Impact of Respiratory Syncytial Virus Status on Severity of Emergency Department Presentation of Bronchiolitis
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research

Characteristics and Management of Severe Bronchiolitis Occurring in Ski Resorts in the French Alps: A Case Series
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research

Toward a Common Definition of Syncope in Children and Adults
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research

Impact on Admittance of Children on Emergency Department of a Regional Hospital From North of Spain During the COVID-19 State of Alarm
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Belly Dancer Syndrome: An Unusual Cause of Abdominal Pain
Conclusions Belly dancer syndrome is a rare condition often misdiagnosed owing to multiple presentations. Increased awareness is necessary to prevent late diagnosis and incorrect treatment. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Toddler With Intermittent Abnormal Behavior: Is It Isoniazid-Induced Psychosis?
We report a case of drug-induced psychosis secondary to isoniazid intake in a 3-year-old child. She developed intermittent abnormal behavior for 2 weeks after intake of isoniazid. Drug-induced psychosis was a possibility, and the responsible drug was stopped. She improved following the withdrawal of isoniazid. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Suspected Radial Head Subluxation in Infants: The Need for Radiologic Evaluation
We present a case series of 2 nonambulatory infants with forearm fractures that were initially diagnosed as radial head subluxation. Current literature supports the use of x-ray in children with atypical or unclear history prior to an attempted pulled elbow reduction. We suggest that this recommendation should be extended to all nonambulatory infants, given the unlikely diagnosis of radial head subluxation, and the necessity for early recognition of injuries that may be indicators of abuse. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

An Unusual Pediatric Case of Seronegative Systemic Lupus Erythematosus Presented With Acute Abdominal Pain and Gross Hematuria
A child with acute abdomen with gross hematuria occasionally visits the emergency department (ED). Usually, such a condition is subject to differential diagnosis for stones, injuries, or sometimes malignancies in the urinary tract. Here we introduce an unusual case of a 9-year-old girl who presented to ED with acute lower abdominal pain and gross hematuria. She had no medical history. An urgent computed tomographic image revealed a renal vein thrombosis. Laboratory tests for autoimmune diseases and coagulaopathies were performed, and the results were within normal ranges. At the time, she did not fulfil the criteria for sy...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

