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Pain , pediatrics, emergency

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https://www.readbyqxmd.com/read/27902672/essential-content-for-discharge-instructions-in-pediatric-emergency-care-a-delphi-study
#1
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/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#2
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#3
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/27898627/publishing-trends-in-the-field-of-pediatric-emergency-medicine-from-2004-to-2013
#4
Nancy S Rixe, Jeffrey Rixe, Joshua Glick, Erik Lehman, Robert P Olympia
OBJECTIVE: To identify publishing trends within the field of pediatric emergency medicine between 2004 and 2013. METHODS: We conducted a MEDLINE search of pediatric emergency medicine articles, filtered by clinical trial, published between 2004 and 2013 in ten journals from the fields of pediatrics, emergency medicine, general medicine, and pediatric emergency medicine. Each article was classified by journal type, study design, results (positive or negative/equivocal), age/type of subjects, and major topic (based on the objective of the study)...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27894556/benchmarking-pain-assessment-rate-in-critical-care-transport
#5
Ryan J Reichert, M David Gothard, Hamilton P Schwartz, Michael T Bigham
The purpose of this study is to determine the rate of pain assessment in pediatric neonatal critical care transport (PNCCT). The GAMUT database was interrogated for an 18-month period and excluded programs with less than 10% pediatric or neonatal patient contacts and less than 3 months of any metric data reporting during the study period. We hypothesized pain assessment during PNCCT is superior to prehospital pain assessment rates, although inferior to in-hospital rates. Sixty-two programs representing 104,445 patient contacts were analyzed...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27893572/pain-management-in-pediatric-burn-patients-review-of-recent-literature-and-future-directions
#6
Omar Pardesi, Gennadiy Fuzaylov
Childhood burns are a profoundly traumatic and painful experience. Despite recognition of the prevalence of burn injuries in children and the severity of the associated pain, burn pain remains undertreated. At the same time, more evidence is emerging to suggest that undertreated pain has serious long-term medical and psychiatric consequences, many of which can be ameliorated with improved pain control. Pain in burn patients is, however, notoriously difficult to treat, perhaps because there is a chronic pain aspect underlying the acute pain that accompanies wound care and procedures...
November 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27893516/caregiver-expectations-and-satisfaction-of-urgent-care-in-a-pediatric-emergency-department
#7
Greg P Marconi, Phung K Pham, Alan L Nager
Health care delivery expectations that may affect patient and caregiver satisfaction are not clearly understood. This study examined caregiver expectations and satisfaction with urgent care in a pediatric emergency department. Of 201 caregivers surveyed, we found that caregivers have specific expectations regarding clinical care of their child in terms of radiographic imaging, blood testing, antibiotics, pain management, and subspecialty consultation. Caregivers were generally less dissatisfied with the actual care provided than the urgent care physicians expected...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27891287/sapovirus-gastroenteritis-in-young-children-presenting-as-distal-small-bowel-obstruction-a-report-of-2-cases-and-literature-review
#8
Lynn Model, Cathy Anne Burnweit
Abdominal pain and distention in children are commonly encountered problems in the pediatric emergency room. The majority of complaints are found to be due to benign entities such as gastroenteritis and constipation. What confounds these diagnoses is that young children often deliver a challenging and unreliable exam. Thus, it often becomes exceedingly problematic to differentiate these benign conditions from surgical conditions requiring prompt attention including small or large bowel obstruction, volvulus, and appendicitis...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27890780/a-clinical-score-to-predict-appendicitis-in-older-male-children
#9
Anupam B Kharbanda, Michael C Monuteaux, Richard G Bachur, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Jonathan E Bennett, Kelly Sinclair, Peter S Dayan
OBJECTIVE: To develop a clinical score to predict appendicitis among older, male children who present to the emergency department (ED) with suspected appendicitis. METHODS: Patients with suspected appendicitis were prospectively recruited at 9 pediatric EDs. A total 2,625 patients enrolled; a subset of 961 males, age 8-18 were analyzed in this secondary analysis. Outcomes determined by pathology, operative reports and follow-up calls. Clinical and laboratory predictors with < 10% missing data and Kappa > 0...
