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https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#1
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29784512/epidemiology-and-etiology-of-invasive-bacterial-infection-in-infants-%C3%A2-60-days-old-treated-in-emergency-departments
#2
Christopher Woll, Mark I Neuman, Christopher M Pruitt, Marie E Wang, Eugene D Shapiro, Samir S Shah, Russell J McCulloh, Lise E Nigrovic, Sanyukta Desai, Adrienne G DePorre, Rianna C Leazer, Richard D Marble, Fran Balamuth, Elana A Feldman, Laura F Sartori, Whitney L Browning, Paul L Aronson
OBJECTIVES: To help guide empiric treatment of infants ≤60 days old with suspected invasive bacterial infection by describing pathogens and their antimicrobial susceptibilities. STUDY DESIGN: Cross-sectional study of infants ≤60 days old with invasive bacterial infection (bacteremia and/or bacterial meningitis) evaluated in the emergency departments of 11 children's hospitals between July 1, 2011 and June 30, 2016. Each site's microbiology laboratory database or electronic medical record system was queried to identify infants from whom a bacterial pathogen was isolated from either blood or cerebrospinal fluid...
May 18, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29784474/point-of-care-ultrasound-differentiation-of-lung-consolidation-and-normal-thymus-in-pediatric-patients-an-educational-case-series
#3
Cynthia A Gravel, Richard G Bachur
BACKGROUND: There is a growing body of evidence to support the utility of lung point-of-care ultrasound (POCUS) in pediatric patients with multiple pulmonary pathologies, particularly pneumonia. As we increase our use of lung POCUS for pediatric patients with respiratory complaints, we must be mindful of the normal anatomy and sonographic findings within the pediatric chest and aware of how to distinguish normal findings (e.g., thymus) from pathologic findings (e.g., consolidation). CASE REPORTS: We report four cases of pediatric patients who presented to the Emergency Department with respiratory complaints for which POCUS was able to distinguish lung consolidation and normal thymus in the anterior chest...
May 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29781945/appropriateness-of-pediatric-orthopaedic-transfers-to-a-level-1-hospital
#4
Jaclyn McKenna, David Novikov, Amanda Pawlak, Jihye Park, Jie Yang, Hariharan Iyer, James Barsi
OBJECTIVE: The purpose of this study was to compare a cohort of transferred pediatric orthopaedic patients with orthopaedic patients who primarily presented to a Level 1 pediatric emergency department to identify risk factors for transfer. DESIGN: Retrospective cohort study. SETTING: This study was performed at a level one trauma center in New York. PATIENTS: The cohort consisted of patients under age 18 who presented to one level 1 pediatric trauma center between January 1, 2013 - December 31, 2013 with an orthopaedic fracture diagnosis code (ICD-9 805...
May 16, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29775132/evaluation-of-lateral-atlantodental-interval-asymmetry-in-the-pediatric-age-group-normative-values
#5
Stephen K Mendenhall, Andrew Huh, Janit Pandya, Vincent Alentado, Karl Balsara, Chang Ho, Andrew Jea
OBJECTIVE The revelation of normative radiographic measurements for the developing pediatric spine is incomplete. The purpose of this analysis was to determine the normal range of asymmetry of the lateral atlantodental interval (LADI) and define age- and sex-related differences. METHODS A total of 3072 children aged 0-18 years who underwent CT scanning of the cervical spine were identified at Riley Hospital for Children between 2005 and 2017. Patients were stratified by sex and age (in years) into 36 cohorts...
May 18, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29774760/safety-of-nonsteroidal-anti-inflammatory-drugs-in-copperhead-snakebite-patients
#6
Hoang X Pham, Michael E Mullins
INTRODUCTION: Current management guidelines for pit viper envenomations recommend against the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control due to concern for platelet dysfunction and resulting coagulopathy. However, prior research suggests that copperhead snakes generally do not cause coagulopathy and they are responsible for most of the venomous snakebites in the USA. Thus, we compared the occurrences of clinically apparent bleeding and most abnormal laboratory values of coagulation between copperhead envenomation patients who received NSAIDs and those who did not...
May 18, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29774515/eating-disorder-or-oesophageal-achalasia-during-adolescence-diagnostic-difficulties
#7
REVIEW
Aurélie Letranchant, Bénédicte Pigneur, Martine Flament, Nathalie Godart
Marine was a fourteen and a half-year-old adolescent female hospitalized for an eating disorder (ED) of the anorexic type with purging behaviors. She has had a complicated life course, made up of disruptions and discontinuities, both family and school. Since the age of five, Marine had been intermittently treated in psychiatry for a diagnosis of oppositional defiant disorder. The current illness started with spontaneous and induced vomiting associated with major weight loss (body mass index, 15.27 kg m-2 )...
