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https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#1
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28701637/retention-and-caries-preventive-effect-of-glass-ionomer-and-resin-based-sealants-an-18-month-randomized-clinical-trial
#2
Asma Al-Jobair, Nouf Al-Hammad, Salwa Alsadhan, Fouad Salama
The objective of this study was to compare the retention and caries-preventive effect of glass ionomer (Fuji Triage) and resin-based (Clinpro) sealants among 6-9-year-old children. This split-mouth, randomized clinical trial covered 35 children/140 fully erupted permanent first molars. Evaluation was conducted by two independent examiners after 6, 12, and 18 months and the data were compared in relation to the children's caries risk and age groups. The Kaplan-Meier survival method and chi-square test were used for analysis...
July 12, 2017: Dental Materials Journal
https://www.readbyqxmd.com/read/28690005/pediatric-emergency-department-resource-utilization-among-children-with-primary-care-clinic-contact-in-the-preceding-2-days-a-cross-sectional-study
#3
Christina K Grech, Molly A Laux, Heather L Burrows, Michelle L Macy, Elaine S Pomeranz
OBJECTIVES: To characterize pediatric patient contacts with their primary care clinic in the 2 days preceding a visit to the emergency department (ED) and explore how the type of clinic contact relates to ED resource use. STUDY DESIGN: We conducted a retrospective chart review of 368 pediatric ED visits in the first 7 days of each month, from September 2012 to August 2013. Visits were included if the family contacted their child's general pediatric clinic in the study health system in the 2 days preceding the ED visit...
July 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28680520/validation-of-different-pediatric-triage-systems-in-the-emergency-department
#4
Kanokwan Aeimchanbanjong, Uthen Pandee
BACKGROUND: Triage system in children seems to be more challenging compared to adults because of their different response to physiological and psychosocial stressors. This study aimed to determine the best triage system in the pediatric emergency department. METHODS: This was a prospective observational study. This study was divided into two phases. The first phase determined the inter-rater reliability of five triage systems: Manchester Triage System (MTS), Emergency Severity Index (ESI) version 4, Pediatric Canadian Triage and Acuity Scale (CTAS), Australasian Triage Scale (ATS), and Ramathibodi Triage System (RTS) by triage nurses and pediatric residents...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28670809/inaccurate-diagnosis-of-paediatric-anaphylaxis-in-three-australian-emergency-departments
#5
Hector Thomson, Robert Seith, Simon Craig
AIM: To determine the accuracy of emergency department (ED) paediatric anaphylaxis diagnosis, and to identify factors associated with misdiagnosis. METHODS: Retrospective chart review of children aged 0-18 years with allergic presentations to three Victorian EDs in 2014. Cases were included if an ED diagnosis of anaphylaxis was recorded, or the presentation met international consensus criteria for anaphylaxis. RESULTS: Of the 60 143 paediatric ED presentations during the study period, 1551 allergy-related presentations were identified and reviewed...
July 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28657243/nurse-triage-in-an-irish-out-of-hours-general-practice-co-operative
#6
D Mulcahy, C O'Callaghan, A Hannigan
Specially trained triage nurses play a crucial role in the operation of out-of-hours GP co-operatives. This study aimed to establish the proportion of all patient contacts with the out-of-hours GP co-operative based in the Mid-West of Ireland (Shannondoc), which were managed by triage nurses. A retrospective, descriptive analysis was conducted on the database of contacts to the Shannondoc urgent, out-of-hours primary care co-operative. Of the 110,039 contacts to the service in 2013, 19,147 (17.4%) were classified as being managed by nurses and 14...
March 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28625711/why-parents-seek-care-for-acute-illness-in-the-clinic-or-the-ed-the-role-of-health-literacy
#7
Meghan May, David C Brousseau, David A Nelson, Kathryn E Flynn, Michael S Wolf, Bryn Lepley, Andrea K Morrison
OBJECTIVE: To explore the decision to seek care and decision-making regarding location of care among parents with low and adequate health literacy. METHODS: Parents of children ≤ 8 years old presenting for 'sick child' visits at a clinic or a non-urgent ED visit (triage level 5) were interviewed. The Newest Vital Sign (NVS) categorized parental health literacy. Interviewers followed a semi-structured interview guide to understand 1) care-seeking for current illness and 2) choice of clinic or ED...
