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Pediatric emergency care

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https://www.readbyqxmd.com/read/29927880/fosphenytoin-population-pharmacokinetics-in-the-acutely-ill-pediatric-population
#1
Brady S Moffett, Mindl M Weingarten, Lindsay R Schmees, Marianne Galati, Jennifer Erklauer, James J Riviello
OBJECTIVE: The purpose of this study is to describe the pharmacokinetics of phenytoin in pediatric patients receiving fosphenytoin. DESIGN: Retrospective, population pharmacokinetic analysis. SETTING: Emergency department or PICU of a large tertiary care children's hospital. PATIENTS: Patients less than 19 years old who received fosphenytoin in the PICU or emergency center for treatment of seizures from January 2011 to June 2017 were included...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927643/trends-in-homeless-children-and-young-adults-seeking-shelter-in-a-boston-pediatric-emergency-department-following-state-housing-policy-changes-2011-2016
#2
Mia Kanak, Amanda Stewart, Robert Vinci, Shanshan Liu, Megan Sandel
OBJECTIVES: To describe a trend in emergency department (ED) use by homeless children and young adults before and after a state housing policy change in 2012 and to quantify financial and time costs to the health care system. METHODS: We retrospectively reviewed de-identified electronic medical records of homeless children and young adults aged 0 to 21 years seeking shelter at an urban tertiary pediatric ED in Boston, Massachusetts, between September 1, 2011, and August 31, 2016...
June 21, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29925447/visitor-restriction-policies-and-practices-in-children-s-hospitals-in-north-america-results-of-an-emerging-infections-network-survey
#3
Alice L Pong, Susan E Beekmann, Mekleet M Faltamo, Philip M Polgreen, Andi L Shane
OBJECTIVE: To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities. DESIGN: An electronic survey to characterize VRPP in pediatric healthcare facilities. METHODS: The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed. RESULTS: A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate...
June 21, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29924893/reliability-of-heartsmap-as-a-tool-for-evaluating-psychosocial-assessment-documentation-practices-in-emergency-departments-for-pediatric-mental-health-complaints
#4
Carson Gill, Brendan Arnold, Sean Nugent, Alykhan Rajwani, Michael Xu, Tyler Black, Quynh Doan
OBJECTIVES: The goal of this study was to assess the reliability of HEARTSMAP as a standardized tool for evaluating the quality of psychosocial assessment documentation of pediatric mental health presentations to the emergency department. In addition, we report on current documentation practices. METHODS: We conducted a retrospective cross-sectional study of pediatric (up to age 17) mental health-related visits to four emergency departments between April 1, 2013 and March 31, 2014...
June 20, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29924663/emergency-department-visits-by-adolescent-and-young-adult-cancer-patients-compared-with-pediatric-cancer-patients-in-the-united-states
#5
Sapna Kaul, Heidi Russell, John A Livingston, Anne C Kirchhoff, Daniel Jupiter
PURPOSE: Limited information exists on emergency department (ED) visits for adolescent and young adult (AYA) patients with cancer. We examined the clinical reasons for ED visits, and outcomes, for AYAs with cancer compared to pediatric cancer patients. METHODS: The 2013 Nationwide Emergency Department Sample data were used to identify 53,274 AYA (ages 15-39) and 6952 pediatric (ages 0-14) cancer ED visits. We evaluated patient (i.e., demographic and diagnosis) and hospital characteristics, and the ED event outcome (admitted to the same hospital or treated/released)...
June 20, 2018: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/29920580/insights-from-the-geographic-spread-of-the-lyme-disease-epidemic
#6
Taylor Eddens, Daniel J Kaplan, Alyce J M Anderson, Andrew J Nowalk, Brian T Campfield
Background: Lyme disease is the most common reportable zoonotic infection in the United States. Recent data suggests spread of the Ixodes tick vector and increasing incidence of Lyme disease in several states, including Pennsylvania. We sought to determine the clinical presentation and healthcare utilization patterns for pediatric Lyme disease in western Pennsylvania. Methods: The electronic medical records of all patients with an ICD9 diagnosis of Lyme disease between 2003-2013 at Children's Hospital of Pittsburgh were individually reviewed for cases meeting the 2011 CDC case definition for Lyme disease...
