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Prehospital pediatric

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https://www.readbyqxmd.com/read/29136270/60-seconds-to-survival-a-pilot-study-of-a-disaster-triage-video-game-for-prehospital-providers
#1
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/29123900/evaluation-of-factors-associated-with-the-difficulty-in-finding-receiving-hospitals-for-traffic-accident-patients-at-the-scene-treated-by-emergency-medical-services-a-population-based-study-in-osaka-city-japan
#2
Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Taku Iwami, Takashi Kawamura, Sumito Hayashida, Hiroshi Ogura, Takeshi Shimazu
Aim: Although the prolongation of the time between injury and hospital arrival of traffic accident patients can influence their prognosis, factors associated with the difficulty in hospital acceptance of these patients have not been sufficiently evaluated in Japan. Methods: We retrospectively analyzed the population-based ambulance records of all traffic accident patients for whom the Osaka Municipal Fire Department (Osaka City, Japan) dispatched an ambulance in 2013...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29096887/definitive-airway-management-after-prehospital-supraglottic-rescue-airway-in-pediatric-trauma
#3
Matthew C Hernandez, Ryan M Antiel, Karthik Balakrishnan, Martin D Zielinski, Denise B Klinkner
INTRODUCTION: Supraglottic airway (SGA) use and outcomes in pediatric trauma are poorly understood. We compared outcomes between patients receiving prehospital SGA versus bag mask ventilation (BVM). METHODS: We reviewed pediatric multisystem trauma patients (2005-2016), comparing SGA and BVM. Primary outcome was adequacy of oxygenation and ventilation. Additional measures included tracheostomy, mortality and abbreviated injury scores (AIS). RESULTS: Ninety patients were included (SGA, n=17 and BVM, n=73)...
October 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29057682/improving-diagnosis-of-childhood-arterial-ischaemic-stroke
#4
Mark T Mackay, Paul Monagle, Franz E Babl
At least half of childhood stroke survivors suffer long-term impairments. Rapid identification of stroke is essential to minimize the extent of injury by restoring perfusion to viable brain. Improving diagnosis of childhood stroke requires correct identification of stroke by prehospital and emergency physicians, rapid performance of appropriate neuroimaging to confirm infarction, and targeted investigations to determine underlying causes, which guide treatment decisions to reduce recurrence risk. Areas covered: This review will summarize the barriers to rapid stroke diagnosis in pre-hospital and emergency department settings, describe recent progress in understanding of the spectrum, presenting clinical features and differential diagnosis of childhood stroke, discuss clinical stroke recognition tools which improve diagnostic accuracy, and their application to children...
November 7, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28989879/root-cause-analysis-of-diabetic-ketoacidosis-admissions-at-a-tertiary-referral-pediatric-emergency-department-in-north-india
#5
Muralidharan Jayashree, Rohit Sasidharan, Sunit Singhi, Karthi Nallasamy, Mullai Baalaaji
OBJECTIVES: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management. MATERIALS AND METHODS: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011)...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28956669/prehospital-pain-management-disparity-by-age-and-race
#6
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
#7
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/28846853/is-this-child-sick-usefulness-of-the-pediatric-assessment-triangle-in-emergency-settings
#8
REVIEW
Ana Fernandez, Javier Benito, Santiago Mintegi
OBJECTIVE: The Pediatric Assessment Triangle is a rapid assessment tool that uses only visual and auditory clues, requires no equipment, and takes 30-60s to perform. It's being used internationally in different emergency settings, but few studies have assessed its performance. The aim of this narrative biomedical review is to summarize the literature available regarding the usefulness of the Pediatric Assessment Triangle in clinical practice. SOURCES: The authors carried out a non-systematic review in the PubMed(®), MEDLINE(®), and EMBASE(®) databases, searching for articles published between 1999-2016 using the keywords "pediatric assessment triangle," "pediatric triage," "pediatric assessment tools," and "pediatric emergency department...
August 25, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28833853/the-pediatric-submersion-score-predicts-children-at-low-risk-for-injury-following-submersions
#9
Rohit P Shenoi, Sachin Allahabadi, Daniel M Rubalcava, Elizabeth A Camp
OBJECTIVES: Pediatric submersion victims often require admission. We wanted to identify a cohort of children at low risk for submersion-related injury who can be safely discharged from the emergency department (ED) after a period of observation. METHODS: This was a single-center retrospective derivation/validation cross-sectional study of children (0-18 years) who presented postsubmersion to a tertiary care, children's hospital ED from 2008 to 2015. We reviewed demographics, comorbidities, and prehospital and ED course...
August 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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/28794661/focused-assessment-with-sonography-for-trauma-current-perspectives
#11
REVIEW
Sorravit Savatmongkorngul, Sirote Wongwaisayawan, Rathachai Kaewlai
Focused assessment with sonography for trauma (FAST) is a part of resuscitation of trauma patients recommended by international panel consensus. The purpose of FAST is to identify free fluid, which necessarily means blood in acute trauma patients. In this article, the authors focused on various aspects of FAST in the emergency department, prehospital care, pediatric setting, training and general pearls/pitfalls. Detailed techniques and interpretation of FAST are beyond the scope of this article.
