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Paediatric emergency medicine

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https://www.readbyqxmd.com/read/29880576/dissemination-of-evidence-in-paediatric-emergency-medicine-a-quantitative-descriptive-evaluation-of-a-16-week-social-media-promotion
#1
Allison Gates, Robin Featherstone, Kassi Shave, Shannon D Scott, Lisa Hartling
OBJECTIVES: TRanslating Emergency Knowledge for Kids (TREKK) and Cochrane Child Health collaborate to develop knowledge products on paediatric emergency medicine topics. Via a targeted social media promotion, we aimed to increase user interaction with the TREKK and Cochrane Child Health Twitter accounts and the uptake of TREKK Bottom Line Recommendations (BLRs) and Cochrane systematic reviews (SRs). DESIGN: Quantitative descriptive evaluation. SETTING: We undertook this study and collected data via the internet...
June 6, 2018: BMJ Open
https://www.readbyqxmd.com/read/29802097/15-minute-consultation-using-point-of-care-ultrasound-to-assess-children-with-respiratory-failure
#2
Helen L Ord, Michael J Griksaitis
Point of care ultrasound (POCUS) is well established in adult emergency medicine and critical care. It is used for immediate diagnosis and evaluation of the impact of bedside interventions in the acutely unwell child. This article highlights how ultrasound can be helpful in paediatric practice when dealing with the neonate, infant or older child with undifferentiated respiratory distress, respiratory failure or ventilation problems. It highlights indications for use, key diagnostic features of common pathology and outlines the benefits of POCUS in everyday practice...
May 25, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29769805/genome-wide-sequencing-technologies-a-primer-for-paediatricians
#3
Robin Z Hayeems, Kym M Boycott
Genetic testing has been a routine part of paediatic medicine for decades. Over time, the number of genetic tests available for children presenting with features thought to be explained by an underlying genetic aetiology has expanded considerably. Genome-wide sequencing approaches (e.g., whole-exome sequencing, whole-genome sequencing) are now emerging as the most comprehensive approaches to genetic diagnosis that we have seen to date; multiple serial tests that were once required for a child under diagnostic investigation can now be accomplished in a single assay...
May 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29754417/teaching-paediatric-basic-life-support-in-medical-schools-using-peer-teaching-or-video-demonstration-a-prospective-randomised-trial
#4
Frederik Stephan, Hanjo Groetschel, Anja K Büscher, Deniz Serdar, Kjell A Groes, Rainer Büscher
AIM: The outcome of children with an out-of-hospital cardiac arrest is still poor, but bystander cardiopulmonary resuscitation can increase survival and minimise severe neurological sequelae. While teaching basic life support is standardised in emergency medicine classes, paediatric basic life support (PBLS) in neonates and toddlers is under-represented in paediatric curricula during university education. The appropriate mixture of E-learning and peer teaching lessons remains controversial in teaching paediatric basic skills...
May 13, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#5
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29695885/post-earthquake-health-service-support-nepal
#6
Sophie Goyet, Rajan Rayamajhi, Badry Nath Gyawali, Bhola Ram Shrestha, Guna Raj Lohani, Damodar Adhikari, Edwin Salvador, Roderico Ofrin, Jos Vandelaer, Reuben Samuel
Problem: Seven months after the April 2015 Nepal earthquake, and as relief efforts were scaling down, health authorities faced ongoing challenges in health-service provision and disease surveillance reporting. Approach: In January 2016, the World Health Organization recruited and trained 12 Nepalese medical doctors to provide technical assistance to the health authorities in the most affected districts by the earthquake. These emergency support officers monitored the recovery of health services and reconstruction of health facilities, monitored stocks of essential medicines, facilitated disease surveillance reporting to the health ministry and assisted in outbreak investigations...
April 1, 2018: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29663461/the-legal-frameworks-that-govern-fetal-surgery-in-the-united-kingdom-european-union-and-the-united-states
#7
REVIEW
Kevin X Cao, Alice Booth, Sebastien Ourselin, Anna L David, Richard Ashcroft
The specialty of fetal surgery or fetal intervention is one of the most exciting emerging fields of modern medicine. It is made possible by decades of major developments in antenatal imaging, obstetric anaesthesia, fetal medicine, paediatric surgery, and of course by the bold and novel practitioners willing to take new steps to advance the field. Beginning in the 1970s, it has now reached a stage of maturity where there are several established in utero procedures and countless clinical trials and studies to develop more...
