Children and the Use of Emergency Departments During the COVID-19 Pandemic: Where Did the Pain End Up?
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Letter to the Editors Source Type: research

Burnout and Resiliency Trends in Pediatric Emergency Medicine Fellows
Conclusions This study shows that many first-year PEM fellows already have signs of burnout and low resiliency. However, by third year, there was improvement in burnout scores. Additional tools provided in fellowship may help prevent burnout in PEM fellows. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Physician Wellness/Burnout Source Type: research

Risk Stratification of Intermediate-Risk Children With Minor Head Injury
The Pediatric Emergency Care Applied Research Network rule helps emergency physicians identify very low-risk children with minor head injury who can forgo head computed tomography. This rule contributes to reduction in lifetime risk of radiation-induced cancers while minimizing missing clinically important traumatic brain injury. However, in intermediate-risk children, decisions on whether to perform computed tomography remain at the emergency physicians' discretion. To reduce this gray zone, this review summarizes evidence for risk stratification of intermediate-risk children with minor head injury. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Review Article Source Type: research

Two-Year-Old With Sleep Disturbance and Left Arm Movements
A 29-month-old boy presented to a pediatric emergency department with complaints of trouble sleeping for more than a week. History consisted of episodes of screaming while asleep from which he could not be awakened. A detailed physical examination revealed left arm dystonia and left plantar reflex to be upgoing. Upon admission, all imaging and an electroencephalogram were normal. Extensive laboratory work was done showing positive anti-N-methyl-D-Aspartate (NMDA) antibody in the cerebrospinal fluid. Inpatient care included intravenous immunoglobulin (IVIG) and Solumedrol. Cellcept was started after definitive diagnosis and...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Domestically Acquired Aural Myiasis in a Tennessee Girl
We present the rare case of a 12-year-old girl from Tennessee with domestically acquired aural myiasis. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Pediatric Bilateral Facial Paralysis: An Unusual Presentation of Lyme Disease
Pediatric bilateral facial nerve paralysis (FNP) is a rare condition, representing less than 2% of all cases of FNP. The differential diagnosis of FNP is extensive (ranging from infectious, traumatic, neurologic, to idiopathic) and often can present as a diagnostic challenge. In contrast to unilateral presentation, bilateral FNP presents as a manifestation of serious systemic conditions, including meningitis (infectious and neoplastic), brain stem encephalitis, Guillain-Barre syndrome, sarcoidosis, Lyme disease, human immunodeficiency virus infection, leukemia, and vasculitis. In the evaluation of a child who presents with...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Spinal Epidural Abscess in an Infant Presenting as Fever and Respiratory Distress
A 9-month-old healthy female presented during winter to the emergency department with a chief complaint of fever and prominent respiratory symptoms. She was discharged on oseltamivir with a presumptive diagnosis of influenza. She returned to the emergency department 2 days later with continued fever and more upper respiratory symptoms. She was admitted for intravenous hydration to the observation unit with a diagnosis of viral illness (with viral testing that returned positive for adenovirus) and dehydration. When her high fevers continued, bloodwork that was concerning for leukocytosis, elevated inflammatory markers, and ...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Retiform Purpura as a Sign of Necrotizing Cellulitis in an Immunocompetent Boy
We present a case of a superficial infection, specifically GAS necrotizing cellulitis, complicated by STSS in a healthy boy with an associated skin finding of retiform purpura that aided in early diagnosis of a NSTI. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Clinical Decision Support in the Electronic Medical Record to Increase Rates of Influenza Vaccination in a Pediatric Emergency Department
Conclusions The ED influenza vaccination program vaccinated approximately 20 times the number of eligible patients after automated EMR screening and ordering. Using knowledge of a multidisciplinary team, integration into the existing workflow, and visual cues in the EMR, we were able to increase the number of influenza vaccines administered substantially. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Research-QI Source Type: research

