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Emergency pediatrics

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https://www.readbyqxmd.com/read/28230713/the-impact-of-ethnic-and-cultural-differences-on-parental-satisfaction-in-the-picu
#1
Qian Wen Sng, Angela H P Kirk, Siti Nur Hanim Buang, Jan Hau Lee
OBJECTIVES: This study examined satisfaction of parents whose children were admitted to the PICU to identify priority areas for improvement. We hypothesized that differences exist in satisfaction of parents of different ethnicities. DESIGN: Prospective observational study. SETTING: PICU in a tertiary care pediatric hospital. PATIENTS: All English-literate parents whose child was admitted to our PICU between February 2014 and February 2015 were eligible after informed consent was obtained...
February 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28229065/foreign-body-aspiration-in-adults-two-unusual-foreign-bodies-knife-and-tube-tracheostomy
#2
Seyed Mozafar Hashemi, Mohsen Kolahdouzan, Shahab Shahabi, Hamid Talebzadeh, Mohammad Taghi Rezaei
INTRODUCTION: Foreign body aspiration is usually a serious condition that is most common among the pediatric population, and rare in adults. In adults, aspiration may be tolerated for a long time. CASE REPORTS: Our first case is a 38-year-old man who presented with a 2-day history of swallowing a foreign body. He was completely asymptomatic. Chest X-ray revealed the presence of 5-cm foreign object in the right main bronchus. Rigid bronchoscopy was performed and a knife was removed from the right main bronchus...
January 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28228882/renal-lymphangiomatosis-a-rare-differential-diagnosis-for-autosomal-recessive-polycystic-kidney-disease-in-pediatric-patients
#3
Amna A Kashgari, Nabil Ozair, Amin Al Zahrani, Mohammed O Al Otibi, Khalid Al Fakeeh
Renal lymphangiomatosis is a rare, benign malformation, characterized by developmental malformation of the perirenal, peripelvic, and intrarenal lymphatics. Radiologist knowledge of the unique radiological features of this entity helps patient's safety in terms of management. We study the case of a 27-month-old boy presented to the emergency department with upper respiratory tract infection. He had a high blood pressure and had been diagnosed earlier with autosomal recessive polycystic kidney disease based on renal ultrasound findings...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228344/emergency-department-return-visits-within-a-large-geographic-area
#4
Mimi Truong, Garth Meckler, Quynh H Doan
BACKGROUND: Return visits to the emergency department (RTED) contribute to overcrowding and may be a quality of care indicator. Previous studies focused on factors predicting returns to and from the same center. Little is known about RTEDs across a range of community and specialty hospitals within a large geographic area. OBJECTIVE: We sought to measure the frequency of pediatric RTEDs and describe their directional pattern across centers in a large catchment area...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228009/emergency-ultrasonography-of-the-gastrointestinal-tract-of-children
#5
Jae-Yeon Hwang
Ultrasonography (US) is widely used to evaluate most body parts in pediatric patients because it is simple, noninvasive, easy to use, and applicable in a wide variety of clinical situations. US is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients because of their small body habitus and the presence of less fat tissue in the abdominal wall and peritoneal cavity. The most important factor in performing pediatric emergency US is the graded compression technique and selection of the proper transducer...
