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https://www.readbyqxmd.com/read/29240569/paediatric-procedural-sedation-and-analgesia-by-emergency-physicians-in-a-country-with-a-recent-establishment-of-emergency-medicine
#1
Maybritt I Kuypers, Gaël J P Smits, Eva P Baerends, Erick Oskam, Eef P J Reijners, Lisette A A Mignot-Evers, Wendy A M H Thijssen, Frans B Plötz, Erik H M Korsten
OBJECTIVES: Paediatric patients receive less procedural sedation and analgesia (PSA) in the emergency department compared with adults, especially in countries where emergency medicine is at an early stage of development. The objectives of this study were to evaluate the adverse events and efficacy of paediatric PSA in a country with a recent establishment of emergency medicine and to describe which factors aided implementation. METHODS: This is a prospective, multicentre, observational study of paediatric patients undergoing PSA by the first trained emergency physicians (EPs) in The Netherlands...
December 13, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29237400/accuracy-of-acute-burns-diagnosis-made-using-smartphones-and-tablets-a-questionnaire-based-study-among-medical-experts
#2
Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg, Lucie Laflamme
BACKGROUND: Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD: A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults...
December 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29236779/detection-and-molecular-characterization-of-the-novel-recombinant-norovirus-gii-p16-gii-4-sydney-in-southeastern-brazil-in-2016
#3
Débora Maria Pires Gonçalves Barreira, Túlio Machado Fumian, Marco André Loureiro Tonini, Lays Paula Bondi Volpini, Rodrigo Pratte Santos, Anézia Lima Chaves Ribeiro, José Paulo Gagliardi Leite, Márcia Terezinha Baroni de Moraes E Souza, Patrícia Brasil, Denise Cotrim da Cunha, Marize Pereira Miagostovich, Liliana Cruz Spano
Noroviruses are the leading cause of acute gastroenteritis (AGE) in all age groups worldwide. Despite the high genetic diversity of noroviruses, most AGE outbreaks are caused by a single norovirus genotype: GII.4. Since 1995, several different variants of norovirus GII.4 have been associated with pandemics, with each variant circulating for 3 to 8 years. The Sydney_2012 variant was first reported in Australia and then in other countries. A new variant, GII.P16-GII.4, was recently described in Japan and South Korea and then in the USA, France, Germany and England...
2017: PloS One
https://www.readbyqxmd.com/read/29227054/auditing-surgical-service-provision-at-a-south-african-tertiary-institution-implications-for-the-development-of-district-services
#4
G L Laing, D L Skinner, J L Bruce, C Aldous, V Govindasamy, S R Thomson, D L Clarke
BACKGROUND: The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. METHOD: The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29218501/evaluating-safety-reporting-in-paediatric-antibiotic-trials-2000-2016-a-systematic-review-and-meta-analysis
#5
REVIEW
Paola Pansa, Yingfen Hsia, Julia Bielicki, Irja Lutsar, A Sarah Walker, Mike Sharland, Laura Folgori
BACKGROUND: There are very few options to treat multidrug-resistant bacterial infections in children. A major barrier is the duration and complexity of regulatory trials of new antibiotics. Extrapolation of safety data from adult trials could facilitate drug development for children. OBJECTIVE: We performed a systematic review on the safety of antibiotic clinical trials (CTs) in children (0-18 years) to evaluate the overall quality of safety trials conducted in children and to determine if age-specific adverse events (AEs) could be identified for specific antibiotic classes...
December 7, 2017: Drugs
https://www.readbyqxmd.com/read/29210712/optimizing-hiv-transition-services-for-young-adults
#6
Caroline Foster, Sarah Fidler
PURPOSE OF REVIEW: A total of 1.8 million adolescents live with HIV and constitute the only age group in which HIV-associated mortality continues to rise. Meeting their healthcare needs as they transition from paediatric services to adult care is vital for their own health and in prevention of onward transmission to partners and offspring. In this review, we discuss the issues around transition, both within HIV health care and the wider transitions adolescents negotiate as they move out of childhood and into adult life...