Asthma-Related Emergency Department Visits Among Low-Income Families With Young Children by Race/Ethnicity and Primary Language
Conclusions The findings suggest that racial/ethnic and language disparities exist in eventual asthma-related hospitalizations and repeat ED visits. Continued research is needed to understand the existence of these differences and to inform future comprehensive and linguistically appropriate asthma interventions for children in low-income families. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Transport Practices Among Prehospital Providers
Discussion Our survey demonstrates that despite published best practices for the safe transport of children, many providers are unfamiliar with the safest way to transport these patients. In addition, we identified several existing barriers that may contribute to unsafe practices. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Postpartum Depression Screening and Referral in a Pediatric Emergency Department
Conclusions Approximately 1 in 4 mothers screened positive for PPD in a PED, with almost 1 in 10 reporting suicidal thoughts. The majority of PPD screen–positive mothers had not been screened previously. Our study helps to inform future efforts for interventions to support mothers of young infants who use the PED for care. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Emergency Medicine Providers' Knowledge and Management of Pediatric Tropical Diseases: A Needs Assessment
Conclusions Pediatric EM and EM providers' knowledge and evaluation for pediatric tropical diseases are variable. Providers recognized their knowledge gaps and expressed interest in gaining access to resources and guidelines to standardize and improve evaluation and treatment of these diseases. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Trends in Severe Pediatric Emergency Conditions in a National Cohort, 2008 to 2014
Conclusions The most common serious condition in children presenting to United States emergency departments is serious respiratory disease. Anaphylaxis is the fastest increasing serious condition. Additional research attention to these diagnoses is warranted. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Emergency Provider Sexually Transmitted Infection Screening Practices in Adolescents With Oropharyngeal or Anorectal Chief Complaints
Conclusions In an urban PED, only 20% of visits for adolescents with oropharyngeal or anorectal symptoms included STI consideration. Testing was performed in only 5% of cases and often at an inappropriate anatomic site or with the incorrect test. Interventions to increase awareness of appropriate STI consideration and testing for individuals presenting with possible extragenital complaints may help reduce STIs among adolescents. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Association of Glasgow Coma Scale Score With Clinically Important Traumatic Brain Injuries in Children
Conclusions A nearly linear relationship exists between the initial GCS score and ciTBI in children with blunt head trauma. The highest prevalence of ciTBI and neurosurgical intervention occurred in children with GCS scores of 4. Children presenting with GCS scores of 14 had a nonnegligible prevalence of ciTBI. These findings are critical to providers caring for children with blunt head trauma to accurately formulate pretest probabilities of ciTBI. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Ocular Injury Presenting to a Level-III Pediatric Trauma Center
Conclusions At our institution, a level-III trauma center, we evaluated and managed approximately 1 ocular injury case per week and children required surgical repair in the operating room at a higher rate than higher-level trauma centers. Injuries secondary to dog bites remain a clinically significant etiology. The purpose of this study is to describe pediatric ocular injuries presenting to a level-III pediatric trauma center and emergency department. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Development of a Clinical Prediction Model for Central Line‚ÄďAssociated Bloodstream Infection in Children Presenting to the Emergency Department
Conclusions We were able to identify risk factors and develop a clinical prediction model for CLABSI in children presenting to the emergency department. Once validated in future study, this clinical prediction model could be used to assess the need for hospitalization and/or antibiotics among this group of patients. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Distinguishing Multisystem Inflammatory Syndrome in Children From Kawasaki Disease and Benign Inflammatory Illnesses in the SARS-CoV-2 Pandemic
Conclusions We describe 3 groups with inflammatory syndromes during the SARS-CoV-2 pandemic. The initial profile of lymphopenia, thrombocytopenia, hyponatremia, and abnormal creatinine may help distinguish critically ill MIS-C patients from classic/atypical KD or more benign acute inflammation. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Special Features Source Type: research

COVID-19: Transatlantic Declines in Pediatric Emergency Admissions
Conclusions Although the absolute numbers of children and adolescents attending the PED and being admitted decreased after lockdown, the acuity of illness of those attending appears to be higher. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Special Features Source Type: research

Pediatric Emergency Medicine Fellowship Directors' Collective Statement on Virtual Interviews
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Special Features Source Type: research

Lung Point-of-Care Ultrasound in Pediatric COVID-19: A Case Series
The objective of this case series was to describe lung POCUS findings in pediatric patients with COVID-19. Three patients with COVID-19 who had lung POCUS performed in a pediatric emergency department were included. Point-of-care ultrasound revealed bilateral abnormalities in all patients, including pleural line irregularities, scattered and coalescing B-lines, consolidations, and pleural effusions. Additional pediatric studies are necessary to gain a broader understanding of COVID-19's sonographic appearance in this age group and to determine whether POCUS may be helpful to facilitate diagnosis and expedite management dec...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Ultrasound Case Review Source Type: research

Current Approach to the Evaluation and Management of Incomplete Kawasaki Disease in the Emergency Department
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: CME Review Article Source Type: research

Current Approach to the Evaluation and Management of Incomplete Kawasaki Disease in the Emergency Department
Kawasaki disease (KD) is one of the most common vasculitides of childhood and frequently presents to the emergency department. Although the diagnosis of KD is based on clinical criteria, children who do not fulfill the criteria but have sufficient supportive features of KD are diagnosed as having incomplete KD and warrant the same course of therapy as children with classic KD. The diagnosis of incomplete KD is challenging and requires a high index of suspicion. The purpose of this article is to review presenting features of incomplete KD and the diagnostic approach and management of children in the emergency department. (S...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: CME Review Article Source Type: research

