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Pediatric emergency care

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https://www.readbyqxmd.com/read/27933399/implementation-of-clinical-decision-support-in-young-children-with-acute-gastroenteritis-a-randomized-controlled-trial-at-the-emergency-department
#1
Dorien Geurts, Evelien de Vos-Kerkhof, Suzanne Polinder, Ewout Steyerberg, Johan van der Lei, Henriëtte Moll, Rianne Oostenbrink
: Acute gastroenteritis (AGE) is one of the most frequent reasons for young children to visit emergency departments (EDs). We aimed to evaluate (1) feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE and (2) the impact on diagnostics, treatment, and costs compared with usual care by attending physician. A randomized controlled trial was performed in 222 children, aged 1 month to 5 years at the ED of the Erasmus MC-Sophia Children's hospital in The Netherlands ( 2010-2012)...
December 8, 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27933286/viral-infection-in-the-development-and-progression-of-pediatric-acute-respiratory-distress-syndrome
#2
REVIEW
Steven Nye, Richard J Whitley, Michele Kong
Viral infections are an important cause of pediatric acute respiratory distress syndrome (ARDS). Numerous viruses, including respiratory syncytial virus (RSV) and influenza A (H1N1) virus, have been implicated in the progression of pneumonia to ARDS; yet the incidence of progression is unknown. Despite acute and chronic morbidity associated with respiratory viral infections, particularly in "at risk" populations, treatment options are limited. Thus, with few exceptions, care is symptomatic. In addition, mortality rates for viral-related ARDS have yet to be determined...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27931533/care-transition-interventions-for-children-with-asthma-in-the-emergency-department
#3
REVIEW
Molly A Martin, Valerie G Press, Sharmilee M Nyenhuis, Jerry A Krishnan, Kim Erwin, Giselle Mosnaim, Helen Margellos-Anast, S Margaret Paik, Stacy Ignoffo, Michael McDermott
The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many interventions on care transition for pediatric asthma have been tested, only a few were actually conducted in the ED setting. Most of these targeted both care coordination and self-management education but ultimately did not improve attendance at follow-up appointments with primary care providers, improve asthma control, or reduce health care utilization...
December 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27930564/effects-of-intraoperative-dexmedetomidine-with-intravenous-anesthesia-on-postoperative-emergence-agitation-delirium-in-pediatric-patients-undergoing-tonsillectomy-with-or-without-adenoidectomy-a-consort-prospective-randomized-controlled-clinical-trial
#4
Jun-Li Cao, Yu-Ping Pei, Jing-Qiu Wei, Yue-Ying Zhang
Postoperative emergence agitation/delirium (POED) is a common complication in pediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression. This study aims to investigate the safety and efficacy of intraoperative infusion of dexmedetomidine (DEX) and its effects on POED in pediatric patients undergoing tonsillectomy with or without adenoidectomy.Sixty patients scheduled for tonsillectomy with or without adenoidectomy, aged 2 to 8 years, were randomly allocated into 2 groups (n = 30)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27929691/association-between-pediatric-home-management-plan-of-care-compliance-and-asthma-readmission
#5
Ronen Zipkin, Sheree M Schrager, Eugene Nguyen, Mary Rose Mamey, Ingrid Banuelos, Susan Wu
OBJECTIVES: In 2007, The Joint Commission implemented three children's asthma care (CAC) measures to help improve the quality of care for patients admitted with asthma. Due to lack of consistent evidence showing a relationship between home management plan of care (HMPC) compliance and readmission rates, CAC-3 was retired in 2016. We aimed to understand the relationship between HMPC compliance and revisits to the hospital, and investigate which components of the HMPC, if any, were driving the effect...
December 8, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27928814/the-adrenal-gland-an-organ-neglected-in-pediatric-trauma-cases
#6
Bahattin Aydogdu, Mehmet Hanifi Okur, Serkan Arslan, Mehmet Serif Arslan, Hikmet Zeytun, Erol Basuguy, Mustafa Icer, Cemil Goya, Ibrahim Uygun, Murat Kemal Cigdem, Abdurrahman Onen, Selcuk Otcu
PURPOSE: Adrenal gland injury (AGI) caused by trauma may cause bleeding and life-threatening problems in children.The objective of this study was to analyze the prevalence of AGI in final diagnoses of trauma. MATERIALS AND METHODS: The records of 458 patients with abdominal trauma (out of a total 8,200 pediatric patientswith trauma of any sort), who were referred to our clinic between January 2009 and July 2014, were reviewed retrospectively.The numbers of patients with AGI and their ages, gender, trauma patterns, affected organs, pediatrictrauma scores (PTSs), and injury severity scores (ISSs) were recorded, as well as the associated ultrasound (US)and tomographic scan data, treatments, and complications...
December 8, 2016: Urology Journal
https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#7
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27923754/successful-coil-embolization-of-pediatric-carotid-cavernous-fistula-due-to-ruptured-post-traumatic-giant-internal-carotid-artery-aneurysm
#8
Daisuke Wajima, Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery (ICA). However, for the ipsilateral post-traumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high flow direct CCF would be better for the prevention of hyper-perfusion syndrome and the intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy was suffered from severe head trauma caused by being hit by a car...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#9
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#10
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27916021/use-of-point-of-care-ultrasound-in-long-bone-fractures-a-systematic-review-and-meta-analysis
#11
Lucas B Chartier, Laura Bosco, Lauren Lapointe-Shaw, Jordan Chenkin
OBJECTIVES: Long bone fractures (LBFs) are among the most frequent traumatic injuries seen in emergency departments. Reduction and immobilization is the most common form of treatment for displaced fractures. Point-of-care ultrasound (PoCUS) is a promising technique for diagnosing LBFs and assessing the success of reduction attempts. This article offers a comprehensive review of the use of PoCUS for the diagnosis and reduction of LBFs. Data source MEDLINE and EMBASE databases were searched through July 19, 2015...