April 16, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29617989/knowledge-of-venomous-snakes-snakebite-first-aid-treatment-and-prevention-among-clinicians-in-northern-nigeria-a-cross-sectional-multicentre-study
#8
Godpower C Michael, Bukar A Grema, Ibrahim Aliyu, Mohammed A Alhaji, Teslim O Lawal, Haliru Ibrahim, Aminu G Fikin, Fatima S Gyaran, Kennedy N Kane, Thomas D Thacher, Abba K Badamasi, Emmanuel Ogwuche
Background: Snakebite envenoming causes considerable morbidity and mortality in northern Nigeria. The clinician's knowledge of snakebite impacts outcome. We assessed clinicians' knowledge of snakebite envenoming to highlight knowledge and practice gaps for possible intervention to improve snakebite outcomes. Methods: This was a cross-sectional multicentre study of 374 doctors selected from the accident and emergency, internal medicine, family medicine/general outpatient, paediatrics and surgery departments of nine tertiary hospitals in northern Nigeria using a multistage sampling technique...
February 1, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29584455/vestibular-and-oculomotor-findings-in-neurologically-normal-non-concussed-children
#9
Daniel J Corwin, Mark R Zonfrillo, Douglas J Wiebe, Christina L Master, Matthew F Grady, Kristy B Arbogast
OBJECTIVE: To determine the proportion of non-concussed, neurologically normal children with failures on a vestibular and oculomotor examination for concussion performed in an acute setting. DESIGN: This was a cross-sectional study of subjects 6-18 years old presenting to a paediatric emergency department with non-neurologic chief complaints. The examination was administered by a paediatric emergency medicine physician, and includes assessments of dysmetria, nystagmus, smooth pursuits, saccades, gaze stability, near-point of convergence, and gait/balance testing...
2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29528889/new-directions-in-point-of-care-ultrasound-at-the-crossroads-of-paediatric-emergency-and-critical-care
#10
William Bortcosh, Ashkon Shaahinfar, Sakina Sojar, Jean E Klig
PURPOSE OF REVIEW: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research. RECENT FINDINGS: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration...
June 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29514811/clinician-s-gaze-behaviour-in-simulated-paediatric-emergencies
#11
Ben McNaughten, Caroline Hart, Stephen Gallagher, Carol Junk, Patricia Coulter, Andrew Thompson, Thomas Bourke
AIM: Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency. METHODS: Clinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions...
March 7, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29500216/negotiating-acceptable-termination-of-pregnancy-for-non-lethal-fetal-anomaly-a-qualitative-study-of-professional-perspectives
#12
Lisa Crowe, Ruth H Graham, Stephen C Robson, Judith Rankin
OBJECTIVE: This study aims to explore the perspectives of professionals around the issue of termination of pregnancy for non-lethal fetal anomaly (TOPFA). METHODS: Semi-structured interviews were undertaken with medical professionals (14 consultants in fetal medicine, obstetrics, neonatology and paediatrics) and social care professionals (nine individuals with roles supporting people living with impairment) from the Northeast of England. Analysis adopted an inductive thematic approach facilitated by NVivo...
March 1, 2018: BMJ Open
https://www.readbyqxmd.com/read/29473300/review-article-managing-medical-emergencies-in-rural-australia-a-systematic-review-of-the-training-needs
#13
REVIEW
Tarsh Pandit, Robin Ray, Sabe Sabesan
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. Only peer-reviewed articles, available in full-text that focussed on the training needs of rural doctors were reviewed...
February 22, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29472799/setting-the-impact-improve-access-to-clinical-trial-data-observatory-baseline
#14
REVIEW
Mersiha Mahmić-Kaknjo, Josip Šimić, Karmela Krleža-Jerić
Introduction: The aim of the IMPACT (IMProving Access to Clinical Trial data) Observatory is to assess the transformation of clinical trials (CT) related to the evolution of sharing of CT data. The objective of this study is to establish a baseline for monitoring CT data sharing by the Observatory. Materials and methods: In this scoping review we searched for publications that address sharing, dissemination, transparency or reuse of CT data published prior to December 31st 2000...