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#12
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/28719478/a-review-of-nonfatal-drowning-in-the-pediatric-age-group-a-10-year-experience-at-a-university-hospital-in-saudi-arabia
#13
Faisal O Al-Qurashi, Abdullah A Yousef, Abdullah Aljoudi, Saleh M Alzahrani, Nasser Y Al-Jawder, Abdulrahman K Al-Ahmar, Mosab S Al-Majed, Hussam M Abouollo
OBJECTIVE: The aim of this study was to evaluate the nonfatal drowning experience, risk factors, intrahospital assessment and postincidental outcomes for children admitted to King Fahd Hospital of the University, AlKhobar, Saudi Arabia, over a 10-year period. METHODS: Children up to the age of 14 years who were admitted with the diagnosis of nonfatal drowning from July 2005 to June 2015 were included. Data regarding demographics, timing, season and location of drowning, presence of an assigned lifeguard, duration of submersion and transport to hospital, cardiopulmonary resuscitation, initial Glasgow Coma Scale, temperature, pH, blood sugar level, total hospital stay, and discharge status were extrapolated, and their effects on the patient's outcome analyzed...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28717780/epidemiology-of-prehospital-emergency-medical-service-use-in-korean-children
#14
Se Uk Lee, Dongbum Suh, Hahn Bom Kim, Jin Hee Jung, Ki Jeong Hong, Jin Hee Lee, Hye Young Jang, Hyun Noh, Jae Yun Jung, Do Kyun Kim, Young Ho Kwak
OBJECTIVE: The aim of this study was to elucidate the epidemiology of pediatric patients transported by the National 119 Rescue Services in Korea. METHODS: We enrolled all pediatric patients (<16 years old) who used the National 119 Rescue Services in Korea between January 2006 and December 2008, and analyzed the 119 ambulance patient care record databases. RESULTS: The total number of the cases was 238,644 for 3 years. The median age was 6 years old and 59...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28711194/factors-associated-with-epinephrine-administration-for-anaphylaxis-in-children-before-arrival-to-the-emergency-department
#15
Melissa Robinson, Matthew Greenhawt, David R Stukus
BACKGROUND: Epinephrine is the first-line treatment for anaphylaxis but may be underused by patients and medical personnel. OBJECTIVE: To evaluate factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). METHODS: We performed a retrospective review of electronic medical records for all patients aged 0 to 25 years presenting with anaphylaxis to the ED or UCC at a pediatric academic referral center during 2009 to 2013...
August 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28657831/case-report-life-saving-application-of-commercial-tourniquet-in-pediatric-extremity-hemorrhage
#16
David W Callaway, Andrew Puciaty, Josh Robertson, Tony Hannon, Sarah E Fabiano
Hemorrhage is the leading preventable cause of death in civilian and military trauma. Recent data from the ongoing conflicts in Iraq and Afghanistan suggest that early and aggressive tourniquet utilization is a safe and effective way to dramatically reduce mortality from extremity hemorrhage. As a result, prehospital tourniquet use is now endorsed by a majority of professional emergency medicine, emergency medical service and trauma professional societies. However, there currently exists scant evidence supporting the efficacy of commercially available tourniquets in controlling extremity hemorrhage in pediatric trauma patients...
November 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28657816/retrospective-evaluation-of-risk-factors-for-pediatric-secondary-transport
#17
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/28615900/predictors-of-outcome-in-children-with-status-epilepticus-during-resuscitation-in-pediatric-emergency-department-a-retrospective-observational-study
#18
Indumathy Santhanam, Sangeetha Yoganathan, V Akila Sivakumar, Rubini Ramakrishnamurugan, Sharada Sathish, Murali Thandavarayan
OBJECTIVES: To study the clinical profile and predictors of outcome in children with status epilepticus (SE) during resuscitation in pediatric emergency department. MATERIALS AND METHODS: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD), and subtle SE until all parameters resolved...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28602381/variability-of-care-in-infants-with-severe-bronchiolitis-less-invasive-respiratory-management-leads-to-similar-outcomes
#19
MULTICENTER STUDY
Sandrine Essouri, Florent Baudin, Laurent Chevret, Mélanie Vincent, Guillaume Emeriaud, Philippe Jouvet
OBJECTIVE: To compare the management of children with severe bronchiolitis requiring intensive care (based on duration of ventilatory support and duration of pediatric intensive care unit [PICU] stay) in 2 countries with differing pediatric transport and PICU organizations. STUDY DESIGN: This was a prospective observational care study in 2 PICUs of tertiary care university hospitals, 1 in France and 1 in Canada. All children with bronchiolitis who required admission to the PICU between November 1, 2013, and March 31, 2014, were included...
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28590996/helicopter-transport-from-the-scene-of-injury-are-there-improved-outcomes-for-pediatric-trauma-patients
#20
Sandra M Farach, Nebbie E Walford, Lindsey Bendure, Ernest K Amankwah, Paul D Danielson, Nicole M Chandler
BACKGROUND: There is conflicting data to support the routine use of helicopter transport (HT) for the transfer of trauma patients. The purpose of this study was to evaluate outcomes for trauma patients transported via helicopter from the scene of injury to a regional pediatric trauma center. METHODS: The institutional trauma registry was queried for trauma patients presenting from January 2000 through March 2012. Of 9119 patients, 1709 patients who presented from the scene were selected for further evaluation...
June 6, 2017: Pediatric Emergency Care
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