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Pediatrics trauma

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https://www.readbyqxmd.com/read/29912812/multicenter-review-of-current-practices-associated-with-venous-thromboembolism-prophylaxis-in-pediatric-patients-after-trauma
#1
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
June 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912087/ocular-injury-presenting-to-a-level-iii-pediatric-trauma-center
#2
Kari Schneider, Hai Nguyen-Tran, Bradley J Segura, Raymond G Areaux, Dan Nerheim, Jeffrey P Louie
The purpose of this study is to describe pediatric ocular injuries presenting to a level-III pediatric trauma center and emergency department. METHODS: We performed a retrospective study and identified children from January 1, 2011, to January 1, 2016. Charts were reviewed for any subject, age from newborn to younger than 18 years, based on International Classification of Diseases, ninth and tenth revision, codes for any ocular injury. Data abstraction included age, sex, means of arrival, eye involved, mechanism of injury, type of ocular injury, imaging studies obtained, procedures performed, location of definitive repair (in the operating room or emergency department), and subspecialty services involved...
June 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29912086/current-practices-in-pediatric-emergency-medicine-fellowship-trauma-training
#3
Diana T Fleisher, Rachel J Katz-Sidlow, James A Meltzer
OBJECTIVE: The management of injured children is a required element of pediatric emergency medicine (PEM) fellowship training. Given the relatively infrequent exposure of trainees to major trauma, it is important to understand how programs train fellows and assess their competency in pediatric trauma. METHODS: An online survey was sent to 84 PEM fellowship program directors (PDs). Program directors were asked to describe their program's characteristics, the degree of fellow independence, educational techniques used to train fellows in trauma, and their expectation of fellows' competency in 14 core trauma-related skills upon graduation...
June 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29912083/caring-for-pediatric-patients-with-epidermolysis-bullosa-in-the-emergency-department
#4
Helena A Jenkinson, Ashley D Lundgren, Moise L Levy, Lucia Z Diaz
Epidermolysis bullosa (EB) refers to a heterogeneous group of genetic disorders characterized by epithelial fragility. We provide guidelines for management of pediatric patients with EB in the emergency department based on a review of literature, as well as insights from our own experiences caring for patients with EB. The purpose of the guidelines proposed is prevention of avoidable iatrogenic trauma to the skin and mucosa of patients with EB who are presenting to the emergency department for a variety of reasons...
June 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29907353/determinants-of-skeletal-muscle-protein-turnover-following-severe-burn-trauma-in-children
#5
Ioannis Malagaris, David N Herndon, Efstathia Polychronopoulou, Victoria G Rontoyanni, Clark R Andersen, Oscar E Suman, Craig Porter, Labros S Sidossis
BACKGROUND & AIMS: Burns remain the fifth cause of non-fatal pediatric injuries globally, with muscle cachexia being a hallmark of the stress response to burns. Burn-induced muscle wasting is associated with morbidity, yet the determinants of muscle protein catabolism in response to burn trauma remains unclear. Our objective was to determine the effect of patient and injury characteristics on muscle protein kinetics in burn patients. METHODS: This retrospective, observational study was performed using protein kinetic data from pediatric patients who had severe burns (>30% of the total body surface area burned) and underwent cross-limb stable isotope infusions between 1999 and 2008 as part of prospective clinical trials...
