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https://www.readbyqxmd.com/read/29346231/the-complex-association-of-race-ethnicity-with-pain-treatment-quality-in-an-urban-medical-center-with-2-pediatric-emergency-departments
#1
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29333809/assessment-of-orofacial-pain-management-in-a-pediatric-emergency-department-and-at-home-after-discharge
#2
Yurena Aguilar de la Red, Gema Manrique Martín, Gloria Guerrero López, Concepción González Herrero, Paula López Vázquez, Concepción Míguez Navarro
INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29324631/pediatric-appendicitis-association-of-chief-complaint-with-missed-appendicitis
#3
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29321112/the-evaluation-and-management-of-urolithiasis-in-the-emergency-department-a-review-of-the-literature
#4
REVIEW
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Urolithiasis is a common condition in the U.S. Patients frequently present to the emergency department (ED) for care, including analgesia and treatments to facilitate stone passage. OBJECTIVE: With the new evidence concerning the evaluation and treatment of urolithiasis, this review summarizes current literature regarding the ED management of urolithiasis. DISCUSSION: Urolithiasis occurs primarily through supersaturation of urine and commonly presents with flank pain, hematuria, and nausea/vomiting...
January 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29310365/ebv-lymphoproliferative-associated-disease-and-primary-cardiac-t-cell-lymphoma-in-a-stk4-deficient-patient-a-case-report
#5
Roya Sherkat, Mohammad Reza Sabri, Bahar Dehghan, Hamid Bigdelian, Nahid Reisi, Nooshin Afsharmoghadam, Hamid Rahimi, Narges Rahmanian, Cristoph Klein
RATIONALE: Primary cardiac lymphoma (PLC) is an extremely uncommon malignancy. PCL is more common in secondary immunodeficient patients. In this report, we describe a unique case of PLC who had been diagnosed as a STK4 deficient patient. This case is the first Primary immunodeficiency (PID) patient developing PCL in the world. PATIENT CONCERNS: An eleven-year-old girl, a known case of PID, was referred to the pediatric cardiology department because of chest pain and dyspnea...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29239803/ultrasound-guided-ureteroscopy-in-children-safety-and-success
#6
Jeffrey C Morrison, Jason P Van Batavia, Kassa Darge, Christopher J Long, Aseem R Shukla, Arun K Srinivasan
INTRODUCTION: Ureteroscopy has been shown to be a highly efficacious and safe modality for the treatment of pediatric urolithiasis. However, conventional ureteroscopy relies on fluoroscopy for intraoperative guidance, exposing both patient and operating room personnel to ionizing radiation. Pediatric urolithiasis patients are at a particularly increased risk from this radiation exposure. The use of ultrasound in place of fluoroscopy for intraoperative guidance has emerged as one modification that can reduce radiation exposure during ureteroscopy...
October 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29232351/randomized-clinical-trial-of-lidocaine-analgesia-for-transurethral-bladder-catheterization-delivered-via-blunt-tipped-applicator-in-young-children
#7
Neil G Uspal, Bonnie Strelitz, Jesse Gritton, Kristin Follmer, Miranda C Bradford, Taryn L Colton, Paul A Merguerian, Eileen J Klein
OBJECTIVE: Transurethral bladder catheterization (TUBC) is a painful, frequently performed procedure for collecting sterile urine. We sought to determine if administration of intraurethral lidocaine before TUBC using a blunt tipped syringe decreases procedural pain in young children in the pediatric emergency department. METHODS: Randomized clinical trial of children 0 to 36 months old requiring TUBC for collection of urine in a pediatric emergency department was performed...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#8
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29201481/cystic-lymphangioma-of-the-chest-wall-in-a-5-year-old-male-patient-a-rare-and-atypical-localization-a-case-report-and-comprehensive-review-of-the-literature
#9
Dimitrios Patoulias, Ioannis Patoulias, Christos Kaselas, Maria Kalogirou, Chatzopoulos Kyriakos, Farmakis Konstantinos, Thomas Feidantsis, Papacrivou Eleni
Lymphangioma is a benign congenital malformation. The extremely rare and atypical localization of a lymphangioma in the chest wall was the real motive for the present case study. A 5-year-old boy was admitted to the Emergency Department of the 1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, due to the presence of a mildly painful swelling in the left lateral chest wall, which was first noticed three months ago, after a blunt injury during sport. Physical examination revealed the presence of a palpable, spherical, painful, nut-sized subcutaneous lesion in the left lateral chest wall, respectively, with the anterior axillary line, at the height of the 6th to 7th intercostal space...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29200140/evaluating-the-implementation-barriers-of-an-intranasal-fentanyl-pain-pathway-for-pediatric-long-bone-fractures