June 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29916338/emergency-organization-of-child-psychiatric-care-following-the-terrorist-attack-on-july-14-2016-in-nice-france
#7
Lucie Chauvelin, Morgane Gindt, Bertrand Olliac, Philippe Robert, Susanne Thümmler, Florence Askenazy
In the actual context of terrorism targeting children and families, it seems essential to describe different experiences of pediatric psychological emergency devices after such unexpected mass trauma. Here we testify our experience of the psychological emergency care setup dedicated to children and families during the first 48 hours after the terrorist attack of Nice, France, on July 14, 2016. Activated within the hour following the attack, the device included two child psychiatry teams turning over each day, receiving at least 163 individuals (99 children and 64 adults) within the first 2 days...
June 19, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29912846/dissemination-of-the-methicillin-resistance-staphylococcus-aureus-pediatric-clone-st5-t002-iv-pvl-as-a-major-cause-of-community-associated-staphylococcal-infections-in-bedouin-children-southern-israel
#8
Assaf Rokney, Moti Baum, Shalom Ben-Shimol, Orli Sagi, Einav Anuka, Vered Agmon, David Greenberg, Lea Valinsky, Dana Danino
INTRODUCTION: Pediatric community associated methicillin resistant Staphylococcus aureus (CA-MRSA) infections are emerging worldwide. High CA-MRSA carriage rates were previously described in healthy Bedouin children. We assessed demographic, clinical and molecular characteristics of pediatric MRSA infections in southern Israel. METHODS: The Soroka University Medical Center laboratory serves the entire population of southern Israel, divided into two ethnic groups, Bedouins and Jews...
June 15, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29912086/current-practices-in-pediatric-emergency-medicine-fellowship-trauma-training
#9
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
#10
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/29911433/hunger-a-missed-opportunity-for-screening-in-the-pediatric-emergency-department
#11
Tamar Robinson, Leah Bryan, Veda Johnson, Terri McFadden, Sarah Lazarus, Harold K Simon
BACKGROUND: The American Academy of Pediatrics and pediatric community recognize the importance of addressing social determinants of health. There are limited data on the prevalence of food insecurity or literature establishing protocols assessing food insecurity in the emergency department (ED). METHODS: Two anonymous surveys were administered, one to families during their ED visit and another to ED staff to assess perceptions on the ED's role in providing social support...
June 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29907210/nonoperative-management-of-penetrating-abdominal-solid-organ-injuries-in-children
#12
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/29904163/physicians-perspectives-on-receiving-unsolicited-genomic-results
#13
Douglas B Pet, Ingrid A Holm, Janet L Williams, Melanie F Myers, Laurie L Novak, Kyle B Brothers, Georgia L Wiesner, Ellen W Clayton
PURPOSE: Physicians increasingly receive genomic test results they did not order, which we term "unsolicited genomic results" (UGRs). We asked physicians how they think such results will affect them and their patients. METHODS: Semistructured interviews were conducted with adult and pediatric primary care and subspecialty physicians at four sites affiliated with a large-scale return-of-results project led by the Electronic Medical Records and Genomics (eMERGE) Network...
June 14, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29901794/accuracy-of-prehospital-care-providers-in-determining-total-body-surface-area-burned-in-severe-pediatric-thermal-injury
#14
Christopher McCulloh, Andrew Nordin, Lindsay J Talbot, Junxin Shi, Renata Fabia, Rajan K Thakkar
Accurate measurement of total body surface area (TBSA) burned is a key factor in the care of pediatric patients with burn, especially those with large thermal injuries. There is a paucity of data on the accuracy of these measurements by prehospital, nonburn center, and emergency department (ED) providers, which can have drastic implications for patient management and outcomes. We sought to determine the accuracy of these estimates for large pediatric burns. A retrospective chart review was conducted of patients with TBSA ≥10% admitted to an American Burn Association (ABA)-verified pediatric burn center from 2007 to 2015...
