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triage in children

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https://www.readbyqxmd.com/read/28235966/inter-rater-reliability-between-nurses-for-a-new-paediatric-triage-system-based-primarily-on-vital-parameters-the-paediatric-triage-instrument-peti
#1
Jaana Karjala, Staffan Eriksson
INTRODUCTION: The major paediatric triage systems are primarily based on flow charts involving signs and symptoms for orientation and subjective estimates of the patient's condition. In contrast, the 4-level Paediatric Triage Instrument (PETI) is primarily based on vital parameters and was developed exclusively for paediatric triage in patients with medical symptoms. The aim of this study was to assess the inter-rater reliability of this triage system in children when used by nurses. METHODS: A design was employed in which triage was performed simultaneously and independently by a research nurse and an emergency department (ED) nurse using the PETI...
February 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28235428/validation-of-a-hand-held-point-of-care-device-for-lactate-in-adult-and-pediatric-patients-using-traditional-and-locally-smoothed-median-and-maximum-absolute-difference-curves
#2
Jessica Marie Colon-Franco, Stanley F Lo, Sergey S Tarima, David Gourlay, Amy L Drendel, E Brook Lerner
BACKGROUND: Lactate is commonly used in septic patients and is a viable biomarker for trauma patients. Its pre-hospital use could assist triaging and managing patients with these conditions. METHODS: We evaluated the analytical performance of the point-of-care (POC) StatStrip Xpress Lactate Meter (Nova Biomedical) and compared it to the ABL 800 (Radiometer). We measured lactate in 250 adult and 250 pediatric whole blood samples in 2 laboratories. The performance of the POC meter was assessed by traditional linear regression and Bland-Altman plots, and locally-smoothed (LS) median absolute difference and maximum absolute difference (MAD and MaxAD) curves...
February 21, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28221282/characteristics-and-triage-of-children-presenting-in-mental-health-crisis-to-emergency-departments-at-detroit-regional-hospitals
#3
Kristen Williams, Amanda R Levine, David M Ledgerwood, Alireza Amirsadri, Leslie H Lundahl
OBJECTIVES: The number of children in the United States utilizing emergency department (ED) services for psychiatric crises is increasing, and psychiatric-related ED visits disproportionately burden hospital resources. Yet, there is limited available information on the epidemiology and outcomes of pediatric mental health emergencies. The present study sought to characterize pediatric mental health-related ED presentations in a large urban center and identify factors predictive of inpatient hospitalization...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28212900/basic-educational-needs-of-midwifery-students-for-taking-the-role-of-an-assistance-in-disaster-situations-a-cross-sectional-study-in-iran
#4
Z Taghizadeh, M Khoshnam Rad, A Montazeri
BACKGROUND: After disasters, the disaster medical assistance team composed of skilful healthcare staff should be available at the disaster site for providing care to disaster's victims. It is believed that midwives are at the front line of the disaster management team and should be prepared for providing care to mothers and children. OBJECTIVES: To investigate the midwifery students' basic educational needs for taking the role of an assistant in disaster situations...
January 22, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28177940/emergency-department-pain-management-in-children-with-appendicitis-in-a-bi-ethnic-population
#5
Ron Jacob, Baruch Krauss, Gal Twito, Ronit Leiba, Itai Shavit
OBJECTIVES: Our goal was to examine factors associated with the administration of ED analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children's hospital in Israel, and to examine ethnic differences. METHODS: A retrospective cohort study of children evaluated in the ED, who had ICD-9 diagnosis of acute appendicitis. Regression analysis was used to test the effect of multiple variables on the provision of analgesia. Medications were administered according to a nurse-driven pain protocol...
February 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28151987/validity-of-the-manchester-triage-system-in-emergency-care-a-prospective-observational-study
#6
Joany M Zachariasse, Nienke Seiger, Pleunie P M Rood, Claudio F Alves, Paulo Freitas, Frank J Smit, Gert R Roukema, Henriëtte A Moll
OBJECTIVES: To determine the validity of the Manchester Triage System (MTS) in emergency care for the general population of patients attending the emergency department, for children and elderly, and for commonly used MTS flowcharts and discriminators across three different emergency care settings. METHODS: This was a prospective observational study in three European emergency departments. All consecutive patients attending the emergency department during a 1-year study period (2010-2012) were included...
