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Pediatric AND Emergency Medicine

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https://www.readbyqxmd.com/read/29746359/evaluation-of-a-focused-cardiac-ultrasound-protocol-in-a-pediatric-emergency-department
#1
Antonio Riera, Bevin Weeks, Beth L Emerson, Lei Chen
OBJECTIVES: The objective of this study was to evaluate the implementation of a focused cardiac ultrasound (FoCUS) protocol in a pediatric emergency department (PED). METHODS: We conducted a cross-sectional, observational, quality improvement project in a PED of an urban tertiary care children's hospital. A FoCUS protocol was collaboratively developed by pediatric cardiology and pediatric emergency medicine. This included a reference document with definitions, indications, image acquisition guidelines, and interpretation expectations...
May 9, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29730649/diagnostic-accuracy-in-family-medicine-residents-using-a-clinical-decision-support-system-dxplain-a-randomized-controlled-trial
#2
Adrian Israel Martinez-Franco, Melchor Sanchez-Mendiola, Juan Jose Mazon-Ramirez, Isaias Hernandez-Torres, Carlos Rivero-Lopez, Troy Spicer, Adrian Martinez-Gonzalez
BACKGROUND: Clinical reasoning is an essential skill in physicians, required to address the challenges of accurate patient diagnoses. The goal of the study was to compare the diagnostic accuracy in Family Medicine residents, with and without the use of a clinical decision support tool (DXplain http://www.mghlcs.org/projects/dxplain). METHODS: A total of 87 first-year Family Medicine residents, training at the National Autonomous University of Mexico (UNAM) Postgraduate Studies Division in Mexico City, participated voluntarily in the study...
May 7, 2018: Diagnosis
https://www.readbyqxmd.com/read/29726431/telemedicine-in-diagnosis-treatment-and-management-of-diseases-in-children
#3
Abbas Sheikhtaheri, Farzaneh Kermani
The purpose of this study was to review different telemedicine services in diagnosis, treatment and management of various children diseases and providing an overview of systematic reviews conducted in this regard. We searched English articles published in peer-reviewed journals between 2000 to 2016. We found that tele-pediatric services have been reported in various areas such as cardiology, burn, diabetes, obesity, emergency medicine, speech and hearing loss, Ear, Nose and Throat, psychology and psychiatry, radiology, oncology, home healthcare, asthma, genetics and dentistry...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29721487/executive-function-deficits-in-seriously-ill-children-emerging-challenges-and-possibilities-for-clinical-care
#4
Annet Bluschke, Maja von der Hagen, Barbara Novotna, Veit Roessner, Christian Beste
The past years have seen an incredible increase in the quality and success rates of treatments in pediatric medicine. One of the resulting major challenges refers to the management of primary or secondary residual executive function deficits in affected children. These deficits lead to problems in the ability to acquire, understand, and apply abstract and complex knowledge and to plan, direct, and control actions. Executive functions deficits are important to consider because they are highly predictive of functioning in social and academic aspects of daily life...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29718649/synthetic-drug-intoxication-in-children-recognition-and-management-in-the-emergency-department-digest
#5
Rahul Shah, Carl R Baum, Kathryn H Pade
When children and adolescents present to the emergency department with agitation or mental status changes, intoxication from synthetic drug use should be in the differential diagnosis. Identifying the responsible compound(s) may be difficult, so asking the patient broad questions and utilizing appropriate diagnostic studies, when indicated, will aid in making the diagnosis and help identify more-serious complications. This issue discusses the challenges presented by the changing chemical formulations of synthetic cannabinoids, cathinones, and phenethylamines; outlines common presentations of intoxication from these substances; and summarizes best practices for evaluating and managing patients who present with intoxication after consumption of these synthetic drugs of abuse...
