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Guideline pediatric emergency

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https://www.readbyqxmd.com/read/29018599/qualitative-study-of-healthcare-providers-current-practice-patterns-and-barriers-to-successful-rehydration-for-pediatric-diarrheal-illnesses-in-kenya
#1
Darlene R House, Philip Cheptinga, Daniel E Rusyniak, Rachel C Vreeman
BACKGROUND: For children worldwide, diarrhea is the second leading cause of death. These deaths are preventable by fluid resuscitation. Nasogastric tubes (NGs) have been shown to be equivalent to intravenous fluids for rehydration and recommended by the World Health Organization (WHO) for use in severe dehydration. Despite this, NGs are rarely used for rehydration in Kenya. Our objective was to evaluate clinicians' adherence to rehydration guidelines and to identify barriers to the use of NGs for resuscitating dehydrated children...
2017: PeerJ
https://www.readbyqxmd.com/read/28977717/a-collaborative-in-situ-simulation-based-pediatric-readiness-improvement-program-for-community-emergency-departments
#2
Kamal Abulebda, Riad Lutfi, Travis Whitfill, Samer Abu-Sultaneh, Kellie J Leeper, Elizabeth Weinstein, Marc A Auerbach
BACKGROUND: More than 30 million children are cared for across 5,000 US emergency departments each year (ED). Most of these EDs are not facilities designed and operated solely for children. A web-based survey provided a national and state-by-state assessment of pediatric readiness and noted a national average score was 69 on a 100-point scale. This survey noted wide variations in ED readiness with scores ranging from 61 in low-pediatric-volume EDs to 90 in the high-pediatric-volume EDs...
October 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28966488/changing-prevalence-and-antibiotic-drug-resistance-pattern-of-pathogens-seen-in-community-acquired-pediatric-urinary-tract-infections-at-a-tertiary-care-hospital-of-north-india
#3
Vrushali Patwardhan, Dinesh Kumar, Varun Goel, Sarman Singh
AIMS AND OBJECTIVES: The aim and objective of this study was to assess the temporal changes in the microbiological profiles and antimicrobial resistance patterns of uropathogens in pediatric community-acquired UTI. MATERIALS AND METHODS: This is a retrospective analysis of data collected over a Scattered period of 5 years. The baseline data collected were from January to December 2009, and the second period considered for comparison was from January to December 2014...
October 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28942942/-management-of-unintentional-pediatric-female-genital-trauma
#4
D Guerre, C Bréhin, E Gurrera, K Pinnagoda, P Galinier, I Claudet, O Abbo
INTRODUCTION: Unintentional pediatric female genital trauma is frequent in the daily practice of emergency wards. However, scientific data are rare in the literature, leading to variability in their management. The aim of this study was to evaluate our practice in order to obtain epidemiological data and define clinical guidelines. MATERIAL AND METHODS: We conducted a retrospective study from March 2013 to January 2015 and identified all emergency visits for this pathology...
September 21, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#5
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department (ED) treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
September 20, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28937299/pediatric-playground-related-injuries-treated-in-hospital-emergency-departments-in-the-united-states
#6
Sarah L Adelson, Thitphalak Chounthirath, Nichole L Hodges, Christy L Collins, Gary A Smith
This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment-related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = ...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28936143/assessment-of-readiness-of-academic-emergency-departments-in-the-central-region-of-saudi-arabia-to-receive-a-sick-child
#7
Fahad Saleh Alhajjaj, Abdullah Saleh Aldamigh
OBJECTIVE: We sought to assess the readiness of general emergency departments (EDs) in academic hospitals in the central region of the Kingdom of Saudi Arabia (KSA) to manage pediatric patients using an international tool: The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association guidelines, which include facilities, personnel, safety, and other components. METHODS: We assessed eligible centers during multiple visits from January 2016 to May 2016 in which we inspected the EDs and conducted interviews with their respective leadership in which we independently recorded our observations...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28927772/-antiglomerular-basement-disease-in-children-literature-review-and-therapeutic-options
#8
G Dorval, S Guérin, L Berteloot, S Krid, R Salomon, L Galmiche-Rolland, O Boyer
Antiglomerular basement membrane glomerulonephritis is a rare autoimmune disease characterized by rapidly progressive glomerulonephritis that may be associated with pulmonary hemorrhage (Goodpasture syndrome). The disease is caused by autoantibodies (classically IgGs) directed against the α3 subunit of type IV collagen. This is a rare disease in the adult population and extremely rare in children, with a reported cumulative annual incidence at 1/10(6) people/year. Among scarce reported pediatric cases (n=31), most are girls (M/F sex ratio, 1:4), and the mean age at diagnoses is 9...