2017: PloS One
https://www.readbyqxmd.com/read/28148468/tachycardia-may-prognosticate-life-or-organ-threatening-diseases-in-children-with-abdominal-pain
#7
Itaru Hayakawa, Hiroshi Sakakibara, Yukari Atsumi, Hiroshi Hataya, Toshiro Terakawa
BACKGROUND: Abdominal pain is common in children, but expeditious diagnosis of life- or organ-threatening diseases can be challenging. An evidence-based definition of tachycardia in children was established recently, but its diagnostic utility has not yet been studied. OBJECTIVE: To test the hypothesis that abdominal pain with tachycardia may pose a higher likelihood of life- or organ-threatening diseases in children. METHODS: A nested case-control study was conducted in a pediatric emergency department in 2013...
January 24, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28145196/recognition-and-management-of-foreign-body-ingestion-and-aspiration
#8
Oliver William McKinney, Paul Anthony Heaton, Jane Gamble, Siba Prosad Paul
Foreign body ingestion and foreign body aspiration commonly affect children. The most vulnerable age is between six months and four years, when children tend to explore new objects with their mouths. Many of these events remain asymptomatic, with the swallowed object passing through the gastrointestinal tract without causing harm. However, the frequency of serious complications as a result of the ingestion of hazardous objects has increased in recent years, in particular button batteries and magnets. To increase the likelihood of identifying foreign body ingestion and aspiration, healthcare professionals should maintain a high index of suspicion, be aware of the variation in presentations and include it as a differential diagnosis in children presenting with non-specific symptoms, such as fever, cough, drooling, dysphagia and abdominal pain...
February 1, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28132766/piloting-a-pediatric-trauma-course-in-western-jamaica-lessons-learned-and-future-directions
#9
Hadley K Wesson, Valerie Plant, Marieka Helou, Karen Wharton, Delroy Fray, Jeffrey Haynes, Charles Bagwell
INTRODUCTION: Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development...
January 10, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28124200/operational-demands-on-pre-hospital-emergency-care-for-burn-injuries-in-a-middle-income-setting-a-study-in-the-western-cape-south-africa
#10
Rachel L Allgaier, Lucie Laflamme, Lee A Wallis
BACKGROUND: Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres, yet a well-developed pre-hospital system. This paper describes the burn cases from a viewpoint of operational factors important to pre-hospital emergency medical services. METHODS: A retrospective, cross-sectional study of administrative and patient records was conducted...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28122537/reliability-and-validity-of-pediatric-triage-tools-evaluated-in-low-resource-settings-a-systematic-review
#11
Bhakti Hansoti, Alexander Jenson, Devin Keefe, Sarah Stewart De Ramirez, Trisha Anest, Michelle Twomey, Katie Lobner, Gabor Kelen, Lee Wallis
BACKGROUND: Despite the high burden of pediatric mortality from preventable conditions in low and middle income countries and the existence of multiple tools to prioritize critically ill children in low-resource settings, no analysis exists of the reliability and validity of these tools in identifying critically ill children in these scenarios. METHODS: The authors performed a systematic search of the peer-reviewed literature published, for studies pertaining to for triage and IMCI in low and middle-income countries in English language, from January 01, 2000 to October 22, 2013...
January 26, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28114415/managing-neonatal-and-early-childhood-syndromic-sepsis-in-sub-district-hospitals-in-resource-poor-settings-improvement-in-quality-of-care-through-introduction-of-a-package-of-interventions-in-rural-bangladesh
#12
Ahmed Ehsanur Rahman, Afrin Iqbal, D M Emdadul Hoque, Md Moinuddin, Sojib Bin Zaman, Qazi Sadeq-Ur Rahman, Tahmina Begum, Atique Iqbal Chowdhury, Rafiqul Haider, Shams El Arifeen, Niranjan Kissoon, Charles P Larson
INTRODUCTION: Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments...
2017: PloS One
https://www.readbyqxmd.com/read/28108810/independent-risk-factors-for-recurrence-of-apparent-life-threatening-events-in-infants
#13
Riyo Ueda, Osamu Nomura, Takanobu Maekawa, Hirokazu Sakai, Satoshi Nakagawa, Akira Ishiguro
: The risk factors for recurrent apparent life-threatening event (ALTE) are unclear although the risk of recurrent ALTE is an important consideration for the management of ALTE patients. This study aimed to identify the risk factors for recurrent ALTE. We conducted a secondary analysis of the data from a single center retrospective cohort study in Japan conducted from March 2002 to January 2012, which included children diagnosed with ALTE at a pediatric emergency department (ED) in Tokyo...
