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Paediatric Emergency

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https://www.readbyqxmd.com/read/29330169/inter-rater-reliability-in-the-paediatric-observation-priority-score-pops
#1
Lisa Langton, Adam Bonfield, Damian Roland
OBJECTIVE: The primary objective of this study was to determine the level of inter-rater reliability between nursing staff for the Paediatric Observation Priority Score (POPS). DESIGN: Retrospective observational study. SETTING: Single-centre paediatric emergency department. PARTICIPANTS: 12 participants from a convenience sample of 21 nursing staff. INTERVENTIONS: Participants were shown video footage of three pre-recorded paediatric assessments and asked to record their own POPS for each child...
January 12, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29326858/improving-management-of-paediatric-buckle-fracture-in-orthopaedic-outpatients-a-completed-audit-loop
#2
M N Baig, C Egan
Introduction Paediatric patient bone fractures are the source of a large number of orthopaedic outpatient visits, especially for fracture clinics. The National Institute for Health and Care Excellence (NICE) guideline NG38 provides guidance on assessing and managing non-complex fractures, such as buckle (i.e., torus) fractures in paediatric patients. Objective We retrospectively audited outpatient records of children younger than 12 years presenting with distal radius buckle fractures for May and June 2017...
November 8, 2017: Curēus
https://www.readbyqxmd.com/read/29325595/mortality-impact-of-an-increased-blood-glucose-cut-off-level-for-hypoglycaemia-treatment-in-severely-sick-children-in-malawi-sugarfact-trial-study-protocol-for-a-randomised-controlled-trial
#3
Tim Baker, Queen Dube, Josephine Langton, Helena Hildenwall
BACKGROUND: Mortality in children remains high in sub-Saharan African hospitals. While antimalarial drugs, antibiotics and other definitive treatments are well understood, the role of emergency care with supportive therapies, such as maintaining normal glucose and electrolyte balances, has been given limited attention. Hypoglycaemia is common in children admitted to hospital in low-income settings. The current definition of hypoglycaemia is a blood glucose level < 2.5 mmol/L in a well-nourished child...
January 11, 2018: Trials
https://www.readbyqxmd.com/read/29318431/computed-tomography-use-in-a-large-italian-region-trend-analysis-2004-2014-of-emergency-and-outpatient-ct-examinations-in-children-and-adults
#4
Andrea Pola, Daniela Corbella, Andrea Righini, Alberto Torresin, Paola E Colombo, Luigi Vismara, Luca Trombetta, Michele Maddalo, Maria Vittoria Introini, Daniela Tinelli, Laura Strohmenger, Giovanna Garattini, Angelica Munari, Fabio Triulzi
OBJECTIVES: To analyse CT use in recent years in a high-density Italian area (±10 million inhabitants, including 1 million children), focusing on developing age. METHODS: Retrospective analysis of records from HealthCare IT System, covering >400 hospitals and clinics. Description of CT use between 2004-2014 in emergency and outpatient care and assessment of radiation exposure trend. RESULTS: Over 9 million scans were performed. Emergency procedures showed a global increase of 230 %, mainly head examinations...
January 9, 2018: European Radiology
https://www.readbyqxmd.com/read/29316202/anticoagulant-prophylaxis-and-therapy-in-children-current-challenges-and-emerging-issues
#5
Fiona Newall, Brian Branchford, Christoph Male
This review aims to describe the unique challenges of anticoagulant prophylaxis and treatment in children, and to highlight areas for research for improving clinical outcomes of children with thromboembolic disease. The evidence presented demonstrates the challenges of advancing the evidence-base informing optimal management of thromboembolic disease in children. Recent observational studies have identified risk factors of venous thromboembolism in children, but there are few interventional studies assessing the benefit-risk of using thromboprophylaxis in risk-stratified clinical subgroups...
January 6, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29314552/australian-multicentre-study-of-current-real-world-prophylaxis-practice-in-severe-and-moderate-haemophilia-a-and-b
#6
J A Mason, S Parikh, H Tran, J Rowell, S McRae
INTRODUCTION: With the emergence of novel treatment products for haemophilia and an increasing focus on the benefits of pharmacokinetic driven individualized prophylaxis, robust national data with regard to current patterns of factor consumption and adherence are required. AIM: To characterize current Australian practice with regard to use of prophylactic clotting factor infusions in patients with moderate or severe haemophilia A (HA) and haemophilia B (HB). METHODS: This was a retrospective, non-interventional study utilizing Australian Bleeding Disorder Registry (ABDR) data collected over a 12 month period...
