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Pediatric transport

Sarah E Velasquez, Enrique Chaves-Carballo, Eve-Lynn Nelson
BACKGROUND: Approximately 2.7 million individuals in the United States are affected by epilepsy. It is the fourth most common neurological disorder and affects people of all ages, races, and economic backgrounds. In many rural states, the few pediatric neurologists commonly practice in the metropolitan areas. The inadequate resources present challenges for families residing in rural areas or with limited transportation resources. One remedy for this situation is to deliver pediatric neurology services to rural areas through videoconferencing...
August 10, 2016: Pediatric Neurology
E Brooke Lerner, Amy L Drendel, Jeremy T Cushman, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines for Field Triage of Injured Patients assist EMS providers in identifying children who need the resources of a trauma center. OBJECTIVE: To determine the accuracy of the Physiologic Criteria (Step 1) of the Field Triage Guidelines in identifying injured children who need the resources of a trauma center. METHODS: EMS providers who transported injured children 15 years and younger to pediatric trauma centers in 3 mid-sized cities were interviewed regarding patient demographics and the presence or absence of each of the Field Triage Guidelines criteria...
October 6, 2016: Prehospital Emergency Care
Erwan d'Aranda, Bruno Pastene, Fabrice Ughetto, Jean Cotte, Pierre Esnault, Virginie Fouilloux, Cécilia Mazzeo, Julien Mancini, Stéphane Lebel, Olivier Paut
PURPOSE: To compare characteristics and outcome in children undergoing extracorporeal life support initiated in an extracorporeal life support center or at the patient's bedside in a local hospital, by means of a mobile cardiorespiratory assistance unit. METHODS: A retrospective study in a single PICU during 6 years. Extracorporeal life support was started either in our center (control group) or in the local hospital (mobile cardiorespiratory assistance unit group)...
October 2016: Pediatric Critical Care Medicine
Christopher E Bayne, Patrick T Gomella, John M DiBianco, Tanya D Davis, Hans G Pohl, H G Rushton
PURPOSE: Examine testicular torsion presentation and referral trends at our institution before and after pediatric urology subspecialty certification. MATERIALS AND METHODS: We reviewed cases of testicular torsion presenting directly to our children's hospital emergency department (ED) ("direct") and transferred from an outside ED ("referred") that underwent detorsion and orchiopexy or orchiectomy between 2005 and 2015. Presentations were considered acute (<24 hours) or delayed (≥24 hours) based on time from symptom onset...
September 30, 2016: Journal of Urology
S de la Mata, M Escobar, M Cabrerizo, M Gómez, R González, J López-Herce Cid
OBJECTIVE: To study the organization of inter-hospital transport of pediatric and neonatal patients in Spain, Portugal and Latin America. DESIGN: An observational study was performed. An on-line survey was sent by email including questions about characteristics of national, regional and local health transport systems, vehicles, material, and composition of the transport team and their training. SETTING: Hospital pediatric healthcare professionals treating children in Spain, Portugal and Latin America RESULTS: A total of 117 surveys from 15 countries were analyzed...
September 30, 2016: Medicina Intensiva
Nooshin Razani, Michael A Kohn, Nancy M Wells, Doug Thompson, Hanna Hamilton Flores, George W Rutherford
BACKGROUND: Contact with nature improves human health; stress reduction is a mediating pathway. Stay Healthy in Nature Everyday (SHINE) is a stress reduction and health promotion intervention for low-income families at an urban Federally Qualified Health Center. We plan to evaluate two service-delivery models for SHINE and present here the intervention design and evaluation protocol. METHODS: Behavioral change theory and environmental education literature informed the intervention...
September 29, 2016: Contemporary Clinical Trials
Madison M Hunt, Austin M Stevens, Kristine W Hansen, Stephen J Fenton
PURPOSE: To expedite flow of injured children suspected to require operative intervention, a "trauma 1 OP" (T1OP) activation classification was created. The purpose of this study was to review this strategy at a level 1 pediatric trauma center. METHODS: A retrospective review of T1OP activations between 2003 and 2015 was performed. Children suspected of requiring neurosurgical intervention were classified as trauma 1 OP neuro (T1OP(N)). Comparisons were made to trauma 1 (T1) patients who required emergent operative intervention, excluding orthopedic injuries...