January 25, 2017: Ultrasonography
https://www.readbyqxmd.com/read/28226598/estimation-of-resting-state-effective-connectivity-in-epilepsy-using-direct-directed-transfer-function
#6
Biswajit Maharathi, Jeffrey A Loeb, James Patton, Biswajit Maharathi, Jeffrey A Loeb, James Patton, Biswajit Maharathi, James Patton, Jeffrey A Loeb
There has been an increasing demand among neuroscientists to understand the complex network of functionally connected neural assemblies in the human brain. For this purpose, computational EEG research is widely used by researchers due to its remarkable advantage in providing high temporal resolution, and ease of analysis across different frequency bands. Here we analyzed Electrocorticographic (ECoG) signals of electrodes placed on frontal-parietal neocortex brain region of 8 pediatric epileptic patients. In order to evaluate the directed causal relationship among different brain regions, we employed a Granger causality based multivariate connectivity estimator named direct Directed Transfer Function (dDTF) to identify signal propagations among the selected set of electrode in the frequency range 1-50Hz...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#7
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225375/impact-of-a-child-life-and-music-therapy-procedural-support-intervention-on-parental-perception-of-their-child-s-distress-during-intravenous-placement
#8
Gabriela S Ortiz, Todd OʼConnor, Jessa Carey, Adam Vella, Audrey Paul, Diane Rode, Alan Weinberg
OBJECTIVES: Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225374/characterizing-the-toxicity-and-dose-effect-profile-of-tramadol-ingestions-in-children
#9
Gina L Stassinos, Lawrence Gonzales, Wendy Klein-Schwartz
OBJECTIVES: Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. METHODS: A retrospective evaluation of cases from the National Poison Center Data System between January 1, 2000, and December 31, 2013, was performed...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224938/overview-on-the-challenges-and-benefits-of-using-telehealth-tools-in-a-pediatric-population
#10
REVIEW
Patrick D Brophy
Telehealth in Pediatric Medicine presents many of the same benefits and challenges noted in adult-based medicine. In terms of health care delivery, the promise of improving access and reducing costs using telehealth in Pediatrics, particularly chronic care, is high. The ability to address clinician shortages and provide remote guidance for chronic care pathways from pediatric subspecialists to rural-based referring physicians is a developing model that represents a sustainable and cost-effective strategy to improve pediatric care...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28223319/development-and-testing-of-the-pediatric-respiratory-illness-measurement-system-primes-quality-indicators
#11
Rita Mangione-Smith, Carol P Roth, Maria T Britto, Alex Y Chen, Julie McGalliard, Thomas F Boat, John L Adams, Elizabeth A McGlynn
OBJECTIVES: To develop and test quality indicators for assessing care in pediatric hospital settings for common respiratory illnesses. PATIENTS: A sample of 2796 children discharged from the emergency department or inpatient setting at 1 of the 3 participating hospitals with a primary diagnosis of asthma, bronchiolitis, croup, or community-acquired pneumonia (CAP) between January 1, 2010, and December 31, 2011. SETTING: Three tertiary care children's hospitals in the United States...
February 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#12
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28221822/clinical-characteristics-and-spatial-distribution-of-visceral-leishmaniasis-in-children-in-s%C3%A3-o-paulo-state-an-emerging-focus-of-visceral-leishmaniasis-in-brazil
#13
Patricia Rodrigues Naufal Spir, Luiz Euribel Prestes-Carneiro, Elivelton Silva Fonseca, Aline Dayse, Rogério Giuffrida, Lourdes Aparecida Zampieri D'Andrea
BACKGROUND: Visceral leishmaniasis (VL) is an emerging zoonosis, and Brazil harbors about 90% of those infected in Latin America. Since 1998, the disease has been spreading quickly in São Paulo state, and the western region is considered an emerging focus of VL in Brazil. Our aim was to evaluate the clinical characteristics and spatial distribution of VL in children referred to a public tertiary hospital located in the western region of São Paulo state, Brazil. METHODS: Medical records of children up to 18 years of age who were diagnosed with VL between January 2006 and December 2010 were reviewed...
