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Pediatric emergencies

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https://www.readbyqxmd.com/read/28731535/ultrasound-guided-drainage-for-pediatric-soft-tissue-abscesses-decreases-clinical-failure-rates-compared-to-drainage-without-ultrasound-a-retrospective-study
#1
Romolo Joseph Gaspari, Alexandra Sanseverino
OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records...
July 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28731404/jackson-pratt-drainage-in-pediatric-craniofacial-reconstructive-surgery-is-it-helping-or-hurting
#2
Kumar Vasudevan, Ahyuda Oh, R Shane Tubbs, David Garcia, Andrew Reisner, Joshua J Chern
OBJECTIVE Jackson-Pratt drains (JPDs) are commonly employed in pediatric craniofacial reconstructive surgery (CRFS) to reduce postoperative wound complications, but their risk profile remains unknown. Perioperative blood loss and volume shifts are major risks of CFRS. The goal of this study was to evaluate the risks of JPD usage in CFRS, particularly with regard to perioperative blood loss, hyponatremia, intensive care unit (ICU) length of stay, and postoperative wound complications. METHODS The authors performed a retrospective review of data obtained in pediatric patients who underwent CFRS at a single institution, as performed by multiple surgeons between January 2010 and December 2014...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28730629/emergency-department-use-for-acute-rhinosinusitis-insurance-dependent-for-children-and-adults
#3
Regan W Bergmark, Stacey L Ishman, Katie M Phillips, Michael J Cunningham, Ahmad R Sedaghat
OBJECTIVES/HYPOTHESIS: Patients with Medicaid or self-pay insurance status are more likely to present to the emergency department (ED) for uncomplicated acute rhinosinusitis (ARS). Our aim was to determine if this pattern holds true for both pediatric and adult visits. STUDY DESIGN: Cross-sectional study using the 2005 to 2012 National Hospital Ambulatory Medical Care Surveys and National Ambulatory Medical Care Surveys. METHODS: We included all visits with International Classification of Diseases, Ninth Revision codes for ARS and without codes for ARS complications...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28729186/-tuberculosis-treatment-for-children-an-update
#4
María José Mellado Peña, Begoña Santiago García, Fernando Baquero-Artigao, David Moreno Pérez, Roi Piñeiro Pérez, Ana Méndez Echevarría, José Tomás Ramos Amador, David Gómez-Pastrana Durán, Antoni Noguera Julian
Tuberculosis (TB) is the most important infectious disease all over the world, with a high morbidity and mortality. Pediatric tuberculosis has been a neglected epidemic, due to the difficulties in assessing its global impact, reduced incidence and lower infectivity compared to adults. In 2015, the WHO reported 1 million cases of paediatric TB and 169,000 deaths. In Europe, the emergence of MDR TB is a major concern, representing 16% of the new diagnosis in Eastern Europe. In 2014, it was estimated that about 219,000 children were infected by MDR-TB-strains in Europe, and 2,120 developed the disease...
July 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28727535/civil-unrest-in-the-context-of-chronic-community-violence-impact-on-maternal-depressive-symptoms
#5
Doris P Yimgang, Yan Wang, Grace Paik, Erin R Hager, Maureen M Black
OBJECTIVES: To examine changes in maternal-child health surrounding the April 2015 civil unrest in Baltimore, Maryland, following Freddie Gray's death while in police custody. METHODS: We conducted cross-sectional Children's HealthWatch surveys January 2014 through December 2015 in pediatric emergency departments and primary care clinics on maternal-child health and June 2015 through October 2015 on daily and community routines. We used trend analysis and piecewise logistic regression to examine effects of time, residential proximity moderation, and mediation analysis to assess proximity and maternal-child health relations via maternal concerns...
July 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28727180/why-was-a-local-anaesthetic-used-before-administering-intranasal-ketamine-for-paediatric-injuries
#6
Sabine Lemoine, Daniel Jost, Kilian Bertho, Jean Pierre Tourtier
We were very interested to read Scheier et al's brief report on the use of intranasal ketamine in their pediatric emergency department, specifically for pain and anxiety in children who had resisted venipuncture or intravenous placement (1). Intravenous access can be difficult for pre-hospital medical teams that are not specialised in paediatric care, namely when children complain of pain from, for example suspected fractures and burns. This article is protected by copyright. All rights reserved.