May 17, 2018: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/29771484/management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#8
Andria Tatem, Rupa Kapoor
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29768298/orbital-cellulitis-when-computed-tomography-imaging-is-falsely-reassuring
#9
Arsany Basily, Sasha Mansukhani, Andrew Anzeljc, Peter Gutierrez
An 8-year-old male presented to the pediatric emergency department with subjective fever, blurry vision, and left eye pain. On physical examination, there was mild left lower lid erythema and a subtle left eye elevation deficit. Computed tomography demonstrated preseptal soft tissue swelling without orbital involvement; however, there was varying amounts of paranasal sinus opacification. Despite the negative scan, a diagnosis of orbital cellulitis associated with sinusitis was made and treatment with intravenous antibiotics was initiated...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768297/pediatric-esophageal-foreign-body-possible-role-for-digital-tomosynthesis
#10
Andrew Johansen, Gregory P Conners, Jacob Lee, Amie L Robinson, William L Chew, Sherwin S Chan
OBJECTIVES: Foreign body (FB) ingestion is a common reason for emergency department visits, affecting more than 80,000 children in the United States annually. Whereas most ingested FBs are coins or other radiopaque objects, some are radiolucent FBs such as food. Digital tomosynthesis (DTS) is a radiographic technique that produces cross-sectional images with in-plane resolution similar to that of traditional radiographs. Our pilot study evaluated the sensitivity and specificity of DTS to detect FB in comparison to esophagram and clinical impression...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768296/pediatric-diabetic-ketoacidosis-with-hypotensive-shock-and-rash-an-unusual-presentation
#11
Yehonatan Pasternak, Omer Niv, Yehezkel Hezi Waisman
We describe a previously healthy adolescent boy who presented with respiratory distress, hypotensive shock, and a diffuse erythematous rash. The final diagnosis was diabetic ketoacidosis. Caregivers should be alert to this unusual combination of symptoms in the emergency department setting in order to improve the recognition and management of children with new-onset diabetes.
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768295/requirement-for-head-magnetic-resonance-imaging-in-children-who-present-to-the-emergency-department-with-acute-nontraumatic-visual-disturbance
#12
Jeong-Yong Lee, Jung-Heon Kim, Hyung-Rae Cho, Jong-Seung Lee, Jeong-Min Ryu, Mi-Sun Yum, Tae-Sung Ko
OBJECTIVES: This study aimed to investigate the clinical features and head magnetic resonance imaging (MRI) findings in children who presented to the emergency department with acute nontraumatic visual disturbance and to study related clinical factors for discovering positive lesions on head MRI. METHODS: We performed a retrospective study of 1-month to 15-year-old children who underwent head MRI as an evaluation for acute nontraumatic visual disturbance as a chief complaint in our pediatric emergency department between March 2010 and March 2015...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768294/a-pilot-study-to-reduce-computed-tomography-utilization-for-pediatric-mild-head-injury-in-the-emergency-department-using-a-clinical-decision-support-tool-and-a-structured-parent-discussion-tool
#13
Rakesh S Engineer, Seth R Podolsky, Baruch S Fertel, Purva Grover, Heather Jimenez, Erin L Simon, Courtney M Smalley
INTRODUCTION: The American College of Emergency Physicians embarked on the "Choosing Wisely" campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool. METHODS: A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768293/seasonality-of-common-pediatric-infectious-diseases
#14
Susan C Lipsett, Michael C Monuteaux, Andrew M Fine
BACKGROUND/OBJECTIVE: Traditional sources cite seasonal patterns for common infectious diseases, often based on microbiologic data, but little is known about cyclical trends in clinically diagnosed infectious conditions in the emergency department (ED). We leveraged the publicly available Nationwide Emergency Department Sample database to measure the seasonality of the most common pediatric infectious diseases diagnosed in US EDs. METHODS: We searched the Nationwide Emergency Department Sample database to identify infectious diagnoses comprising at least 1% of all diagnosis codes ascribed to patients 21 years and younger in US EDs from 2009 to 2013...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768291/quality-of-the-triage-of-children-with-anaphylaxis-at-the-emergency-department
#15
Esozia Arroabarren, Jorge Alvarez-Garcia, Marta Anda, Montserrat de Prada, Maria Carmen Ponce, Miriam Palacios
OBJECTIVE: Early recognition of symptoms is essential in anaphylaxis management. The Canadian Paediatric Emergency Triage and Acuity Scale prioritizes anaphylaxis to level I or II (resuscitation or emergency). We analyzed the accuracy of pediatric anaphylaxis triage. METHODS: This was a retrospective review of the triage charts (adaptation of the Canadian Paediatric Emergency Triage and Acuity Scale) of 137 children attended for anaphylaxis at our pediatric emergency department...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#16
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#17
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29762453/microvascular-replantation-following-facial-dog-bites-in-children-systematic-review-and-management-algorithm
#18
Amanda J Williams, Jeremy M Powers, Jennifer L Rhodes, Andrea L Pozez
BACKGROUND: Pediatric dog bite injuries account for 1% of emergency department visits per year and represent an underrecognized and underreported public health problem. Reconstructive surgery is frequently utilized, and in the most extreme injuries, microvascular replantation may be considered. We sought to systematically review the available literature on microvascular replantation after facial dog bite injuries in children, with particular attention to perioperative morbidity and long-term follow-up...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762336/radiology-callbacks-to-a-pediatric-emergency-department-and-their-clinical-impact
#19
Rajan Arora, Nirupama Kannikeswaran
BACKGROUND: Clinical impact of radiology callbacks (missed initial radiologic diagnosis) remains largely unknown in the pediatric emergency department (PED). OBJECTIVE: The aim of this study was to describe the incidence, nature of radiology callbacks, and the impact on clinical care during the return visit (RV). METHODS: We performed a retrospective chart review of quality assurance database of RVs for radiology callbacks to our PED over a 1-year period...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29762335/correlation-of-level-of-trauma-activation-with-emergency-department-intervention
#20
Michael C Cooper, Geetanjali Srivastava
BACKGROUND: In-hospital trauma team activation criteria are formulated to identify severely injured patients requiring specialized multidisciplinary care. Efficacy of trauma activation (TA) criteria is commonly measured by emergency department (ED) disposition, injury severity score, and mortality. Necessity of critical ED interventions is another measure that has been proposed to evaluate the appropriateness of TA criteria. METHODS: Two-year retrospective cohort study of 1715 patients from our trauma registry at a Level 1 pediatric trauma center...
May 14, 2018: Pediatric Emergency Care
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