February 21, 2017: Pathogens and Global Health
https://www.readbyqxmd.com/read/28221282/characteristics-and-triage-of-children-presenting-in-mental-health-crisis-to-emergency-departments-at-detroit-regional-hospitals
#14
Kristen Williams, Amanda R Levine, David M Ledgerwood, Alireza Amirsadri, Leslie H Lundahl
OBJECTIVES: The number of children in the United States utilizing emergency department (ED) services for psychiatric crises is increasing, and psychiatric-related ED visits disproportionately burden hospital resources. Yet, there is limited available information on the epidemiology and outcomes of pediatric mental health emergencies. The present study sought to characterize pediatric mental health-related ED presentations in a large urban center and identify factors predictive of inpatient hospitalization...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221281/first-attempt-success-longevity-and-complication-rates-of-ultrasound-guided-peripheral-intravenous-catheters-in-children
#15
Alexandra M Vinograd, Joseph J Zorc, Anthony J Dean, Mary Kate F Abbadessa, Aaron E Chen
OBJECTIVE: The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department. METHODS: The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221204/frequency-and-risk-factors-for-malnutrition-in-children-undergoing-general-anaesthesia-in-a-french-university-hospital
#16
Louis Gerbaud-Morlaes, Eric Frison, Florence Babre, Arnaud De Luca, Anne Didier, Maryline Borde, Brigitte Zaghet, Hélène Batoz, François Semjen, Karine Nouette-Gaulain, Raphael Enaud, Régis Hankard, Thierry Lamireau
BACKGROUND: Malnutrition is often underdiagnosed in hospitalised children, although it is associated with postoperative complications, longer hospital lengths of stay and increased healthcare-related costs. OBJECTIVE: We aimed to estimate the frequency of, and identify factors associated with, malnutrition in children undergoing anaesthesia. DESIGN: Cross-sectional observational study. SETTING: Paediatric anaesthesia department at the University Children's Hospital, Bordeaux, France...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28221155/super-mini-pcnl-smp-material-indications-technique-advantages-and-results
#17
Zhijian Zhao, Aierken Tuerxu, Yongda Liu, Wenqi Wu, Abulizi Simayi, Wen Zhong, Wenzhong Chen, Abudukahaer Batuer, Guohua Zeng
OBJECTIVE: To introduce an emerging technique termed 'super-mini- percutaneous nephrolithotomy' (SMP) and describe its application in practice. METHODS: We described the technique of SMP in the treatment of renal stones with emphasis on the material, indications, technique procedure, advantages, and results. RESULTS: SMP refers to a 7 Ch. nephroscope placed through a 10-14 Ch. metal access sheath with functions of both irrigation and suction-evacuation, to achieve stone fragmentation via laser or pneumatic lithotripsy...
January 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28219966/the-child-witness-in-the-courtroom
#18
Robert H Pantell
Beginning in the 1980s, children have increasingly served as witnesses in the criminal, civil, and family courts; currently, >100 000 children appear in court each year. This statement updates the 1992 American Academy of Pediatrics (AAP) policy statement "The Child as a Witness" and the subsequent 1999 "The Child in Court: A Subject Review." It also builds on existing AAP policy on adverse life events affecting children and resources developed to understand and address childhood trauma. The purpose of this policy statement is to provide background information on some of the legal issues involving children testifying in court, including the accuracy and psychological impact of child testimony; to provide suggestions for how pediatricians can support patients who will testify in court; and to make recommendations for policy improvements to minimize the adverse psychological consequences for child witnesses...
February 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28219462/the-use-of-a-computerized-provider-order-entry-alert-to-decrease-rates-of-clostridium-difficile-testing-in-young-pediatric-patients
#19
Maribeth R Nicholson, Peter N Freswick, M Cecilia Di Pentima, Li Wang, Kathryn M Edwards, Gregory J Wilson, Thomas R Talbot
BACKGROUND Infants and young children are frequently colonized with C. difficile but rarely have symptomatic disease. However, C. difficile testing remains prevalent in this age group. OBJECTIVE To design a computerized provider order entry (CPOE) alert to decrease testing for C. difficile in young children and infants. DESIGN An interventional age-targeted before-after trial with comparison group SETTING Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, Tennessee. PATIENTS All children seen in the inpatient or emergency room settings from July 2012 through July 2013 (pre-CPOE alert) and September 2013 through September 2014 (post-CPOE alert) INTERVENTION In August of 2013, we implemented a CPOE alert advising against testing in infants and young children based on the American Academy of Pediatrics recommendations with an optional override...
February 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28219136/-an-epidemiological-investigation-of-pediatric-patients-under-14-with-large-area-burns-a-multicenter-study
#20
W F Cheng, D X Zhao, Z A Shen, H Y Zhang, J J Tu, Z Q Yuan, P Duan, G D Song
Objective: To investigate and evaluate the epidemiological characteristics of patients under 14 with large area burns in China. Methods: Data of pediatric patients aged 0-14yr with ≥30% total body surface area (TBSA) burned admitted into 106 burn centers in the mainland of China in 2014 were retrieved. The children were divided into three age groups: 0-3, 4-6 and 7-14 years according to the age. Information of age, gender, time of burn injury, causes of burns, admission time, prehospital emergency care of burn wound, burn area, inhalation injuries, the case fatality rate and length of hospital stay were collected for analysis...
February 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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