Putative Mechanisms Associated With Lipid Emulsion Treatment for Cardiac Toxicity Caused by Yew Intoxication
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Letter to the Editor Source Type: research

Reliability of Smartphone-based Instant Messaging Application for Diagnosis, Classification, and Decision Making in Pediatric Orthopedic Trauma: Methodological Issue
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Letter to the Editor Source Type: research

“Lego Sign” at Esophagogastric Junction
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Letter to the Editor Source Type: research

Utilization of Imaging in the Management of Pediatric Dog Bites
Conclusions Our review indicates that imaging studies are overused in the initial workup of these patients, and the majority of these studies are negative. This study confirms that it is feasible to institute guidelines for ordering imaging studies in dog bite patients. This will ultimately reduce radiation exposure and the cost of care for these injuries. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Improving Intubation Success in Pediatric and Neonatal Transport Using Simulation
Background Pediatric and neonatal first-pass intubation rates are higher in adult trained retrieval services than in neonatal or pediatric trained services. Some authors have attributed this to more frequent opportunities to practice the skill in the adult population. Objective The aim of this study was to increase the first-pass intubation rate without adverse events by introducing daily intubation simulation at our mixed neonatal and pediatric retrieval service. Methods This prospective cohort study performed from July to December 2018 in our mixed neonatal and pediatric retrieval service involved 16 me...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Low Concordance Between Pediatric Emergency Attendings and Pediatric Residents for Predictors of Serious Intracranial Injury
Conclusions Resident assessment of children presenting to the ED with minor head trauma is often poorly concordant with attending assessment on the major predictors of clinically important traumatic brain injury (abnormal GCS, AMS, signs of skull fracture) based on the PECARN-CDR. Future work may explore the reasons for low concordance and seek ways to improve pediatric resident education in the diagnosis and management of trauma. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Patient and Visit Characteristics of Pediatric Patients With High-frequency Low-acuity Emergency Department Visits
Conclusions In our sample, most high-frequency low-acuity ED patients were infants, African American and have public insurance. Many are seen during clinic hours and are paneled at affiliated clinics. Among superusers, the majority of the visits did not require any testing, intervention, or treatment. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Poorly Controlled Pediatric Fracture Pain Requiring Unplanned Medical Assistance or Advice
Conclusions A notable proportion of children seek assistance for poorly controlled fracture-related pain. Medical providers should target discharge instructions to the identified risk factors and engage caregivers in shared decision making if opioids are recommended. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Hypoglycemia in a Pediatric Emergency Department: Single-Center Experience on 402 Children
This study aimed to establish the rate, etiology, and short-term outcome of hypoglycemia in infants and children accessing an emergency department of a tertiary care pediatric hospital. Methods The study was retrospectively conducted on the clinical records of children with hypoglycemia aged 15 days to 17 years who were admitted consecutively to the emergency department during a 6-year period for various clinical conditions. Hypoglycemia was defined as a venous plasma glucose level lower than 45 mg/dL. Results Hypoglycemia was detected in 402 patients (female-to-male ratio, 1.26; mean age, 2.6 ± 1.8 ye...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Respiratory Pathogen Detection in Pediatric Patients Intubated for Presumed Infection
Conclusions Bacterial codetection is common and not associated with anticipated patient-related factors or with a specific virus. These results suggest consideration of empiric antibiotics in infants with respiratory illness requiring intubation. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Screening Electrocardiograms Have Low Utility in Medical Clearance Before Pediatric Inpatient Psychiatric Admission
Conclusions In the absence of concerning individual or family history or cardiac symptoms, routine screening ECGs as part of medical clearance for psychiatric admission are not warranted given the low yield of meaningful findings. The decision to obtain an ECG should be made with careful consideration of medical history and in the presence of specific indications. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Antibiotic Prescribing Errors in Patients Discharged From the Pediatric Emergency Department
Objectives The pediatric emergency department (PED) is an especially high-risk setting for medication errors. Several factors contribute to this risk including the need to provide care to complex patients who are unknown to staff, the frequent use of verbal orders, and the necessity of weight-based dosing. This investigation sought to assess one potentially error-prone event, antibiotic prescriptions written for patients being discharged from the PED, and to characterize the occurrence of medication errors to identify opportunities for improvement. Methods This was a retrospective study of pediatric patients see...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Childhood Acute Urticaria and Seasonal Patterns Presenting in the Emergency Department of a Teaching Hospital in London, United Kingdom
