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Pediatric emergency care

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https://www.readbyqxmd.com/read/29036004/the-utility-of-clinical-ultrasonography-in-identifying-distal-forearm-fractures-in-the-pediatric-emergency-department
#1
Iratxe Galletebeitia Laka, Frederic Samson, Inigo Gorostiza, Andrés Gonzalez, Carlos Gonzalez
OBJECTIVE: The aim of this study is to evaluate the utility of Point-Of-Care Ultrasound (POCUS) for diagnosing distal forearm fractures in pediatric emergency departments (ED). PATIENTS AND METHODS: A prospective observational study was carried out in children aged younger than 15 years attended in an ED with an indication of radiography because of a suspected distal forearm fracture. The POCUS was performed considering cortical irregularity or disruption compatible with fracture...
October 13, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29034999/home-supply-of-emergency-oral-steroids-and-reduction-in-asthma-healthcare-utilization
#2
Lisa M Sarzynski, Tiffany Turner, David R Stukus, Elizabeth Allen
OBJECTIVE: To determine if children with moderate-to-severe persistent asthma have decreased healthcare utilization after receiving a prescription and instructions to use an at home emergency supply of oral steroids during asthma exacerbations. METHODS: A quasi-experimental design study with a historical control from retrospective chart review was performed for patients aged 2-18 years seen in a tertiary care pediatric pulmonary clinic for moderate to severe persistent asthma...
October 16, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29032703/the-use-of-telepsychiatry-to-provide-cost-efficient-care-during-pediatric-mental-health-emergencies
#3
John F Thomas, Douglas K Novins, Patrick W Hosokawa, Christina A Olson, Dru Hunter, Alison S Brent, Gerard Frunzi, Anne M Libby
OBJECTIVE: This study evaluated a videoconference-based psychiatric emergency consultation program (telepsychiatry) at geographically dispersed emergency department (ED) sites that are part of the network of care of an academic children's hospital system. The study compared program outcomes with those of usual care involving ambulance transport to the hospital for in-person psychiatric emergency consultation prior to disposition to inpatient care or discharge home. METHODS: This study compared process outcomes in a cross-sectional, pre-post design at five network-of-care sites before and after systemwide implementation of telepsychiatry consultation in 2015...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29029580/uncovering-longitudinal-health-care-behaviors-for-millions-of-medicaid-enrollees-a-multistate-comparison-of-pediatric-asthma-utilization
#4
Ross Hilton, Yuchen Zheng, Anne Fitzpatrick, Nicoleta Serban
BACKGROUND: This study introduces a framework for analyzing and visualizing health care utilization for millions of children, with a focus on pediatric asthma, one of the major chronic respiratory conditions. METHODS: The data source is the 2005 to 2012 Medicaid Analytic Extract claims for 10 Southeast states. The study population consists of Medicaid-enrolled children with persistent asthma. We translate multiyear, individual-level medical claims into sequences of discrete utilization events, which are modeled using Markov renewal processes and model-based clustering...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#5
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29028076/intestinal-probiotics-in-relieving-clinical-symptoms-of-severe-hand-foot-and-mouth-disease-and-potential-mechanism-analysis
#6
F Zhu, Z Jiang, H-W Li
OBJECTIVE: In this prospective cohort study, the efficacy and action mechanism of an intestinal probiotic formulation, Golden Bifid, in severe hand, foot, and mouth disease (HFMD) were determined in 63 consecutively admitted patients successfully treated in the Pediatrics Emergency Department of our hospital. PATIENTS AND METHODS: All patients had a persistent fever; 43 patients had rashes on hands, feet, crissum, and hips; and 45 patients had neurological signs and symptoms...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29019905/bezold-jarisch-reflex-occurred-in-a-pediatric-patient-with-giant-intra-abdominal-teratoma-during-induction-of-anesthesia-a-case-report
#7
Kai-Ming Yuan, Shu-Ying Fu, Jun Li, Wang-Ning Shangguan, Qing-Quan Lian
RATIONALE: Bezold-Jarisch reflex (BJR) occurs when the cardioinhibitory receptors in the walls of ventricles are activated by various stimuli, with typical features of bradycardia, vasorelaxation, and hypotension. This reflex usually happens in parturient intrathecal anesthesia, as a result of decreased venous return by compression of inferior vena cava, but it is only rarely reported during general anesthesia. PATIENT CONCERNS: Severe bradycardia and hypotension, indicating BJR, occurred during the induction of general anesthesia in a 3-month-old female child with giant intra-abdominal teratoma...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019627/dry-drowning-myths-and-misconceptions