A Case of Pott's Puffy Tumor Associated With Barosinusitis From Scuba Diving
Barosinusitis, or sinus barotrauma, is a well-described condition associated with changes in barometric pressure during flight and diving that can result in sinonasal mucosal injury. In this case report, we present an adolescent who experienced barosinusitis during scuba diving and subsequently developed Pott's puffy tumor (PPT), characterized by frontal sinusitis, frontal bone osteomyelitis, and overlying subperiosteal abscess. This unique case of PPT following scuba diving provides the opportunity to review the pathophysiology of both barotrauma-induced sinus disease and PPT, a rare and unreported serious complication of...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Orbital Cellulitis—When Computed Tomography Imaging Is Falsely Reassuring
An 8-year-old male presented to the pediatric emergency department with subjective fever, blurry vision, and left eye pain. On physical examination, there was mild left lower lid erythema and a subtle left eye elevation deficit. Computed tomography demonstrated preseptal soft tissue swelling without orbital involvement; however, there was varying amounts of paranasal sinus opacification. Despite the negative scan, a diagnosis of orbital cellulitis associated with sinusitis was made and treatment with intravenous antibiotics was initiated. A magnetic resonance imaging performed subsequently revealed orbital fat stranding an...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Factors Associated With First Medication Time for Children Treated in the Emergency Department for Asthma
Conclusions Our study found that patient severity (acuity level, arrival mode) and level of ED crowing—but not demographic factors—are associated with the administration of medication in the first hour to pediatric patients with asthma. Our findings may be helpful in redesigning asthma care management strategies. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Intimate Partner Violence Educational Materials in the Acute Care Setting: Acceptability and Impact on Female Caregiver Attitudes Toward Screening
Conclusions Intimate partner violence materials in this study were acceptable to most participants and did not negatively impact attitudes toward IPV screening or willingness to disclose IPV. Display of IPV materials should be considered as a component of IPV intervention. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Severe Fireworks-Related Injuries: Demographic Characteristics, Injury Patterns, and Firework Types in 294 Consecutive Patients
Conclusions Children, teens, and adults experience severe fireworks-related injuries differently, by demographic characteristics, injury patterns, and firework types. Tailored public health interventions could target safety messaging and injury prevention outreach efforts to reduce firework injuries among children and adolescents. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Effect of Combined Clinical Practice Guideline and Electronic Order Set Implementation on Febrile Infant Evaluation and Management
Conclusions Antibiotic use and lumbar puncture performance modestly changed in accordance with CPG recommendations provided in the electronic order set and algorithm, suggesting that the presence of embedded prompts may affect clinician decision-making. Our results highlight the potential usefulness of these decision aids to improve adherence to CPG recommendations. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pediatric Prehospital Intraosseous Access During Combat Operations in Iraq and Afghanistan
Background Vascular access in critically ill pediatric patients can be challenging with delays potentially leading to worse outcomes. Intraosseous (IO) access has a low rate of complications and can be utilized to administer lifesaving medications. Combat medics are trained to treat adults but may also be required to treat children in the deployed setting. Vascular access in children can be challenging, especially in a hypovolemic state. There are limited data on prehospital lifesaving interventions in children in the combat setting. We sought to characterize the use of IO access in pediatric patients who sustained tra...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Quantification of Pain and Distress Associated With Intranasal Midazolam Administration in Children and Evaluation of Validity of Four Observational Measures
Conclusions We have identified estimates of pain and distress associated with administration of IN midazolam in young children that can be used to determine desired effect sizes for trials that study interventions to treat this pain and distress. The OSBD-R, CHEOPS, and FLACC scales are suitable choices for outcome measures. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Synthetic Cannabinoid Exposure in Adolescents Presenting for Emergency Care
Conclusions Synthetic cannabinoid exposure in adolescents is primarily characterized by CNS manifestations, which are varied and may be life-threatening. Frontline caregivers should maintain a high index of suspicion for synthetic cannabinoids, especially in adolescents who present with unexplained CNS manifestations, as there is no specific toxidrome or confirmatory rapid drug screen to detect them. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Trends in Pediatric Poisoning-Related Emergency Department Visits: 2001–2011
Objectives We sought to understand the burden of pediatric poisonings on the health care system by characterizing poisoning-related emergency department (ED) visits among children on a national level. Methods This was a repeated cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey from 2001 to 2011 of children 21 years or younger who presented to an ED. We measured annual rates of visits, trends over time, and patient and visit characteristics associated with poisoning-related ED visits using multivariable logistic regression. We also compared accidental to intentional poisonings. ...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Cervical Spine Imaging and Injuries in Young Children With Non-Motor Vehicle Crash-Associated Traumatic Brain Injury
Conclusions Abusive head trauma victims appear to be at increased risk of cervical injuries. Prospective studies are needed to define the risk of cervical injury in children with TBI concerning for AHT and to inform development of imaging guidelines. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Abdominal Pain in a Young Female Adolescent: Point-of-Care Ultrasound Added Value: Erratum
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Erratum Source Type: research

A National US Survey of Pediatric Emergency Department Coronavirus Pandemic Preparedness
Conclusions This national survey provides insight into PED preparedness efforts, training innovations, and practice changes implemented during the start of COVID-19 pandemic. Pediatric emergency departments implemented broad strategies including modifications to staffing, workflow, and clinical practice while using video/teleconference and simulation as preferred training modalities. Further research is needed to advance the level of preparedness and support deep learning about which preparedness actions were effective for future pandemics. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Special Features Source Type: research