July 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28725844/teaching-about-better-family-clinician-partnerships-in-high-risk-pediatric-asthma-care
#7
Georgia Michalopoulou, Sherylyn Briller, Stephanie Myers-Schim, Kaitlin C Muklewicz, Kimberly Compton Katzer, Elizabeth Secord, Beverly Crider, Julia Wasiluk
Family-clinician partnership including communication, trust, respect, and power leveling is essential in pediatrics. Our case study illustrates elements supporting/hindering partnership in a high-risk urban pediatric asthma clinic. Data from observation of a 100-minute visit were qualitatively analyzed by applying codes to themes, using family-centered principles. Three key categories emerged from examining interactions and their sequencing: (1) partnership supported, (2) partnership missed, and (3) partnership hindered...
September 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28722694/early-life-vincristine-exposure-evokes-mechanical-pain-hypersensitivity-in-the-developing-rat
#8
Katie A Schappacher, Lauren Styczynski, Mark L Baccei
Vincristine (VNC) is commonly used to treat pediatric cancers, including the most prevalent childhood malignancy, acute lymphoblastic leukemia. Although clinical evidence suggests that VNC causes peripheral neuropathy in children, the degree to which pediatric chemotherapeutic regimens influence pain sensitivity throughout life remains unclear, in part because of the lack of an established animal model of chemotherapy-induced neuropathic pain during early life. Therefore, this study investigated the effects of VNC exposure between postnatal days (P) 11 and 21 on mechanical and thermal pain sensitivity in the developing rat...
May 30, 2017: Pain
https://www.readbyqxmd.com/read/28719626/impact-of-respiratory-infections-outdoor-pollen-and-socioeconomic-status-on-associations-between-air-pollutants-and-pediatric-asthma-hospital-admissions
#9
Julie E Goodman, Christine T Loftus, Xiaobin Liu, Ke Zu
BACKGROUND: Epidemiology studies have shown that ambient concentrations of ozone and fine particulate matter (PM2.5) are associated with increased emergency department (ED) visits and hospital admissions (HAs) for asthma. OBJECTIVE: Evaluate the impact of outdoor pollen, respiratory infections, and socioeconomic status (SES) on the associations between ambient ozone and PM2.5 and asthma HAs in New York City. METHODS: Daily ozone, PM2.5, meteorological factors, pollen, and hospitalization records during 1999 to 2009 were obtained for New York City residents...
2017: PloS One
https://www.readbyqxmd.com/read/28719499/a-retrospective-cohort-study-of-the-incidence-healthcare-resource-utilization-and-costs-of-icd-9-diagnosed-influenza-and-related-complications-in-us-children
#10
Philip O Buck, David M Smith, Rahul Shenolikar, Debra E Irwin
BACKGROUND: There is a paucity of data on the clinical and economic impact of seasonal influenza in children. This study estimated the incidence of diagnosed influenza and related complications, and associated healthcare resource utilization (HRU) and costs in US children. METHODS: Children ≥6 months and <18 years old diagnosed with influenza using ICD-9 codes and enrolled in a health plan during at least one influenza season between 2010-2014 were matched to similar patients without diagnosed influenza (GSK study identifier: HO-15-15728)...
July 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28719482/teaching-incision-and-drainage-perceived-educational-value-of-abscess-models
#11
Cynthia M Adams, Lise E Nigrovic, Gavin Hayes, Peter H Weinstock, Joshua Nagler
OBJECTIVES: Incision and drainage (I&D) of skin abscesses is an important procedural skill for pediatric emergency medicine providers. Practical skills training using simulation provides an opportunity to learn and gain confidence with this invasive procedure. Our objective was to assess the perceived educational value of 2 versions of an abscess model as part of an educational workshop for teaching I&D. METHODS: A combined didactic and practical skills workshop was developed for use at 2 national conferences...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719481/opioid-prescribing-practices-in-pediatric-acute-care-settings
#12
Michelle DePhillips, Jennifer Watts, Jennifer Lowry, M Denise Dowd
OBJECTIVES: Deaths due to prescription opioid overdoses are at record-high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy. The purpose of this study was to describe the opioid prescribing practices in the emergency departments and urgent care sites of a Midwestern tertiary care children's hospital system. METHODS: This retrospective medical record review examined the visits from the 2 pediatric emergency departments and 2 pediatric urgent care sites in the system from June 1, 2012, to May 31, 2013, during which an outpatient opioid prescription was written...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719480/a-rare-pediatric-case-of-posttraumatic-pseudoaneurysm-case-report-and-literature-review
#13
Ada Gu, April J Kam
Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thrill, and an audible to-and-fro murmur" (1), which can be confirmed by various imaging techniques. In this report, we describe the case of a 4-year-old boy who presented to the pediatric emergency department 3 weeks after falling and subsequently getting cut by glass...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#14
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719089/development-and-implementation-of-an-emergency-department-telephone-follow-up-system
#15
O John Ma, Mary Tanski, Beech Burns, Elizabeth F Spizman, James A Heilman
Implementing a telephone follow-up system after a patient's emergency department (ED) visit is challenging, but it may improve patient safety and care. This study's objective was to describe the development and implementation of a comprehensive ED telephone follow-up system over a 9-year period. Discharged patients who received a follow-up telephone call within 48 hours of their ED visit included all pediatric patients, those who left without being seen by a provider, and any adult patient with a "high-risk chief complaint," which was defined as a headache, visual problem, chest pain, dyspnea, abdominal pain, syncope, trauma, and neurological-related problems...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28717780/epidemiology-of-prehospital-emergency-medical-service-use-in-korean-children
#16
Se Uk Lee, Dongbum Suh, Hahn Bom Kim, Jin Hee Jung, Ki Jeong Hong, Jin Hee Lee, Hye Young Jang, Hyun Noh, Jae Yun Jung, Do Kyun Kim, Young Ho Kwak
OBJECTIVE: The aim of this study was to elucidate the epidemiology of pediatric patients transported by the National 119 Rescue Services in Korea. METHODS: We enrolled all pediatric patients (<16 years old) who used the National 119 Rescue Services in Korea between January 2006 and December 2008, and analyzed the 119 ambulance patient care record databases. RESULTS: The total number of the cases was 238,644 for 3 years. The median age was 6 years old and 59...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717779/impact-of-middle-east-respiratory-syndrome-outbreak-on-the-use-of-emergency-medical-resources-in-febrile-patients
#17
Hyunho Jeong, Sikyoung Jeong, Juseok Oh, Seon Hee Woo, Byung Hak So, Jeong Hee Wee, Ji Hoon Kim, Ji Yong Im, Seung Pill Choi, Kyoungnam Park, Byul Nim Hee Cho, Sungyoup Hong
OBJECTIVE: Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. METHODS: An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716517/lethal-suicide-attempt-with-a-mixed-drug-intoxication-of-metoprolol-and-propafenone-a-first-pediatric-case-report
#18
Ivana Kacirova, Milan Grundmann, Martin Kolek, Erika Vyskocilova-Hrudikova, Romana Urinovska, Petr Handlos
INTRODUCTION: The β1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination. CASE: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1g) and propafenone (probably 1.5-3g) in a suicide attempt...
June 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28713667/absent-congenital-cervical-pedicle-nearly-misdiagnosed-as-a-facet-dislocation-a-case-report
#19
Scott Safir, Jonathan Rasouli, Jeremy Steinberger, Branko Skovrlj, Amish Doshi, Konstantinos Margetis, Saadi Ghatan
BACKGROUND: Cervical spinal injury encompasses up to 1.5% of all pediatric injuries. Children, and more specifically infants, are a difficult subset of patients to obtain neurological exam in the setting of trauma, thus necessitating the use of cervical X-rays, CT scans, and MRI imaging. CASE DESCRIPTION: A healthy, 15-month-old boy had an unwitnessed fall down a flight of stairs and received a CT scan of the head and cervical spine in the emergency department due to cephalohematoma and mechanism of injury...
September 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/28712662/enteropathogen-detection-in-children-with-diarrhoea-or-vomiting-or-both-comparing-rectal-flocked-swabs-with-stool-specimens-an-outpatient-cohort-study
#20
Stephen B Freedman, Jianling Xie, Alberto Nettel-Aguirre, Bonita Lee, Linda Chui, Xiao-Li Pang, Ran Zhuo, Brendon Parsons, James A Dickinson, Otto G Vanderkooi, Samina Ali, Lara Osterreicher, Karen Lowerison, Phillip I Tarr
BACKGROUND: Enteropathogen detection traditionally relies on diarrhoeal stool samples, but these are inconvenient to collect if they are not immediately available, leading to suboptimum return rates of samples and delayed or missed diagnostic opportunities. We sought to compare the enteropathogen yields of rectal swabs and stool specimens in children with diarrhoea or vomiting, or both. METHODS: The Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) did a study in three outpatient cohorts in Calgary and Edmonton (AB, Canada)-children enrolled in the Pediatric Emergency Research Canada emergency departments, children receiving routine vaccinations at a Calgary health clinic, and symptomatic children who met criteria for treatment at home...
July 13, 2017: Lancet. Gastroenterology & Hepatology
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