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Pediatric emergency medicine

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https://www.readbyqxmd.com/read/28803593/predictors-of-obtaining-follow-up-care-in-the-province-of-ontario-canada-following-a-new-diagnosis-of-atrial-fibrillation-heart-failure-and-hypertension-in-the-emergency-department
#1
Clare L Atzema, Bing Yu, Noah M Ivers, Paula A Rochon, Douglas S Lee, Michael J Schull, Peter C Austin
OBJECTIVE: Patients with cardiovascular diseases are common in the emergency department (ED), and continuity of care following that visit is needed to ensure that they receive evidence-based diagnostic tests and therapy. We examined the frequency of follow-up care after discharge from an ED with a new diagnosis of one of three cardiovascular diseases. METHODS: We performed a retrospective cohort study of patients with a new diagnosis of heart failure, atrial fibrillation, or hypertension, who were discharged from 157 non-pediatric EDs in Ontario, Canada, between April 2007 and March 2014...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28798907/building-sustainable-partnerships-to-strengthen-pediatric-capacity-at-a-government-hospital-in-malawi
#2
Michelle Eckerle, Heather L Crouse, Msandeni Chiume, Ajib Phiri, Peter N Kazembe, Hanny Friesen, Tisungane Mvalo, Marideth C Rus, Elizabeth F Fitzgerald, Allyson McKenney, Irving F Hoffman, Megan Coe, Beatrice M Mkandawire, Charles Schubert
INTRODUCTION: To achieve sustained reductions in child mortality in low- and middle-income countries, increased local capacity is necessary. One approach to capacity building is support offered via partnerships with institutions in high-income countries. However, lack of cooperation between institutions can create barriers to successful implementation of programs and may inadvertently weaken the health system they are striving to improve. A coordinated approach is necessary. BACKGROUND: Three U...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#3
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
December 2016: Global Health Action
https://www.readbyqxmd.com/read/28792519/dominance-and-leadership-in-research-activities-collaboration-between-countries-of-differing-human-development-is-reflected-through-authorship-order-and-designation-as-corresponding-authors-in-scientific-publications
#4
Gregorio González-Alcaide, Jinseo Park, Charles Huamaní, José M Ramos
INTRODUCTION: Scientific collaboration is an important mechanism that enables the integration of the least developed countries into research activities. In the present study, we use the order of author signatures and addresses for correspondence in scientific publications as variables to analyze the interactions between countries of very high (VHHD), high (HHD), medium (MHD), and low human development (LHD). METHODOLOGY: We identified all documents published between 2011 and 2015 in journals included in the Science Citation Index-Expanded categories' of Tropical Medicine, Infectious Diseases, Parasitology, and Pediatrics...
2017: PloS One
https://www.readbyqxmd.com/read/28777272/pediatric-emergency-medicine-legal-briefs
#5
(no author information available yet)
No abstract text is available yet for this article.
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28777270/point-of-care-ultrasound-identification-of-an-abdominal-hernia
#6
Michael Alfonzo, Anna von Reinhart, Antonio Riera
Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall hernia but subsequently determined to be an unusual presentation of an inguinal hernia with testicular entrapment. We review each of these diagnoses in addition to relevant POCUS findings.
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28749627/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department-digest
#7
Daniel Mohrer, Melissa Langhan, Pradip Chaudhari
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28749625/diphtheria-pertussis-and-tetanus-evidence-based-management-of-pediatric-patients-in-the-emergency-department-digest
#8
Lara Zibners, Pradip Chaudhari
Diphtheria, pertussis, and tetanus are potentially deadly bacterial infections that are largely preventable through vaccination, though they remain in the population. This issue reviews the epidemiology, pathophysiology, diagnosis, and current recommended emergency management of these conditions. Disease-specific medications, as well as treatment of the secondary complications, are examined in light of the best current evidence. Resources include obtaining diphtheria antitoxin from the United States Centers for Disease Control and Prevention and best-practice recommendations with regard to testing, involvement of government health agencies, isolation of the patient, and identification and treatment of close contacts...
February 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28749111/syncope-in-pediatric-patients-a-practical-approach-to-differential-diagnosis-and-management-in-the-emergency-department-digest
#9
Colleen Fant, Ari Cohen, Michelle N Vazquez
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope...
April 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28747930/parental-involvement-and-child-and-adolescent-eating-disorders-perspectives-from-residents-in-psychiatry-pediatrics-and-family-medicine
#10
Tamara Davidson Marcon, Laura Girz, Amanda Stillar, Carole Tessier, Adele Lafrance
OBJECTIVES: Best practice guidelines encourage the involvement of parents in the assessment and treatment of child/adolescent eating disorders (ED). This study investigated medical residents' perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED. METHOD: Five hundred and eighty-four medical residents from 17 Canadian residency programs specializing in family medicine, pediatrics, and psychiatry completed a web-based survey...
