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Pediatric emergence

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https://www.readbyqxmd.com/read/29792280/resource-utilization-and-indications-for-helicopter-transport-of-head-injured-children
#1
Clay M Elswick, Deidre Wyrick, Lori A Gurien, Malik Rettiganti, Marie Gowen, Ambre' Pownall, Diaa Bahgat, R Todd Maxson, Eylem Öcal, Gregory W Albert
INTRODUCTION: Helicopter emergency medical services (HEMS) have provided benefit for severely injured patients. However, HEMS are likely overused for the transportation of both adult and pediatric trauma patients. In this study, we aim to evaluate the degree of overuse of helicopter as a mode of transport for head-injured children. In addition, we propose criteria that can be used to determine if a particular patient is suitable for air versus ground transport. MATERIALS AND METHODS: We identified patients who were transported to our facility for head injuries...
May 1, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29791967/global-emergency-medicine-a-review-of-the-literature-from-2017
#2
Torben K Becker, Indi Trehan, Alison Schroth Hayward, Braden J Hexom, Sean M Kivlehan, Kevin M Lunney, Payal Modi, Maxwell Osei-Ampofo, Amelia Pousson, Daniel K Cho, Adam C Levine
OBJECTIVES: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS: This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM...
May 23, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29791930/the-pediatric-emergency-care-applied-research-network-registry-a-multicenter-electronic-health-record-registry-of-pediatric-emergency-care
#3
Sara J Deakyne Davies, Robert W Grundmeier, Diego A Campos, Katie L Hayes, Jamie Bell, Evaline A Alessandrini, Lalit Bajaj, James M Chamberlain, Marc H Gorelick, Rene Enriquez, T Charles Casper, Beth Scheid, Marlena Kittick, J Michael Dean, Elizabeth R Alpern
BACKGROUND:  Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29790268/ask-me-children-s-experiences-of-pain-explored-using-the-draw-write-and-tell-method
#4
Nicole Pope, Mary Tallon, Gavin Leslie, Sally Wilson
PURPOSE: Pain management within emergency departments (ED) remains challenging. Given that unrelieved pain in children is linked to a number of negative physiological and psychological consequences, optimal management of children's pain is paramount. Many studies exploring children's pain have adopted quantitative methods or sought the perspectives of adults. Compared to adults, studies examining children's views on pain and pain management are limited. This study aimed to explore children's pain experiences, their perception of pain management and expectations of the role of the nurse...
May 23, 2018: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/29789451/zebrafish-models-of-rare-hereditary-pediatric-diseases
#5
REVIEW
Máté Varga, Dorottya Ralbovszki, Eszter Balogh, Renáta Hamar, Magdolna Keszthelyi, Kálmán Tory
Recent advances in sequencing technologies have made it significantly easier to find the genetic roots of rare hereditary pediatric diseases. These novel methods are not panaceas, however, and they often give ambiguous results, highlighting multiple possible causative mutations in affected patients. Furthermore, even when the mapping results are unambiguous, the affected gene might be of unknown function. In these cases, understanding how a particular genotype can result in a phenotype also needs carefully designed experimental work...
May 22, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29789038/pain-management-practices-surrounding-lumbar-punctures-in-children-a-survey-of-canadian-emergency-physicians
#6
Naveen Poonai, Victoria Brzozowski, Antonia S Stang, Amy L Drendel, Philippe Boisclair, Michael Miller, Stuart Harman, Samina Ali
CLINICIAN'S CAPSULE What is known about the topic? Few physicians adhere to recommendations surrounding analgesia for pediatric lumbar punctures (LPs). What did this study ask? How willing are emergency physicians to provide analgesia for pediatric LPs? What did this study find? Compared to older children, the willingness to provide analgesia was suboptimal in a young infant. Why does this study matter to clinicians? Knowledge translation should focus on dispelling misconceptions and emphasize the importance of analgesia for young infants undergoing LPs...
May 23, 2018: CJEM
https://www.readbyqxmd.com/read/29788338/clinical-pharmacology-in-adult-and-pediatric-inflammatory-bowel-disease
#7
Amy Hemperly, William J Sandborn, Niels Vande Casteele
This review describes the clinical pharmacology of the major drugs used for the treatment of patients with inflammatory bowel disease (IBD). Pharmacokinetics, drug metabolism, mechanism of action, efficacy, and safety profile are discussed. Some small molecules were developed to act systemically (eg, ozanimod) or locally (eg, aminosalicylates) and thus have disparate pharmacokinetic properties. In addition, locally acting compounds have been optimized to mitigate systemic exposure-eg, budesonide, which undergoes extensive first-pass metabolism-thereby reducing systemic bioavailability and side effects...
May 17, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29788027/the-neonatal-microbiome-and-its-partial-role-in-mediating-the-association-between-birth-by-cesarean-section-and-adverse-pediatric-outcomes
#8
Diana Montoya-Williams, Dominick J Lemas, Lisa Spiryda, Keval Patel, O'neshia Olivia Carney, Josef Neu, Tiffany L Carson
BACKGROUND: Cesarean sections (CS) are among the most commonly performed surgical procedures in the world. Epidemiologic data has associated delivery by CS with an increased risk of certain adverse health outcomes in children, such as asthma and obesity. OBJECTIVE: To explore what is known about the effect of mode of delivery on the development of the infant microbiome and discuss the potentially mediating role of CS-related microbial dysbiosis in the development of adverse pediatric health outcomes...
