the modifications will affect the number of injured children identified by EMS providers as needing transport to a trauma center. OBJECTIVE: To determine the change in under- and over-triage rates when the 2011 Field Triage Guidelines are compared to the 2006 and 1999 versions...
July 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#20
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
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