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Pediatric AND Emergency Medicine

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https://www.readbyqxmd.com/read/28341087/the-impact-of-a-pediatric-emergency-department-facility-verification-system-on-pediatric-mortality-rates-in-arizona
#1
Amber Rice, Jennifer Dudek, Toni Gross, Tomi St Mars, Dale Woolridge
BACKGROUND: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. OBJECTIVE: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336016/review-of-issues-and-challenges-of-practicing-emergency-medicine-above-30-000-feet-altitude-2-anonymized-cases
#2
Kam Lun Hon, Karen Ka Yan Leung
We present 2 anonymized cases to identify issues and challenges associated with long-haul in-flight medical emergencies. The first case involved a middle-aged man with a history of carditis on a systemic steroid who developed vomiting and rigor. Four physicians, including a pediatric intensivist, responded to the emergency call. In the second case, a pediatric trainee who was the only onboard medical personnel was summoned for help when a middle-aged man developed acute shortness of breath while traveling on a commercial flight...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28334565/year-end-resident-clinic-handoffs-narrative-review-and-recommendations-for-improvement
#3
Amber T Pincavage, Michael J Donnelly, John Q Young, Vineet M Arora
BACKGROUND: Year-end clinic handoffs in resident continuity clinics are an important patient safety issue. METHODS: Intervention articles addressing the year-end resident clinic handoff were identified in a targeted literature search. These articles were reviewed and abstracted to summarize the current literature. On the basis of these reviews and consensus expert opinion, recommendations to improve year-end clinic handoffs were developed. RESULTS: Of 23 identified articles, 10 intervention articles in the fields of internal medicine, internal medicine-pediatrics, psychiatry, and family medicine were ultimately included...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328696/enterocolitis-in-a-child-with-hirschsprung-disease
#4
Alexander W D Guillaume, Andrew C Miller, Michael C Nguyen
Hirschsprung disease is a congenital abnormality that can be surgically corrected. However, Hirschsprung-associated enterocolitis can be a life-threatening sequela. Very little has been published in the emergency medicine literature about the risk of enterocolitis and shock in patients with a history of Hirschsprung disease. We describe the case of a 6-month-old male infant with a history of multiple surgeries for Hirschsprung disease who presented to the emergency department with a seemingly benign viral gastrointestinal illness...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328691/factors-associated-with-discharge-home-after-transfer-to-a-pediatric-emergency-department
#5
Erin R Peebles, Michael R Miller, Tim P Lynch, Janice A Tijssen
OBJECTIVES: The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building. METHODS: We conducted a retrospective chart review of all patients (aged 0-17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#6
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28301267/hypotonic-hyporesponsive-episodes-after-administration-of-hexavalent-dtp-based-combination-vaccine-a-description-of-12-cases
#7
Alessandro Vigo, Giulia Costagliola, Elisa Ferrero, Silvia Noce
Hypotonic-hyporesponsive (HHE) episodes are known and recognized phenomena, which typically occur within 48 hours of immunisation..Our aim is to describe 12 cases of HHE brought to the Center of Pediatric Sleep Medicine, with attention to the clinical features of the episode and their follow-up. Medical charts of infants visited between 2005-2015 were reviewed. Twelve infants showed a HHE using HHE using Brighton Collaboration Criteria. All infants received a Hexavalent diphtheria -tetanus -pertussis acellular component -hepatitis B-,inactivated poliovirus- Haemophilus influenzae type-b conjugate vaccine...
February 21, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28291151/research-interest-in-pediatric-emergency-medicine-fellows
#8
Kenneth A Michelson, Lise E Nigrovic, Joshua Nagler, Constance M McAneney, Rakesh D Mistry
OBJECTIVE: Factors predictive of research career interest among pediatric emergency medicine (PEM) fellows are not known. We sought to determine the prevalence and determinants of interest in research careers among PEM fellows. METHODS: We performed an electronically distributed national survey of current PEM fellows. We assessed demographics, barriers to successful research, and beliefs about research using 4-point ordinal scales. The primary outcome was the fellow-reported predicted percentage of time devoted to clinical research 5 years after graduation...
March 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#9
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#10
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28282104/retrospective-analysis-of-emerging-drugs-use-in-a-quebec-women-s-and-children-s-university-hospital-and-perspectives-for-safe-and-optimal-drug-use
#11
Jennifer Corny, Elaine Pelletier, Denis Lebel, Jean-François Bussières
BACKGROUND: Only few medicines are licensed for children. The use of emerging drugs (unmarketed drug, off-label drug with poorly documented use, and/or costly drugs) might represent an essential alternative for pediatric patients. OBJECTIVES: The objective of the study was to assess emerging drug uses rate and profile in our women's and children's centre to support the implementation of an appropriate policy. METHODS: We identified retrospectively emerging drugs used between 2013-01-01 and 2014-02-28, using computerized pharmacist software extraction of drugs used...
