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https://www.readbyqxmd.com/read/28923560/computed-tomography-findings-in-young-children-with-minor-head-injury-presenting-to-the-emergency-department-greater-than-24h-post-injury
#1
Renana Gelernter, Giora Weiser, Eran Kozer
BACKGROUND: Large studies which developed decision rules for the use of Computed tomography (CT) in children with minor head trauma excluded children with late presentation (more than 24h). OBJECTIVE: To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the emergency department (ED) more than 24h from the injury. METHODS: A retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted...
September 11, 2017: Injury
https://www.readbyqxmd.com/read/28872046/racial-and-ethnic-differences-in-antibiotic-use-for-viral-illness-in-emergency-departments
#2
Monika K Goyal, Tiffani J Johnson, James M Chamberlain, T Charles Casper, Timothy Simmons, Evaline A Alessandrini, Lalit Bajaj, Robert W Grundmeier, Jeffrey S Gerber, Scott A Lorch, Elizabeth R Alpern
BACKGROUND AND OBJECTIVES: In the primary care setting, there are racial and ethnic differences in antibiotic prescribing for acute respiratory tract infections (ARTIs). Viral ARTIs are commonly diagnosed in the pediatric emergency department (PED), in which racial and ethnic differences in antibiotic prescribing have not been previously reported. We sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral ARTIs in the PED...
September 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28856440/the-impact-of-the-introduction-of-pecarn-head-ct-rules-on-the-utilisation-of-head-ct-scans-in-a-private-tertiary-hospital-in-sub-saharan-africa
#3
Isaac O Kobe, Mahmoud M Qureshi, Saidi Hassan, David L Oluoch-Olunya
BACKGROUND: The decision to order head CT scans to rule out clinically significant traumatic brain injury in mild head injury in children is made on the basis of clinical decision rules of which the Paediatric Emergency Care Applied Research Network (PECARN) CT head rules have been found to be most sensitive. PURPOSES: The purpose of this study is to determine the proportion of head CT scans done for children with mild head injury and to determine disposition of patients from casualty after the introduction of PECARN head CT rules compared to the period before...
August 30, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28814616/the-yale-observation-scale-score-and-the-risk-of-serious-bacterial-infections-in-febrile-infants
#4
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/28759413/the-yale-observation-scale-score-and-the-risk-of-serious-bacterial-infections-in-febrile-infants
#5
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/28643031/pediatric-emergency-care-applied-research-network-pecarn-prediction-rules-in-identifying-high-risk-children-with-mild-traumatic-brain-injury
#6
B Nakhjavan-Shahraki, M Yousefifard, M J Hajighanbari, A Oraii, S Safari, M Hosseini
PURPOSE: Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prognostic rules is a scoring system for prediction of the need for computed tomography (CT) scanning in children with mild TBI. However, its validation has not been assessed in developing countries. Therefore, the present study was designed to assess the value of PECARN rule in identification of children with clinically important TBI (ciTBI). METHOD: In this prospective cross-sectional study, 594 children (mean age: 7...
June 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28606098/determining-the-longitudinal-validity-and-meaningful-differences-in-hrql-of-the-pedsql%C3%A2-sickle-cell-disease-module
#7
Julie A Panepinto, J Paul Scott, Oluwakemi Badaki-Makun, Deepika S Darbari, Corrie E Chumpitazi, Gladstone E Airewele, Angela M Ellison, Kim Smith-Whitley, Prashant Mahajan, Sharada A Sarnaik, T Charles Casper, Larry J Cook, Julie Leonard, Monica L Hulbert, Elizabeth C Powell, Robert I Liem, Robert Hickey, Lakshmanan Krishnamurti, Cheryl A Hillery, David C Brousseau
BACKGROUND: Detecting change in health status over time and ascertaining meaningful changes are critical elements when using health-related quality of life (HRQL) instruments to measure patient-centered outcomes. The PedsQL™ Sickle Cell Disease module, a disease specific HRQL instrument, has previously been shown to be valid and reliable. Our objectives were to determine the longitudinal validity of the PedsQL™ Sickle Cell Disease module and the change in HRQL that is meaningful to patients...
June 12, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28423460/individual-and-neighborhood-characteristics-of-children-seeking-emergency-department-care-for-firearm-injuries-within-the-pecarn-network
#8
Patrick M Carter, Lawrence J Cook, Michelle L Macy, Mark R Zonfrillo, Rachel M Stanley, James M Chamberlain, Joel A Fein, Elizabeth R Alpern, Rebecca M Cunningham
OBJECTIVE: The objective was to describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network and assess the influence of both individual and neighborhood factors on firearm-related injury risk. METHODS: This was a retrospective, multicenter cross-sectional analysis of children (<19 years old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent...