September 14, 2016: Journal of Pediatric Surgery
Todd Chassee, Diann Reischmann, Michael Mancera, John D Hoyle
BACKGROUND: Prehospital pediatric drug dosing errors affect 56,000 U.S. children annually. An accurate weight is the first step in accurate dosing. To date, the accuracy of Emergency Medical Dispatcher (EMD) obtained weights has not been evaluated. We hypothesized that EMD could obtain accurate pediatric weights. METHODS: We used a convenience sample of patients 12 years and younger that were transported by EMS to one children's hospital. EMD obtained patient weight (DW) from the 9-1-1 caller...
September 30, 2016: Prehospital Emergency Care
Leire Iparraguirre, Angela Gutierrez-Camino, Maitane Umerez, Idoia Martin-Guerrero, Itziar Astigarraga, Aurora Navajas, Ana Sastre, Nagore Garcia de Andoin, Africa Garcia-Orad
OBJECTIVES: Methotrexate (MTX), the key drug in childhood B-cell acute lymphoblastic leukemia (B-ALL) therapy, often causes toxicity. An association between genetic variants in MTX transport genes and toxicity has been found. It is known that these transporters are regulated by microRNAs (miRNAs), and miRNA single nucleotide polymorphisms (SNPs) interfere with miRNA levels or function. With regard to B-cell ALL, we have previously found rs56103835 in miR-323b that targets ABCC4 associated with MTX plasma levels...
November 2016: Pharmacogenetics and Genomics
James H Hertzog, Thomas E Pearson, Marc A Priest, Ellen Spurrier, Ryan R Davies
Ventricular assist devices (VADs) for the mechanical support of cardiac failure are being used more frequently in children of increasingly younger age. These children have significant and multiple medical comorbidities, and their length of hospital stay has been increasing. As this population of hospitalized VAD-supported children increases, so does the possibility of their need for interfacility transport for specialized diagnostic or therapeutic procedures. Reports on such transports are limited to 3 children who underwent scheduled elective transfers...
September 2016: Air Medical Journal
Katherine Remick, Christopher Redgate, Daniel Ostermayer, Amy H Kaji, Marianne Gausche-Hill
OBJECTIVE: Many Emergency Medicine Services (EMS) protocols require point-of-care blood glucose testing (BGT) for any pediatric patient who presents with seizure or altered level of conscious. Few data describe the diagnostic yield of BGT when performed on all pediatric seizures regardless of presenting mental status. We analyzed a large single center dataset of pediatric patients presenting with prehospital seizures to determine the prevalence of hypoglycemic seizures and the utility of repeat BGT in the emergency department (ED)...
September 16, 2016: Prehospital Emergency Care
Amanda Calhoun, Martin Keller, Junxin Shi, Celeste Brancato, Kathy Donovan, Diana Kraus, Julie C Leonard
INTRODUCTION: Studies show that pediatric trauma centers produce better outcomes and reduced mortality for injured children. Yet, most children do not have timely access to a pediatric trauma center and require stabilization locally with subsequent transfer. Investigators have demonstrated that pediatric transport teams (PTT) improve outcomes for critically ill children; however, these studies did not differentiate outcomes for injured children. It may be that moderate to severely injured children actually fare worse with PTT due to slower transport times inherent to their remote locations and thus delays in important interventions...
September 16, 2016: Prehospital Emergency Care
Matthew Hansen, William Loker, Craig Warden
INTRODUCTION: The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS) run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. METHODS: This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas...
September 2016: Western Journal of Emergency Medicine
Bruno Gonçalves Schröder E Souza, Tiago Evangelista de Melo, Tales Pereira Lisboa, Marcos Bastos Miranda, Thiago Gonçalves Schroder E Souza, Valdeci Manoel de Oliveira
OBJECTIVE: to obtain information about the current knowledge and habits of parents who transport children in cars in Brazil. METHODS: a cross-sectional survey was conducted using specifically designed self-responded questionnaires, to parents of children attending a private pediatric office in town in southwest Brazil. Data was collected about children's age, gender, height and weight, possession of automobile children's restraint systems (CRS), its type, frequency and adequacy of use, reasons for not possessing or not using the devices...