June 4, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29907210/nonoperative-management-of-penetrating-abdominal-solid-organ-injuries-in-children
#6
Reid Sakamoto, Kazuhide Matsushima, Amory de Roulet, Kristine Beetham, Aaron Strumwasser, Damon Clark, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Nonoperative management (NOM) of penetrating solid organ injuries (SOI) has not been well described in the pediatric population. The objective of this study was to characterize the epidemiology, injury patterns, and factors associated with trial and failure of NOM. METHODS: This is a retrospective cohort analysis of the National Trauma Data Bank for the period of 2007-2014. The study population included patients ≤18 y with penetrating injury to the liver, spleen, or kidney...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907202/errors-in-cervical-spine-immobilization-during-pediatric-trauma-evaluation
#7
Omar Z Ahmed, Rachel B Webman, Puja D Sheth, Jonah I Donnenfield, JaeWon Yang, Aleksandra Sarcevic, Ivan Marsic, Randall S Burd
BACKGROUND: The purpose of this study was to identify factors during trauma evaluation that increase the likelihood of errors in cervical spine immobilization ('lapses'). MATERIALS AND METHODS: Multivariate analysis was used to identify the associations between patient characteristics, event features, and tasks performed in proximity to the head and neck and the occurrence and duration of a lapse in maintaining cervical spine immobilization during 56 pediatric trauma evaluations...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29906381/points-pearls-management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#8
Andria Tatem, Rupa Kapoor, Bryan Wilson
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29903429/simulation-based-research-to-improve-infant-health-outcomes-using-the-infant-simulator-to-prevent-infant-shaking
#9
Kirsten Bechtel
Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator...
June 11, 2018: Infant Behavior & Development
https://www.readbyqxmd.com/read/29902825/liquid-posterior-fossa-epidural-hematoma-in-pediatric-trauma-a-single-center-case-series
#10
Kun Han, Zhaojian Li, Hongwei Yin, Weicheng Yao, Xiaolei Lan, Yongli Bo
BACKGROUND:  Liquid posterior fossa epidural hematoma (LPFEH) following head trauma is uncommon, and very few such cases have been described in the literature. Eight patients with this entity and their treatments are presented here. METHODS:  We performed a single-institution retrospective analysis of all patients with diagnosed LPFEH over a 3-year period. Collected data included clinical history, laboratory results, treatment, and review of all imaging studies performed...
June 14, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29901592/the-heterogeneous-management-of-pediatric-ankle-traumas-a-retrospective-descriptive-study
#11
Philippe Voizard, James Moore, Stéphane Leduc, Marie-Lyne Nault
Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901559/aneursymal-bone-cyst-an-uncommon-paraspinal-tumor-in-children
#12
Nilay Shah, Thomas Scharschmidt, Bonita Fung, Miriam Conces, Bhuvana A Setty
Paraspinal tumors with benign histology in the absence of trauma rarely arise in children. Treatment of such benign tumors, in contrast to malignancies, generally consists of surgical resection of the lesion with confirmation of histology via pathologic evaluation. We present a pediatric case of an atraumatic paraspinal mass with a histologic diagnosis of aneurysmal bone cyst, and USP6 gene rearrangement supporting the histologic diagnosis. The patient underwent gross total resection of the paraspinal lesion with no additional intervention...
June 12, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29901540/a-computed-tomography-study-of-the-c7-vertebra-screws-fixation-in-children
#13
Junhao Liu, Wei Ji, Zucheng Huang, Ganggang Kong, Qi Liu, Zhiping Huang, Xiuhua Wu, Qingan Zhu
STUDY DESIGN: Retrospective analysis of computed tomographic images of 92 normal pediatric cervical vertebrae. OBJECTIVE: To ascertain the feasibility of the pedicle, intralaminar, and lateral mass screws fixation in children. SUMMARY OF BACKGROUND DATA: Fixation techniques of C7 vertebrae is technically challenging in the pediatric population. Although the techniques offer alternatives to screws placement at C7 spine in adult, there is no consensus to apply these screws in children...
June 12, 2018: Spine
https://www.readbyqxmd.com/read/29895725/pediatric-headache-clinic-model-implementation-of-integrative-therapies-in-practice
#14
REVIEW
Anna Esparham, Anne Herbert, Emily Pierzchalski, Catherine Tran, Jennifer Dilts, Madeline Boorigie, Tammie Wingert, Mark Connelly, Jennifer Bickel
The demand for integrative medicine has risen in recent years as research has demonstrated the efficacy of such treatments. The public has also become more conscientious of the potential limitations of conventional treatment alone. Because primary headache syndromes are often the culmination of genetics, lifestyle, stress, trauma, and environmental factors, they are best treated with therapies that are equally multifaceted. The Children’s Mercy Hospital, Kansas City, Missouri Headache Clinic has successfully incorporated integrative therapies including nutraceuticals, acupuncture, aromatherapy, biofeedback, relaxation training, hypnosis, psychology services, and lifestyle recommendations for headache management...