September 15, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28921622/national-survey-on-managing-minor-childhood-traumatic-head-injuries-in-the-netherlands-shows-low-guideline-adherence-and-large-inter-hospital-variations
#9
Nicky Niele, Lonneke Willemars, Marlies van Houten, Frans B Plötz
More than 12,000 children are seen in Dutch emergency departments with a mild traumatic head injury (MTHI) every year. In The Netherlands, the paediatric MTHI guidelines are primarily based on the Pediatric Emergency Care Applied Research Network study (1). The guidelines define several criteria, based on the patient's age, to help clinicians to decide whether they need to perform a computed tomography (CT) scan (2). This national study determined the adherence to the guidelines and the reasons why clinicians deviated from them...
September 16, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28913332/the-impact-of-disclosure-on-health-and-related-outcomes-in-human-immunodeficiency-virus-infected-children-a-literature-review
#10
REVIEW
Angela Odiachi
This review explores the association between pediatric human immunodeficiency virus (HIV) disclosure and health and related outcomes among children living with HIV. A multi-stage process was used to search for relevant articles on the ISI Web of Knowledge database. Fifteen articles met the inclusion criteria. Five major outcomes emerged from children's knowledge of their HIV-seropositive status: physical/physiological outcomes; adherence to antiretroviral therapy; psychosocial outcomes; sexual and reproductive health, including HIV prevention outcomes; and disclosure of status by the children...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28888560/unintentional-cannabis-ingestion-in-children-a-systematic-review
#11
John R Richards, Nishelle E Smith, Aimee K Moulin
OBJECTIVE: To analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. STUDY DESIGN: PubMed, OpenGrey, and Google Scholar were systematically searched. Articles were selected, reviewed, and graded using Oxford Center for Evidence-Based Medicine guidelines. RESULTS: Of 3316 articles, 44 were included (3582 children age ≤12 years). We found no high quality (Oxford Center for Evidence-Based Medicine level I or II) studies and 10 level III studies documenting lethargy as the most common presenting sign and confirming increasing incidence of unintentional ingestion in states having decriminalized medical and recreational cannabis...
September 6, 2017: Journal of Pediatrics
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
#12
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/28882440/determinants-of-under-immunization-and-cumulative-time-spent-under-immunized-in-a-quebec-cohort
#13
Shauna O'Donnell, Eve Dubé, Bruce Tapiero, Arnaud Gagneur, Margaret K Doll, Caroline Quach
BACKGROUND: Under-immunization refers to a state of sub-optimal protection against vaccine preventable diseases. Vaccine coverage for age may not capture intentional or non-intentional spacing of vaccines in the recommended provincial immunization guidelines. We aimed to identify factors associated with coverage and under-immunization and to determine the number of days during which children were under-immunized during their first 24months of life. METHODS: Secondary analysis of children ≤3years recruited through active surveillance for gastroenteritis from three Quebec pediatric emergency departments from 2012 to 2014...
September 4, 2017: Vaccine
https://www.readbyqxmd.com/read/28877729/effect-of-enhanced-feedback-to-hospitals-that-are-part-of-an-emerging-clinical-information-network-on-uptake-of-revised-childhood-pneumonia-treatment-policy-study-protocol-for-a-cluster-randomized-trial
#14
Philip Ayieko, Grace Irimu, Mike English
BACKGROUND: The national pneumonia treatment guidelines in Kenya changed in February 2016 but such guideline changes are often characterized by prolonged delays in affecting practice. We designed an enhanced feedback intervention, delivered within an ongoing clinical network that provides a general form of feedback, aimed at improving and sustaining uptake of the revised pneumonia treatment policy. The objective was to determine whether an enhanced feedback intervention will improve correctness of classification and treatment of childhood pneumonia, compared to an existing approach to feedback, after nationwide treatment policy change and within an existing hospital network...
September 7, 2017: Trials
https://www.readbyqxmd.com/read/28853957/reducing-emergency-department-visits-utilizing-a-primary-care-asthma-specialty-clinic-in-a-high-risk-patient-population
#15
Dane A Snyder, Olivia W Thomas, Sean P Gleeson, David R Stukus, LaQuita M Jones, Christopher Regan, Ashley Shamansky, Elizabeth D Allen
OBJECTIVE: Asthma is a leading cause of pediatric emergency department (ED) use. Optimizing asthma outcomes is a goal of Nationwide Children's Hospital (NCH) and its affiliated Accountable Care Organization. NCH's Primary Care Network, comprised of 12 offices serving a predominantly Medicaid population, sought to determine whether an Asthma Specialty Clinic (ASC) operated within a single primary care office could reduce ED asthma rates and improve quality measures, relative to all other network offices...