June 15, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28601795/the-role-of-nurses-clinical-impression-in-the-first-assessment-of-children-at-the-emergency-department
#8
Joany M Zachariasse, Dominique van der Lee, Nienke Seiger, Evelien de Vos-Kerkhof, Rianne Oostenbrink, Henriëtte A Moll
OBJECTIVE: To assess the diagnostic value and determinants of nurses' clinical impression for the recognition of children with a serious illness on presentation to the emergency department (ED). DESIGN: Secondary analysis of a prospective cohort. SETTING AND PATIENTS: 6390 consecutive children <16 years of age presenting to a paediatric ED with a non-surgical chief complaint and complete data available. MAIN OUTCOME MEASURES: Diagnostic accuracy of nurses' clinical impression for the prediction of serious illness, defined by intensive care unit (ICU) and hospital admission...
June 10, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28587699/accurate-diagnosis-of-chd-by-paediatricians-with-expertise-in-cardiology
#9
Hannah C Jacob, Hannah Massey, Robert W M Yates, A Wilfred Kelsall
Introduction Paediatricians with Expertise in Cardiology assess children with a full history, examination, and often perform an echocardiogram. A minority are then referred to an outreach clinic run jointly with a visiting paediatric cardiologist. The accuracy of the echocardiography diagnosis made by the Paediatrician with Expertise in Cardiology is unknown. Materials and methods We conducted a retrospective review of clinic letters for children seen in the outreach clinic for the first time between March, 2004 and March, 2011...
August 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28562465/occult-head-injury-in-children-less-than-2-years-with-suspected-child-abuse-in-the-emergency-department
#10
Huma Shaikh, Brian H Wrotniak, Paula M Mazur
OBJECTIVE: This study aims to determine the frequency of clinically significant findings requiring emergent neurosurgical intervention on computed tomography (CT) in neurologically intact children admitted to the hospital with suspected abuse. METHODS: This was a retrospective review of neurologically stable children (0-24 months) in whom both skeletal survey and CT head were performed for child abuse evaluation from 2000 to 2011. RESULTS: A total of 132 patients met inclusion criteria (mean age, 7...
May 30, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28558759/the-danish-regions-pediatric-triage-model-has-a-limited-ability-to-detect-both-critically-ill-children-as-well-as-children-to-be-sent-home-without-treatment-a-study-of-diagnostic-accuracy
#11
Lotte Høeg Hansen, Christian Backer Mogensen, Lena Wittenhoff, Helene Skjøt-Arkil
BACKGROUND: The Danish Regions Pediatric Triage model (DRPT) was introduced in 2012 and subsequent implemented in most Danish acute pediatric departments. The aim was to evaluate the validity of DRPT as a screening tool to detect both the most serious acute conditions and the non-serious conditions in the acute referred patients in a pediatric department. METHOD: The study was prospective observational, with follow-up on all children with acute referral to pediatric department from October to December 2015...
May 30, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28550456/what-doesn-t-work-for-whom-exploring-heterogeneity-in-responsiveness-to-the-family-check-up-in-early-childhood-using-a-mixture-model-approach
#12
William E Pelham, Thomas J Dishion, Jenn-Yun Tein, Daniel S Shaw, Melvin N Wilson
This study applied latent class analysis to a family-centered prevention trial in early childhood to identify subgroups of families with differential responsiveness to the Family Check-Up (FCU) intervention. The sample included 731 families with 2-year-olds randomized to the FCU or control condition and followed through age 5 with yearly follow-up assessments. A two-step mixture model was used to examine whether specific constellations of family characteristics at age 2 (baseline) were related to intervention response across ages 3, 4, and 5...
May 27, 2017: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/28547532/prehospital-blood-transfusions-in-pediatric-trauma-and-nontrauma-patients-a-single-center-review-of-safety-and-outcomes
#13
Aodhnait S Fahy, Cornelius A Thiels, Stephanie F Polites, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
PURPOSE: Prehospital transfusions are a novel yet increasingly accepted intervention in the adult population as part of remote damage control resuscitation, but prehospital transfusions remain controversial in children. Our purpose was to review our pediatric prehospital transfusion experience over 12 years to describe the safety of prehospital transfusion in appropriately triaged trauma and nontrauma patients. METHODS: Children (<18 years) transfused with packed red blood cells (pRBC) or plasma during transport to a single regional academic medical center between 2002 and 2014 were identified...