June 12, 2018: Children
https://www.readbyqxmd.com/read/29895534/neurologic-outcome-predictors-in-pediatric-intracerebral-hemorrhage-a-prospective-study
#15
Giulia S Porcari, Lauren A Beslow, Rebecca N Ichord, Daniel J Licht, Jonathan T Kleinman, Lori C Jordan
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a considerable source of morbidity and mortality. This 3-center study describes outcomes of pediatric intracerebral hemorrhage and identifies 2-year neurological outcome predictors. METHODS: Children 29 days to 18 years of age presenting with intracerebral hemorrhage from March 2007 to May 2015 were enrolled prospectively. Exclusion criteria included trauma; intracranial tumor; hemorrhagic transformation of arterial ischemic stroke or cerebral sinovenous thrombosis; isolated subdural, epidural, or subarachnoid hemorrhage; and abnormal baseline neurological function...
June 12, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29893520/calculated-decisions-pecarn-pediatric-head-injury-trauma-algorithm
#16
Daniel Runde, Joshua Beiner
The PECARN Pediatric Head Injury Prediction Rule is a well-validated clinical decision aid that allows clinicians to safely rule out the presence of clinically important traumatic brain injuries.
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29892330/unusual-superolateral-dislocation-of-mandibular-condyle
#17
Tabishur Rahman
We describe a case of maxillofacial trauma in a pediatric patient in whom the mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact. In addition, there was an associated mandibular symphyseal fracture. To our knowledge, this case is the first of its kind to be reported in the literature. We also observed a complication in the form of development of ankylosis in the involved joint which required another surgery.
June 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29884589/the-risk-of-snow-sport-injury-in-pediatric-patients
#18
Robert J McLoughlin, Jonathan Green, Pradeep P Nazarey, Michael P Hirsh, Muriel Cleary, Jeremy T Aidlen
PURPOSE: In 2015, approximately 13,436 snowboarding or skiing injuries occurred in children younger than 15. We describe injury patterns of pediatric snow sport participants based on age, activity at the time of injury, and use of protective equipment. METHODS: A retrospective analysis was performed of 10-17 year old patients with snow-sport related injuries at a Level-1 trauma center from 2005 to 2015. Participants were divided into groups, 10-13 (middle-school, MS) and 14-17 years (high-school, HS) and compared using chi-square, Student's t-tests, and multivariable logistic regression...
June 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29884556/long-term-sustainability-of-washington-state-s-quality-improvement-initiative-for-the-management-of-pediatric-spleen-injuries
#19
Benjamin J Booth, Stephen M Bowman, Mauricio A Escobar, Sam R Sharar
BACKGROUND: Initial results of Washington State's quality improvement initiative addressing the management of blunt traumatic pediatric spleen injuries were published in 2008. In this update, we evaluated whether these effects were sustained over time. METHODS: Data from the Washington Trauma Registry for years 1999-2001 (pre-intervention), 2003-2005 (post-intervention), and 2012-2014 (follow-up) were used in a retrospective cohort study. Children between ages 0 to 14 years who were hospitalized with a traumatic blunt spleen injury were included...
May 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29884553/analysis-of-the-etiology-and-treatment-of-chylothorax-in-119-pediatric-patients-in-a-single-clinical-center
#20
Chun Wu, Zhengxia Pan, Yuhao Wu, Quan Wang, Yonggang Li, Yong An, Hongbo Li, Gang Wang, Yi Wang, Jiangtao Dai
PURPOSE: To summarize the etiology and treatment of 119 patients with chylothorax in our hospital. METHODS: A total of 119 patients with chylothorax, divided into a neonate group, an infant group, and an older-than-1-year group, were included in our study and analyzed from January 2000 to July 2017 in the Children's Hospital of Chongqing Medical University. RESULTS: A total of 90 males and 29 females were included in our study. In the neonate group, 21 chylothorax cases were due to idiopathic factors, constituting 72...
May 18, 2018: Journal of Pediatric Surgery
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