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Emergency Pediatrics

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30 papers 0 to 25 followers
Kevin M Overmann, Todd A Florin
No abstract text is available yet for this article.
August 2016: Evidence-based Medicine
Alkan Bal, Murat Anl, Müge Nartürk, Tunç Özdemir, Ahmet Arkan, Gökhan Köylüoğlu, Burak Polat, Nuri Erdoğan, Umit Bayol, Alp Özgüzer, Ayfer Çolak
OBJECTIVE: The aim of the present study was to compare the pediatric appendicitis score (PAS), the Alvarado score (AS), white blood cell count (WBC), absolute neutrophil count (ANC), C-reactive protein (CRP) level, procalcitonin level, and ultrasound (US) data, with the appendectomy decisions of pediatric surgeons diagnosing acute appendicitis (AA) in a real-life setting; this was a top-level, high-volume pediatric emergency department (PED) in a developing country. METHODS: The study was conducted prospectively between January 2012 and June 2013 in the PED of the Tepecik Teaching and Research Hospital in Izmir, Turkey...
June 21, 2016: Pediatric Emergency Care
Kate Miller, Xianghong Tan, Andrew Dillon Hobson, Asaduzzaman Khan, Jenny Ziviani, Eavan OʼBrien, Kim Barua, Craig A McBride, Roy M Kimble
OBJECTIVES: Intravenous (IV) cannulation is commonly performed in pediatric emergency departments (EDs). The busy ED environment is often not conducive to conventional nonpharmacological pain management. This study assessed the use of Ditto (Diversionary Therapy Technologies, Brisbane, Australia), a handheld electronic device which provides procedural preparation and distraction, as a means of managing pain and distress during IV cannulation performed in the pediatric ED. METHODS: A randomized controlled trial with 98 participants, aged 3 to 12 years, was conducted in a pediatric ED...
July 2016: Pediatric Emergency Care
Daniel B Fenster, Peter S Dayan, John Babineau, Linda Aponte-Patel, Daniel S Tsze
OBJECTIVES: Abscess incision and drainage (I&D) are painful and distressing procedures in children. Intranasal (IN) fentanyl is an effective analgesic for reducing symptomatic pain associated with fractures and burns but has not been studied for reducing procedural pain during abscess I&D. Our objective was to compare the analgesic efficacy of IN fentanyl with intravenous (IV) morphine for abscess I&D in children. METHODS: We performed a randomized noninferiority trial in children aged 4 to 18 years undergoing abscess I&D in a pediatric emergency department...
July 12, 2016: Pediatric Emergency Care
Katelyn Johnson Yackey, Annie Heffernan Rominger
OBJECTIVES: There are no recent national data on analgesic use for pain treatment in children. Our objective was to determine if there is adequate pain treatment for children in US emergency departments (EDs) and determine predictors of nonopioid and opioid analgesic administration. METHODS: Children younger than 18 years with the diagnosis of extremity fracture, appendicitis, or urinary tract stones were obtained from the National Health Ambulatory Medical Care Survey (NHAMCS) (2006-2010) and analyzed using logistic regression for complex samples...
January 2018: Pediatric Emergency Care
Antoine Roul-Levy, Vincent Looten, Manon Bachy, Emmanuel Grimprel, Ricardo Carbajal, Raphaël Vialle
The treatment of acute hematogenous osteomyelitis has evolved in recent years to a shorter parenteral treatment with an early switch to the oral route. Current publications recommend a 2- to 4-day parenteral treatment before the oral switch. We retrospectively analyzed a series of 45 children aged 1 to 11 years and treated in our department for acute osteomyelitis without severity criterion. Nineteen of 45 patients were treated by an exclusive ambulatory oral treatment by amoxicillin and clavulanic acid. Twenty six of 45 patients had a 2- to 4-day parenteral treatment before the oral switch...
March 2016: Pediatric Emergency Care
Yagnaram Ravichandran, Prince Harrison, Eugene Garrow, Jennifer H Chao
Ultrasound is the initial diagnostic modality of choice for evaluation of pediatric appendicitis. We report a case that highlights the importance of pain control, distraction, focusing on the appearance of the appendix and the surrounding structures, the value of size cutoff points for appendicitis, and repeating ultrasound examinations to optimize yield.
