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https://www.readbyqxmd.com/read/28108810/independent-risk-factors-for-recurrence-of-apparent-life-threatening-events-in-infants
#1
Riyo Ueda, Osamu Nomura, Takanobu Maekawa, Hirokazu Sakai, Satoshi Nakagawa, Akira Ishiguro
: The risk factors for recurrent apparent life-threatening event (ALTE) are unclear although the risk of recurrent ALTE is an important consideration for the management of ALTE patients. This study aimed to identify the risk factors for recurrent ALTE. We conducted a secondary analysis of the data from a single center retrospective cohort study in Japan conducted from March 2002 to January 2012, which included children diagnosed with ALTE at a pediatric emergency department (ED) in Tokyo...
January 20, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28108126/expert-perspectives-on-time-sensitivity-and-a-related-metric-for-children-involved-in-motor-vehicle-crashes
#2
Andrea N Doud, Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, John K Petty, J Wayne Meredith, Joel D Stitzel
OBJECTIVE: Advanced Automatic Crash Notification (AACN) uses vehicle telemetry data to predict risk of serious injury among motor vehicle crash occupants and can thus improve the accuracy with which injured children are triaged by first responders. To better define serious injury for AACN systems (which typically use Abbreviated Injury Scale [AIS] metrics), an age-specific approach evaluating severity, time sensitivity (TS), and predictability of injury has been developed. This study outlines the development of the TS score...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#3
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/28094679/a-retrospective-analysis-of-a-pediatric-tele-echocardiography-service-to-treat-triage-and-reduce-trans-pacific-transport
#4
Christopher A Rouse, Brandon T Woods, C Becket Mahnke
Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#5
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28034476/defining-cases-of-severe-pediatric-diarrhea-for-an-efficacy-trial-of-an-enterotoxigenic-escherichia-coli-etec-vaccine-report-on-an-international-workshop-washington-dc-march-2016
#6
Thomas F Wierzba, Alexandra Bourgis
Enterotoxigenic Escherichia coli (ETEC) causes severe acute watery diarrhea. No ETEC vaccine is available but candidates are in development, including ETVAX, an oral, whole-cell inactivated vaccine. ETVAX is being tested in a descending-age trial in Bangladesh. If found safe and immunogenic, investigators may test it for efficacy in children. Like oral rotavirus vaccines, we expect that ETVAX will be most effective at decreasing the incidence of moderate-to-severe ETEC episodes. Thus, for an efficacy trial outcome, it will be necessary to triage patients into moderate-to-severe versus mild disease...
December 26, 2016: Vaccine
https://www.readbyqxmd.com/read/28030523/successful-introduction-of-fine-needle-aspiration-biopsy-for-diagnosis-of-pediatric-lymphadenopathy
#7
Candice Sher-Locketz, Pawel T Schubert, Samuel W Moore, Colleen A Wright
BACKGROUND: Accurate and rapid diagnosis of extrapulmonary nodal tuberculosis in children is of paramount importance in order to initiate immediate treatment and prevent complications. Fine needle aspiration biopsy (FNAB) provides a means of triage, and also identifies patients with suspected hematological or metastatic neoplasms.This study aims to demonstrate how a laboratory-run FNAB service, which largely replaced the previous surgical practice of lymph node excision biopsy can provide a clinically acceptable and effective diagnostic service...
December 27, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28030519/incorporating-a-computerized-cognitive-battery-into-the-emergency-department-care-of-pediatric-mild-traumatic-brain-injuries-is-it-feasible
#8
Aneesh M Khetani, Brian L Brooks, Angelo Mikrogianakis, Karen M Barlow
OBJECTIVES: The use of computers to test cognitive function acutely after a concussion is becoming increasingly popular, especially after sport-related concussion. Although commonly performed in the community, it is not yet performed routinely in the emergency department (ED), where most injured children present. The challenges of performing computerized cognitive testing (CCT) in a busy ED are considerable. The aim of this study was to evaluate the feasibility of CCT in the pediatric ED after concussion...
December 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28012507/the-utility-of-a-handheld-metal-detector-in-detection-and-localization-of-pediatric-metallic-foreign-body-ingestion
#9
Javan Nation, Wen Jiang
OBJECTIVE: To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. METHODS: Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. RESULTS: Thirty-seven of the 38 ingested foreign bodies were MFBs...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28011610/characteristics-and-outcomes-of-pediatric-patients-with-ebola-virus-disease-admitted-to-treatment-units-in-liberia-and-sierra-leone-a-retrospective-cohort-study
#10
Michael A Smit, Ian C Michelow, Justin Glavis-Bloom, Vanessa Wolfman, Adam C Levine
BACKGROUND: The clinical and virologic characteristics of Ebola virus disease (EVD) in children have not been thoroughly documented. METHODS: Consecutive children aged <18 years with real-time polymerase chain reaction (RT-PCR)-confirmed EVD were enrolled retrospectively in 5 Ebola treatment units in Liberia and Sierra Leone in 2014/2015. Data collection and medical management were based on standardized International Medical Corps protocols. We performed descriptive statistics, multivariate logistic regression, and Kaplan-Meier survival analyses...