November 27, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29208883/tumor-lysis-syndrome-and-hyperleukocytosis-in-childhood-acute-lymphoblastic-leukemia-in-a-tertiary-care-hospital
#7
R Tasmeen, A Islam, S T Alam, M Begum
Acute lymphoblastic leukemia is the most common (77%) childhood leukemia and also the most common neoplastic disease in children. Acute lymphoblastic leukemia initially present with hyperleukocytosis (WBC count more than 50,000/mm³) in twenty percent cases. These children are particularly at risk of development of tumor lysis syndrome (TLS). Tumor lysis syndrome is a metabolic disorder consists of hyperuricaemia, hyperkalemia, hyperphosphataemia, hypocalcaemia with or without renal insufficiency. It is the most common disease related emergency encountered by physicians caring for cancer of children and adult...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29207707/diagnostic-approach-to-viral-acute-encephalitis-syndrome-aes-in-paediatric-age-group-a-study-from-new-delhi
#8
Shipra Goel, Anita Chakravarti, Mukta Mantan, Surinder Kumar, Md Anzar Ashraf
Introduction: Acute Encephalitis Syndrome has heralded the emergence of multiple virulent pathogens, which may result in severe morbidity and mortality. In India, encephalitis is not notified and there has been a dearth of analysis for trends in encephalitis death rates and causation. A downward trend has been observed in encephalitis deaths, due to 'known' causes, which can be largely explained by improvement in diagnostic, treatment, and prevention methods. There is still a very high proportion of encephalitis deaths in developing countries, where the aetiological diagnosis of the pathogen is not established and thus, lies the importance of monitoring encephalitis morbidity and mortality with a view to improve pathogen diagnosis and identify emerging infectious diseases...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29206360/effect-of-a-children-s-at-home-nursing-team-on-reducing-emergency-admissions
#9
Laura Farnham, Hannah Harwood, Meredith Robertson
This article explores the effect of a children's at-home nursing team, Hospital at Home (H@H), which aimed to reduce demand on acute hospital beds, support families to improve patient experience, and empower parents to care safely for their unwell children and help prevent emergency department (ED) reattendance. Data on demographics and clinical presentation of H@H and ED attendances were collected and compared. A survey measuring parents' confidence in managing their unwell children was also conducted. Of 72 patients treated by the H@H service between May and July 2016, 32 (44%) would have been admitted to hospital from the ED if the H@H service had not existed...
December 5, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29206097/a-closed-claim-analysis-of-complaints-after-paediatric-antebrachial-fractures
#10
Christian Wong, Søren Bødtker, Peter Buxbom, Michael Schultz-Larsen
INTRODUCTION: Antebrachial fractures in children (AFC) are common and account for one third of all paediatric fractures. The Danish Patient Compensation Association (PCA) receives complaints from patients who believe that they have sustained injuries due to potential malpractice or unfortunate circumstances. Case files on AFC from the PCA were assessed to identify causality and factors contributing to complaints and potential malpractice. METHODS: A closed-claim analysis was performed in 138 cases with the diagnosis codes DS52...
December 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29198262/medical-missions-for-the-provision-of-paediatric-cardiac-surgery-in-low-and-middle-income-countries
#11
Frank J Molloy, Nguyenvu Nguyen, Marisa Mize, Gavin Wright, Cecilia St George-Hyslop, Maura O'Callaghan, Emma Scanlan, William M Novick
This review will outline the role of visiting cardiac surgical teams in low- and middle-income countries drawing on the collective experience of the authors in a wide range of locations. Requests for assistance can emerge from local programmes at a beginner or advanced stage. However, in all circumstances, careful pre-trip planning is necessary in conjunction with clinical and non-clinical local partners. The clinical evaluation, surgical procedures, and postoperative care all serve as a template for collaboration and education between the visiting and local teams in every aspect of care...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29194756/a-higher-level-of-ketonaemia-does-not-predict-oral-rehydration-failure-in-vomiting-paediatric-patients-and-routine-measurement-is-unnecessary
#12
Lucía Torres, Marina Sánchez, Blanca Cid, Eva Vicente, Roberto Velasco
AIM: This study determined if blood levels of beta-hydroxybutyrate were associated with the rate of failure in oral rehydration in paediatric patients with vomiting. METHODS: This was a prospective observational study that was carried out from 1 December 2015 to 30 November 2016 in the Rio Hortega University Hospital, Valladolid, Spain. The study cohort were patients up to 14 years old who attended the emergency department with three or more vomiting episodes in the last four hours and glycaemia higher than 45mg/dl...
December 1, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29183644/the-meaning-of-personal-diaries-to-children-and-families-in-the-paediatric-intensive-care-unit-a-qualitative-study
#13
Gitte Mikkelsen
OBJECTIVE: To explore children's' and families' experiences of using intensive care diaries after discharge and the role of diaries in the process of recovering from a stay in the paediatric intensive care unit. DESIGN AND SETTING: Qualitative, exploratory design. Data collection consisted of semi-structured interviews with five children and their families, conducted four to six months after discharge from the intensive care unit. Inclusion criteria were children and their families, with a stay for more than three days who had a diary written for them...
November 25, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29181625/development-of-a-high-resolution-infrared-thermographic-imaging-method-as-a-diagnostic-tool-for-acute-undifferentiated-limp-in-young-children
#14
R Owen, S Ramlakhan, R Saatchi, D Burke
Acute limp is a common presenting condition in the paediatric emergency department. There are a number of causes of acute limp that include traumatic injury, infection and malignancy. These causes in young children are not easily distinguished. In this pilot study, an infrared thermographic imaging technique to diagnose acute undifferentiated limp in young children was developed. Following required ethics approval, 30 children (mean age = 5.2 years, standard deviation = 3.3 years) were recruited. The exposed lower limbs of participants were imaged using a high-resolution thermal camera...
