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Pediatric ed

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https://www.readbyqxmd.com/read/29346512/validation-of-the-pids-idsa-severity-criteria-in-children-with-community-acquired-pneumonia
#1
Todd A Florin, Cole Brokamp, Rachel Mantyla, Bradley DePaoli, Richard Ruddy, Samir S Shah, Lilliam Ambroggio
Background: The Pediatric Infectious Diseases Society (PIDS)/Infectious Diseases Society of America (IDSA) guideline for community-acquired pneumonia (CAP) recommends intensive care unit (ICU) admission or continuous monitoring for children meeting severity criteria. Our objective was to validate these criteria. Methods: This was a retrospective cohort study of children age 3 months-18 years diagnosed with CAP in a pediatric Emergency Department (ED) from 9/2014-8/2015...
January 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29346238/trends-in-severe-pediatric-emergency-conditions-in-a-national-cohort-2008-to-2014
#2
Kenneth A Michelson, Joel D Hudgins, Laura G Burke, Todd W Lyons, Michael C Monuteaux, Richard G Bachur, Jonathan A Finkelstein
OBJECTIVE: The objective of this study was to determine the incidence and recent trends in serious pediatric emergency conditions. METHODS: We conducted a cross-sectional study of the Nationwide Emergency Department Sample from 2008 through 2014, and included patients with age below 18 years with a serious condition, defined as each diagnosis group in the diagnosis grouping system with a severity classification system score of 5. We calculated national incidences for each serious condition using annualized weighted condition counts divided by annual United States census child population counts...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346234/a-qualitative-study-of-multidisciplinary-providers-experiences-with-the-transfer-process-for-injured-children-and-ideas-for-improvement
#3
Marcie Gawel, Beth Emerson, John S Giuliano, Alana Rosenberg, Karl E Minges, Shelli Feder, Pina Violano, Patricia Morrell, Judy Petersen, Emily Christison-Lagay, Marc Auerbach
OBJECTIVE: Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. METHODS: This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346232/use-of-point-of-care-ultrasound-to-guide-pediatric-gastrostomy-tube-replacement-in-the-emergency-department
#4
Toby C Myatt, Anthony J Medak, Samuel H F Lam
The presentation of a pediatric patient to the emergency department for a malfunctioning or dislodged gastrostomy tube (G-tube) is not uncommon. As such, these tubes are often replaced at the bedside. Improper placement can result in a number of complications, including perforation, fistula tract formation, peritonitis, and sepsis. The current criterion standard method to confirm proper G-tube placement is contrast-enhanced radiography. However, point-of-care ultrasound may be an alternative method to guide and confirm pediatric G-tube replacement in the emergency department...
January 16, 2018: Pediatric Emergency Care
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
#5
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/29346230/chronic-hematoma-of-the-neck
#6
Kristen H Angster, Victor Da Costa
Chronic hematomas are defined as hematomas with slow, progressive growth over many weeks. They are an extremely rare cause of acute neck swelling in the pediatric population. They consist of an organized central mass of blood with granulation tissue and fibrotic changes peripherally. The presence of a capsule prevents resorption but allows for intracapsular bleeding with subsequent expansion. We describe a case of a 6-year-old girl who presented to the emergency department with a spontaneously occurring left neck mass in the supraclavicular region...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#7
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29342449/increased-use-of-adrenaline-in-the-management-of-childhood-anaphylaxis-over-the-last-decade
#8
Kristina Rueter, Brennan Ta, Natasha Bear, Michaela Lucas, Meredith L Borland, Susan L Prescott
BACKGROUND: We recently determined that allergy training programs have improved physician recognition and diagnosis of pediatric anaphylaxis in the last decade. OBJECTIVE: To investigate for changes in management, in particular the appropriate use of adrenaline for the treatment of anaphylaxis in a tertiary pediatric emergency department (PED). METHODS: We conducted a retrospective case note study including children aged 0 to 16 years coded and verified for anaphylaxis comparing cases in years 2003/2004 with 2012...
January 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29339564/accuracy-of-the-urinalysis-for-urinary-tract-infections-in-febrile-infants-60-days-and-younger
#9
Leah Tzimenatos, Prashant Mahajan, Peter S Dayan, Melissa Vitale, James G Linakis, Stephen Blumberg, Dominic Borgialli, Richard M Ruddy, John Van Buren, Octavio Ramilo, Nathan Kuppermann
OBJECTIVES: Reports of the test accuracy of the urinalysis for diagnosing urinary tract infections (UTIs) in young febrile infants have been variable. We evaluated the test characteristics of the urinalysis for diagnosing UTIs, with and without associated bacteremia, in young febrile infants. METHODS: We performed a planned secondary analysis of data from a prospective study of febrile infants ≤60 days old at 26 emergency departments in the Pediatric Emergency Care Applied Research Network...