July 2017: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28745857/altered-level-of-consciousness-evidence-based-management-in-the-emergency-department-digest
#11
Joo Lee Song, Vincent J Wang, Michelle N Vazquez
A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring...
January 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745856/severe-traumatic-brain-injury-in-children-an-evidence-based-review-of-emergency-department-management-digest
#12
Kirsten Morrissey, Hilary Fairbrother, Michelle N Vazquez
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745855/managing-acute-complications-of-sickle-cell-disease-in-pediatric-patients-digest
#13
Sathyaseelan Subramaniam, Jennifer H Chao, Pradip Chaudhari
Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management...
November 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745854/vaccine-preventable-diseases-in-pediatric-patients-a-review-of-measles-mumps-rubella-and-varicella-digest
#14
Deborah A Levine, Kathryn H Pade
Vaccine-preventable diseases such as measles, mumps, rubella, and varicella continue to plague children and adults worldwide. Although public health programs have helped decrease the prevalence and sequelae of these diseases, outbreaks still occur. To limit the spread of these diseases, emergency clinicians must be able to readily identify the characteristic presentations of the rashes associated with measles, rubella, and varicella, as well as the common presenting features associated with mumps. Diagnostic laboratory studies are not usually necessary, as a complete history and physical examination usually lead to an accurate diagnosis...
December 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#15
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745852/vascular-access-in-pediatric-patients-in-the-emergency-department-types-of-access-indications-and-complications-digest
#16
Rachel Whitney, Melissa Langhan, Kathryn H Pade
Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed...
June 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745850/noninvasive-ventilation-for-patients-in-acute-respiratory-distress-an-update-digest
#17
Nikita Joshi, Molly K Estes, Kayla Shipley, Hyun-Chul Danny Lee, Milana Zaurova
Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Characteristics of patients who are most likely to benefit from NIV are reviewed, including those in respiratory distress from chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema...
February 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28742308/nonaccidental-injury-in-pediatric-patients-detection-evaluation-and-treatment-digest
#18
Gunjan Tiyyagura, Meghan Beucher, Kirsten Bechtel, Kathryn H Pade
Emergency clinicians are likely to encounter physical abuse in children, and they must be prepared to recognize its many manifestations and take swift action. Pediatric nonaccidental injury causes considerable morbidity and mortality that can often be prevented by early recognition. Nonaccidental injuries present with a wide array of symptoms that may appear to be medically inconsequential (such as bruising in a premobile infant), but are actually sentinel injuries indicative of child abuse. This issue provides guidance regarding factors that contribute to abuse in children, key findings on history and physical examination that should trigger an evaluation for physical abuse, and laboratory and radiologic tests to perform when child abuse is suspected...
July 21, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28719482/teaching-incision-and-drainage-perceived-educational-value-of-abscess-models
#19
Cynthia M Adams, Lise E Nigrovic, Gavin Hayes, Peter H Weinstock, Joshua Nagler
OBJECTIVES: Incision and drainage (I&D) of skin abscesses is an important procedural skill for pediatric emergency medicine providers. Practical skills training using simulation provides an opportunity to learn and gain confidence with this invasive procedure. Our objective was to assess the perceived educational value of 2 versions of an abscess model as part of an educational workshop for teaching I&D. METHODS: A combined didactic and practical skills workshop was developed for use at 2 national conferences...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28705656/impact-of-enteroviral-polymerase-chain-reaction-testing-on-length-of-stay-for-infants-60-days-old-or-younger
#20
Paul L Aronson, Todd W Lyons, Andrea T Cruz, Stephen B Freedman, Pamela J Okada, Alesia H Fleming, Joseph L Arms, Amy D Thompson, Suzanne M Schmidt, Jeffrey Louie, Michael J Alfonzo, Michael C Monuteaux, Lise E Nigrovic
OBJECTIVE: To determine the impact of a cerebrospinal fluid enterovirus polymerase chain reaction (PCR) test performance on hospital length of stay (LOS) in a large multicenter cohort of infants undergoing evaluation for central nervous system infection. STUDY DESIGN: We performed a planned secondary analysis of a retrospective cohort of hospitalized infants ≤60 days of age who had a cerebrospinal fluid culture obtained at 1 of 18 participating centers (2005-2013)...
July 10, 2017: Journal of Pediatrics
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