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Pediatric critical and emergency care

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https://www.readbyqxmd.com/read/28924562/assessment-of-analytical-performance-of-glucose-meter-in-pediatric-age-group-at-tertiary-care-referral-hospital
#1
Mohit Vijay Rojekar, Vandana Kumawat, Jayesh Panot, Surekha Khedkar, Arati Adhe-Rojekar
BACKGROUND: Glucometers are the excellent tools for self-monitoring of blood glucose (SMBG). They are important especially in the circumstances where continuous monitoring is mandatory and at decision making levels. Tight glycemic control protocols are important for preventing the ill effects of fluctuating glucose levels. This increases the use of glucometers in various healthcare settings. As technology advances, glucometers are getting better in terms of quality of results. But still some lacunae are there...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#2
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#3
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28916012/preliminary-outcomes-from-an-integrated-pediatric-mental-health-outpatient-clinic
#4
REVIEW
Gary R Maslow, Adrienne Banny, McLean Pollock, Kristen Stefureac, Kendra Rosa, Barbara Keith Walter, Katherine Hobbs Knutson, Joseph Lucas, Nicole Heilbron
An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28911938/-families-experiences-and-satisfaction-with-a-pediatric-emergency-service
#5
S Perret, M Gehri, J Pluies, I Rossi, C Akre
OBJECTIVE: Today, pediatric emergency services receive a rising number of "non-urgent" cases, which are due to parental anxiety or a miscomprehension of medical explanations. The aim of this study was therefore to understand what those families experience and need when they consult in such cases, in order to respond with adapted solutions. METHODS: Semi-structured interviews and questionnaires with parents, after the consultation or in the waiting room. RESULTS: Based on the families' narratives, we present the results in six steps, which correspond to the steps they experience from the decision to go to the hospital to the consultation...
September 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28888507/pediatric-nurses-perspectives-on-medication-teaching-in-a-children-s-hospital
#6
Cori A Gibson, Ashley J Stelter, Kristin A Haglund, Stacee M Lerret
PURPOSE: To explore inpatient pediatric nurses' current experiences and perspectives on medication teaching. DESIGN AND METHODS: A descriptive qualitative study was conducted at a Midwest pediatric hospital. Using convenience sampling, 26 nurses participated in six focus groups. Data were analyzed in an iterative group coding process. RESULTS: Three themes emerged. 1) Medication teaching is an opportunity. 2) Medication teaching is challenging...
September 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28887926/developing-an-extracorporeal-membrane-oxygenation-program
#7
REVIEW
Julia Jones-Akhtarekhavari, Thomas A Tribble, Joseph B Zwischenberger
The development of a successful extracorporeal membrane oxygenation (ECMO) program requires an institutional commitment and the multidisciplinary cooperation of trained specialty personnel from nursing, internal medicine, anesthesiology, pulmonology, emergency medicine, critical care, and surgery and often pediatrics as well. The specialized training necessary to cultivate an integrated team capable of providing life-saving ECMO cannot be underestimated. The development of a successful ECMO program is best suited to a tertiary medical center that is centrally/regionally located and capable of financially supporting the level of expertise required as well as managing the program's overall cost effectiveness...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28885390/epidemiology-of-admissions-from-the-emergency-department-among-febrile-infants-younger-than-90-days-in-the-united-states-2002-to-2012
#8
Diana K Nguyen, Ross J Fleischman, Scott Friedlander, Kenneth M Zangwill
BACKGROUND AND OBJECTIVES: Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. Our objective was to determine the likelihood of admission and associated complications of care for such infants, particularly those at lowest risk for SBI. METHODS: This is a retrospective cohort study including multisite emergency department (ED) visits using administrative data from the Pediatric Emergency Care Applied Research Network Core Data Project...
September 5, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28872981/sex-differences-in-outcomes-after-discharge-from-alberta-emergency-departments-for-asthma-a-large-population-based-study
#9
Rhonda J Rosychuk, Maria Ospina, Jingbin Zhang, Richard Leigh, Andrew Cave, Brian H Rowe
OBJECTIVE: Asthma exacerbations frequently result in emergency department (ED) visits. While sex differences have been identified in some asthma studies, there is a paucity of literature on sex differences in the ED setting, especially population-based ones. This study examines sex differences in important outcomes of patients discharged from EDs for acute asthma in Alberta, Canada. METHODS: Alberta residents aged 2 to 55 years discharged from EDs with a primary diagnosis of asthma during 1999- 2011 were identified from administrative databases from a single-payer health care system for the entire geographic region of Alberta...
September 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28845042/factors-determining-parents-decisions-to-bring-their-children-to-the-pediatric-emergency-department-for-a-minor-illness
#10
Sigita Burokienė, Juozas Raistenskis, Emilija Burokaitė, Rimantė Čerkauskienė, Vytautas Usonis
BACKGROUND The number of children visiting Emergency Departments (EDs) is increasing in Lithuania; therefore, the aim of this study was to determine the factors influencing the parental decision to bring their child to the ED for a minor illness that could be managed in a primary healthcare setting, and to compare parents' and medical professionals' attitudes toward a child's health status and need for urgent care. MATERIAL AND METHODS A prospective observational study was performed at the tertiary-level teaching Children's Hospital in Vilnius...