May 25, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28538608/assessing-dehydration-employing-end-tidal-carbon-dioxide-in-children-with-vomiting-and-diarrhea
#14
Stephen B Freedman, David W Johnson, Alberto Nettel-Aguirre, Angelo Mikrogianakis, Sarah Williamson-Urquhart, Nicholas Monfries, Adam Cheng
OBJECTIVE: Serum bicarbonate reflects dehydration severity in children with gastroenteritis. Previous work in children receiving intravenous rehydration has correlated end-tidal carbon dioxide (EtCO2) with serum bicarbonate. We evaluated whether EtCO2 predicts weight change in children with vomiting and/or diarrhea. METHODS: A prospective cohort study was conducted. Eligible children were 3 months to 10 years old and presented for emergency department (ED) care because of vomiting and/or diarrhea...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28520684/pediatric-trauma-undertriage-in-ohio
#15
Juan P Gurria, Lynn Haas, Misty Troutt, Suzanne Moody, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio, there are 6 verified pediatric trauma centers (PTCs) across 8 state regions. The purpose of this study was to better understand the pediatric undertriage rates in the state. METHODS: We used the Ohio Trauma Registry from 2007 to 2012, consisting of 14,045 records of children younger than 16 years admitted to a hospital for more than 48 hours or who sustained a traumatic death...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28513890/risk-of-hospitalisation-after-early-revisit-in-the-emergency-department
#16
Giorgio Cozzi, Sergio Ghirardo, Ilaria Fiorese, Ilaria Proietti, Lorenzo Monasta, Marta Minute, Egidio Barbi, Lorenzo Calligaris
AIM: Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease. METHODS: Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children's hospital in Italy...
May 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28503359/maintaining-maternal-and-child-health-services-during-the-ebola-outbreak-experience-from-pujehun-sierra-leone
#17
GianLuca Quaglio, Damiano Pizzol, David Bome, Atiba Kebbie, Zainab Bangura, Vandi Massaquoi, Clara Frasson, Donata Dalla Riva, Giovanni Putoto
BACKGROUND: During the Ebola outbreak the overall confidence of the population in the national health system declined in Sierra Leone, with a reduction in the use of health services. The objective of this study is to provide information on understanding of how Ebola impacted maternal and child health services in Sierra Leone. Data come from an operational setting which is representative of the communities affected by the outbreak. METHODS: By integrating hospital registers and contact tracing form data with healthcare workers and local population interviews, the transmission chain was reconstructed...
June 2, 2016: PLoS Currents
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
#18
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/28484942/minimal-training-sufficient-to-diagnose-pediatric-wrist-fractures-with-ultrasound
#19
Henrik Hedelin, Christian Tingström, Hanna Hebelka, Jon Karlsson
BACKGROUND: In children, non-fractured wrists generally need no treatment and those that are fractured may only require a 3-week cast without any clinical follow-up. The ability to perform a point-of-care triage decision if radiographs are needed could improve patient flow and decrease unnecessary radiographs. The aim of this study was to evaluate the role of ultrasound (US) as a point-of-care triage tool for pediatric wrist injuries with limited training. METHODS: Physicians with no previous US experience attended a 1...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28478879/tumor-lysis-syndrome-a-unique-solute-disturbance
#20
REVIEW
Penelope Z Strauss, Shannan K Hamlin, Johnny Dang
Tumor lysis syndrome (TLS) is a life-threatening disorder that is an oncologic emergency. Risk factors for TLS are well-known, but the current literature shows case descriptions of unexpected acute TLS. Solid tumors and untreated hematologic tumors can lyse under various circumstances in children and adults. International guidelines and recommendations, including the early involvement of the critical care team, have been put forward to help clinicians properly manage the syndrome. Advanced practice nurses may be in the position of triaging and initiating treatment of patients with TLS, and need a thorough understanding of the syndrome and its treatment...
June 2017: Nursing Clinics of North America
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