Conclusions A total of 163 cases of AU were identified between January 2018 and January 2020. A seasonal trend of AU in autumn was observed. Respiratory infections were found to be the most commonly associated potential trigger of AU cases. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Medical Emergencies and Injury Prevention Practices in the Pediatric Emergency Unit of Kenyatta National Hospital, Nairobi, Kenya
Conclusions Chief complaints and diagnoses in the PEU population were congruent with communicable disease burdens seen globally. Measures for primary injury prevention were reported as rarely used in the sample studied. The epidemiology described by this study provides a framework for improving public health education and provider training in resource-limited settings. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department
Conclusions At our center, infusion of vasoactive drugs through a PVL was shown to be safe and allowed for adherence to the current guidelines for pediatric septic shock. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Impact of Pediatric Emergency Care Applied Research Network Rules on Admission, Cranial Computed Tomography and Skull X-ray Rates in a Central European Hospital
Objectives Mild head injury is a common cause of pediatric emergency department visits. Cranial computed tomography (CCT) is the diagnostic standard, although it involves inherent radiation risks. Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules were developed to reduce the number of CCT scans. They provide a guideline for CCT use in mild head injuries, based on clinical parameters. Our study aims to evaluate the impact of PECARN rules on hospital admission and CCT rate in children with mild head injury. Methods In this retrospective study, we investigated 729 children with...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Helmets Protect Pediatric Bicyclists From Head Injury and Do Not Increase Risk of Cervical Spine Injury
This study sought to determine the incidence of helmeted riders among pediatric bicyclists involved in a collision and hypothesized the risk of a serious head and cervical spine injuries to be higher in nonhelmeted bicyclists (NHBs) compared with helmeted bicyclists (HBs). Methods The Pediatric Trauma Quality Improvement Program (2014–2016) was queried for pediatric (age (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Recognition and Outcomes of Pneumococcal Meningitis in 2 Tertiary Pediatric Hospitals Since the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine
This study used a retrospective analysis of pediatric pneumococcal meningitis cases at 2 tertiary healthcare systems in the Southeastern United States from 2010 to 2018. Results We describe 21 cases of pneumococcal meningitis. All patients presented with fever, 95% had altered mental status by history or examination, and 48% had meningeal signs. Forty-three percent had seen another provider within 48 hours of admission. Forty-eight percent had delay in lumbar puncture (LP) of more than 6 hours after antibiotic administration, decreasing rates of positive cerebrospinal fluid cultures from 100% to 40% (P (Source: Pedi...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Trauma Arrival Times and the Swing Shift
Background Trauma center staff and trainees are often assigned to a day and night shift. However, for adult trauma, the swing shift has been found to offer superior clinical exposure compared with a standard day or night shift for trainees. We characterized patterns in pediatric trauma arrival times based on the hour, weekday, and month and studied whether or not the swing shift also maximizes exposure to hands-on experiences in managing pediatric trauma. Methods We performed a retrospective review of the trauma database at our urban, level 2 pediatric trauma center. We identified all the pediatric trauma activa...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Design and Test of a Graphic Medication Dosage Calculator in Paramedic Practice With Children
Discussion The results show that the graphic calculator was usable, more effective, efficient, and preferred compared with the current dosage calculation method. Technologies such as the graphic calculator designed and tested in this study can help not only with the rare cases, such as pediatrics, but might also mitigate skill decay. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Quality of Resuscitative Care Provided to an Infant With Abusive Head Trauma in Community Emergency Departments: An In Situ, Prospective, Simulation-Based Study
Conclusions This study used in situ simulation to describe quality of resuscitative care provided to an infant presenting with AHT across a diverse set of CEDs, revealing variability in the initial recognition and stabilizing efforts and provided and targets for improvement. Future interventions focusing on reducing these gaps could improve the performance of CED providers and lead to improved patient outcomes. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Quality Indicators for Children With Traumatic Brain Injury After Transition to an American College of Surgeons Level I Pediatric Trauma Center
Objective The aim of the study was to compare quality indicators, including frequency of acute surgical and emergent interventions, and resource utilization before and after American College of Surgeons (ACS) level I trauma verification among children with moderate or severe traumatic brain injury (TBI). Methods This is a retrospective review of patients younger than 18 years treated for moderate or severe TBI, as determined by International Classification of Disease codes. Our institution obtained ACS level I trauma verification in 2013. Outcomes during the pre-ACS (June 2003–May 2008), interim (June 2008...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

National Survey to Describe the Current Patterns of Procedural Sedation Practices Among Pediatric Emergency Medicine Practitioners in the United States
Conclusions Our study demonstrates a wide variability in several aspects of PPS and low adherence to national PPS guidelines. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Assessing the Necessity for the “Joint Above and Below” Radiography Approach for Lower-extremity Long Bone Fractures in Children
