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Pediatric AND Emergency Medicine

Shiva Kalidindi, Thomas A Lacy
Emergencies do occur in pediatric primary care offices. The American Academy of Pediatrics Committee on Pediatric Emergency Medicine recommends that primary care offices perform a self-assessment of office readiness for emergencies. Primary care offices should develop an emergency response plan to recognize, stabilize, and transfer sick children. They should also ensure their offices have the essential equipment, supplies, and medications readily available in case of emergencies. Primary care offices can prepare and practice for office emergencies through "mock codes" and by maintaining certification in basic and advanced life support courses...
March 1, 2018: Pediatric Annals
Jennifer Setlik
No abstract text is available yet for this article.
March 1, 2018: Pediatric Annals
Vanessa A Thomas, Heather L Crouse, Kristy O Murray, Deborah C Hsu, Elizabeth A Camp, Andrea T Cruz
OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations...
March 12, 2018: Pediatric Emergency Care
Mackensie A Yore, Matthew C Strehlow, Lily D Yan, Elizabeth A Pirrotta, Joan L Woods, Koy Somontha, Yim Sovannra, Lauren Auerbach, Rebecca Backer, Christophe Grundmann, Swaminatha V Mahadevan
BACKGROUND: Emergency medicine is a young specialty in many low- and middle-income countries (LMICs). Although many patients seeking emergency or acute care are children, little information is available about the needs and current treatment of this group in LMICs. In this observational study, we sought to describe characteristics, chief complaints, management, and outcomes of children presenting for unscheduled visits to two Cambodian public hospitals. METHODS: Children enrolled in the study presented without appointment for treatment at one of two Cambodian public referral hospitals during a 4-week period in 2012...
March 13, 2018: International Journal of Emergency Medicine
Ahmad Khobrani, Nirali H Patel, Richard L George, Neil L McNinch, Rami A Ahmed
Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees' basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern's curricular conceptual framework...
2018: Emergency Medicine International
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
Caroline C Swift, Meryle J Eklund, Jacqueline M Kraveka, Adina L Alazraki
Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system. It is the most common extracranial solid tumor of childhood and accounts for up to 15% of all pediatric cancer fatalities. The manifestation of neuroblastoma is variable depending on the location of the tumor and on the presence or absence of paraneoplastic syndromes. The prognosis of neuroblastoma is also highly variable, ranging from spontaneous regression to widespread metastatic disease that is unresponsive to treatment. The age of the patient, stage of disease, histopathologic results, and multiple biologic factors contribute to the presurgical and pretreatment risk stratification of a patient with neuroblastoma...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Corrie E McDaniel, Wren Haaland, Joshua Parlaman, Chuan Zhou, Arti D Desai
OBJECTIVES: The majority of children with community acquired pneumonia (CAP) are primarily evaluated in community hospital emergency departments (EDs); however, studies on the management of pediatric CAP have largely targeted care provided in free-standing children's hospital EDs or inpatient settings. The objectives of this study were to examine whether implementation of a CAP pathway within three community hospital EDs and inpatient units improved process measures related to appropriate laboratory testing and antibiotic prescribing, and to compare performance on these measures between the community hospitals and a free-standing children's hospital...
March 7, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Caroline R Paul, Meg G Keeley, Gregory S Rebella, John Frohna
OBJECTIVES: To evaluate a pediatric otoscopy curriculum with use of outcome measures that included assessment of skills with real patients. METHODS: Thirty-three residents in an intervention group from two institutions received the curriculum. In the prior year, 21 residents in a non-intervention group did not receive the curriculum. Both groups were evaluated at the beginning and end of their internship year with the same outcome assessments: 1) a written test 2) an Objective Standardized Clinical Examination (OSCE), and 3) direct observation of skills in real patients using a checklist with established validity...
February 27, 2018: Academic Pediatrics
Wenti Xu, Liru Guo, Xiaochun Dong, Xiaoxia Li, Penghui Zhou, Qiang Ni, Xinying Zhou, Abram L Wagner, Lin Li
Severe acute respiratory infection (SARI) occupies a huge disease and economic burden in the world. The aim of this study was to describe the frequency and types of different infectious etiologies among hospitalized patients with SARI in Tianjin, China, from 2015-2016. SARI patients' basic information was collected, along with a throat or serum sample. Nine viruses were detected by RT-PCR, and Mycoplasma pneumoniae was detected by the serodia Myco II gelatin particle agglutination test. 585 specimens from 2290 SARI cases were collected...
February 28, 2018: Japanese Journal of Infectious Diseases
Asalim Thabet, Tyler Greenfield, Richard M Cantor, Bryan Wilson
Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis...