February 15, 2018: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/29371599/cell-death-based-treatment-of-childhood-cancer
#15
REVIEW
Mike-Andrew Westhoff, Nicolas Marschall, Michael Grunert, Georg Karpel-Massler, Stefan Burdach, Klaus-Michael Debatin
Any therapy that aims at eradicating a cancerous growth will have at its core a cell death-inducing component. Here we argue that paediatric oncology presents with its unique set of considerations and problems, which-while taking the lead from oncological research experiences obtained from the adult population-need to be clinically evaluated independently. This is particularly true when considering long-term side effects. Precision medicine offers a promising new approach in therapy, but given as a monotherapy and in a limited combination, as found in an apoptosis inducer/sensitiser combination, it will most likely lead to mutation escape of the target cell population and the emergence of resistance...
January 25, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29355793/position-of-the-french-working-group-on-perioperative-haemostasis-gihp-on-viscoelastic-tests-what-role-for-which-indication-in-bleeding-situations
#16
Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
PURPOSE: Viscoelastic tests (VETs), thromboelastography (TEG® ) and thromboelastometry (ROTEM® ) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years...
February 3, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29240569/paediatric-procedural-sedation-and-analgesia-by-emergency-physicians-in-a-country-with-a-recent-establishment-of-emergency-medicine
#17
Maybritt I Kuypers, Gaël J P Smits, Eva P Baerends, Erick Oskam, Eef P J Reijners, Lisette A A Mignot-Evers, Wendy A M H Thijssen, Frans B Plötz, Erik H M Korsten
OBJECTIVES: Paediatric patients receive less procedural sedation and analgesia (PSA) in the emergency department compared with adults, especially in countries where emergency medicine is at an early stage of development. The objectives of this study were to evaluate the adverse events and efficacy of paediatric PSA in a country with a recent establishment of emergency medicine and to describe which factors aided implementation. METHODS: This is a prospective, multicentre, observational study of paediatric patients undergoing PSA by the first trained emergency physicians (EPs) in The Netherlands...
December 13, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29237400/accuracy-of-acute-burns-diagnosis-made-using-smartphones-and-tablets-a-questionnaire-based-study-among-medical-experts
#18
Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg, Lucie Laflamme
BACKGROUND: Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD: A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults...
December 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29158036/paediatric-weight-estimation-by-age-in-the-digital-era-optimising-a-necessary-evil
#19
Nicholas Appelbaum, Jonathan Clarke, Ian Maconochie, Ara Darzi
BACKGROUND: Age-based weight estimation methods are regularly used in paediatric emergency medicine despite their well-established inaccuracy. AIM: Determine the potential improvement in accuracy achievable by the use of a new mobile application, based on CDC/WHO weight-for-age centile data, which incorporates a gender assignment, a body habitus assessment, and which is capable of an age-in-months based calculation. METHODS: A theoretical, simulated validation study, comparing the performance of the widely used APLS/EPALS formulae against two contemporary habitus-adjusted methods, and the Helix Weight Estimation Tool...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29111613/management-of-shiga-toxin-producing-escherichia-coli-infected-children-a-multi-national-multi-specialty-survey
#20
Stephen B Freedman, Silviu Grisaru, Jianling Xie, Susan Samuel, Andrew Dixon, Amy C Plint, David Schnadower
AIM: Research has highlighted the potential role that hydration status may play in predicting outcomes in Shiga toxin-producing Escherichia coli (STEC)-infected children. Because little is known about the management of STEC-infected children in the pre-haemolytic uremic syndrome phase, we compared paediatric emergency medicine and nephrologist-stated management approaches to STEC-infected children. METHODS: Members of the Pediatric Emergency Research Canada (PERC; n = 228), the Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC; n = 221) and the Canadian Association of Pediatric Nephrologists (CAPN; n = 66) were surveyed...
April 2018: Journal of Paediatrics and Child Health
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