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Guideline pediatric emergency

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https://www.readbyqxmd.com/read/29212880/standardizing-the-evaluation-of-nonaccidental-trauma-in-a-large-pediatric-emergency-department
#1
Lauren C Riney, Theresa M Frey, Emily T Fain, Elena M Duma, Berkeley L Bennett, Eileen Murtagh Kurowski
BACKGROUND AND OBJECTIVES: Variability exists in the evaluation of nonaccidental trauma (NAT) in the pediatric emergency department because of misconceptions and individual bias of clinicians. Further maltreatment, injury, and death can ensue if these children are not evaluated appropriately. The implementation of guidelines for NAT evaluation has been successful in decreasing differences in care as influenced by race and ethnicity of the patient and their family. Our Specific, Measurable, Achievable, Realistic, and Timely aim was to increase the percent of patients evaluated in the emergency department for NAT who receive guideline-adherent evaluation from 47% to 80% by December 31, 2016...
December 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/29189637/strategies-for-prevention-and-management-of-bleeding-following-pediatric-cardiac-surgery-on-cardiopulmonary-bypass-a-scoping-review
#2
Kristina Siemens, Dilanee P Sangaran, Beverley J Hunt, Ian A Murdoch, Shane M Tibby
OBJECTIVE: We aimed to systematically describe, via a scoping review, the literature reporting strategies for prevention and management of mediastinal bleeding post pediatric cardiopulmonary bypass surgery. DATA SOURCES: MEDLINE, EMBASE, PubMed, and Cochrane CENTRAL Register. STUDY SELECTION: Two authors independently screened publications from 1980 to 2016 reporting the effect of therapeutic interventions on bleeding-related postoperative outcomes, including mediastinal drain loss, transfusion, chest re-exploration rate, and coagulation variables...
November 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189611/appropriate-and-inappropriate-treatment-of-acute-otitis-media-in-the-pediatric-emergency-department
#3
Sarah Rothman, Jacob Pitaro, Asher Hackett, Eran Kozer, Haim Gavriel, Limor Muallem-Kalmovich, Ephraim Eviatar, Tal Marom
BACKGROUND: Over-treatment of acute otitis media (AOM) with antibiotics is common, and poses a high burden on healthcare systems. METHODS: Records of children 6-36 months of age with AOM visiting a university-affiliated pediatric emergency department (PED) between 2014-2016 were reviewed for the treatment given: watchful waiting (WW) vs. antibiotics. If antibiotics were prescribed, the type and duration were recorded. We evaluated appropriate and inappropriate treatment rates of eligible AOM cases, in respect to the local guidelines, which encourage WW in most mild-moderate cases...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29189596/procedural-training-and-assessment-for-pediatric-emergency-medicine-physicians-within-the-united-states-and-canada-a-survey-study
#4
Rebekah A Burns, Neil G Uspal
OBJECTIVES: The aims of this study were to determine current practices in procedural training and skill assessment for attending physicians working in pediatric emergency departments within the United States and Canada and identify barriers to providing training and assessment. METHODS: This was a cross-sectional survey study. Members of the pediatric emergency medicine fellowship program directors and associate program directors Listserv were invited to participate in an anonymous survey about attending physician training and assessment practices for 9 specific procedures and barriers to training and assessment...
November 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29174941/is-delayed-phase-ct-imaging-necessary-after-blunt-renal-trauma-in-children
#5
Molly E Fuchs, Nicholas Beecroft, Daniel G Dajusta, Daryl J McLeod
Objectives To characterize the utilization of delayed phase computed tomography (CT) imaging in blunt renal trauma and determine if the omission of delayed phase CT imaging affected clinical outcomes in children. Methods A prospectively collected trauma database was reviewed between 2006 and 2016 to identify patients ≤21 years of age with a diagnosis of renal injury from blunt trauma. Demographic characteristics, injury grade, injury severity score (ISS), non-kidney organ injuries, radiologic studies, and clinical course were reviewed...
November 23, 2017: Urology
https://www.readbyqxmd.com/read/29167080/psychosocial-care-models-for-families-of-critically-ill-children-in-pediatric-emergency-department-settings-a-scoping-review
#6
Alys-Marie Manguy, Lynette Joubert, Ed Oakley, Rob Gordon
PROBLEM: Critical illness in children is a significant and stressful life event for families. Within pediatric emergency department (ED) settings it is acknowledged that these crises are challenging for both the families of these children, and for the clinical staff treating the child. Literature recommends routine care should include an offer to the family to be present with their critically ill child, however there is a lack of clarity regarding specific family care models or evidence-based interventions to guide clinical practice...