January 16, 2018: Pediatrics
https://www.readbyqxmd.com/read/29339536/length-of-stay-and-hospital-revisit-after-bacterial-tracheostomy-associated-respiratory-tract-infection-hospitalizations
#10
Christopher J Russell, Mary R Mamey, Joyce Y Koh, Sheree M Schrager, Michael N Neely, Susan Wu
OBJECTIVES: To identify factors associated with longer length of stay (LOS) and higher 30-day hospital revisit rates for children hospitalized with bacterial tracheostomy-associated respiratory tract infections (bTARTIs). METHODS: This was a multicenter, retrospective cohort study using administrative data from the Pediatric Health Information System database between 2007 and 2014 of patients 30 days to 17 years old with a principal discharge diagnosis of bTARTI or a principal discharge diagnosis of bTARTI symptoms with a secondary diagnosis of bTARTI...
January 16, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29336838/pediatric-concussion-update-what-ed-nurses-should-know-after-humpty-dumpty-falls
#11
Patricia A Normandin, Stacey A Benotti
No abstract text is available yet for this article.
January 11, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29336799/access-to-high-pediatric-readiness-emergency-care-in-the-united-states
#12
Kristin N Ray, Lenora M Olson, Elizabeth A Edgerton, Michael Ely, Marianne Gausche-Hill, Patricia Schmuhl, David J Wallace, Jeremy M Kahn
OBJECTIVE: To determine the geographic accessibility of emergency departments (EDs) with high pediatric readiness by assessing the percentage of US children living within a 30-minute drive time of an ED with high pediatric readiness, as defined by collaboratively developed published guidelines. STUDY DESIGN: In this cross-sectional analysis, we examined geographic access to an ED with high pediatric readiness among US children. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) of US hospitals based on the 2013 National Pediatric Readiness Project (NPRP) survey...
January 12, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#13
Richard Sola, Blair A Wormer, William E Anderson, Thomas M Schmelzer, Graham H Cosper
Ultrasound assessments of children with possible acute appendicitis (AA) are often nondiagnostic. We aimed to identify the predictors of nondiagnostic ultrasound and to investigate the outcomes. A retrospective review was conducted on children aged 4 to 17 years evaluated in 2013 for AA with ultrasound at a tertiary hospital pediatric emergency department. Demographics, clinical data, and outcomes were analyzed. Of 528 children, 194 (36.7%) had diagnostic ultrasounds and 334 (63.3%) had nondiagnostic ultrasounds...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336197/neurosensory-deficits-vary-as-a-function-of-point-of-care-in-pediatric-mild-traumatic-brain-injury
#14
Andrew Mayer, Chris Wertz, Sephira Ryman, Eileen Storey, Grace Park, John Phillips, Andrew Burke Dodd, Scott Oglesbee, Richard Campbell, Ron Yeo, Ben Wasserott, Nicholas Shaff, John J Leddy, Rebekah Mannix, Kristy B Arbogast, Timothy Meier, Matthew Grady, Christina Master
Neurosensory abnormalities are frequently observed following pediatric mild traumatic brain injury (pmTBI) and may underlie the expression of several common concussion symptoms and delay recovery. Importantly, active evaluation of neurosensory functioning more closely approximates real-world (e.g., physical and academic) environments that provoke symptom-worsening. The current study determined whether symptom provocation (i.e., during neurosensory exam) improved classification accuracy relative to pre-exam symptom levels and whether symptoms varied as a function of point of care...
January 16, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29334996/italian-guidelines-on-the-assessment-and-management-of-pediatric-head-injury-in-the-emergency-department
#15
REVIEW
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29333809/assessment-of-orofacial-pain-management-in-a-pediatric-emergency-department-and-at-home-after-discharge
#16
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/29333786/the-added-value-of-the-lateral-chest-radiograph-for-diagnosing-community-acquired-pneumonia-in-the-pediatric-emergency-department
#17
Michalle Soudack, Semion Plotkin, Aviva Ben-Shlush, Lisa Raviv-Zilka, Jeffrey M Jacobson, Michael Benacon, Arie Augarten
BACKGROUND: Opinions differ as to the need of a lateral radiograph for diagnosing community acquired pneumonia in children referred to the emergency department. A lateral radiograph increases the ionizing radiation burden but at the same time may improve specificity and sensitivity in this population. OBJECTIVES: To determine the value of the frontal and lateral chest radiographs compared to frontal view stand-alone images for the management of children with suspected community acquired pneumonia seen in a pediatric emergency department...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#18
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
January 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29329727/parent-activation-in-the-pediatric-emergency-department-theory-vs-reality
#19
Danica B Liberman, Phung K Pham
OBJECTIVE: To measure parent activation and test for its associations with sociodemographics, clinical factors, and short-term outcomes. METHODS: By convenience sampling, 246 parents of children treated in an emergency department (ED) of a children's hospital completed the Parent-Patient Activation Measure (P-PAM) and answered sociodemographic questions. Clinical information was abstracted from medical records. Phone calls to parents and primary care physician offices were conducted within one-month post-ED visit for information about short-term outcomes...
January 8, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29326819/association-between-bullying-and-pediatric-psychiatric-hospitalizations
#20
Hadassa Leader, Jasmine Singh, Ayesha Ghaffar, Cheryl de Silva
Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3-12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit and emergency department...
2018: SAGE Open Medicine
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