Pediatric Inflammatory Multisystem Syndrome Associated With SARS-CoV-2: A Case Series Quantitative Systematic Review
Pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies of PIMS-TS, including 468 children reported before July 1, 2020. We found a myriad of clinical features, but we were able to describe common characteristics: previously healthy school-aged children, persistent fever and gastrointestinal symptoms, lymphopenia, and high inflammatory markers. Clinical syndromes such as myocarditis and Kawasaki disease were present in o...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Special Features Source Type: research

Utility of Point-of-Care Ultrasound for the Diagnosis of Hill-Sachs Deformity in the Pediatric Emergency Department
We report a case of a 20-year-old man presenting to our pediatric emergency department with an anterior shoulder dislocation. Point-of-care ultrasound demonstrated a Hill-Sachs deformity. The potential role of ultrasound and the clinical importance of identifying patients with Hill-Sachs deformities are discussed. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Ultrasound Case Review Source Type: research

Evaluation of Hip Pain and Management of Toxic Synovitis in the Ultrasound Era
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: CME Review Article Source Type: research

Evaluation of Hip Pain and Management of Toxic Synovitis in the Ultrasound Era
The cause of acute onset hip pain in children can be difficult to determine. Once trauma is excluded, the workup revolves around determining whether there is a hip effusion and eliminating orthopedic emergencies. Point-of-care-ultrasound can be used as an adjunct in the workup. In this article, we review (1) differential diagnosis of hip pain, with a focus on toxic synovitis; (2) the evaluation of a hip for the presence of effusion, including the point-of-care ultrasound technique; and (3) the management of toxic synovitis. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: CME Review Article Source Type: research

Child Car Safety: A Parental Survey at a Tertiary Care Emergency Treatment Center in Greece
Conclusions Child restraint systems use was inappropriately low under routine conditions and declined even further under emergency circumstances. Most children younger than 2 years and older than 4 years traveled inappropriately restrained in a forward-facing restraint seat. Parents should be more intensively educated on child car safety seat and the proper CRS use. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Impact of a Displayed Checklist on Simulated Pediatric Trauma Resuscitations
Conclusions Despite a structured approach to trauma resuscitations, omissions still occur. The use of a displayed checklist improves performance and reduces omissions without delaying assessment. Better compliance with Advanced Trauma Life Support protocols may improve patient outcomes. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Quality of the Triage of Children With Anaphylaxis at the Emergency Department
Objective Early recognition of symptoms is essential in anaphylaxis management. The Canadian Paediatric Emergency Triage and Acuity Scale prioritizes anaphylaxis to level I or II (resuscitation or emergency). We analyzed the accuracy of pediatric anaphylaxis triage. Methods This was a retrospective review of the triage charts (adaptation of the Canadian Paediatric Emergency Triage and Acuity Scale) of 137 children attended for anaphylaxis at our pediatric emergency department. Per triages' accuracy, charts were divided into TR1 (levels I–II) and TR2 (levels III–V), comparing demographics, initial tri...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Centralization of Prehospital Triage Improves Triage of Pediatric Trauma Patients
Conclusions Centralization of prehospital trauma triage at a level 1 pediatric trauma facility significantly reduced undertriage rates. Trauma centers should consider similar processes to improve prehospital triage. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Friendly Faces: Characteristics of Children and Adolescents With Repeat Visits to a Specialized Child Psychiatric Emergency Program
Conclusions Revisits to the ED are driven by both clinical factors, including severity and psychosocial complexity, and barriers to accessing services. Addressing the problem of return ED visits will require the development of a robust mental health service system that is accessible to children and families of all socioeconomic levels. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department
Objective The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period. Methods A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003–June 30, 2004 (period 1) and July 1, 2013–June 30, 2014 (period 2...
Source: Pediatric Emergency Care - January 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Note to Reviewers
No abstract available (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Note to Reviewers Source Type: research

Severe Agitation in a Teenager With Spastic Cerebral Palsy: A Clinical Challenge
We present a case of a 16-year-old boy with spastic cerebral palsy who presented with severe agitation, hyperthermia, and autonomic dysfunction. He arrived to a community pediatric hospital without a caregiver to provide a detailed history, which further complicated his management. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