October 26, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29150146/annual-trends-in-follow-up-visits-for-pediatric-concussion-in-emergency-departments-and-physicians-offices
#7
Liraz Fridman, Michal Scolnik, Alison Macpherson, Linda Rothman, Astrid Guttmann, Anne M Grool, Daniel Rodriguez Duque, Roger L Zemek
OBJECTIVE: To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. STUDY DESIGN: We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up...
November 14, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29149393/challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#8
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#9
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29135701/verification-of-the-optimal-chest-compression-depth-for-children-in-the-2015-american-heart-association-guidelines-computed-tomography-study
#10
Yong Hwan Kim, Jun Ho Lee, Kwang Won Cho, Dong Woo Lee, Mun Ju Kang, Kyoung Yul Lee, Joung Hun Byun, Young Hwan Lee, Seong Youn Hwang, Na Kyoung Lee
OBJECTIVE: The 2015 American Heart Association guidelines recommended pediatric rescue chest compressions of at least one-third the anteroposterior diameter of the chest, which equates to approximately 5 cm. This study evaluated the appropriateness of these two types by comparing their safeties in chest compression depth simulated by CT. DESIGN: Retrospective study with data analysis conducted from January 2005 to June 2015 SETTING:: Regional emergency center in South Korea...
November 11, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29130608/impact-of-web-based-clinical-practice-guidelines-on-paediatric-fracture-clinics
#11
Mark W Camp, James R Barnes, Mohita Damany, Leo T Donnan
BACKGROUND: In an effort to standardize management and reduce over-treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web-based paediatric fracture pathways. The aim of this study was to determine the impact of web-based fracture pathways on the clinic volume at a tertiary-care paediatric fracture clinic. METHODS: A comparative retrospective review was performed at a large, urban, tertiary-care children's hospital...
November 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29123602/rehabilitation-of-vulnerable-groups-in-emergencies-and-disasters-a-systematic-review
#12
REVIEW
Hojjat Sheikhbardsiri, Mohammad H Yarmohammadian, Fatemeh Rezaei, Mohammad Reza Maracy
BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters. METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29114009/2017-american-heart-association-focused-update-on-pediatric-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#13
REVIEW
Dianne L Atkins, Allan R de Caen, Stuart Berger, Ricardo A Samson, Stephen M Schexnayder, Benny L Joyner, Blair L Bigham, Dana E Niles, Jonathan P Duff, Elizabeth A Hunt, Peter A Meaney
This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29098998/the-emergence-of-multidrug-resistant-pseudomonas-aeruginosa-in-cystic-fibrosis-patients-on-inhaled-antibiotics
#14
Atqah AbdulWahab, Khalid Zahraldin, Mazen A Sid Ahmed, Sulieman Abu Jarir, Mohammed Muneer, Shehab F Mohamed, Jemal M Hamid, Abubaker A I Hassan, Emad Bashir Ibrahim
INTRODUCTION: Multidrug-resistant Pseudomonas aeruginosa (MDR-PA) is an important and growing issue in the care of patients with cystic fibrosis (CF), and a major cause of morbidity and mortality. OBJECTIVE: The objective of the study was to describe the frequency of MDR-PA recovered from the lower respiratory samples of pediatric and adult CF patients, and its antibiotic resistance pattern to commonly used antimicrobial agents including β-lactams, aminoglycosides, and fluoroquinolones...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29094518/disparities-in-rate-triggers-and-management-in-pediatric-and-adult-cases-of-suspected-drug-induced-anaphylaxis-in-canada
#15
REVIEW
Sofianne Gabrielli, Ann E Clarke, Harley Eisman, Judy Morris, Lawrence Joseph, Sebastien La Vieille, Peter Small, Rodrick Lim, Paul Enarson, Michal Zelcer, Edmond S Chan, Chris Mill, Moshe Ben-Shoshan
INTRODUCTION: Data is sparse on drug-induced anaphylaxis (DIA) and there have not been studies assessing the differences in clinical characteristics and management of DIA between adults and children. OBJECTIVE: We assessed the percentage, diagnosis, and management of DIA among all anaphylaxis visits in three pediatric and one adult emergency departments (ED) across Canada. METHODS: Children presenting to the Montreal Children's Hospital (MCH), British Columbia Children's Hospital (BCCH), and Children's Hospital at London Health Sciences Center and adults presenting to Hôpital du Sacré-Coeur with anaphylaxis were recruited as part of the Cross-Canada Anaphylaxis Registry...