August 28, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28814616/the-yale-observation-scale-score-and-the-risk-of-serious-bacterial-infections-in-febrile-infants
#11
Lise E Nigrovic, Prashant V Mahajan, Stephen M Blumberg, Lorin R Browne, James G Linakis, Richard M Ruddy, Jonathan E Bennett, Alexander J Rogers, Leah Tzimenatos, Elizabeth C Powell, Elizabeth R Alpern, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
OBJECTIVES: To assess the performance of the Yale Observation Scale (YOS) score and unstructured clinician suspicion to identify febrile infants ≤60 days of age with and without serious bacterial infections (SBIs). METHODS: We performed a planned secondary analysis of a prospective cohort of non-critically ill, febrile, full-term infants ≤60 days of age presenting to 1 of 26 participating emergency departments in the Pediatric Emergency Care Applied Research Network...
June 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/28798907/building-sustainable-partnerships-to-strengthen-pediatric-capacity-at-a-government-hospital-in-malawi
#12
Michelle Eckerle, Heather L Crouse, Msandeni Chiume, Ajib Phiri, Peter N Kazembe, Hanny Friesen, Tisungane Mvalo, Marideth C Rus, Elizabeth F Fitzgerald, Allyson McKenney, Irving F Hoffman, Megan Coe, Beatrice M Mkandawire, Charles Schubert
INTRODUCTION: To achieve sustained reductions in child mortality in low- and middle-income countries, increased local capacity is necessary. One approach to capacity building is support offered via partnerships with institutions in high-income countries. However, lack of cooperation between institutions can create barriers to successful implementation of programs and may inadvertently weaken the health system they are striving to improve. A coordinated approach is necessary. BACKGROUND: Three U...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28774498/vaccine-hesitancy-where-we-are-and-where-we-are-going
#13
REVIEW
Catherine C McClure, Jessica R Cataldi, Sean T O'Leary
PURPOSE: Vaccines represent one of the most important aspects of pediatric preventive care. However, parents are increasingly questioning the safety of and need for vaccines, and as a result, vaccination rates have fallen to dangerously low levels in certain communities. The effects of vaccine hesitancy are widespread. Community pediatricians who interact regularly with vaccine-hesitant parents report higher levels of burnout and lower levels of job satisfaction. Not surprisingly, vaccine hesitancy has also had direct influence on vaccination rates, which in turn are linked to increased emergency department use, morbidity, and mortality...
July 31, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28759413/the-yale-observation-scale-score-and-the-risk-of-serious-bacterial-infections-in-febrile-infants
#14
Lise E Nigrovic, Prashant V Mahajan, Stephen M Blumberg, Lorin R Browne, James G Linakis, Richard M Ruddy, Jonathan E Bennett, Alexander J Rogers, Leah Tzimenatos, Elizabeth C Powell, Elizabeth R Alpern, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
OBJECTIVES: To assess the performance of the Yale Observation Scale (YOS) score and unstructured clinician suspicion to identify febrile infants ≤60 days of age with and without serious bacterial infections (SBIs). METHODS: We performed a planned secondary analysis of a prospective cohort of non-critically ill, febrile, full-term infants ≤60 days of age presenting to 1 of 26 participating emergency departments in the Pediatric Emergency Care Applied Research Network...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28749111/syncope-in-pediatric-patients-a-practical-approach-to-differential-diagnosis-and-management-in-the-emergency-department-digest
#15
Colleen Fant, Ari Cohen, Michelle N Vazquez
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope...
April 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28737594/identifying-risk-for-acute-kidney-injury-in-infants-and-children-following-cardiac-arrest
#16
Tara M Neumayr, Jeff Gill, Julie C Fitzgerald, Avihu Z Gazit, Jose A Pineda, Robert A Berg, J Michael Dean, Frank W Moler, Allan Doctor
OBJECTIVES: Our goal was to identify risk factors for acute kidney injury in children surviving cardiac arrest. DESIGN: Retrospective analysis of a public access dataset. SETTING: Fifteen children's hospitals associated with the Pediatric Emergency Care Applied Research Network. PATIENTS: Two hundred ninety-six subjects between 1 day and 18 years old who experienced in-hospital or out-of-hospital cardiac arrest between July 1, 2003, and December 31, 2004...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28697170/critically-ill-children-with-hemophagocytic-lymphohistiocytosis-a-case-series-of-14-patients
#17
Esther Huimin Leow, Shui Yen Soh, Ah Moy Tan, Yee Hui Mok, Mei Yoke Chan, Jan Hau Lee
Children with hemophagocytic lymphohistiocytosis (HLH) are at an increased risk of critical illness. In this study, we described the clinical characteristics of critically ill children with HLH and identify factors associated with poor clinical outcomes. Children who were diagnosed with HLH with emergent admission to Children's Intensive Care Unit (CICU) between January 1, 2000 and October 31, 2015 were included. The primary outcome was CICU mortality. Over the 15-year period, there were 14 critically ill patients with HLH with 23 CICU admissions...
August 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28691958/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#18
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between two organizations, American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric (> 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were scanned for relevance...
July 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#19
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28686844/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#20
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
July 2017: JPEN. Journal of Parenteral and Enteral Nutrition
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