#10
Tamara Arnautovic, Kathryn Sommese, Paul C Mullan, Steven Barron Frazier, Turaj Vazifedan, Dana Erikson Ramirez
OBJECTIVES: This study aimed to assess physician comfort, knowledge, and implementation barriers regarding the use of intranasal fentanyl (INF) for pain management in patients with long-bone fractures in a pediatric emergency department (ED) with an INF pain pathway. METHODS: A retrospective chart review was conducted of patients, 3 to 21 years old, in our ED with an International Classification of Diseases-9th Revision code for a long-bone fracture from September 1, 2013, to August 31, 2015...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29189591/luc-s-abscess-and-temporomandibular-joint-septic-arthritis-two-rare-sequelae-of-acute-otitis-media
#11
Carmelle Tsai, Jennifer Deramo, Xiaofan Shen, Kathleen Vandiver, Vineeta Mittal
A 5-year-old previously healthy child presented with right-sided otalgia, right facial and temporal swelling, and right jaw pain in the setting of 6 days of low-grade fever. The child had no trauma, vomiting, or prior dental treatments. On physical examination, the patient had facial swelling, erythema, and tenderness over the right temporal region along with trismus, as well as pain on palpation of the right temporomandibular joint (TMJ). A computed tomography scan revealed otitis media, Luc's abscess, and TMJ septic arthritis requiring surgical drainage and intravenous antibiotics...
November 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29173273/incidence-of-bleeding-in-children-undergoing-circumcision-with-ketorolac-administration
#12
Bruce Gao
INTRODUCTION: Circumcision is the most common surgical procedure performed by pediatric urologists. Ketorolac has been shown to have an efficacy similar to morphine in multimodal analgesic regimens without the commonly associated adverse effects. Concerns with perioperative bleeding limit the use of ketorolac as an adjunct for pain control in surgical patients. As such, we sought to evaluate our institutional outcomes with respect to ketorolac and postoperative bleeding. METHODS: We retrospectively reviewed all pediatric patients undergoing circumcision from January 1, 2014 to December 31, 2015 at the Alberta Children's Hospital...
December 1, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29166854/a-single-dose-of-dezocine-suppresses-emergence-agitation-in-preschool-children-anesthetized-with-sevoflurane-remifentanil
#13
Li-Jun An, Yang Zhang, Zheng Su, Xian-Long Zhang, Hai-Lin Liu, Zhi-Jie Zhang, Jian-Lin Hu, Shi-Tong Li
BACKGROUND: Emergence agitation (EA) is a common phenomenon in preschool children during emergence from general anesthesia. This study evaluated the safety and efficacy of dezocine for emergence agitation in preschool children anesthetized with sevoflurane-remifentanil. METHODS: A total of 100 preschool children, scheduled for elective laparoscopic repair of an inguinal hernia by high ligation of the hernia sac under sevoflurane-remifentanil anesthesia were randomized into two groups: Group C (n = 50) received Ringer's lactate 10 mL and Group D received Ringer's lactate 10 mL containing dezocine 0...
November 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29145243/obstructive-internal-hernia-caused-by-mesodiverticular-bands-in-children-two-case-reports-and-a-review-of-the-literature
#14
Mirko Bertozzi, Berardino Melissa, Elisa Magrini, Giuseppe Di Cara, Susanna Esposito, Antonino Apignani
INTRODUCTION: The mesodiverticular band (MDB) is an embryologic remnant of the vitelline circulation, which carries the arterial supply to the Meckel diverticulum. In the event of an error of involution, a patent or nonpatent arterial band persists and extends from the mesentery to the apex of the antimesenteric diverticulum. This creates a snare-like opening through which bowel loops may herniate and become obstructed. This report describes 2 rare cases of small bowel occlusion owing to an internal hernia caused by a MDB...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29126579/chest-pain-as-a-manifestation-of-hypokalemia-in-a-pediatric-patient
#15
Jonathan S Schiffman
Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. These diverse etiologies present a diagnostic and management challenge to the ER physician who is tasked to minimize unnecessary diagnostics while not missing any significant disease...