February 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27940752/improving-guideline-based-care-of-acute-asthma-in-a-pediatric-emergency-department
#11
Matthew P Gray, Grant E Keeney, Michael J Grahl, Marc H Gorelick, Christopher D Spahr
BACKGROUND AND OBJECTIVE: Rapid repetitive administration of short-acting β-agonists (SABA) is the most effective means of reducing acute airflow obstruction in asthma. Little evidence exists that assesses process measures (ie, timeliness) and outcomes for asthma. We used quality improvement (QI) methods to improve emergency department care in accordance with national guidelines including timely SABA administration and use of asthma severity scores. METHODS: The Model for Improvement was used and interventions were targeted at 4 key drivers: knowledge, engagement, decision support, and workflow enhancement...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27929695/secondhand-smoke-exposure-illness-severity-and-resource-utilization-in-pediatric-emergency-department-patients-with-respiratory-illnesses
#12
Ashley L Merianos, Cinnamon A Dixon, E Melinda Mahabee-Gittens
OBJECTIVE: Hospital-based data reveal that children who have secondhand smoke exposure (SHSe) experience severe respiratory illnesses and greater resource utilization. Our objective was to assess the relationship between SHSe and illness severity/resource utilization among children presenting to the pediatric emergency department (PED) with three common respiratory conditions - asthma, bronchiolitis, and pneumonia. METHODS: A retrospective review of a yearlong consecutive sample of PED patients with SHSe status documentation and asthma, bronchiolitis, or pneumonia diagnoses was performed...
December 8, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#13
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27876588/predicting-subsequent-high-frequency-low-acuity-utilization-of-the-pediatric-emergency-department
#14
Margaret E Samuels-Kalow, Matthew W Bryan, Kathy N Shaw
OBJECTIVE: To derive and test a predictive model for high-frequency (>= four visits/year), low-acuity (Emergency Severity Index 4 or 5) utilization of the pediatric emergency department. METHODS: The study sample used three years of data (2012-14) from a single tertiary care children's hospital for patients <21 years of age. Utilization in 2013 defined the index visit; prior utilization was drawn from 2012; and 2014 was used for outcome measurement. Candidate predictor variables were those that would be available at the time of triage...
November 19, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27852453/current-use-and-outcomes-of-helicopter-transport-in-pediatric-trauma-a-review-of-18-291-transports
#15
Brian R Englum, Kristy L Rialon, Jina Kim, Mark L Shapiro, John E Scarborough, Henry E Rice, Obinna O Adibe, Elisabeth T Tracy
PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27850746/1109-implementation-of-a-nurse-led-triaging-protocol-for-pediatric-procedural-sedation
#16
Sangita Basnet, Ira Shukla, Joseph Dario, Georgia Mueller, Ryan Majcina, Giovanna Caprirolo
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27822127/objective-triage-in-the-disaster-setting-will-children-and-expecting-mothers-be-treated-like-others
#17
Timur Kouliev
The study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make basing decisions on a succinct and efficient algorithm. A survey of triage professionals in international settings was designed to identify possible emotionally led bias that affects objective decision making in identifying victims most likely to benefit from immediate life support intervention. This survey suggests a lack of correlation between triage priority and predictable clinical outcomes as predicted by the Revised Trauma Score tool...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27799583/accuracy-and-efficiency-of-orthoptists-in-comprehensive-pediatric-eye-examinations
#18
Jane Scheetz, Konstandina Koklanis, Maureen Long, Meg E Morris
INTRODUCTION AND PURPOSE: To investigate the level of agreement between orthoptists and medical practitioners in the comprehensive eye examination of children seen in an orthoptist-led triage clinic. PATIENTS AND METHODS: Patient records over a 6-month period were retrospectively reviewed. Those with a presenting complaint related to vision or ocular motility were triaged into the orthoptist-led clinic and included in the study. Patients who did not meet the triage protocol and those who were not assessed by a medical practitioner at a subsequent appointment were excluded from analysis...
January 2016: American Orthoptic Journal
https://www.readbyqxmd.com/read/27798478/use-of-transportable-radiation-detection-instruments-to-assess-internal-contamination-from-intakes-of-radionuclides-part-ii-calibration-factors-and-icat-computer-program
#19
Robert Anigstein, Richard H Olsher, Donald A Loomis, Armin Ansari
The detonation of a radiological dispersion device or other radiological incidents could result in widespread releases of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure radiation from gamma-emitting radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for in vitro assessments. The present study derived sets of calibration factors for four instruments: the Ludlum Model 44-2 gamma scintillator, a survey meter containing a 2...
December 2016: Health Physics
https://www.readbyqxmd.com/read/27792290/the-reliability-of-the-manchester-triage-system-mts-a-meta-analysis
#20
Amir Mirhaghi, Reza Mazlom, Abbas Heydari, Mohsen Ebrahimi
OBJECTIVE: Although the Manchester Triage System (MTS) was first developed two decades ago, the reliability of the MTS has not been questioned through comparison with a moderating variable; therefore, the aim of this study is to determine the extent of the reliability of MTS using a meta-analytic review. METHOD: Electronic databases were searched up to March 1st, 2014. Studies were only included if they had reported sample sizes, reliability coefficients, and adequate description of the Emergency Severity Index (ESI) reliability assessment...
September 9, 2016: Journal of Evidence-based Medicine
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