November 24, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27876541/diagnostic-performance-of-a-biomarker-panel-as-a-negative-predictor-for-acute-appendicitis-in-adult-emergency-department-patients-with-abdominal-pain
#10
David S Huckins, Karen Copeland, Wesley Self, Cheryl Vance, Phyllis Hendry, Keith Borg, Joseph Gogain
OBJECTIVES: Evaluate the diagnostic accuracy of the APPY1TM biomarker panel, previously described for use in pediatric patients, for identifying adult ED patients with abdominal pain who are at low risk of acute appendicitis. METHODS: This study prospectively enrolled subjects >18years of age presenting to seven U.S. emergency departments with <72hours of abdominal pain suggesting possible acute appendicitis. The APPY1 panel was performed on blood samples drawn from each patient at the time of initial evaluation and results were correlated with the final diagnosis either positive or negative for acute appendicitis...
November 11, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876028/clinical-assessment-of-children-with-renal-abscesses-presenting-to-the-pediatric-emergency-department
#11
Chun-Yu Chen, Huang-Tsung Kuo, Yu-Jun Chang, Kang-Hsi Wu, Wen-Chieh Yang, Han-Ping Wu
BACKGROUND: Renal abscesses are relatively uncommon in children but may result in prolonged hospital stays and life-threatening events. We undertook this study to analyze the clinical spectrum of renal abscesses in children admitted to the pediatric emergency department (ED) and to find helpful clinical characteristics that can potentially aid emergency physicians for detecting renal abscesses in children earlier. METHODS: From 2004 to 2011, we retrospectively analyzed 17 patients, aged 18 years or younger, with a definite diagnosis of renal abscess admitted to the ED...
November 22, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27870784/intussusception-with-cecal-cyst-as-lead-point-in-a-child
#12
Michelle Lai, Brian A Coakley, Eric M Webber, Ran D Goldman
Intussusception is a pediatric abdominal emergency in early childhood involving telescoping of 1 part of the bowel into another part. In most children, the condition is idiopathic with no identifiable lead point. Meckel diverticulum is the most common lead point, followed by polyps and duplication cysts. We describe a case of a boy with intussusception caused by a duplication cyst that was drawn retrograde through the ileocecal valve. The patient presented after a 3-month period of symptomatology and had been considered to have constipation before signs of intestinal obstruction developed...
November 19, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27864995/a-systematic-review-effectiveness-of-pediatric-peripheral-intravenous-catheterization-strategies
#13
REVIEW
Shannon I A Parker, Karen Benzies, K Alix Hayden
AIM: To identify interventions associated with peripheral intravenous catheterization first attempt success in pediatric inpatients and emergency department patients who require vascular access for therapeutic interventions. BACKGROUND: Unsuccessful peripheral intravenous catheterization puts children at risk for increased pain and treatment delays. Effective interventions to increase peripheral intravenous catheterization first attempt success are unclear. DESIGN: Systematic review of randomized controlled trials according to the Cochrane Handbook for the Systematic Review of Interventions...
November 16, 2016: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/27848889/contemporary-pediatric-palliative-care-myths-and-barriers-to-integration-into-clinical-care
#14
Stefan J Friedrichsdorf
At least 20 million children would benefit from Pediatric Palliative Care (PPC) annually, and 8 million children would need specialized PPC services. In the USA alone, more than 42,000 children 0-19 years died in 2013, fifty-five percent of them infants younger than 1 year. This article aims to critically review eight common assumptions, myths and barriers, which may hinder the implementation of PPC into the care of a child with advanced serious illnesses. Interdisciplinary PPC is about matching treatment to patient goals and is considered specialized medical care for children with serious illness...