November 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29122973/capsaicin-cream-for-treatment-of-cannabinoid-hyperemesis-syndrome-in-adolescents-a-case-series
#16
Jessica Graham, Michael Barberio, George Sam Wang
Cannabinoid hyperemesis syndrome (CHS) is an underrecognized diagnosis among adolescents. In the adult literature, it is characterized as nausea, vomiting, and abdominal pain in patients with chronic marijuana use. CHS is often refractory to the standard treatment of nausea and vomiting. Unconventional antiemetics, such as haloperidol, have been successful in alleviating symptoms; however, even 1 dose of haloperidol can lead to grave adverse effects, such as dystonia, extrapyramidal reactions, and neuroleptic malignant syndrome...
December 2017: Pediatrics
https://www.readbyqxmd.com/read/29112108/nitrous-oxide-70-for-procedural-analgosedation-in-a-pediatric-emergency-department-with-or-without-intranasal-fentanyl-analgesic-efficacy-and-adverse-events-if-combined-with-intranasal-fentanyl
#17
Michelle Seiler, Markus A Landolt, Georg Staubli
OBJECTIVES: Nitrous oxide 70% (N20 70%) is an excellent medication for procedural analgosedation in a pediatric emergency department. However, its analgesic efficacy remains uncertain for painful procedures; therefore, a combination with intranasal fentanyl (INF), an opioid, was suggested. This study aimed at observing and assessing the analgesic efficacy and rate of adverse events using N20 70% with and without INF. METHODS: Children who received N20 70% in a tertiary children's hospital emergency department from January 1, 2014 to June 30, 2015 were included in this observational study with prospective data collection...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29108736/a-randomized-double-blind-trial-comparing-the-effect-on-pain-of-an-oral-sucrose-solution-vs-placebo-in-children-1-to-3%C3%A2-months-old-undergoing-simple-venipuncture
#18
Serge Gouin, Nathalie Gaucher, Denis Lebel, Marie Pier Desjardins
BACKGROUND: Few clinical trials evaluating the efficacy of oral sweet solutions for procedures in the emergency department (ED) have been published. OBJECTIVES: To compare the efficacy of an oral sucrose solution vs. a placebo in reducing pain in infants undergoing venipuncture without cannulation. METHODS: A randomized, double-blinded clinical trial was conducted in a pediatric ED. Infants 1 to 3 months old were randomly allocated to receive 2 mL of 88% sucrose or 2 mL of placebo, 2 min prior to venipuncture...
November 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29084069/patient-reported-pain-outcomes-for-children-attending-an-emergency-department-with-limb-injury
#19
Adrianna D M Clapp, Jennifer Thull-Freedman, Tatum Mitra, Brendan Cord Lethebe, Tyler Williamson, Antonia Schirmer Stang
OBJECTIVES: The aim of this study was to describe patient-reported pain outcomes at various stages of an emergency department (ED) visit for pediatric limb injury. METHODS: This prospective cohort consisted of 905 patients aged 4 to 17 years with acute limb injury and a minimum initial pain score of 4/10. Patients reported pain scores and treatments offered and received at each stage of their ED visit. Multiple logistic regression was used to identify predictors for severe pain on initial assessment and moderate or severe pain at ED discharge...
October 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29077648/initial-pain-management-in-pediatric-acute-pancreatitis-opioid-vs-non-opioid
#20
Amit S Grover, Paul D Mitchell, Shannon F Manzi, Victor L Fox
Nearly all patients with acute pancreatitis (AP) experience some degree of abdominal pain that is severe enough to prompt medical evaluation and necessitate analgesia. Effective analgesia is a priority in caring for such patients. Despite its importance, strategies for pain management in AP have been poorly studied, particularly in the field of pediatrics. Currently, no published data examine the management of pain due to acute pancreatitis in children at the time of initial presentation. Management approaches are often extrapolated from adult practice and based on anecdotal experience in the absence of objective data...
October 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
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