A Case Report of Pediatric Paraneoplastic Dysautonomia
We present the case of a 16-year-old girl who presented with severe refractory orthostatic hypotension secondary to pandysautonomia. Initially, she was treated for Guillain-Barré syndrome given clinical symptoms and increased protein on cerebrospinal fluid, but the severity of symptoms and lack of response to intravenous immunoglobulin prompted further evaluation for an autoimmune etiology. She was ultimately diagnosed with paraneoplastic neuropathy secondary to Hodgkin lymphoma. Paraneoplastic neurologic phenomena are rare, occurring in just 0.01% of cancers, and prompt recognition is crucial for initiating appropr...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Adolescent With Spontaneous Splenic Rupture as a Cause of Hemoperitoneum in the Emergency Department: Case Report and Literature Review
We present the case of a 15-year-old girl with abdominal pain and clinical data of hypovolemic shock. The simple tomographic study revealed deformation of the splenic architecture and hemoperitoneum. Surgery demonstrated splenic rupture with ptosis spleen and intraperitoneal free blood. The anatomopathological examination showed the presence of splenomegaly and findings suggestive of peliosis. It also highlights the known causes related to spontaneous splenic rupture. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Herpes Simplex Virus Pneumonia in an Immunocompetent Child on Corticosteroids for Acute Wheezing
We describe a previously healthy child, with no evidence of an immunodeficiency, who presented to the emergency department with severe pneumonia, wheezing, and pleural effusions with a history of orolabial HSV infection. On admission, he was started on antibiotics and systemic corticosteroids but continued to deteriorate. Oral lesions, blood, and pleural fluid tested positive for HSV, and improvement was achieved only after the addition of acyclovir and discontinuation of steroids. We suggest that steroids should be used with caution in patients presenting with lower respiratory tract symptoms and herpetic oral lesions. (S...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Puss Caterpillar Envenomation: Erucism Mimicking Appendicitis in a Young Child
A 4-year-old female presented to the emergency department with 2 days of abdominal pain, nausea, and vomiting. She was tachycardic and had abdominal tenderness. Laboratory studies revealed a leukocytosis, hypokalemia, and metabolic acidosis. Her Pediatric Appendicitis Score (MDCalc) was calculated as 6, indicating that appendicitis could not be excluded. She was transferred to our pediatric hospital for further evaluation. Her ultrasound at our facility was normal. Upon reexamination, the patient was noted to have a red mark on her left index finger, and the family reported that the patient may have been stung by a puss ca...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Pediatric Emergency Department Return Visits: An Innovative and Systematic Approach to Promote Quality Improvement and Patient Safety
Conclusions Systematic monitoring and investigation of all ED RVs provides an innovative and effective approach to seeking provider- and system-level improvement opportunities. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Research-QI Source Type: research