May 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#6
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29715216/sports-related-concussions-in-children-differences-in-care-and-expectations-when-seen-in-an-emergency-department-versus-a-sports-medicine-clinic
#7
Kraigher Allan OʼKeefe, Bradley Beamon, Kori L Brewer, Brock Niceler
OBJECTIVES: Patient and parent expectations can potentially influence management of care. We compared expectations in the diagnosis of concussion between patients who presented to a pediatric emergency department (ED) and those who presented to a sports medicine clinic, and if there was a difference in computed tomography (CT) scans performed. METHODS: Head-injured athletes aged 8 to 18 years presenting to a pediatric ED and a sports medicine clinic were enrolled...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29698338/physician-confidence-in-dental-trauma-treatment-and-the-introduction-of-a-dental-trauma-decision-making-pathway-for-the-pediatric-emergency-department
#8
Matthew Cully, Jennifer Cully, Paul J Nietert, M Olivia Titus
OBJECTIVES: The objectives of this study were to (1) survey and report the awareness and confidence of pediatric emergency medicine physicians in the management of dental trauma and (2) determine the prevalence of dental trauma decision-making pathway utilization in the pediatric emergency department. METHODS: A survey was distributed through e-mail to the pediatric emergency medicine discussion list via Brown University LISTSERV. The survey study included 10 questions and was multiple-choice...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29694615/criminal-liability-of-medical-professionals-in-the-s%C3%A3-o-paulo-state-court-of-appeals
#9
Isabel de Fátima Alvim Braga, Laila Zelkcovicz Ertler, Rodrigo Moreira de Aquino, Bruno de Avilla da Fonseca E Silva, Renata Bastos Mello Pereira
Objective To collect criminal justice data involving medical professionals in the São Paulo State Court of Appeals and to establish the number of criminal proceedings involving said professionals, the content of the accusations and the conviction rate per specialty. Methods A keyword search was carried out in the State Appellate Court case law website with the term "medical error" for decisions rendered from January 1st, 2011 to December 31st, 2016, and the subject "criminal law" was selected...
2018: Einstein
https://www.readbyqxmd.com/read/29685065/noninvasive-brain-stimulation-challenges-and-opportunities-for-a-new-clinical-specialty
#10
Aaron D Boes, Michael S Kelly, Nicholas T Trapp, Adam P Stern, Daniel Z Press, Alvaro Pascual-Leone
Noninvasive brain stimulation refers to a set of technologies and techniques with which to modulate the excitability of the brain via transcranial stimulation. Two major modalities of noninvasive brain stimulation are transcranial magnetic stimulation (TMS) and transcranial current stimulation. Six TMS devices now have approved uses by the U.S. Food and Drug Administration and are used in clinical practice: five for treating medication refractory depression and the sixth for presurgical mapping of motor and speech areas...
April 24, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29659856/integration-of-physical-abuse-clinical-decision-support-into-the-electronic-health-record-at-a-tertiary-care-children-s-hospital
#11
Srinivasan Suresh, Richard A Saladino, Janet Fromkin, Emily Heineman, Tom McGinn, Rudolph Richichi, Rachel P Berger
Objective: To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. Methods: A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set...
April 12, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#12
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29645365/pre-procedural-ultrasound-for-infant-lumbar-puncture-a-randomized-clinical-trial
#13
David Kessler, Vartan Pahalyants, Joshua Kriger, Gerald Behr, Peter Dayan
BACKGROUND: Our purpose was to determine the potential effect of pre-procedural ultrasound to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized ultrasound protocol. METHODS: This prospective, two-arm, parallel group randomized trial was conducted in a single-center pediatric emergency department. We compared pre-procedural ultrasound vs. palpation method on success with infant LPs...
April 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29625732/healthcare-use-patterns-and-economic-burden-of-chronic-musculoskeletal-pain-in-children-before-diagnosis
#14
Frances Tian, Patsy Guittar, Melissa Moore-Clingenpeel, Gloria Higgins, Stacy P Ardoin, Charles H Spencer, Karla Jones, Bethanne Thomas, Shoghik Akoghlanian, Sharon Bout-Tabaku
OBJECTIVES: To evaluate the healthcare use and costs of amplified musculoskeletal pain syndrome (AMPS) in children before diagnosis. STUDY DESIGN: We performed a retrospective study in children with AMPS at a pediatric rheumatology clinic between 2010 and 2014. Data were abstracted on 80 patients after primary rheumatic diseases were excluded. Healthcare visits, medications and diagnostic testing that occurred in the years before diagnosis were collected. The Medical Expenditure Panel Survey was used to estimate visit costs...