January 3, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29310644/challenges-and-opportunities-for-healthcare-workers-in-a-rural-district-of-chad
#7
Fabienne N Jaeger, Mahamat Bechir, Moumini Harouna, Daugla D Moto, Jürg Utzinger
BACKGROUND: Trained healthcare workers are an essential resource for effective health systems. However, healthcare workers' perspective on healthcare, the challenges they face to provide quality health services, and opportunities to improve motivation and providing adequate care are rarely investigated in resource-constrained settings of sub-Saharan Africa. METHODS: All reachable nurses of Abou Deia, a primarily rural district in the south-eastern part of Chad, were invited to participate...
January 8, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#8
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29306373/benefit-risk-communication-in-paediatric-imaging-what-do-referring-physicians-radiographers-and-radiologists-think-say-and-do
#9
J L Portelli, J P McNulty, P Bezzina, L Rainford
INTRODUCTION: To assess how referrers and practitioners disclose benefit-risk information about medical imaging examinations to paediatric patients and their parents/guardians; to gauge their confidence in doing so; and to seek their opinion about who is responsible for disclosing such information. METHODS: This study followed on from a previously published study, with a questionnaire distributed in staggered phases to 146 radiographers, 22 radiology practitioners, 55 emergency physicians and 43 paediatricians at a primary paediatric referral centre in Malta...
February 2018: Radiography
https://www.readbyqxmd.com/read/29304841/paediatric-medical-emergency-calls-to-a-danish-emergency-medical-dispatch-centre-a-retrospective-observational-study
#10
Kasper Andersen, Søren Mikkelsen, Gitte Jørgensen, Stine Thorhauge Zwisler
BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years...
January 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29304160/a-retrospective-review-of-vital-signs-and-clinical-outcomes-of-febrile-infants-younger-than-3-months-old-presenting-to-the-emergency-department
#11
Shu-Ling Chong, Gene Yong-Kwang Ong, Wendy Yi Wen Chin, John Mingzhou Chua, Praseetha Nair, Alicia Shu Zhen Ong, Kee Chong Ng, Ian Maconochie
OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED...
2018: PloS One
https://www.readbyqxmd.com/read/29298777/prevalence-of-keratoconus-in-paediatric-patients-in-riyadh-saudi-arabia
#12
Emilio Almeida Torres Netto, Wafa Majed Al-Otaibi, Nikki L Hafezi, Sabine Kling, Haya M Al-Farhan, J Bradley Randleman, Farhad Hafezi
BACKGROUND/AIM: Keratoconus (KC) is a ectatic corneal disorder with marked progression during childhood and puberty that may lead to severe visual loss. In addition to KC prevalence, estimate shows major geographical variations; recent studies using Scheimpflug technology are in contrast to the 1980s and 1990s literature. The present study aims to determine the prevalence of KC in paediatric patients in Riyadh, Saudi Arabia (KSA). METHODS: This prospective, cross-sectional, observational, multicentre study collected data from paediatric patients from 6 years and 21 years of age who were seen at multiple non-ophthalmic emergency departments within KSA...
January 3, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29289525/review-of-the-phenotype-of-early-onset-generalised-progressive-dystonia-due-to-mutations-in-kmt2b
#13
REVIEW
K M Gorman, E Meyer, M A Kurian
In 2016, two research groups independently identified microdeletions and pathogenic variants in the lysine-specific histone methyltransferase 2B gene, KMT2B in patients with early-onset progressive dystonia. KMT2B-dystonia (DYT28) is emerging as an important and frequent cause of childhood-onset progressive generalised dystonia and is estimated to potentially account for up to 10% of early-onset generalised dystonia. Herein, we review variants in KMT2B associated with dystonia, as well as the clinical phenotype, treatment and underlying disease mechanisms...