March 1, 2018: Pediatric Emergency Medicine Practice
Meredith Merz Lind, Marco Corridore, Cameron Sheehan, Melissa Moore-Clingenpeel, Tensing Maa
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Samantha W Gee, Philip L Holt, Michael J Stoner
INTRODUCTION: Critically ill children who require transfer to tertiary care centers often require transport by specialized transport teams (TT). These interfacility transports require a medical control physician (MCP). Traditionally this role is assigned to fellows who are taught "on-the-job", but achieving competency in communication for those trained this way may not be optimal. We sought to close this curriculum gap by developing a MCP training program immersing emergency medicine (EM) and critical care (CC) fellows together with TT members to manage a simulated patient...
March 2018: Air Medical Journal
Leah K Crockett, Carly Leggett, Janet A Curran, Lisa Knisley, Gwenyth Brockman, Shannon D Scott, Lisa Hartling, Mona Jabbour, Terry P Klassen
CLINICIAN'S CAPSULE What is known about this topic? Evidence-based pediatric emergency care is variably applied across general and pediatric emergency departments. What did this study ask? What are the information-seeking patterns of pediatric emergency medicine network members? What did this study find? There remains a need to share successful methods of local dissemination and implementation across the network, and to leverage local professional champions such as clinical nurse liaisons. Why does this study matter to clinicians? Tailoring knowledge mobilization efforts to end-user priorities is essential to ensure impact and spread of outreach efforts...
February 22, 2018: CJEM
Idio Alves de Sousa Filho, Tatiane Martins Lobo, Cesar Koppe Grisolia, Ingrid Távora Weber, Marly Eiko Osugi
Etoposide is an antineoplastic agent used for treating lung cancer, testicular cancer, breast cancer, pediatric cancers, and lymphomas. It is a pollutant due to its mutagenic and carcinogenic potential. Disposal of waste from this drug is still insufficiently safe, and there is no appropriate waste treatment. Therefore, it is important to use advanced oxidative processes (AOPs) for the treatment and disposal of medicines like this. The use of strontium stannate (SrSnO3 ) as a catalyst in heterogeneous photocatalysis reactions has emerged as an alternative for the removal of organic pollutants...
February 20, 2018: Environmental Science and Pollution Research International
Lena M Napolitano, Venkatakrishna Rajajee, Kyle J Gunnerson, Michael D Maile, Michael Quasney, Robert C Hyzy
Critical care fellowship training in the United States differs based on specific specialty, and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine and neurocritical care training pathways. We provide an update regarding the number and growth of U.S. critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education (ACGME) and specialty boards [American Board of Internal Medicine (ABIM), American Board of Surgery (ABS), American Board of Anesthesiology (ABA), American Board of Pediatrics (ABP), American Board of Emergency Medicine (ABEM)] and the United Council for Neurologic Subspecialties (UCNS) for the last 16 years (2001-2017)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Lee Benjamin, Karen Frush, Kathy Shaw, Joan E Shook, Sally K Snow
No abstract text is available yet for this article.
March 2018: Annals of Emergency Medicine
Joanna Thomson, Heidi Sucharew, Andrea T Cruz, Lise E Nigrovic, Stephen B Freedman, Aris C Garro, Fran Balamuth, Rakesh D Mistry, Joseph L Arms, Paul T Ishimine, Dina M Kulik, Mark I Neuman, Samir S Shah
OBJECTIVES: To determine age-specific reference values and quantify age-related changes for cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein and glucose concentrations in infants ≤60 days of age. METHODS: This multicenter, cross-sectional study included infants ≤60 days old with CSF cultures and complete CSF profiles obtained within 24 hours of presentation. Those with conditions suspected or known to cause abnormal CSF parameters (eg, meningitis) and those with a hospital length of stay of >72 hours were excluded...
February 2, 2018: Pediatrics
Anupam B Kharbanda, Eric W Christensen, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Richard G Bachur, Jonathan E Bennett, Kelly Sinclair, Brianna McMichael, Peter S Dayan
OBJECTIVE: The use of computed tomography (CT) and ultrasound (US) in patients with acute abdominal pain has substantial variation across pediatric emergency departments (ED). This study compares the cost of diagnosing and treating suspected appendicitis across a multi-center network of children's hospitals. METHODS: This study is a secondary analysis using de-identified data of a prospective, observational study of patients with suspected appendicitis at nine pediatric EDs...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Hugo Paquin, Ilana Bank, Meredith Young, Lily H P Nguyen, Rachel Fisher, Peter Nugus
Purpose Complex clinical situations, involving multiple medical specialists, create potential for tension or lack of clarity over leadership roles and may result in miscommunication, errors and poor patient outcomes. Even though copresence has been shown to overcome some differences among team members, the coordination literature provides little guidance on the relationship between coordination and leadership in highly specialized health settings. The purpose of this paper is to determine how different specialties involved in critical medical situations perceive the role of a leader and its contribution to effective crisis management, to better define leadership and improve interdisciplinary leadership and education...
February 5, 2018: Leadership in Health Services
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