June 13, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29901556/universal-recommendations-for-the-management-of-acute-diarrhea-in-non-malnourished-children
#15
Alfredo Guarino, Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Dario Bruzzese, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar-Lindo, Bhupinder Sandhu, Philip M Sherman, Toshiaki Shimizu
OBJECTIVES: Despite a substantial consistency in recommendations for the management of children with acute gastroenteritis (AGE), a high variability in clinical practice and a high rate of inappropriate medical interventions persist in both developing and developed countries.Aim of this study was to develop a set of clinical recommendations for the management of non-severely malnourished children with AGE to be applied worldwide. METHODS: The Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) Working Group (WG) selected care protocols on the management of acute diarrhea in infants and children aged between 1 month and 18 years...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29901527/knowledge-accrual-following-participation-in-pediatric-fundamental-critical-care-support-course-in-gaborone-botswana
#16
Megan Cox, Natasha Afonso, Loeto Mazhani, David Kloeck, Mohan Mysore, Kevin Roy, Segolame Setlhare, Tlamelo Daman, Peter A Meaney
OBJECTIVES: To describe provider characteristics, knowledge acquisition, perceived relevance, and instruction quality of the Society of Critical Care Medicine's Pediatric Fundamentals of Critical Care Support course pilot implementation in Botswana. DESIGN: Observational, single center. SETTING: Academic, upper middle-income country. SUBJECTS: Healthcare providers in Botswana. INTERVENTIONS: A cohort of healthcare providers completed the standard 2-day Pediatric Fundamentals of Critical Care Support course and qualitative survey during the course...
June 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29898800/screening-brief-intervention-and-referral-to-treatment-for-adolescent-alcohol-use-in-canadian-pediatric-emergency-departments-a-national-survey-of-pediatric-emergency-physicians
#17
Shelly Jun, Amy C Plint, Sarah Curtis, Amanda S Newton
CLINICIAN'S CAPSULE What is known about the topic? Emergency department (ED) visits for adolescent alcohol-related concerns offer the opportunity for early intervention; however, the underlying alcohol problem generally remains unaddressed. What did this study ask? What are ED physicians' perceptions regarding adolescent alcohol use and ED-based intervention? What are their current intervention practices? What did this study find? While the majority of ED physicians feel the responsibility to address problematic adolescent alcohol use, interventional practices are unstandardized and lacking...
June 14, 2018: CJEM
https://www.readbyqxmd.com/read/29895662/acute-lymphoblastic-leukemia-in-adolescent-and-young-adults-treat-as-adults-or-as-children
#18
Nicolas Boissel, André Baruchel
Adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) are recognized as a unique population with specific characteristics and needs. In adolescents aged 15-20 years old, the use of full pediatric protocols is supported by many comparative studies of pediatric and adult cooperative groups. In young adults, growing evidence suggests that pediatric-inspired or even fully pediatric approaches may also dramatically improve outcomes, leading to long-term survival rates of almost 70%, despite diminishing indications of hematopoietic stem cell transplantation...
June 12, 2018: Blood
https://www.readbyqxmd.com/read/29893624/developmental-disorders-and-medical-complications-among-infants-with-subclinical-intrauterine-opioid-exposures
#19
Eric S Hall, Jennifer M McAllister, Scott L Wexelblatt
The objective was to compare diagnosis rates representing developmental outcomes and medical complications between infants with intrauterine opioid exposures who did not receive pharmacologic treatment for neonatal abstinence syndrome at the time of birth and infants for whom no exposure to substances of abuse were detected. This retrospective, descriptive study included approximately 95% of Hamilton County, Ohio resident births in 2014 and 2015. Universal maternal drug test results, performed at the time of birth, were documented and linked to electronic health records representing pediatric primary and subspecialty follow-up care as well as urgent care, emergency care, and inpatient services provided by Cincinnati Children's Hospital Medical Center through 2017, when all children were at least 24 months old...
June 12, 2018: Population Health Management
https://www.readbyqxmd.com/read/29892562/impact-of-vitamin-d-treatment-on-25-hydroxy-vitamin-d-levels-and-insulin-homeostasis-in-obese-african-american-adolescents-in-a-randomized-trial
#20
Usha Sethuraman, Marwan A Zidan, Lynae Hanks, Minoo Bagheri, Ambika Ashraf
Background: Obesity is affecting children in epidemic proportions in the United States with nearly 25% of children being obese. Consequences of obesity including dyslipidemia, type 2 diabetes and cardiovascular disease are leading to morbidity at younger ages. Parallel to the obesity and diabetes epidemics, the prevalence of vitamin D deficiency has reached very high levels and has been associated with insulin resistance and dyslipidemia. Studies exploring the impact of vitamin D repletion on insulin sensitivity and dyslipidemia in children are sparse...
June 2018: Journal of Clinical & Translational Endocrinology
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