September 13, 2016: Traffic Injury Prevention
Ana Savić Mlakar, Iva Hojsak, Mladen Jergović, Valerija Vojvoda Parčina, Žarko Babić, Branko Troskot, Željko Mihaljević, Krešo Bendelja
OBJECTIVES: Ulcerative colitis (UC), a chronic inflammation of the colon, is often more severe in children than adults. Identification of altered expression of efflux transporters, cytokines and suppressor of cytokine signalling (SOCS) molecules in pediatric vs. adult patients could provide insight to the differential molecular patterns related to the age and disease pathology. METHODS: Mucosal samples from terminal ileum and colon in pediatric (9 UC-New; 4 UC-Remission) and adult (9 UC-New; 8 UC-Remission) patients were compared to healthy subjects (15 children and 10 adults) for mRNA expressions of several efflux transporters, cytokines and SOCS molecules...
September 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
Arthur J Nowak, Amy S Kim, Jo Anna M Scott, Joel H Berg
PURPOSES: Pacifiers are the most common device used by children to satisfy their sucking needs. Because of their design, reports of anterior open bite and increased overjet are common. The purposes of this pilot study were to measure the effects of a unique pacifier in toddlers who have existing open bites and increased overjets; and secondly to determine the feasibility of recruiting and retaining toddlers for a six-month study. METHODS: Toddlers with existing open bite and increased overjet currently using a conventional pacifier were recruited from a university pediatric dental clinic...
2016: Journal of Dentistry for Children
Sue Creviston Kaste, Scott E Snyder, Monika L Metzger, John T Sandlund, Scott Howard, Matthew Krasin, Barry L Shulkin
BACKGROUND: Methionine transport across plasma membranes occurs via large amino acid transporter ( LAT1), which is overexpressed in malignant cells leading to tracer accumulation within tumors. We investigated the uptake of (11)C-methionine in children and young adults newly diagnosed with Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) and compared the biodistribution of (11)C-methionine PET-CTs ((11)C- METPET) to that of (18)F-FDG PET-CT ((18)F-FDGPET). METHODS & MATERIALS: Conducted under an IND, we prospectively enrolled patients with newly diagnosed HL (N = 19) and NHL (N = 2) onto the IRB-approved investigation of (11)C-METPET...
September 8, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Hiroyuki Matsuura
Cardiac catheterization of childhood pulmonary arterial hypertension (PAH) plays a pivotal role in assessing the severity of the disease as well as its prognosis, selection of the most adequate pulmonary vasodilators, and evaluation of effectiveness. However, sudden deterioration of cardiovascular hemodynamics can be easily induced by pain, a patient's agitation, catheter manipulation, and by vasodilator provocation tests; these could trigger a pulmonary hypertension crisis, vagotony, respiratory distress, and hemoptysis resulting in critical complications, including death...
September 7, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Atilla Şenaylı, Fatma Öztürk, Müjdem Nur Azılı, Sabri Demir, Rabia Demir, Emrah Şenel
BACKGROUND: Burns constitute one of the most important, potentially fatal types of trauma. Appropriate emergency management is essential in the avoidance of complication and the success of treatment. Emergency management and indications of transfer throughout the country were reviewed in the present study. METHODS: Charts of 187 patients transferred to the present hospital from other cities between January 2009 and December 2013 were evaluated. Factors included demographics, referral vehicles, intravenous fluid therapy, respiratory conditions, urine drainage, and surgical complications...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Guillaume Mortamet, Manoelle Kossorotoff, Amandine Baptiste, Nathalie Boddaert, Martin Castelle, Philippe Hubert, Fabrice Lesage, Sylvain Renolleau, Mehdi Oualha
BACKGROUND: The authors aimed to collect all brain magnetic resonance imaging (MRI) performed in critically ill children in the authors' medical pediatric intensive care unit over a 2-year period (2012-2013) to (1) describe the findings and (2) assess its contribution on practical patient care. METHODS: This is a single-center and retrospective study. All children without traumatic brain injury who underwent a brain MRI during pediatric intensive care unit stays were included...
September 2, 2016: Journal of Child Neurology
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