January 20, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28108126/expert-perspectives-on-time-sensitivity-and-a-related-metric-for-children-involved-in-motor-vehicle-crashes
#14
Andrea N Doud, Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, John K Petty, J Wayne Meredith, Joel D Stitzel
OBJECTIVE: Advanced Automatic Crash Notification (AACN) uses vehicle telemetry data to predict risk of serious injury among motor vehicle crash occupants and can thus improve the accuracy with which injured children are triaged by first responders. To better define serious injury for AACN systems (which typically use Abbreviated Injury Scale [AIS] metrics), an age-specific approach evaluating severity, time sensitivity (TS), and predictability of injury has been developed. This study outlines the development of the TS score...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28095408/patient-safety-incidents-involving-sick-children-in-primary-care-in-england-and-wales-a-mixed-methods-analysis
#15
Philippa Rees, Adrian Edwards, Colin Powell, Peter Hibbert, Huw Williams, Meredith Makeham, Ben Carter, Donna Luff, Gareth Parry, Anthony Avery, Aziz Sheikh, Liam Donaldson, Andrew Carson-Stevens
BACKGROUND: The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting. METHODS AND FINDINGS: We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013...
January 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#16
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040554/proteinuria-during-dengue-fever-in-children
#17
Anne-Claire Andries, Veasna Duong, Julien Cappelle, Sivuth Ong, Alexandra Kerleguer, Sowath Ly, Arnaud Tarantola, Paul F Horwood, Anavaj Sakuntabhai, Philippe Dussart, Philippe Buchy
OBJECTIVES: This study aimed to investigate proteinuria occurring during dengue disease in children and assess if measurement of this parameter can help physicians in the clinical management of patients. METHODS: Proteinuria was assessed by dipstick and quantified by urine protein:creatinine ratio (UPCR) in samples from patients hospitalized with a confirmed dengue infection and in healthy controls. RESULTS: The dipstick tested positive in 42...
December 28, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28034883/an-evidence-based-algorithm-for-early-prognosis-of-severe-dengue-in-the-outpatient-setting
#18
Minh Tuan Nguyen, Thi Nhan Ho, Van Vinh Chau Nguyen, Thanh Hung Nguyen, Manh Tuan Ha, Van Tram Ta, Le Da Ha Nguyen, Loi Phan, Khoi Quang Han, Thi Hue Kien Duong, Nguyen Bich Chau Tran, Wills Bridget, Marcel Wolbers, Cameron P Simmons
BACKGROUND: Early prediction of severe dengue could significantly assist patient triage and case management METHODS: We prospectively investigated 7563 children with ≤3 days of fever recruited in the outpatient departments of six hospitals in southern Vietnam between 2010 and 2013. The primary endpoint of interest was severe dengue (2009 WHO Guidelines) and pre-defined risk variables were collected at the time of enrolment to enable prognostic model development. RESULTS: The analysis population comprised 7544 patients, of whom 2060 (27...
December 28, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28034476/defining-cases-of-severe-pediatric-diarrhea-for-an-efficacy-trial-of-an-enterotoxigenic-escherichia-coli-etec-vaccine-report-on-an-international-workshop-washington-dc-march-2016
#19
Thomas F Wierzba, Alexandra Bourgis
Enterotoxigenic Escherichia coli (ETEC) causes severe acute watery diarrhea. No ETEC vaccine is available but candidates are in development, including ETVAX, an oral, whole-cell inactivated vaccine. ETVAX is being tested in a descending-age trial in Bangladesh. If found safe and immunogenic, investigators may test it for efficacy in children. Like oral rotavirus vaccines, we expect that ETVAX will be most effective at decreasing the incidence of moderate-to-severe ETEC episodes. Thus, for an efficacy trial outcome, it will be necessary to triage patients into moderate-to-severe versus mild disease...
January 23, 2017: Vaccine
https://www.readbyqxmd.com/read/28031190/risk-factors-for-death-in-children-during-inpatient-treatment-of-severe-acute-malnutrition-a-prospective-cohort-study
#20
Maren Jh Rytter, Esther Babirekere-Iriso, Hanifa Namusoke, Vibeke B Christensen, Kim F Michaelsen, Christian Ritz, Charlotte G Mortensen, Ezekiel Mupere, Henrik Friis
BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants, and recorded the nutritional therapy given in hospital...
December 28, 2016: American Journal of Clinical Nutrition
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