August 30, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28853520/-anti-n-methyl-d-aspartate-nmda-encephalitis-the-israeli-pediatric-multi-center-experience
#16
Keren Politi, Dafna Marom, Shay Ashkenazi, Gilat Livni, Hadassa Goldberg, Avinoam Shuper, Tami Steinberg, Eli Lahat, Eli Haiman, Rachel Shtrausberg
Anti-N-methyl-D-aspartate (NMDA) encephalitis is a disorder characterized by acute neuro-psychiatric symptoms, appearing mostly after a recent febrile disease, with a gradual progressive course, associated with laboratory or radiologic evidence of active inflammation. Many of the patients will present with a continuous neuro-cognitive disorder which could lead to major morbidity and even mortality. It was recently reported that this disorder can present at childhood as a primary disease or as a secondary complication of herpes simplex infection...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28835381/reliability-of-examination-findings-in-suspected-community-acquired-pneumonia
#17
Todd A Florin, Lilliam Ambroggio, Cole Brokamp, Mantosh S Rattan, Eric J Crotty, Andrea Kachelmeyer, Richard M Ruddy, Samir S Shah
BACKGROUND: The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. METHODS: This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28830854/a-mobile-device-app-to-reduce-medication-errors-and-time-to-drug-delivery-during-pediatric-cardiopulmonary-resuscitation-study-protocol-of-a-multicenter-randomized-controlled-crossover-trial
#18
Johan N Siebert, Frederic Ehrler, Christian Lovis, Christophe Combescure, Kevin Haddad, Alain Gervaix, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusions is complex and time-consuming. The need for individual specific weight-based drug dose calculation and preparation places children at higher risk than adults for medication errors. Following an evidence-based and ergonomic driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28828034/splenic-trauma-wses-classification-and-guidelines-for-adult-and-pediatric-patients
#19
REVIEW
Federico Coccolini, Giulia Montori, Fausto Catena, Yoram Kluger, Walter Biffl, Ernest E Moore, Viktor Reva, Camilla Bing, Miklosh Bala, Paola Fugazzola, Hany Bahouth, Ingo Marzi, George Velmahos, Rao Ivatury, Kjetil Soreide, Tal Horer, Richard Ten Broek, Bruno M Pereira, Gustavo P Fraga, Kenji Inaba, Joseph Kashuk, Neil Parry, Peter T Masiakos, Konstantinos S Mylonas, Andrew Kirkpatrick, Fikri Abu-Zidan, Carlos Augusto Gomes, Simone Vasilij Benatti, Noel Naidoo, Francesco Salvetti, Stefano Maccatrozzo, Vanni Agnoletti, Emiliano Gamberini, Leonardo Solaini, Antonio Costanzo, Andrea Celotti, Matteo Tomasoni, Vladimir Khokha, Catherine Arvieux, Lena Napolitano, Lauri Handolin, Michele Pisano, Stefano Magnone, David A Spain, Marc de Moya, Kimberly A Davis, Nicola De Angelis, Ari Leppaniemi, Paula Ferrada, Rifat Latifi, David Costa Navarro, Yashuiro Otomo, Raul Coimbra, Ronald V Maier, Frederick Moore, Sandro Rizoli, Boris Sakakushev, Joseph M Galante, Osvaldo Chiara, Stefania Cimbanassi, Alain Chichom Mefire, Dieter Weber, Marco Ceresoli, Andrew B Peitzman, Liban Wehlie, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni
Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28813753/pre-guideline-trends-associated-with-chest-radiograph-usage-for-pediatric-community-acquired-pneumonia-in-emergency-department-settings
#20
Eric W Jones, Benjamin Meyer, Aaron M Berg, Benson S Hsu
BACKGROUND: Health care spending in the U.S. totaled $3 trillion in 2014 and continues to increase rapidly. Minimizing waste through clinical guidelines is a promising strategy to reduce spending without compromising patient care. In 2011, clinical guidelines recommended against the use of chest X-ray (CXR) for diagnosis of community-acquired pneumonia (CAP) in pediatric ambulatory settings. However, use of CXR has not changed post-guideline. Thus, understanding the drivers of CXR utilization prior to guideline implementation could improve guideline adherence...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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