Objectives A common strategy for evaluation of extremity fractures is the “joint above and below” (JAB) radiograph approach, which includes dedicated imaging of the joint proximal and distal to a fracture independent of clinical suspicion for an injury involving the joint. The incidence of concomitant ipsilateral lower-extremity fractures or dislocations associated with lower-extremity long bone fractures in children has not been commonly reported and represents an evidential gap for determining a radiograph approach. Our purpose was to determine the frequency of and risk factors for concomitant ipsilateral...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Do Victims of Abusive Head Trauma Visit Emergency Departments More Often Than Children Hospitalized for Fever? A Case-Control Study
Objective During the first years of life, infant crying is a common trigger of abusive head trauma (AHT). Emergency department (ED) use by AHT victims before visits for child abuse symptoms is not well known, particularly for infant crying. Furthermore, diagnosis could be missed. In the same period, fever is a common reason for hospitalization unconnected with AHT. The main goal of our study was to compare the ED use by AHT victims before visits for child abuse symptoms and by children of the same age hospitalized for fever. Methods We conducted a retrospective case-control study from 2011 to June 2018 in a Fren...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Determining Intentionality of Pediatric Firearm Injuries by International Classification of Disease Code
The objective of this study was to assess the validity of documented ICD codes for firearm injury intent compared with chart review. Methods We performed a retrospective cohort study of children ( (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Use of Cardiac Point-of-Care Ultrasound in the Pediatric Emergency Department
Conclusions Cardiac POCUS is both sensitive and specific for identifying pericardial effusion and left ventricular systolic dysfunction when performed by PEM attendings with focused training. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Critical Care Transport: Survey of Current State in Latin America. Latin American Society of Pediatric Intensive Care Transport Committee
Conclusions In LA, there is a great variability in personnel training, equipment for pediatric-neonatal transport, transport team composition, and characterization of critical care transport systems. Continued efforts to improve conditions in our countries by generating documents that standardize practices and generating scientific information on the epidemiology of pediatric transfers, especially of critically ill patients, may help reduce patient morbidity and mortality. Transport of the critically ill and injured pediatric patient often represents a challenge especially in resource-limited setting. The regional h...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Impact of Terbutaline as Adjuvant Therapy in the Treatment of Severe Asthma in the Pediatric Emergency Department
Objective Methods Patients were identified using a retrospective cohort analysis from a single, tertiary care, urban children's hospital. Patients presenting directly to our emergency department aged 2 to 18 years were included if they had a diagnosis of severe asthma exacerbation, defined by an initial Respiratory Clinical Score (RCS) of 9 or higher. A total of 787 patients were identified during the study timeframe (December 16, 2017, to December 31, 2018), and of those, 651 patients met study criteria and were included in the analysis. The χ2 test was used to establish P values for categorical variables. For...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Association of Risk of Mortality in Pediatric Patients Transferred From Scene by Helicopter With Major But Not Minor Injuries
Conclusions The rate of HEMS in pediatric trauma has decreased. However, there is room for improvement as 14% of those with minor trauma are transported by HEMS. Given the similar risk of mortality compared with GEMS, further development of guidelines that avoid the unnecessary use of HEMS appears warranted. However, utilization of HEMS for transport of pediatric major trauma should continue. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

“Good Catch, Kiddo”—Enhancing Patient Safety in the Pediatric Emergency Department Through Simulation
Conclusions The simulation training enabled learners to identify hazards and near misses and enhanced their ability to report hazards through organizational incident reporting systems. Learners at all levels of training identified safety hazards at comparable rates, which demonstrates the role that trainees play in critically observing clinical settings with fresh eyes and identifying and reporting patient safety hazards. Interventions to promote patient safety need to prioritize building situational awareness of potential hazards associated with EHR use. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Point-of-Care Ultrasound for Central Venous Assessment in the Emergency Department: A Prospective Study Comparing the Femoral and Internal Jugular Veins
The objective of this study was to estimate the width, height, and depth of the femoral vein (FV) and internal jugular vein (IJV), both sites of potential central line placement in children, using point-of-care ultrasound. Methods This was a prospective observational study. Point-of-care ultrasound was used to measure the width, height, and depth of the right FV and IJV in 100 children. The primary outcome was a comparison of the widths of the FV and the IJV in the same child. Our primary hypothesis was that the IJV would be wider than the FV. Secondary outcome measures included comparison of the heights and depths ...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Which Device Is Favorable for Intubation Attempts of Pediatric Residents on Four Different Pediatric Airway Simulations?
