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https://www.readbyqxmd.com/read/27862642/external-validation-of-the-pecarn-head-trauma-prediction-rules-in-japan
#1
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...
November 12, 2016: 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
#2
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...
November 17, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27850061/421-concordance-of-clinical-criteria-between-resident-and-attending-using-the-pecarn-tool
#3
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
#4
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
#5
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
#6
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 (GCS) scores of 3-12...
September 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27552618/association-of-rna-biosignatures-with-bacterial-infections-in-febrile-infants-aged-60-days-or-younger
#7
MULTICENTER STUDY
Prashant Mahajan, Nathan Kuppermann, Asuncion Mejias, Nicolas Suarez, Damien Chaussabel, T Charles Casper, Bennett Smith, Elizabeth R Alpern, Jennifer Anders, Shireen M Atabaki, Jonathan E Bennett, Stephen Blumberg, Bema Bonsu, Dominic Borgialli, Anne Brayer, Lorin Browne, Daniel M Cohen, Ellen F Crain, Andrea T Cruz, Peter S Dayan, Rajender Gattu, Richard Greenberg, John D Hoyle, David M Jaffe, Deborah A Levine, Kathleen Lillis, James G Linakis, Jared Muenzer, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Genie Roosevelt, Richard M Ruddy, Mary Saunders, Michael G Tunik, Leah Tzimenatos, Melissa Vitale, J Michael Dean, Octavio Ramilo
IMPORTANCE: Young febrile infants are at substantial risk of serious bacterial infections; however, the current culture-based diagnosis has limitations. Analysis of host expression patterns ("RNA biosignatures") in response to infections may provide an alternative diagnostic approach. OBJECTIVE: To assess whether RNA biosignatures can distinguish febrile infants aged 60 days or younger with and without serious bacterial infections. DESIGN, SETTING, AND PARTICIPANTS: Prospective observational study involving a convenience sample of febrile infants 60 days or younger evaluated for fever (temperature >38° C) in 22 emergency departments from December 2008 to December 2010 who underwent laboratory evaluations including blood cultures...
August 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27488722/validation-of-the-pecarn-clinical-decision-rule-for-children-with-minor-head-trauma-a-french-multicenter-prospective-study
#8
F Lorton, C Poullaouec, E Legallais, J Simon-Pimmel, M A Chêne, H Leroy, M Roy, E Launay, C Gras-Le Guen
BACKGROUND: To date, the Pediatric Emergency Care Applied Research Network (PECARN) rule for identifying children who are at very low risk of clinically-important traumatic brain injuries after minor head trauma has not been validated prospectively in an independent population. Our goal was to evaluate the diagnostic performance of the PECARN clinical decision rule in a French pediatric population in multiple clinical settings. METHODS: We conducted a multicenter, prospective, non-interventional cohort study of patients with minor head trauma who presented to three emergency departments in France...
August 4, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27471139/clinical-presentations-and-outcomes-of-children-with-basilar-skull-fractures-after-blunt-head-trauma
#9
Michael G Tunik, Elizabeth C Powell, Prashant Mahajan, Jeff E Schunk, Elizabeth Jacobs, Michelle Miskin, Sally Jo Zuspan, Sandra Wootton-Gorges, Shireen M Atabaki, John D Hoyle, James F Holmes, Peter S Dayan, Nathan Kuppermann
STUDY OBJECTIVE: We describe presentations and outcomes of children with basilar skull fractures in the emergency department (ED) after blunt head trauma. METHODS: This was a secondary analysis of an observational cohort of children with blunt head trauma. Basilar skull fracture was defined as physical examination signs of basilar skull fracture without basilar skull fracture on computed tomography (CT), or basilar skull fracture on CT regardless of physical examination signs of basilar skull fracture...