April 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29622329/pediatric-emergency-noninvasive-ventilation
#15
REVIEW
Chad D Viscusi, Garrett S Pacheco
Noninvasive ventilation (NIV) has emerged as a powerful tool for the pediatric emergency management of acute respiratory failure (ARF). This therapy is safe and well tolerated and seems to frequently prevent both the need for invasive mechanical ventilation and the associated risks/complications. Although NIV can be the primary treatment of ARF resulting from multiple respiratory disease states, it must be meticulously monitored and, when unsuccessful, may aid in preoxygenation for prompt endotracheal intubation and invasive mechanical ventilation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29618583/reducing-electrolyte-testing-in-hospitalized-children-by-using-quality-improvement-methods
#16
Michael J Tchou, Sonya Tang Girdwood, Benjamin Wormser, Meifawn Poole, Stephanie Davis-Rodriguez, J Timothy Caldwell, Lauren Shannon, Philip A Hagedorn, Eric Biondi, Jeffrey Simmons, Jeffrey Anderson, Patrick W Brady
BACKGROUND AND OBJECTIVES: Despite studies indicating a high rate of overuse, electrolyte testing remains common in pediatric inpatient care. Frequently repeated electrolyte tests often return normal results and can lead to patient harm and increased cost. We aimed to reduce electrolyte testing within a hospital medicine service by >25% within 6 months. METHODS: We conducted an improvement project in which we targeted 6 hospital medicine teams at a large academic children's hospital system by using the Model for Improvement...
April 4, 2018: Pediatrics
https://www.readbyqxmd.com/read/29608973/health-care-utilization-and-costs-associated-with-pediatric-chronic-pain
#17
Dmitry Tumin, David Drees, Rebecca Miller, Sharon Wrona, Don Hayes, Joseph D Tobias, Tarun Bhalla
The population prevalence of pediatric chronic pain is not well characterized, in part due to lack of nationally representative data. Previous research suggests that pediatric chronic pain prolongs inpatient stay and increases costs, but the population-level association between pediatric chronic pain and health care utilization is unclear. We use the 2016 National Survey of Children's Health to describe the prevalence of pediatric chronic pain, and compare health care utilization among children ages 0-17 years according to the presence of chronic pain...
March 30, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29601465/pediatric-emergency-medicine-fellowship-programs
#18
In K Kim
No abstract text is available yet for this article.
April 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29592851/development-of-a-provisional-essential-medicines-list-for-children-in-canada-consensus-process
#19
Hannah Woods, Efosa Oronsaye, Anjli Bali, Yathavan Rajakulasingam, Taehoon Lee, Norman Umali, Eyal Cohen, Yaron Finkelstein, Martin Offringa, Nav Persaud
BACKGROUND: Worldwide, many countries have developed a list of essential medicines for children to improve prescribing. We aimed to create an essential medicines list for children in Canada. METHODS: We adapted the previously created preliminary list of essential medicines for adults in Canada and the WHO Model List of Essential Medicines for Children to create a provisional list of essential medicines for children in Canada. Canadian clinicians made suggestions for changes...
March 26, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29587869/perspectives-of-health-professionals-on-the-best-care-settings-for-pediatric-trauma-casualties-a-qualitative-study
#20
Raya Madar, Bruria Adini, David Greenberg, Yehezkel Waisman, Avishay Goldberg
BACKGROUND: Critically-injured children are frequently treated by providers who lack specialty pediatric training in facilities that have not been modified for the care of children. We set out to understand the attitudes and perspectives of policy makers, and senior nursing and medical managers in the Israeli healthcare system, concerning the provision of medical care to pediatric trauma casualties in emergency departments. METHODS: We conducted semi-structured interviews with 17 health professionals from medical centers across Israel and the Ministry of Health...
March 28, 2018: Israel Journal of Health Policy Research
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