November 2016: Pediatric Emergency Care
Adrian P Murphy, Macartan Hughes, Siobhan Mccoy, Gloria Crispino, Abel Wakai, Ronan O'Sullivan
INTRODUCTION: Acute pain is the most common symptom in the emergency setting and its optimal management continues to challenge prehospital emergency care practitioners, particularly in the paediatric population. Difficulty in establishing vascular access and fear of opiate administration to small children are recognized reasons for oligoanalgesia. Intranasal fentanyl (INF) has been shown to be as safe and effective as intravenous morphine in the treatment of severe pain in children in the Emergency Department setting...
December 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Sean K Golden, John B Harringa, Perry J Pickhardt, Alexander Ebinger, James E Svenson, Ying-Qi Zhao, Zhanhai Li, Ryan P Westergaard, William J Ehlenbach, Michael D Repplinger
OBJECTIVE: To determine whether clinical scoring systems or physician gestalt can obviate the need for computed tomography (CT) in patients with possible appendicitis. METHODS: Prospective, observational study of patients with abdominal pain at an academic emergency department (ED) from February 2012 to February 2014. Patients over 11 years old who had a CT ordered for possible appendicitis were eligible. All parameters needed to calculate the scores were recorded on standardised forms prior to CT...
July 2016: Emergency Medicine Journal: EMJ
Gary L Freed, Amy R Allen, Erin Turbitt, Caroline Nicolas, Ed Oakley
OBJECTIVE: The age band with, by far, the greatest number of ED presentations is children 0-4 years, with other paediatric age bands also among the highest. As the majority of these presentations are for lower urgency conditions, we sought to determine why parents seek ED care for their child for lower urgency conditions. METHODS: A survey study of 1150 parents or guardians of children with lower urgency conditions (triage category 4 or 5) presenting to the EDs of three public general and one paediatric specialty hospital in metropolitan Melbourne...
April 2016: Emergency Medicine Australasia: EMA
Amy C Plint, Monica Taljaard, Candice McGahern, Shannon D Scott, Jeremy M Grimshaw, Terry P Klassen, David W Johnson
OBJECTIVES: Bronchiolitis is the leading cause of hospital admission for infants, but few studies have examined management of this condition in community hospital settings. We reviewed the management of children with bronchiolitis presenting to community hospitals in Ontario. METHODS: We retrospectively reviewed a consecutive cohort of infants less than 12 months old with bronchiolitis who presented to 28 Ontario community hospitals over a two-year period. Bronchiolitis was defined as first episode of wheezing associated with signs of an upper respiratory tract infection during respiratory syncytial virus season...
November 2016: CJEM
Stephanie J Doniger, Margaret Salmon, Resa E Lewiss
We present a case series describing an infant and a child who presented with abdominal discomfort and their conditions were diagnosed with intussusception by point-of-care ultrasound. These cases illustrate how point-of-care ultrasound led to the expeditious diagnosis of intussusception.
May 2016: Pediatric Emergency Care
Andrew G Marsh, James S Robertson, Anna Godman, Jennifer Boyle, James S Huntley
BACKGROUND: Neurological examination in children presenting with upper limb fractures is often poorly performed in the Emergency Department (ED). We aimed to assess the improvement in documented neurological examination for children presenting with upper limb fractures following introduction of a simple guideline. METHODS: We developed and introduced a simple guideline for upper limb neurological assessment in children ('rock, paper, scissors, OK'). We compared documentation of neurological examination and nerve injury detection at our hospital before and after introduction of this guideline, as well as for children admitted from external hospitals (where the guideline had not been introduced)...
April 2016: Emergency Medicine Journal: EMJ
Alexandre Fabre, Julien Mancini
OBJECTIVE: The aim of this study was to ascertain the validity of the widespread belief in the existence of jinxed physicians during night duty in emergency department (ED). METHODS: We conducted a retrospective study involving 13 pediatricians with more than 12 spells of night duty (8 PM to 8.30 AM) in the ED at the "La Timone" Medical School Hospital in Marseilles, France, during the inclusion period (from November 1, 2010, to October 31, 2011) and 8 night nurses in the same ED...