December 15, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29287837/percutaneous-coronary-artery-interventions-in-the-paediatric-population-periprocedural-and-late-outcome
#14
Zakaria Jalal, Jean-François Piechaud, Olivier Villemain, Fidelio Sitenfane, Sophie Malekzadeh-Milani, Younes Boudjemline
BACKGROUND: Percutaneous coronary interventions (PCIs) are generally performed in adults with ischaemic heart disease, but reports of experience in the paediatric population are relatively limited. AIMS: To report indications, interventional techniques and procedural outcomes for PCI in children treated in two French institutions. METHODS: Medical records of all children in whom a PCI was attempted in two French tertiary institutions between 1998 and 2015 were systematically reviewed...
December 26, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#15
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29286272/landmark-lecture-on-surgery-paediatric-cardiothoracic-surgery-training-the-next-generation-of-congenital-heart-surgeons
#16
Vaughn A Starnes, Maura E Sullivan
Introduction Recent changes in surgical education have had an impact on our congenital training programmes. The mandate of the 8-hour workweek, a rapidly expanding knowledge base, and a host of other mandates has had an impact on the readiness of the fellows who are entering congenital programmes. To understand these issues completely, we interviewed the top congenital experts in the United States of America. The purpose of this paper is to share their insight and offer suggestions to address these challenges...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29284923/a-prerequisite-for-patient-centred-care-is-empowering-and-engaging-patients-in-the-digital-health-report-from-efmi-special-topic-conference-stc-2017
#17
Simon de Lusignan
The European Federation for Medical Informatics (EFMI) held its Special Topic Conference (STC) in October 2017 in Israel. EFMI holds STC's to focus on a particular issue, whereas its major annual conference Medical Informatics Europe (MIE) has a much wider remit. This conference challenged the informatics community to engage patients in digital health. Examples of the gap in digital engagementfrom the conference contributions include: An app to connect parents to a paediatric emergency department was presented...
December 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29284188/repeated-doses-of-salbutamol-and-aeroallergen-sensitisation-both-increased-salbutamol-induced-hypoxia-in-children-and-adolescents-with-acute-asthma
#18
Murat Ozer, Betul Buyuktiryaki, Umit Murat Sahiner, Ozlem Teksam, Betul Karaatmaca, Ozge Soyer, Bulent Enis Sekerel
AIM: We aimed to identify the frequency, magnitude and risk factors of salbutamol-induced hypoxia in children with acute asthma. METHODS: This study was conducted at Hacettepe University on children who presented to the paediatric allergy clinic or the paediatric emergency room with acute asthma between July 2014 and June 2015. Vital signs, pulse oximeter defined oxygen saturation and modified pulmonary index scores were evaluated before and after the first, second and third doses of nebulised salbutamol and repeated one and 10 days later...
December 28, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29276744/a-model-for-habitus-adjusted-paediatric-weight-estimation-by-age-and-data-concerning-the-validation-of-this-method-on-a-large-dataset-of-english-children
#19
Nicholas Appelbaum, Jonathan Clarke, Ian Maconochie, Ara Darzi
It is often not possible to weigh children upon arrival at an emergency room before commencing the provision of emergency care. Because drugs for children are prescribed on the basis of age and body weight, estimations of weight are necessitated. Age-based equations have been one of the most commonly used weight estimation strategies historically. Due to the variability of weight for age in children, and variations in body habitus, these methods are inaccurate by design (Young and Korotzer, 2016) [1].
February 2018: Data in Brief
https://www.readbyqxmd.com/read/29260375/changing-characteristics-of-hospital-admissions-but-not-the-children-admitted-a-whole-population-study-between-2000-and-2013
#20
Maryam Al-Mahtot, Rebecca Barwise-Munro, Philip Wilson, Steve Turner
There are increasing numbers of emergency medical paediatric admissions. Our hypothesis was that characteristics of children and details of their emergency admissions are also changing over time. Details of emergency admissions in Scotland 2000-2013 were analysed. There were 574,403 emergency admissions, median age 2.3 years. The age distribution, proportion of boys and socioeconomic status of children admitted were essentially unchanged. Emergency admissions rose by 49% from 36/1000 children per annum to 54/1000 between 2000 and 2013...
December 19, 2017: European Journal of Pediatrics
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