Pediatric Carbon Monoxide Poisoning in Southern Israel: A Cross-Sectional Study
Conclusions Carbon monoxide poisoning in children is frequent in southern Israel. Education about prevention, implementation of safer standards for home heating systems, and government supervision are required management strategies to decrease the CO poisoning incidence in southern Israel. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Utilization of a Clinical Decision Support Tool to Reduce Child Tobacco Smoke Exposure in the Urgent Care Setting
Conclusions An electronic health record–embedded CDSS was feasible to incorporate into busy UC nurses' workloads and was associated with encouraging changes in the smoking behavior of caregivers. More research on the use of CDSS to screen and counsel caregivers who smoke in the UC and other acute care settings is warranted. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Endoscopic Findings Associated With Button Battery Ingestion in Children: Do We Need to Change the Protocol for Managing Gastric Location?
Conclusion Esophageal BB cause damage within hours. The BB located in the stomach may also cause damage early. Extraction of gastric BB before 48 hours should be considered. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Pelvic Fractures and Differences Compared With the Adult Population
Conclusions Because of the specific characteristics of pelvic fractures in children, fracture patterns are less severe than those of adults, but the injury mechanisms are high-energy traumas. The rate of associated injuries is very high, and a multidisciplinary management in pediatric trauma centers is needed to treat these patients. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Point-of-Care Influenza Testing in the Pediatric Emergency Department
Objectives To see what the impact of introducing a rapid polymerase chain reaction–based influenza test has on length of stay (LOS) in emergency department, use of imaging, serum or urine testing, antibiotic use, and antiviral use. Methods Audit of electronic medical health records was performed for all emergency department visits from 2014 to 2018 between November and March, which was defined as peak flu season. Patients were included if they were between 3 months and 18 years of age, presented during peak flu season, and were tested for influenza. The pre–point of care (POC) period was defined as N...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Improving Time to Antibiotics for Pediatric Oncology Patients With Fever and Suspected Neutropenia by Applying Lean Principles
Background Fever in the setting of neutropenia is a potentially life-threatening complication of cancer treatment. A time of less than 60 minutes from presentation to antibiotic administration is therefore recommended. Objective To use Lean Six Sigma methodology, a quality improvement initiative, to improve time to antibiotics (TTA) for children with chemotherapy-induced febrile neutropenia presenting to the emergency department. Methods Lean Six Sigma is a quality improvement method that engages all impacted stakeholders and focuses on streamlining the process by removing process wastes. Stakeholders ide...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Acute Hemorrhagic Edema of Infancy With Associated Hemorrhagic Lacrimation
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research

Impact of COVID-19 on the Pattern of Access to a Pediatric Emergency Department in the Lombardy Region, Italy
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research

Increased Childhood Peripheral Facial Palsy in the Emergency Department During COVID-19 Pandemic
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research

Pediatric Veno-Veno Extracorporeal Membrane Oxygenation Rescue From Carbon Monoxide Poisoning
Conclusions This is the first time that veno-veno ECMO has been reported for the emergent treatment of carbon monoxide intoxication. If emergency physicians are treating such a patient and cannot administer hyperbaric oxygen therapy, ECMO represents a valuable alternative that is not commonly thought of in this situation before. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

A Mixed Presentation of Serotonin Syndrome vs Neuroleptic Malignant Syndrome in a 12-Year-Old Boy
Conclusion The use of antipsychotic medications for young children with behavioral problems has risen dramatically in the last decade, increasing their risk for developing SS or NMS. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Crohn Disease Presenting as the Cutaneous Rash of Pyoderma Gangrenosum
We present a case of Crohn disease presenting as the inflammatory rash of PG in the absence of significant bowel symptoms. This case highlights the importance of keeping PG in the differential for inflammatory lesions presenting to the emergency department. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Role of Hemodialysis in the Management of Cyanide Intoxication From Apricot Kernels in a 3-Year-Old Child
We report an unusual case of pediatric CN poisoning after ingestion of apricot kernels containing amygdalin, who survived with antidotal therapy and hemodialysis. A 3-year-old girl presented with respiratory distress and coma following tonic-clonic convulsions after ingestion of 3 apricot kernels. She had severe metabolic acidosis (pH 6.91, bicarbonate [HCO3−] 5.6 mEq/L, base excess −26.0 mEq/L). Her blood CN level was measured 3.15 mg/L, 3 hours after ingestion. Hydroxocobalamin could not be administered immediately because it had to be brought from a medical center 4 hours apart. Therefore, a 3-hour hemodialy...
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Two Cases Illustrating the Diagnostic Challenge of Pediatric Blastomycosis Presenting as Osteomyelitis
Blastomyces dermatitidis is a dimorphic fungus endemic to the United States and Canada. Although both Histoplasma and Blastomyces are found in similar geographic regions, Blastomyces is many times more likely to cause dissemination in the immunocompetent host, frequently involving the bone. However, given the indolent nature of this fungal infection and more prevalent bacterial etiologies of osteomyelitis, diagnosis and treatment are often significantly delayed. We review 2 pediatric cases that initially presented with isolated orthopedic symptoms without documented fever or pulmonary complaints, although both had signs of...
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