October 2017: Pediatric Emergency Care
Kenneth A Michelson, Michael C Monuteaux, Mark I Neuman
OBJECTIVES: We sought to determine the extent of variation in treatment of children with anaphylaxis. METHODS: We identified children 1 month to 18 years of age presenting with a primary diagnosis of anaphylaxis to one of the 35 pediatric hospitals included in the Pediatric Health Information System between January 1, 2009, and September 30, 2013. We evaluated the variation in use of β2 agonists, glucocorticoids, histamine-1 (H1) antagonists, histamine-2 (H2) antagonists, inhaled epinephrine, intravenous fluids, and oxygen...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Naveen Poonai, Allyson Cowie, Chloe Davidson, Andréanne Benidir, Graham C Thompson, Philippe Boisclair, Stuart Harman, Michael Miller, Andreana Butter, Rod Lim, Samina Ali
OBJECTIVES: Evidence exists that analgesics are underutilized, delayed, and insufficiently dosed for emergency department (ED) patients with acute abdominal pain. For physicians practicing in a Canadian paediatric ED setting, we (1) explored theoretical practice variation in the provision of analgesia to children with acute abdominal pain; (2) identified reasons for withholding analgesia; and (3) evaluated the relationship between providing analgesia and surgical consultation. METHODS: Physician members of Paediatric Emergency Research Canada (PERC) were prospectively surveyed and presented with three scenarios of undifferentiated acute abdominal pain to assess management...
September 2016: CJEM
Aaron E Kornblith, Stephanie J Doniger
We present two cases of pediatric patients initially presenting with a clinical suspicion of acute appendicitis. In these cases, point-of-care ultrasonography was performed early in the patient's emergency department course, leading to alternate diagnoses. This article highlights a role for point-of-care ultrasound in the diagnoses of two alternate conditions that clinically mimic appendicitis: Meckel diverticulitis and acute ileocecitis. We offer a brief overview of terminology, relevant literature, and ultrasound scanning technique for the right-lower-quadrant point-of-care ultrasound evaluation...
April 2016: Pediatric Emergency Care
Y Liza Kearl, Ilene Claudius, Sol Behar, John Cooper, Ryan Dollbaum, Madhu Hardasmalani, Kevin Hardiman, Emily Rose, Genevieve Santillanes, Carl Berdahl
OBJECTIVES: Suggestive radiographic studies with nonvisualization of the appendix can present a challenge to clinicians in the evaluation of pediatric abdominal pain. The primary objective of this study was to quantify the accuracy of magnetic resonance imaging (MRI) and of ultrasound (US) in the setting of nonvisualization of the appendix. Secondary objectives reported include sensitivity of MRI and US overall and correlation between MRI and US for diagnosis of appendicitis. METHODS: Records of pediatric emergency department patients aged 3 to 21 years undergoing MRI and/or US for the evaluation of appendicitis were retrospectively reviewed...
February 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Samina Ali, Tara McGrath, Amy L Drendel
BACKGROUND: Painful procedures are common in the ED setting and beyond. Although these procedures are often essential to patient management, they can also be distressing for children, parents, and health providers. As such, it is imperative that effective pain and anxiety-minimizing strategies be used consistently in all settings where painful procedures take place for children. OBJECTIVES: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in the ED and beyond...
January 2016: Pediatric Emergency Care
Daniel Asher Abourbih, Sophie Gosselin, Eric Villeneuve, Sara Kazim
OBJECTIVES: Acetaminophen (APAP) elixir is a widely used pediatric antipyretic medication. It has been shown that up to 30% of febrile children presenting to a large urban pediatric emergency department received inadequate APAP dosages at home with errors primarily due to age-based dosing. Parental education material in the form of weight-based dosing guides has been proposed; however, validation of current recommended APAP dosages using pharmacokinetic models is needed. This study used a mathematical model of APAP absorption to predict plasma concentrations and to compare them with the range required to reach and achieve antipyresis (10-20 μg/mL)...
January 2016: Pediatric Emergency Care
2016-01-08 17:16:19
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