#8
M Denise Dowd
Drowning is a leading cause of death in children and is highly preventable. More than 10 people die of drowning in the United States each day, most of them adults. Rates of drowning are highest in children given their developmental vulnerabilities. Drowning incidents that result in cardiopulmonary arrest have a straightforward emergency clinical response, but the management approaches to the more common scenario of brief, nonfatal submersion is less clear. Clinicians must make clinical-care decisions based on evidence to provide safe and effective care in a timely manner and to help families avoid unnecessary anxiety...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29018599/qualitative-study-of-healthcare-providers-current-practice-patterns-and-barriers-to-successful-rehydration-for-pediatric-diarrheal-illnesses-in-kenya
#9
Darlene R House, Philip Cheptinga, Daniel E Rusyniak, Rachel C Vreeman
BACKGROUND: For children worldwide, diarrhea is the second leading cause of death. These deaths are preventable by fluid resuscitation. Nasogastric tubes (NGs) have been shown to be equivalent to intravenous fluids for rehydration and recommended by the World Health Organization (WHO) for use in severe dehydration. Despite this, NGs are rarely used for rehydration in Kenya. Our objective was to evaluate clinicians' adherence to rehydration guidelines and to identify barriers to the use of NGs for resuscitating dehydrated children...
2017: PeerJ
https://www.readbyqxmd.com/read/29018043/educational-added-value-unit-development-and-testing-of-a-measure-for-educational-activities
#10
Amy B Guiot, Eric S Kirkendall, Craig H Gosdin, Samir S Shah, Dominick J DeBlasio, Katie A Meier, Jennifer K O'Toole
OBJECTIVES: University-based hospitalists educate health care professionals as an expectation, often lacking time and support for these activities. The purpose of this study was to (1) develop a tracking tool to record educational activities, (2) demonstrate its applicability and ease of completion for faculty members in different divisions, and (3) compare educational efforts of individuals from different professional pathways and divisions by using the educational added value unit (EAVU)...
October 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29016516/barriers-to-effective-teamwork-relating-to-pediatric-resuscitations-perceptions-of-pediatric-emergency-medicine-staff
#11
Joshua M Sherman, Todd P Chang, Nurit Ziv, Alan L Nager
BACKGROUND: In the pediatric emergency department (PED), resuscitations require medical teams form ad hoc, rarely communicating beforehand. Literature has shown that the medical community has deficiencies in communication and teamwork. However, we as medical providers do not know or understand the perceived barriers of our colleagues. Physicians may perceive a barrier that is different from nurses, respiratory therapists, pharmacists, or technicians. Perhaps we do not know in which area of teamwork and communication we are deficient...
October 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28992868/definitive-diagnosis-of-children-presenting-to-a-pediatric-emergency-department-with-fever-and-extremity-pain
#12
Nicolas V Vardiabasis, John A Schlechter
BACKGROUND: Children who present to the emergency department (ED) with complaint of fever and new-onset joint or extremity pain can be a diagnostic dilemma for many emergency and consulting physicians. OBJECTIVES: The purpose of our study was to identify the etiologies of pediatric fever and extremity pain presenting to a tertiary care pediatric ED and to define factors that were associated with advanced imaging, admission, and surgical intervention. METHODS: The electronic medical records of children presenting to our institution's pediatric ED with fever and extremity pain were retrospectively reviewed...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28992737/asenapine-iloperidone-and-lurasidone-exposures-in-young-children-reported-to-u-s-poison-centers
#13
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: Asenapine, iloperidone and lurasidone are relatively new atypical antipsychotics. There is limited information on toxicity on pediatric exposures to these drugs. The objective of this study was to compare toxicity associated with asenapine, iloperidone and lurasidone exposures in young children. METHODS: A retrospective study of U.S. National Poison Data System from 2010 to 2015 of single substance exposures to asenapine, iloperidone or lurasidone in children <6 years of age that were followed to known outcome was performed...