The Not-So-Soft Spot: Pathophysiology of the Bulging Fontanelle in Association With Roseola
Roseola infantum is a clinical syndrome characterized by high fever followed by the emergence of a rash. Case reports have documented an association between bulging fontanelles and roseola. We propose a novel mechanism for the development of intracranial hypertension caused by human herpesvirus 6–induced cytokine elevation leading to increased cerebrospinal fluid production. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department
Conclusion Our results suggest that adolescents view the ED as an acceptable location for STI screening. Therefore, the ED may serve a role in increasing the accessibility of STI detection and prevention resources for adolescents. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Comparison of 4 Pediatric Intraosseous Access Devices: A Randomized Simulation Study
Conclusions Although the efficacy of devices was demonstrated in simulated environment in novice users, further studies are needed to assess the efficacy and safety of devices in clinical comparative settings. With more experienced users, the success rate may differ considerably as compared with naive users. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Effect of an Observation Unit on Pediatric Minor Head Injury
Conclusions The rate of CT use decreased by 30% as a result of OU institution. The OU was an effective means of avoiding an unnecessary head CT for pediatric minor head injuries. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay
This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. Methods Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed. Treatment adherence to advanced trauma life support guidelines and pediatric advanced life support guidelines and errors per patient were identified. Results During the study period, 128 patients were recorded (65.6% with surgical, 34.4% with me...
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Posttraumatic Stress in Children After Injury: The Role of Acute Pain and Opioid Medication Use
Conclusions Pain during hospitalization may increase susceptibility for persistent PTSS above and beyond the influence of other empirical risk factors. Findings suggest that pain assessment may be a useful addition to pediatric PTSS screening tools and highlight the need for additional research on pharmacological secondary prevention approaches. Given that inadequate pain control and persistent PTSS each hinder recovery and long-term functioning, better understanding of interactions between acute pain and PTSS after injury is essential for improving screening, prevention, and early intervention efforts. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Predictors for Positive Yield Abdominal Computed Tomography in Pediatric Abdominal Trauma
Objectives Abdominal computed tomography (ACT) use in the initial evaluation of pediatric abdominal trauma is liberal in most instances. The aim of this study was to identify the predictors for a positive yield ACT scan in this population. Methods A prospective, cohort, single-center observational study was conducted at Children’s Hospital at Westmead, New South Wales, from January 2008 to June 2015 on 240 pediatric abdominal trauma patients who had abdominal computed tomography. Clinical, laboratory, imaging, and interventional variables were explored with univariate and multivariate analyses among children who...
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

The 3-Minute Ethical Dilemma: Using Personal Protective Equipment Puts Healthcare Providers in the Crossfire of Duty to Care and Staying Healthy
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Special Features Source Type: research

A Novel Pediatric Multisystem Inflammatory Syndrome During the COVID-19 Pandemic
We present 4 patients along with their emergency department course, so providers will have a better understanding of the identification and workup of these patients. Currently, it is unclear when this inflammatory syndrome develops in respect to a COVID-19 infection. The clinical features of this syndrome seem to overlap between Kawasaki disease, toxic shock syndrome, and myocarditis. All patients presenting to our emergency department had fever, variable rash, abdominal pain, vomiting, and/or diarrhea. Patients remained persistently tachycardic and febrile despite being given proper doses of antipyretics. Severity of pres...
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Special Features Source Type: research

Point-of-Care Ultrasound Diagnosis of Ureteropelvic Junction Obstruction in a Child With Recurrent Abdominal Pain and Vomiting
A case is described of a 4 year-old girl who presented with chronic episodic abdominal pain with vomiting. Physical examination was unremarkable aside from hypertension. Point-of-care renal ultrasound showed hydronephrosis, leading to a diagnosis of ureteropelvic junction obstruction presenting with Dietl crisis (episodic abdominal pain secondary to urinary tract obstruction). The clinical utility of point-of-care renal ultrasound in the evaluation of abdominal pain and ultrasound findings of ureteropelvic junction obstruction are highlighted. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Ultrasound Case Review Source Type: research

Tourniquets in Major Extremity Trauma
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: CME Review Article Source Type: research

Tourniquets in Major Extremity Trauma
Much has been learned about hemorrhage control using tourniquets from wartime experiences, and recent mass casualty events. The use of tourniquets for extremity hemorrhage is a lifesaving skill for all providers to learn. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: CME Review Article Source Type: research