July 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#9
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
June 17, 2017: Lancet
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#10
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28341799/use-of-traumatic-brain-injury-prediction-rules-with-clinical-decision-support
#11
MULTICENTER STUDY
Peter S Dayan, Dustin W Ballard, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, David R Vinson, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Jun Wang, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Nathan Kuppermann
OBJECTIVES: We determined whether implementing the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prediction rules and providing risks of clinically important TBIs (ciTBIs) with computerized clinical decision support (CDS) reduces computed tomography (CT) use for children with minor head trauma. METHODS: Nonrandomized trial with concurrent controls at 5 pediatric emergency departments (PEDs) and 8 general EDs (GEDs) between November 2011 and June 2014...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#12
MULTICENTER STUDY
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28170143/prevalence-of-brain-injuries-and-recurrence-of-seizures-in-children-with-posttraumatic-seizures
#13
Mohamed K Badawy, Peter S Dayan, Michael G Tunik, Frances M Nadel, Kathleen A Lillis, Michelle Miskin, Dominic A Borgialli, Michael C Bachman, Shireen M Atabaki, John D Hoyle, James F Holmes, Nathan Kuppermann
OBJECTIVES: Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with posttraumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBIs) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBIs on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28039943/the-pecarn-tbi-rules-do-not-apply-to-abusive-head-trauma
#14
Julia N Magana, Nathan Kuppermann
No abstract text is available yet for this article.
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27862642/external-validation-of-the-pecarn-head-trauma-prediction-rules-in-japan
#15
Kentaro Ide, Satoko Uematsu, Kenichi Tetsuhara, Satoshi Yoshimura, Takahiro Kato, Tohru Kobayashi
OBJECTIVES: The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules are used to assist computed tomography (CT) decision-making for children with minor head trauma. Although the PECARN rules have been validated in North America and Europe, they have not yet been validated in Asia. In Japan, there are no clinical decision rules for children with minor head trauma. The rate of head CT for children with minor head trauma in Japan is high since CT is widely accessible across the country...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27858189/ambulatory-or-inpatient-management-of-mild-tbi-in-children-a-post-concussion-analysis
#16
Danielle S Wendling-Keim, Adriana König, Hans-Georg Dietz, Markus Lehner
BACKGROUND: Diagnosis and treatment of children with mild traumatic brain injury (mTBI) remain a challenge since initial signs and symptoms do not always indicate the severity of the trauma. Therefore, guidelines regarding the decision upon imaging methods and ambulatory or hospitalized treatment are needed. The goal of our study was to investigate if the standard that was allied from the PECARN rules and is applied in this study can ensure that patients with clinically important brain injury are recognized and leads to outcomes with a low complication rate, a high patient satisfaction and minimal post-concussion syndrome incidence...
February 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27850061/421-concordance-of-clinical-criteria-between-resident-and-attending-using-the-pecarn-tool
#17
Ilana Harwayne-Gidansky, Doreen Olvet, Latha Chandran, Kevin Ching
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27749628/cervical-spine-injuries-in-children-associated-with-sports-and-recreational-activities
#18
Lynn Babcock, Cody S Olsen, David M Jaffe, Julie C Leonard
OBJECTIVE: The aim of this study was to ascertain potential factors associated with cervical spine injuries in children injured during sports and recreational activities. METHODS: This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography. Cases had cervical spine injury from sports or recreational activities (n = 179)...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27747549/anticipated-resource-utilization-for-injury-versus-non-injury-pediatric-visits-to-emergency-departments
#19
Mark R Zonfrillo, Michelle L Macy, Lawrence J Cook, Tomohiko Funai, Rachel M Stanley, James M Chamberlain, Rebecca M Cunningham, Elizabeth R Alpern
BACKGROUND: Childhood injuries are increasingly treated in emergency departments (EDs) but the relationship between injury severity and ED resource utilization has not been evaluated. The objective of this study was to compare resource utilization for pediatric injury-related ED visits across injury-severity levels and with non-injury visits, using standardized, validated scales. METHODS: A retrospective analysis of 2004-2008 ED visits from the Pediatric Emergency Care Applied Research Network Core Data Project...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27618167/challenges-enrolling-children-into-traumatic-brain-injury-trials-an-observational-study
#20
MULTICENTER STUDY
Rachel M Stanley, Michael D Johnson, Cheryl Vance, Lalit Bajaj, Lynn Babcock, Shireen Atabaki, Danny Thomas, Harold K Simon, Daniel M Cohen, Daniel Rubacalva, P David Adelson, Blake Bulloch, Alexander J Rogers, Prashant Mahajan, Jill Baren, Lois Lee, John Hoyle, Kimberly Quayle, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVES: In preparation for a clinical trial of therapeutic agents for children with moderate-to-severe blunt traumatic brain injuries (TBIs) in emergency departments (EDs), we conducted this feasibility study to (1) determine the number and clinical characteristics of eligible children, (2) determine the timing of patient and guardian arrival to the ED, and (3) describe the heterogeneity of TBIs on computed tomography (CT) scans. METHODS: We conducted a prospective observational study at 16 EDs of children ≤ 18 years of age presenting with blunt head trauma and Glasgow Coma Scale scores of 3-12...
January 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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