Conclusions The attempts of pediatric residents on infant normal airway and Pierre-Robin sequence infant airway simulations resulted with enhanced glottis view by the utilization of Storz C-MAC PM, but both 2 VLs did not provide the improvement of intubation success rate and TTI compared with DL on these 4 different pediatric manikins. Further clinical studies of different VLs in different clinical courses are required for a reliable utilization in children. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Managing Pediatric Foreign Body Ingestions: A 10-Year Experience
In this study, we retrospectively reviewed all pediatric cases of FB ingestion requiring endoscopic removal over a 10-year period in a tertiary hospital to compare the symptoms at presentation and outcomes with those reported in previous studies and to assess the association of the outcomes with patient and FB characteristics. Methods A retrospective chart review of children 16 years or younger who underwent upper endoscopy for FB ingestion from 2008 to 2018 in a tertiary hospital was included. Data on demographics, clinical presentation, characteristics of FBs, endoscopic findings, and outcomes were reviewed. The c...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Association of Socioeconomic Characteristics With Where Children Receive Emergency Care
Conclusions Nationally, children in lower-income neighborhoods tended to receive care in pediatric EDs with lower volume, an association that appears principally driven by urban-rural differences in access to emergency care. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Patient Outcomes With Febrile Neutropenia Based on Time to Antibiotics in the Emergency Department
Conclusions Time to antibiotic administration of more than 60 minutes did not increase mortality in pediatric oncology patients with FN. Our study adds to the existing literature that TTA of 60 minutes or less does not seem to improve outcomes in pediatric FN. Further larger studies are required to confirm these findings and determine which features predispose pediatric FN patients to morbidity and mortality. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Which Clinical Features of Children on Initial Presentation to the Emergency Department With Head Injury Are Associated With Clinically Important Traumatic Brain Injury, Classification as Abuse, and Poor Prognosis?
The objective of this study was to determine which clinical features associated with head injury in children on initial presentation to the ED trauma bay predict 3 outcomes including clinically important TBI (CiTBI), classification as confirmed abuse by Child Protection Team (CPT), and poor neurologic status on hospital discharge. Participants and Setting Inclusion for this study were children 3 years or younger, presenting to the ED with significant TBI. In addition, presentations where the mechanism of injury was not verifiable such as with falls, being struck by object, or no mechanism of injury reported by careg...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Characteristics of Upper Limb Osteoarticular Infections at the Emergency Department of a Tertiary University Hospital in Spain
Conclusions One third of patients were misdiagnosed at the first consultation, which stresses the importance of a high clinical suspicion to avoid delays in diagnosis and treatment of osteoarticular infections. This study also shows a lower mean age of children with upper limb infection as compared with those with lower limb infection. All patients recovered fully with oral antibiotics. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Radiation-Free Diagnosis of Pediatric Appendicitis: Accuracy of Point-of-Care Ultrasonography and Magnetic Resonance Imaging
Conclusions Using POCUS and MRI for the diagnosis of pediatric appendicitis is a highly accurate way to avoid ionizing radiation in children. In our study, POCUS is as accurate as MRI, although this is limited by being mostly done by a single provider and a high number of equivocal examinations. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Dynamics of Patient Visits to a Public Hospital Pediatric Emergency Department: A Time-Series Model
Conclusion Although PED visits are multifactorial, they may be predicted and explained by a relatively small number of variables. Such a model may be easily reproduced in different settings and represents a relevant tool to improve quality in EDs through correctly adapting human resources to ED demand. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Use of Opioids and Nonopioid Analgesics to Treat Pediatric Postoperative Pain in the Emergency Department