October 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27437059/clinical-decision-support-for-a-multicenter-trial-of-pediatric-head-trauma-development-implementation-and-lessons-learned
#10
Eric Tham, Marguerite Swietlik, Sara Deakyne, Jeffrey M Hoffman, Robert W Grundmeier, Marilyn D Paterno, Beatriz H Rocha, Molly H Schaeffer, Deepika Pabbathi, Evaline Alessandrini, Dustin Ballard, Howard S Goldberg, Nathan Kuppermann, Peter S Dayan
INTRODUCTION: For children who present to emergency departments (EDs) due to blunt head trauma, ED clinicians must decide who requires computed tomography (CT) scanning to evaluate for traumatic brain injury (TBI). The Pediatric Emergency Care Applied Research Network (PECARN) derived and validated two age-based prediction rules to identify children at very low risk of clinically-important traumatic brain injuries (ciTBIs) who do not typically require CT scans. In this case report, we describe the strategy used to implement the PECARN TBI prediction rules via electronic health record (EHR) clinical decision support (CDS) as the intervention in a multicenter clinical trial...
2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27399462/183%C3%A2-a-clinical-risk-score-for-managing-children-with-glasgow-coma-scale-13-to-15-head-injuries-and-intracranial-injury
#11
Jacob K Greenberg, Yan Yan, Christopher Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
INTRODUCTION: Although rigorous decision tools exist to evaluate the need for commuted tomography (CT) imaging in children with Glasgow Coma Scale (GCS) score 13 to 15 head injuries, the appropriate management in children with intracranial injury (ICI) on CT remains unclear. The purpose of this study was to develop a risk score to predict neurosurgical intervention (NI), a concrete measure of neurological impairment or decline requiring intensive care unit observation. METHODS: We included patients younger than 18 years with GCS score 13 to 15 that were enrolled in 1 of 25 hospitals participating in the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury study and had ICI identified on CT...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27231667/anticipated-resource-utilization-for-injury-versus-non-injury-pediatric-visits-to-emergency-departments
#12
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/27197686/performance-of-the-pediatric-glasgow-coma-scale-score-in-the-evaluation-of-children-with-blunt-head-trauma
#13
Dominic A Borgialli, Prashant Mahajan, John D Hoyle, Elizabeth C Powell, Frances M Nadel, Michael G Tunik, Adele Foerster, Lydia Dong, Michelle Miskin, Peter S Dayan, James F Holmes, Nathan Kuppermann
OBJECTIVE: The objective was to compare the accuracy of the pediatric Glasgow Coma Scale (GCS) score in preverbal children to the standard GCS score in older children for identifying those with traumatic brain injuries (TBIs) after blunt head trauma. METHODS: This was a planned secondary analysis of a large prospective observational multicenter cohort study of children with blunt head trauma. Clinical data were recorded onto case report forms before computed tomography (CT) results or clinical outcomes were known...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27194179/criteria-for-ct-and-initial-management-of-head-injured-infants-a-review
#14
Naoto Shiomi, Tadashi Echigo, Akihiko Hino, Naoya Hashimoto, Tarumi Yamaki
Criteria for computed tomography (CT) to head injured infants have not been established. Since the identification of neurological findings is difficult in infants, examination by CT may be necessary in some cases, but it may be difficult to perform CT because of problems with radiation exposure and body movement. Moreover, even though no intracranial abnormality was found immediately after injury, abnormal findings may appear after several hours. From this viewpoint, course observation after injury may be more important than CT in the initial treatment of head trauma in infants...
July 15, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/27193444/traumatic-brain-injury-in-children-role-of-cdrs-pecarn-as-a-clinical-predictive-resource-for-evaluation-of-intracranical-lesions-and-neuropsychiatric-outcomes
#15
Pietro Ferrara, Maria Cristina Basile, Livia Dell'Aquila, Flaminia Vena, Elena Coppo, Antonio Chiaretti, Alberto Verrotti, Fabrizio Paolini, Massimo Caldarelli
Cranial computed tomography (CT) is considered the gold standard for the diagnosis of traumatic brain injury (TBI). The aim of this study was to evaluate if the clinical decision rules proposed by the Pediatric Emergency Care Applied Research Network (CDRs-PECARN) are really able to identify the patients who do not need cranial CT. This study investigates the neuropsychiatric outcome after TBI according to a pediatric version of the Glasgow Outcome Scale-Extended (GOS-E Peds). We calculated the sensitivity, specificity, negative predictive value (NPV) and positive predictive value of the CDRs-PECARN in 2 age groups...