May 22, 2018: Neonatology
https://www.readbyqxmd.com/read/29787558/a-new-weighted-injury-severity-scoring-system-better-predictive-power-for-pediatric-trauma-mortality
#9
Junxin Shi, Jiabin Shen, Sarah Caupp, Angela Wang, Kathryn E Nuss, Brian Kenney, Krista K Wheeler, Bo Lu, Henry Xiang
BACKGROUND: An accurate injury severity measurement is essential for the evaluation of pediatric trauma care and outcome research. The traditional Injury Severity Score (ISS) does not consider the differential risks of the Abbreviated Injury Scale (AIS) from different body regions nor is it pediatric specific. The objective of this study was to develop a weighted injury severity scoring (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. METHODS: Based on the association between mortality and AIS from each of the six ISS body regions, we generated different weights for the component AIS scores used in the calculation of ISS...
May 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787555/implementation-of-a-ct-scan-practice-guideline-for-pediatric-trauma-patients-reduces-unnecessary-scans-without-impacting-outcomes
#10
Patrick R McGrew, Paul J Chestovich, Jay D Fisher, Deborah A Kuhls, Douglas R Fraser, Purvi P Patel, Chad W Katona, Syed Saquib, John J Fildes
INTRODUCTION: Computed Tomography (CT) scans are useful in the evaluation of trauma patients, but are costly and pose risks from ionizing radiation in children. Recent literature has demonstrated the utility of CT scan guidelines in the management of pediatric trauma. This study objective is to review our treatment of pediatric blunt trauma patients and evaluate CT utilization before and after CT-guideline implementation. METHODS: Our Pediatric Level 2 Trauma Center (TC) implemented a CT scan practice guideline for pediatric trauma patients in March 2014...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#11
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/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#12
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29785077/mediterranean-diet-and-nonalcoholic-fatty-liver-disease
#13
REVIEW
Caterina Anania, Francesco Massimo Perla, Francesca Olivero, Lucia Pacifico, Claudio Chiesa
Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common chronic liver disease, and is characterized by a wide spectrum of fat-liver disorders that can result in severe liver disease and cirrhosis. Inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. Currently, there is no consensus concerning the pharmacological treatment of NAFLD. However, lifestyle interventions based on exercise and a balanced diet for quality and quantity, are considered the cornerstone of NAFLD management...
May 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29784538/pediatric-apheresis-emergencies-and-urgencies-an-update
#14
REVIEW
Cesare Perotti, Jerard Seghatchian, Claudia Del Fante
Urgency and emergency in general, and even more in the pediatric setting, remain a thematic debate not yet fully resolved. The decision to undergo a pediatric patient to an invasive treatment not free from potentially serious side effects like an apheresis procedure should be weighted with great attention. At the moment there is no unanimous consensus about the clinical pictures in which an urgency procedure in pediatrics is indicated. Each center acts according to its own experience and not infrequently to its own fears...
May 18, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29784512/epidemiology-and-etiology-of-invasive-bacterial-infection-in-infants-%C3%A2-60-days-old-treated-in-emergency-departments
#15
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/29784511/accuracy-of-herpes-simplex-virus-polymerase-chain-reaction-testing-of-the-blood-for-central-nervous-system-herpes-simplex-virus-infections-in-infants
#16
Todd W Lyons, Andrea T Cruz, Stephen B Freedman, Lise E Nigrovic
There were 1038 infants with herpes simplex virus polymerase chain reaction testing performed of blood and cerebrospinal fluid specimens. There were 21 (2.0%) with a positive cerebrospinal fluid PCR, of whom 16 also had a positive blood PCR (sensitivity 76%; 95% CI, 53%-92%). Blood PCR cannot exclude herpes simplex virus central nervous system infection.
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
#17
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/29784261/reduction-of-postanesthetic-pediatric-distress-a-coordinated-approach
#18
Simon Hayhoe, Scott Pallett, Juliet Zani, Joanne Trott
PURPOSE: Preoperative anxiety in children is associated with postoperative distress in recovery. Both are predictors of long-term maladaptive behavior. Remedies have been suggested to modify individual risk factors, but overall strategy is lacking. DESIGN: An approach to anxiety reduction coordinated throughout the hospital experience has been developed in our day-stay pediatric surgical unit. METHODS: There is a preadmission familiarization visit...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784260/severe-obesity-and-sleep-disordered-breathing-as-risk-factors-for-emergence-agitation-in-pediatric-ambulatory-surgery
#19
Timothy Reynolds, Sumanna Sankaran, Wilson T Chimbira, Thuy Phan, Olubukola O Nafiu
PURPOSE: Sleep-disordered breathing (SDB) may be a critical risk factor for emergence agitation (EA). We hypothesized that SDB diagnosis is a predictor of EA in children after general anesthesia for ambulatory surgery. DESIGN: Prospective, observational, cohort study. METHODS: Children aged 4 to 17 years were assessed for the occurrence of EA. Differences in probability of EA were assessed using multivariable logistic regression analyses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29781945/appropriateness-of-pediatric-orthopaedic-transfers-to-a-level-1-hospital
#20
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
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