November 28, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29170354/57%C3%A2-support-for-suddenly-bereaved-parents-in-the-emergency-unit
#15
Emily Jones, Steffan Simpson
: The Paediatric Emergency Unit at the University Hospital of Wales provides care for over 33 000 children per year. There was no provision in place to support suddenly bereaved families. Staff felt that we could improve the services provided to families who's children sadly died in the unit.The aim was to provide immediate support for the suddenly bereaved families by working in partnership with local Charity 2 Wish Upon a Star. Together we created a Standard Operating Procedure (SOP) that consisted of a checklist and pathway allowing us to refer relatives for immediate physical and emotional support...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170353/56%C3%A2-manipulation-and-reduction-of-paediatric-forearm-fractures-using-es-ketamine-in-a-paediatric-emergency-department-a-5-year-study
#16
Shirley Mulvaney
BACKGROUND: Forearm fractures are the most common paediatric injury presenting to A+E.1,2 Literature supports safe and effective treatment of these injuries in A+E using a variety of sedation methods, including ketamine.3,4 The Paediatric Orthopaedic Trauma Snapshot (POTS) study showed that only 35% of A+Es nationally allow manipulation of these injuries in the department. METHODS: A retrospective analysis was undertaken of all patients presenting with fractures of the forearm between January 2012 to December 2016 who were treated with reduction and manipulation in the Alder Hey A+E department using Es-ketamine...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170351/54%C3%A2-paediatric-traumatic-cardiac-arrest-in-england-and-wales-a-10-year-epidemiological-study
#17
James Vassallo, Melanie Webster, Edward Barnard, Marisol Fragoso Iniguez, Mark Lyttle, Jason Smith
INTRODUCTION: Traumatic cardiac arrest (TCA) has traditionally been described as futile, with poor outcomes. Reported survival rates vary widely, with higher rates observed from mechanisms leading to a respiratory cause of traumatic cardiac arrest (e.g., drowning and hanging). Currently there is little evidence regarding outcomes following TCA in children. The primary aim of our study was to describe 30 day survival following TCA. Secondary aims were to provide an analysis of injury patterns (severe haemorrhage or traumatic brain injury), describe the functional outcome at discharge and to report the association between survival and interventions performed...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170350/53%C3%A2-piloting-patch-providing-assessment-and-treatment-for-children-at-home-and-piecing-together-what-works
#18
Caroline Ward, Katie Knight, Mary-Rose Ballard, Georgina Keogh, Miriam Samuel, Sara Buttle, Claire Robb, Francesca Cleugh
AIMS: PATCH is a pilot acute community children's nurse led service delivering assessment and treatment for children at home who are moderately unwell and might otherwise be admitted to hospital or attend Paediatric Emergency Department (PED). Children are referred by PED or GP and followed up via telephone support and home visits depending on clinical need for duration of acute illness. METHODS: Pilot year funded by Imperial Charity. Using evaluation to build business case for sustained commissioned service...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170348/51%C3%A2-paediatric-emergency-clinicians-are-rarely-exposed-to-non-airway-critical-procedures-a-predict-pern-study
#19
Juan P Garrahan, Mark Lyttle, Ed Oakley, Stuart Dalziel, Lucia Nguyen, Arjun Rao, Santiago Mintegi, Franz Babl
BACKGROUND: Recent studies suggest that approximately one per thousand paediatric ED attendances may require some sort of critical procedure, with intubation being by far the most common. It is unknown how often critical non-airway procedures such as chest decompression, CPR, ED thoracotomy, defibrillation, pacing, and advanced vascular access techniques are performed by paediatric emergency clinicians. OBJECTIVE: To determine the recent performance or supervision, and confidence for various paediatric critical non-airway procedures by senior paediatric emergency clinicians...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29161992/stenotrophomonas-maltophilia-causing-blood-stream-infection-in-neonates-and-infants-a-cause-for-concern
#20
Rinku Sah, Shraddha Siwakoti, Ratna Baral, Rupa S Rajbhandari, Basuda Khanal
Stenotrophomonas maltophilia ( S. maltophilia) is an important Gram-negative, non-fermentative, multidrug resistant (MDR) nosocomial organism. We evaluated the isolation of S. maltophilia from the seven blood culture specimens received from the Paediatric Emergency Department (PED) of BP Koirala Institute of Health Sciences (BPKIHS) over the duration of two weeks. The suspicion of a possible outbreak was raised and the hospital infection control team investigated the source and found the hand of one healthcare provider harbouring a similar organism...
January 1, 2017: Tropical Doctor
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