March 10, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#12
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28261576/personalized-medicine-in-allergic-asthma-at-the-crossroads-of-allergen-immunotherapy-and-biologicals
#13
REVIEW
Benedikt Fritzsching
Major allergic disease can be viewed as clinical syndromes rather than discrete disease entities. Emerging evidence indicates that allergic asthma includes several disease phenotypes. Immunological deviation toward high T helper cell type 2 cytokine levels has been demonstrated for a subgroup of pediatric asthma patients, and now, several novel monoclonal antibodies have been approved for treatment of this subgroup as a stratified approach of "personalized" medicine in allergy. Introduction of component-based IgE testing before allergen immunotherapy (AIT), i...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28249260/standing-posture-at-work-does-not-increase-the-risk-of-varicose-vein-in-health-care-providers-in-taiwan
#14
Hsin-Kai Huang, Shih-Feng Weng, Shih-Bin Su, Jhi-Joung Wang, How-Ran Guo, Chien-Chin Hsu, Chien-Cheng Huang, Hung-Jung Lin
OBJECTIVE: This study compared the risk of varicose vein (VV) among physicians, non-physician health care providers (HCPs), and general population. SUBJECTS AND METHODS: The Taiwan National Health Insurance Research Database was used to identify 28,844 physicians, 26,099 non-physician HCPs, and age- and sex-matched identical number of patients from the general population. Using logistic regression analyses, the VV risk between physicians and general population, non-physician HCPs and general population, physicians and non-physician HCPs, and among physician specialists was compared by tracing their medical history between 2007 and 2011...
February 28, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28248760/precision-medicine-with-point-of-care-ultrasound-the-future-of-personalized-pediatric-emergency-care
#15
David Kessler, Lorraine Ng, Mark Tessaro, Jason Fischer
The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual needs of each patient's disease process. Three-dimensional printing allows medical devices and implants to be custom made-to-order. Technological advances in preoperative imaging have augmented the ability for surgeons to plan a specific surgical approach for each patient...
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28246349/pediatric-hospital-medicine-a-proposed-new-subspecialty
#16
Douglas J Barrett, Gail A McGuinness, Christopher A Cunha, S Jean Emans, William T Gerson, Mary F Hazinski, George Lister, Karen F Murray, Joseph W St Geme, Patricia N Whitley-Williams
Over the past 20 years, hospitalists have emerged as a distinct group of pediatric practitioners. In August of 2014, the American Board of Pediatrics (ABP) received a petition to consider recommending that pediatric hospital medicine (PHM) be recognized as a distinct new subspecialty. PHM as a formal subspecialty raises important considerations related to: (1) quality, cost, and access to pediatric health care; (2) current pediatric residency training; (3) the evolving body of knowledge in pediatrics; and (4) the impact on both primary care generalists and existing subspecialists...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28238498/legal-social-ethical-and-medical-perspectives-on-the-care-of-the-statutory-rape-adolescent-in-the-emergency-department
#17
Shiu-Lin Tsai, Elvira Acosta, Toni Cardenas, Jeremy K Sigall, Kevin Van Geem
Rapes involving adolescents who present to the emergency department (ED) are fraught with ethical and legal complexities and are often emotionally turbulent for patients, their families, and medical providers. Management requires a thoughtful approach from multiple standpoints, including legal, psychosocial, ethical, and medical ones. However, there is no standardized sexual assault education for emergency medicine residents, and management practices vary widely.(1,2) We present a hypothetical statutory rape case based on real cases that occurred in New York City and bring together the perspectives of an attorney on the legal parameters, two social workers on the psychosocial issues, an ethicist on the moral considerations, and a pediatric emergency physician-who is also a sexual assault forensic examiner-on the medical treatments...
February 24, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#18
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224938/overview-on-the-challenges-and-benefits-of-using-telehealth-tools-in-a-pediatric-population
#19
REVIEW
Patrick D Brophy
Telehealth in Pediatric Medicine presents many of the same benefits and challenges noted in adult-based medicine. In terms of health care delivery, the promise of improving access and reducing costs using telehealth in Pediatrics, particularly chronic care, is high. The ability to address clinician shortages and provide remote guidance for chronic care pathways from pediatric subspecialists to rural-based referring physicians is a developing model that represents a sustainable and cost-effective strategy to improve pediatric care...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28178918/global-health-training-among-u-s-residency-specialties-a-systematic-literature-review
#20
Duncan K Hau, Luke R Smart, Jennifer I DiPace, Robert N Peck
BACKGROUND: Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. METHODS: We searched PubMed from its earliest dates until October 2015...
2017: Medical Education Online
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