December 5, 2016: CJEM
https://www.readbyqxmd.com/read/27915322/ocular-morbidity-associated-with-retinopathy-of-prematurity-in-treated-and-untreated-eyes-a-review-of-the-literature-and-data-from-a-tertiary-eye-care-center-in-southern-india
#12
Perumalsamy Vijayalakshmi, Tulika Kara, Clare Gilbert
Retinopathy of prematurity (ROP) is an emerging cause of childhood blindness in low- and middle-income countries. We review the magnitude, causes, prevention and treatment of visual impairment caused by ROP over a time span. A review of literature on short and long term structural and functional outcomes of ROP was conducted through PubMed search primarily focusing on studies published during the last decade. Additionally, we have shared data from our institute located in Southern India. Visual Impairment in ROP-treated children ranged from 4...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#13
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27906995/assessment-of-the-world-health-organization-s-hiv-drug-resistance-early-warning-indicators-in-main-and-decentralized-outreach-antiretroviral-therapy-sites-in-namibia
#14
Nicholus Mutenda, Alexandra Bukowski, Anne-Marie Nitschke, Tuli Nakanyala, Ndapewa Hamunime, Tadesse Mekonen, Francina Tjituka, Greatjoy Mazibuko, Samson Mwinga, David Mabirizi, Evans Sagwa, Rosalia Indongo, Natalie Dean, Michael R Jordan, Steven Y Hong
BACKGROUND: The World Health Organization (WHO) early warning indicators (EWIs) of HIV drug resistance (HIVDR) assess factors at individual ART sites that are known to create situations favourable to the emergence of HIVDR. METHODS: In 2014, the Namibia HIV care and treatment program abstracted the following adult and pediatric EWIs from all public ART sites (50 main sites and 143 outreach sites): On-time pill pick-up, Retention in care, Pharmacy stock-outs, Dispensing practices, and Viral load suppression...
2016: PloS One
https://www.readbyqxmd.com/read/27906411/mental-health-emergencies-in-paediatric-services-characteristics-diagnostic-stability-and-gender-differences
#15
Montserrat Porter, Rebeca Gracia, Joan-Carles Oliva, Montserrat Pàmias, Gemma Garcia-Parés, Jesús Cobo
INTRODUCTION: Child and adolescent psychiatric emergencies have increased in recent years. The main objective of our study is to analyze sociodemographic and clinical characteristics of psychiatric emergencies under 18 years old that came to our hospital. Secondary objectives were to study diagnostic stability made in the emergency department and undertake a gender analysis. METHODS: Descriptive cross-sectional study of patients attending the pediatric emergency department who required consultation to psychiatry service during 2010 and 2011, comparing data with two previous cross-sectional cuts (2002-2003 and 2006-2007)...
November 2016: Actas Españolas de Psiquiatría
https://www.readbyqxmd.com/read/27903852/topical-honey-in-the-management-of-pediatric-peritoneal-dialysis-exit-sites
#16
Thomas A Forbes, Loren Shaw, Catherine Quinlan
International guidelines in peritoneal dialysis (PD) advocate for regular application of topical mupirocin in chronic PD exit-site care. A strong evidence base links this treatment to reduced rates of exit-site infections and peritonitis. However, emerging reports of increasing mupirocin resistance and gram-negative infections are threatening the long-term viability of topical antibiotic ointments as a prophylactic treatment. Medical grade honey has multiple proven antibacterial and wound healing properties...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27902672/essential-content-for-discharge-instructions-in-pediatric-emergency-care-a-delphi-study
#17
Janet A Curran, Andrea Murphy, Emma Burns, Amy Plint, Monica Taljaard, Shannon MacPhee, Eleanor Fitzpatrick, Andrea Bishop, Jill Chorney, Megan Bourque
OBJECTIVE: The aim of this study was to identify the 5 most essential discharge instruction content elements that should be communicated to all caregivers of children who present to the emergency department (ED) with asthma, vomiting/diarrhea, abdominal pain, fever, minor head injury, or bronchiolitis. METHODS: A discharge information content list was developed for each illness presentation following a review of the literature. Using a modified Delphi technique, 6 lists were distributed to a panel of experts from EDs across Canada using a secure online survey tool with the goal of achieving the 5 most essential discharge instruction elements...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#18
Yea-Chyi Lin, York Tien Lee, Jasmine Xun Yi Feng, Li Wei Chiang, Shireen Anne Nah
OBJECTIVES: We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome. METHODS: We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#19
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27898631/traumatic-femoral-artery-thrombosis-diagnosed-by-point-of-care-ultrasonography-in-the-pediatric-emergency-department
#20
Sarah D Jones, Jason Fischer, Charisse Kwan, Mark Tessaro
Femoral artery injuries are a rare complication of blunt trauma in children that require expeditious diagnosis and treatment to prevent permanent limb dysfunction. Point-of-care ultrasonography of femoral vessels is a well-established emergency physician technique for ruling out deep vein thrombosis and guiding femoral vessel catheterization. We present the first report of a pediatric emergency physician diagnosing a traumatic femoral artery thrombus using point-of-care ultrasonography.
December 2016: Pediatric Emergency Care
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