October 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28990685/national-trends-in-otolaryngology-intern-curricula-following-accreditation-council-for-graduate-medical-education-changes
#14
Kevin J Kovatch, Rebecca S Harvey, Mark E P Prince, Marc C Thorne
OBJECTIVES/HYPOTHESIS: In 2016, Accreditation Council for Graduate Medical Education (ACGME) requirements for curriculum and resident experiences were modified to require entering postgraduate year (PGY)-1 residents to spend 6 months of structured education on otolaryngology-head and neck surgery (ORL-HNS) rotations. We aimed to determine how ORL-HNS training programs have adapted curricula in response to 2016 ACGME curriculum requirement changes. STUDY DESIGN: Survey study...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28989879/root-cause-analysis-of-diabetic-ketoacidosis-admissions-at-a-tertiary-referral-pediatric-emergency-department-in-north-india
#15
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/28989289/epidemiology-diagnosis-and-optimal-management-of-glioma-in-adolescents-and-young-adults
#16
REVIEW
Tejan P Diwanji, Alexander Engelman, James W Snider, Pranshu Mohindra
Neoplasms of the central nervous system (CNS) are the most frequently encountered solid tumors of childhood, but are less common in adolescents and young adults (AYA), aged 15-39 years. Gliomas account for 29%-35% of the CNS tumors in AYA, with approximately two-thirds being low-grade glioma (LGG) and the remaining being high-grade glioma (HGG). We review the epidemiology, work-up, and management of LGG and HGG, focusing on the particular issues faced by the AYA population relative to pediatric and adult populations...
2017: Adolescent Health, Medicine and Therapeutics
https://www.readbyqxmd.com/read/28988964/epidemiology-of-bacteremia-in-febrile-infants-aged-60-days-and-younger
#17
Elizabeth C Powell, Prashant V Mahajan, Genie Roosevelt, John D Hoyle, Rajender Gattu, Andrea T Cruz, Alexander J Rogers, Shireen M Atabaki, David M Jaffe, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
STUDY OBJECTIVE: To describe the current epidemiology of bacteremia in febrile infants 60 days of age and younger in the Pediatric Emergency Care Applied Research Network (PECARN). METHODS: We conducted a planned secondary analysis of a prospective observational study of febrile infants 60 days of age and younger presenting to any of 26 PECARN emergency departments (2008 to 2013) who had blood cultures obtained. We excluded infants with significant comorbidities or critically ill appearance...
October 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28988737/hematometrocolpos-disguised-as-abdominal-pain
#18
Ramy Saleh, George Katzenbach, James Espinosa
BACKGROUND: Hematometrocolpos caused by an imperforate hymen is a common form of vaginal outflow obstruction. This is a rare pediatric anomaly that can present with atypical or vague symptomatology, such as abdominal pain or constipation or urinary retention in the setting of amenorrhea. It is essential to obtain a gynecologic history and inquire about menstrual cycles to properly evaluate a young female with such a common complaint as abdominal pain. Failure to perform a gynecologic examination in the emergency department setting may delay diagnosis and appropriate care for this rare condition, which can lead to serious complications...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987305/unintentional-marijuana-exposure-presenting-as-altered-mental-status-in-the-pediatric-emergency-department-a-case-series
#19
Anita A Thomas, Suzan Mazor
BACKGROUND: Unintentional tetrahydrocannabinol (THC) exposure in pediatric patients can present as altered mental status. Altered mental status in a pediatric patient often leads to invasive diagnostic testing. CASE REPORT: The following cases describe 3 pediatric patients in Washington state who presented to a tertiary care children's hospital emergency department (ED) with altered mental status, later found to have urine toxicology screening positive for inactive THC metabolite (positive THC toxicology screen)...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28984751/bla-oxa48-gene-microorganisms-outbreak-in-a-tertiary-children-s-hospital-over-3-years-2012-2014-case-report
#20
Rafael Herruzo, Guillermo Ruiz, Veronica Perez-Blanco, Sara Gallego, Eduardo Mora, Maria Jose Vizcaino, Felix Omeñaca
RATIONALE: Carbapenem-resistant Enterobacteriaceae are an emerging problem in children. Nosocomial spread remains the principal risk factor for acquisition of these microorganisms. PATIENTS CONCERNS: We describe an outbreak of Klebsiella pneumoniae OXA48 (KOXA48) in a tertiary children's hospital during the years 2012 to 2014, as well as the preventive measures put in place in colonized and infected cases. DIAGNOSES: We studied, "in vitro," the KOXA48 susceptibility to antiseptics and surface disinfectants...
October 2017: Medicine (Baltimore)
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