November 1, 2017: Immunity, Inflammation and Disease
https://www.readbyqxmd.com/read/29082333/understanding-online-resource-use-by-transgender-youth-and-caregivers-a-qualitative-study
#16
Yolanda N Evans, Samantha J Gridley, Julia Crouch, Alicia Wang, Megan A Moreno, Kym Ahrens, David J Breland
Purpose: This study assessed what online resources transgender youth and their caregivers use to acquire information about transgender health. Methods: Through a variety of settings, including subspecialty clinics, support groups, and online solicitation, we recruited caregivers of transgender youth aged 22 years or younger and self-identified transgender youth aged 14-22 years. We used a mixed methods approach of conducting in-person focus groups, interviews in person or through phone, and an online survey that allowed for increased flexibility for participants and to triangulate key themes from multiple data sources...
2017: Transgender Health
https://www.readbyqxmd.com/read/29071378/comparison-of-pecarn-and-catch-clinical-decision-rules-in-children-with-minor-blunt-head-trauma
#17
Ö Bozan, G Aksel, H A Kahraman, Ö Giritli, S E Eroğlu
INTRODUCTION AND PURPOSE: Computerized brain tomography (CBT) imaging plays a key role in the management of patients with head trauma, and there is an indication for CBT in moderate and severe injuries. However, it is difficult to determine an indication for CBT in patients with minor head trauma. The primary aim of this study is to compare the efficiency of the most commonly used clinical decision rules: the guidelines of the Pediatric Emergency Care Applied Research Network (PECARN), and those of the Canadian Assessment of Tomography for Childhood Head Injury (CATCH)...
October 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29068090/early-introduction-of-allergenic-foods-for-the-prevention-of-food-allergy-from-an-asian-perspective-an-apapari-consensus-statement
#18
REVIEW
E H Tham, L P Shek, H P Van Bever, P Vichyanond, M Ebisawa, G W K Wong, B W Lee
Emerging evidence for the early introduction of allergenic foods for the prevention of food allergies, such as peanut allergy in Western populations, has led to the recent publication of guidelines in the US and Europe recommending early peanut introduction for high-risk infants with severe eczema or egg allergy. Peanut allergy is, however, much less prevalent in Asia compared to the West. Varying patterns of food allergy are seen even within Asian countries - such as a predominance of wheat allergy in Japan and Thailand and shellfish allergy in Singapore and the Philippines...
October 25, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/29061499/reducing-inappropriate-testing-for-the-evaluation-of-diarrhea-among-hospitalized-patients
#19
Chad E Tewell, Thomas R Talbot, George E Nelson, Bryan D Harris, Whitney A Jones, Narinder Midha, David P Mulherin, Eric B Stephens, Anuj Thirwani, Patty W Wright
BACKGROUND: Diarrhea is one of the most common illnesses in the United States. Evaluation frequently does not follow established guidelines. To evaluate the effectiveness of a computerized physician order entry based test guidance algorithm with regards to the clinical, financial, and operational impacts. METHODS: Our population was patients with diarrheal illness at a tertiary academic medical center. The intervention was a computerized physician order entry (CPOE) based test guidance algorithm that restricted the use of stool cultures and ova and parasites testing of diarrhea in the adult inpatient location versus non-intervention sites which were the emergency department, pediatric inpatient, and outpatient locations...
October 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29048511/impact-of-implementing-national-guidelines-on-antibiotic-prescriptions-for-acute-respiratory-tract-infections-in-pediatric-emergency-departments-an-interrupted-time-series-analysis
#20
Naïm Ouldali, Xavier Bellêttre, Karen Milcent, Romain Guedj, Loïc de Pontual, Bogdan Cojocaru, Valérie Soussan-Banini, Irina Craiu, David Skurnik, Vincent Gajdos, Gérard Chéron, Robert Cohen, Corinne Alberti, François Angoulvant
Background: Many antibiotics are prescribed inappropriately in pediatric emergency departments (PEDs), but little data are available in these settings about effective interventions based on guidelines that follow the antimicrobial stewardship principle. Our aim was to assess the impact of implementing the 2011 national guidelines on antibiotic prescriptions for acute respiratory tract infection (ARTI) in PEDs. Method: We conducted a multicentric, quasiexperimental, interrupted time series analysis of prospectively collected electronic data from 7 French PEDs...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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