2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27120318/the-use-of-angiography-in-pediatric-blunt-abdominal-trauma-patients
#16
Stephen J Fenton, Kristin N Sandoval, Austin M Stevens, Eric R Scaife
BACKGROUND: Angiography is a common treatment used in adults with blunt abdominal trauma and/or severe pelvic fractures. The Committee on Trauma of the American College of Surgeons has recently advocated for this resource to be urgently available at pediatric trauma centers; however, its usefulness in the pediatric setting is unclear. The purpose of this study was to determine the incidence of angiography in the treatment of blunt abdominal trauma among injured children. METHODS: An analysis was performed using an established public use data set of children (younger than 18 years) treated at 20 participating trauma centers for blunt torso trauma through the Pediatric Emergency Care Applied Research Network...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27081930/the-benefits-and-challenges-of-preconsent-in-a-multisite-pediatric-sickle-cell-intervention-trial
#17
Mark Nimmer, Jason Czachor, Laura Turner, Bobbe Thomas, Ashley L Woodford, Karli Carpenter, Victor Gonzalez, Robert I Liem, Angela Ellison, T Charles Casper, David C Brousseau
Enrollment of patients in sickle cell intervention trials has been challenging due to difficulty in obtaining consent from a legal guardian and lack of collaboration between emergency medicine and hematology. We utilized education and preconsent in a pediatric multisite sickle cell intervention trial to overcome these challenges. Overall, 48 patients were enrolled after being preconsented. Variable Institutional Review Board policies related to preconsent validity and its allowable duration decreased the advantages of preconsent at some sites...
September 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27055167/radiologic-safety-events-within-a-pediatric-emergency-medicine-network
#18
Stephen M Blumberg, Prashant V Mahajan, Karen J OʼConnell, James M Chamberlain, Kathy N Shaw, Richard M Ruddy, Richard Lichenstein, Tomohiko Funai, Kathleen A Lillis
OBJECTIVES: The aim of this study was to describe the epidemiology of radiologic safety events using an analysis of deidentified incident reports (IRs) collected within a large multicenter pediatric emergency medicine network. METHODS: This study is a report of a planned subanalysis of IRs that were classified as radiologic events. The parent study was performed in the PECARN (Pediatric Emergency Care Applied Research Network). Incident reports involving radiology were classified into subtypes: delay in test, delay in results, misread or changed reading, wrong patient, wrong site, or other...
April 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/26914184/relationship-of-physician-identified-patient-race-and-ethnicity-to-use-of-computed-tomography-in-pediatric-blunt-torso-trauma
#19
JoAnne E Natale, Jill G Joseph, Alexander J Rogers, Michael Tunik, David Monroe, Benjamin Kerrey, Bema K Bonsu, Lawrence J Cook, Kent Page, Kathleen Adelgais, Kimberly Quayle, Nathan Kuppermann, James F Holmes
OBJECTIVES: The objective was to determine whether a child's race or ethnicity as determined by the treating physician is independently associated with receiving abdominal computed tomography (CT) after blunt torso trauma. METHODS: We performed a planned secondary analysis of a prospective observational cohort of children < 18 years old presenting within 24 hours of blunt torso trauma to 20 North American emergency departments (EDs) participating in a pediatric research network, 2007-2010...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26843376/presenting-characteristics-of-children-who-required-neurosurgical-intervention-for-head-injury
#20
Oren Tavor, Sirisha Boddu, Abhaya V Kulkarni
PURPOSE: The purpose of this study is to describe the presenting characteristics of a large group of children who required neurosurgical intervention (NSI) following a head injury and to retrospectively assess which of the criteria for imaging from Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE), Pediatric Emergency Care Applied Research Network (PECARN), and Canadian Assessment of Tomography for Childhood Head Injury (CATCH) clinical decision rules (CDRs) were met by these patients...
May 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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