November 15, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27814988/bedside-ultrasound-vs-x-ray-for-the-diagnosis-of-forearm-fractures-in-children
#15
Rachel Rowlands, James Rippey, Sing Tie, James Flynn
BACKGROUND: Painful forearm injuries after a fall occur frequently in children. X-ray study is currently the gold standard investigation. Ultrasound (US) is a potential alternative that avoids exposure to ionizing radiation and may be less painful than x-ray study; and familiarity and skill with US is increasing among emergency physicians. OBJECTIVES: The primary aim of this study was to determine if a cohort of physicians with little or no previous experience with US could, after a short training program, safely exclude forearm fractures in children...
November 1, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27798810/emergence-delirium-in-pediatric-anesthesia
#16
REVIEW
Arthura D Moore, Doralina L Anghelescu
Emergence delirium (ED) is a complex of perceptual disturbances and psychomotor agitation that occurs most commonly in preschool-aged children in the early postanesthetic period. The incidence of ED varies between 10 and 80% in children and is perceived as a troublesome clinical situation by 42% of pediatric anesthesiologists. Although these events are often short lived, they increase the risk of self-injury and delayed discharge, require additional nursing staff and can increase medical care costs, all of which are causes for concern...
October 31, 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27798391/pain-management-for-sickle-cell-disease-in-the-pediatric-emergency-department-medications-and-hospitalization-trends
#17
Chantel Cacciotti, Sarah Vaiselbuh, Eleny Romanos-Sirakis
The majority of emergency department (ED) visits and hospitalizations for patients with sickle cell disease (SCD) are pain related. Adequate and timely pain management may improve quality of life and prevent worsening morbidities. We conducted a retrospective chart review of pediatric patients with SCD seen in the ED, selected by sickle cell-related ICD-9 codes. A total of 176 encounters were reviewed from 47 patients to record ED pain management and hospitalization trends. Mean time to pain medication administration was 63 minutes...
October 23, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27789114/pediatric-adnexal-torsion-not-just-a-postmenarchal-problem
#18
Abigail M Schuh, Eileen J Klein, Rebecca J Allred, Ana Christensen, Julie C Brown
BACKGROUND: Pediatric adnexal torsion is rare, can be challenging to recognize, and may result in ovarian loss. OBJECTIVE: We sought to identify and compare the defining characteristics of adnexal torsion in premenarchal and postmenarchal girls. METHODS: A retrospective cohort study was performed at a tertiary care children's hospital, including patients diagnosed postnatally with adnexal (ovarian or tubal) torsion between 1997 and 2013. Proportions were compared using relative risk regression...
October 24, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27780500/adverse-events-following-diagnostic-urethral-catheterization-in-the-pediatric-emergency-department
#19
Julie Ouellet-Pelletier, Chantal Guimont, Marie Gauthier, Jocelyn Gravel
OBJECTIVES: The purpose of this study was to assess adverse events associated with diagnostic urethral catheterization (UC) in young children and to determine their impact on the patient and their family. METHODS: This was a prospective cohort study conducted in the emergency department of a tertiary-care pediatric hospital. All 3- to 24-month-old children with fever who had a diagnostic UC were eligible. Parents who consented to participate were contacted by phone within 7 to 10 days after the UC to answer a standardized questionnaire inquiring about complications...
November 2016: CJEM
https://www.readbyqxmd.com/read/27780176/a-population-based-study-of-quantitative-sensory-testing-in-adolescents-with-and-without-chronic-pain
#20
See Wan Tham, Tonya M Palermo, Amy Lewandowski Holley, Chuan Zhou, Audun Stubhaug, Anne-Sofie Furberg, Christopher Sivert Nielsen
Quantitative sensory testing (QST) has been used to characterize pain sensitivity in individuals with and without pain conditions. Research remains limited in pediatric populations, hindering the ability to expand the utility of QST toward its potential application in clinical settings and clinical predictive value. The aims of this study were to examine pain sensitivity using QST in adolescents with chronic pain compared to adolescents without chronic pain and identify predictors of pain sensitivity. A population-based study conducted from 2010 to 2011 provided data on 941 adolescents, 197 were classified as having chronic pain and 744 were classified without chronic pain...
September 15, 2016: Pain
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