Objectives The incidence, demographic characteristics, and treatment approaches for pediatric patients who present to the ED with a primary complaint of postoperative pain have not been well described. The purpose of this study was to describe opioid and nonopioid prescribing patterns for pediatric patients evaluated for postoperative pain in the Emergency Department (ED). Methods Pediatric Health Information System is an administrative database of encounter-level data from 48 children's hospitals. Emergency department visits for postoperative pain from January 2014 to September 2017 were analyzed. Visits were m...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Group A Streptococcal Pharyngitis Testing Appropriateness in Pediatric Acute Care Settings
Conclusion Quality improvement initiatives are needed to decrease the rate of inappropriate RADTs in pediatric UCC and ED settings. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Evidence-Based Diagnostic Test Accuracy of History, Physical Examination, and Imaging for Intussusception: A Systematic Review and Meta-analysis
Conclusions History and physical examination had low diagnostic test accuracy. Abdominal radiographs had low diagnostic test accuracy, despite moderate discriminatory characteristics. Point-of-care ultrasound had the highest diagnostic test accuracy to rule in or rule out intussusception. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Magnetic Resonance Imaging Availability Reduces Computed Tomography Use for Pediatric Appendicitis Diagnosis
Conclusions Introducing MRI for as an imaging option for children with suspected appendicitis and an inconclusive ultrasound markedly reduced CT use, but did result in a small increase in imaging charges and time to preliminary radiology read. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Racial and Ethnic Disparities in Pediatric Mental Health-Related Emergency Department Visits
Objectives To test the hypotheses that (1) rates of mental health-related concerns presenting to pediatric emergency departments (ED) have increased (2) rates are increasing more in minority than nonminority youth. Methods We performed a 5-year retrospective cohort study of youth with mental health-related ED visits using the Pediatric Health Information System. We calculated rates of mental health-related visits, in aggregate and by race/ethnicity. The Poisson model was used to generate incidence rate ratios of unique mental health-related visits each year using census data as the population denominator. Res...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Clinical Presentation of Acute Osteomyelitis in the Pediatric Emergency Department
Conclusions Fever may be absent in up to a quarter of pediatric patients with acute osteomyelitis. Although highly sensitive, inflammatory marker elevations were more modest than those reported previously in cases of pediatric septic arthritis. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Patterns of Vasoactive Agent Initiation Among Children With Septic Shock in the Pediatric Emergency Department
Conclusions Although there are perceived barriers to vasoactive agent initiation, we found no significant difference in patient-level factors between the timely and delayed groups. This study also identified a group of patients labeled as transient responders, who initially appeared volume responsive but who required vasoactive support within several hours. This cohort requires further study. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Are Complex Skull Fractures Indicative of Either Child Abuse or Major Trauma in the Era of 3-Dimensional Computed Tomography Imaging?
Conclusions Complex skull fractures frequently occur from accidental injuries. This study suggests that the presence of complex skull fractures should not be used alone when making a determination of abuse. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Utilizing Near-Infrared Spectroscopy (NIRS) to Identify Pediatric Trauma Patients Needing Lifesaving Interventions (LSIs): A Retrospective Study
Conclusions Pediatric trauma patients with somatic NIRS less than 70% within 30 minutes of emergency department arrival are associated with the need for LSIs. Continuous NIRS monitoring in the pediatric trauma population should be evaluated prospectively. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Endotracheal Administered Epinephrine Is Effective in Return of Spontaneous Circulation Within a Pediatric Swine Hypovolemic Cardiac Arrest Model
Objective Early administration of epinephrine increases the incidence of return of spontaneous circulation (ROSC) and improves outcomes among pediatric cardiac arrest victims. Rapid endotracheal (ET) intubation can facilitate early administration of epinephrine to pediatric victims. To date, no studies have evaluated the use of ET epinephrine in a pediatric hypovolemic cardiac arrest model to determine the incidence of ROSC. Methods This prospective, experimental study evaluated the pharmacokinetics and/or incidence of ROSC following ET administered epinephrine and compared it to these experimental groups: intra...
Source: Pediatric Emergency Care - January 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research