Effectiveness of Emergency Department Treatment of Pediatric Headache and Relation to Rebound Headache
Conclusions Complete resolution in the PED may not be necessary, given the lack of association between the degree of pain relief and revisit rates. Perhaps, the goal should be to achieve at least 50% pain reduction before discharge. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Vascular Endothelial Growth Factor and Soluble Vascular Endothelial Growth Factor Receptor as Novel Biomarkers for Poor Outcomes in Children With Severe Sepsis and Septic Shock
Objectives Methods Biomarkers measured for each patient at time of presentation to the emergency department were compared in children with septic shock versus children with sepsis without shock. For children with septic shock, the associations between biomarker levels and clinical outcome measures, including intensive care unit and hospital length of stay, vasoactive inotrope score, and measures of organ dysfunction, were assessed. Results Soluble fms-like tyrosine kinase and VEGF were elevated in children with septic shock (n = 73) compared with those with sepsis (n = 93). Elevated sFLT but not VEGF was ass...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Early Hospital Discharge After Helicopter Transport of Pediatric Trauma Patients: Analysis of Rates of Over and Undertriage
Objectives Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. Methods Children ( (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Estimating the Weight of Children During Simulated Emergency Situations Using the Broselow Tape: Are We Underestimating the Risks of Errors?
Conclusions Although most residents reported knowledge of the Broselow tape, 40% made erroneous weight estimations by at least 10% with the first use in this simulation study. With repeated use, they improved significantly over time. Teaching appropriate use of the Broselow tape should be part of residency-training curricula and pediatric advanced life support course. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Two-Thumb Encircling Technique With a Novel Compression Assist Device Provides Safe and Effective Chest Compressions in Infants
Objective Currently, 2-thumb encircling technique is recommended in 2-rescuer infant cardiopulmonary resuscitation (CPR). However, many complications can occur during CPR. Therefore, we developed a novel compression assist device (Reheart) that can reduce chest compression area and determined whether using our device provides better compression quality. Methods A novel compression assist device consists of 2 parts. The upper part was designed to put 2 thumbs together in the thumb sleeves, and the lower part was designed based on a circular rubber plate with a 2.0-cm diameter to confine compression area. Infant m...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Can Providers Use Clinical Skills to Assess the Adequacy of Ventilation in Children During Bag-Valve Mask Ventilation?
Conclusions Normal ventilation is difficult to maintain among providers delivering BVM ventilation to pediatric patients without objective feedback. Incorporation of capnography monitoring may improve BVM ventilation in children. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Exposures to Single-Use Detergent Sacs Reported to a Statewide Poison Control System, 2013–2015
Background Single-use detergent sacs (SUDSs) represent a relatively new household hazard to children. Brand differences and packaging changes may contribute to differential risks with accidental exposure. We sought to identify high-risk features from SUDS exposures in children and to assess whether product packaging changed trends in SUDS exposures reported to poison centers. Methods In this institutional review board–approved, retrospective chart review of SUDS exposures from January 2013 to August 2015, deidentified case records of a large statewide poison control system were extracted and analyzed for c...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Universal Intimate-Partner Violence Assessment in the Pediatric Emergency Department and Urgent Care Setting: A Retrospective Review
Objective The aim of this study was to examine universal intimate-partner violence (IPV) assessment in the pediatric acute care setting. Methods We reviewed universal IPV assessment over 1 year in 2 emergency departments and 3 urgent care centers within a children's hospital system. Written IPV assessment used 2 questions (ie, safety concerns at home, information desired); “yes” to either was considered positive. We identified positive assessments via preexisting quality report. We collected demographics, resource utilization, and reason for positive screen by chart review. Positive assessment for IP...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Use of Chest Computed Tomographic Angiography in Blunt Trauma Pediatric Population
Introduction Blunt chest trauma in children is common. Although rare, associated major thoracic vascular injuries (TVIs) are lethal potential sequelae of these mechanisms. The preferred study for definitive diagnosis of TVI in stable patients is computed tomographic angiography imaging of the chest. This imaging modality is, however, associated with high doses of ionizing radiation that represent significant carcinogenic risk for pediatric patients. The aim of the present investigation was to define the incidence of TVI among blunt pediatric trauma patients in an effort to better elucidate the usefulness of computed to...
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Pain Intensity and Risk of Bone Fracture in Children With Minor Extremity Injuries
Conclusions In this series, pain intensity in children with a minor extremity injury was not a good marker of fracture. Nevertheless, children with mild palpation pain or with a mild increase of pain between spontaneous and palpation pain had a low risk of fracture. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Rapid Administration of Ketamine for Abscess Drainage in Children—A Dose Finding Study
Conclusions We estimated ED50 and ED95 for rapidly infused ketamine for 2 age groups undergoing abscess incision and drainage. Further studies are needed to get a more precise estimate of ED95. The total sedation time with this technique in the abscess group was shorter than most previous studies and is consistent with our previous observations in patients undergoing fracture reduction. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Point-of-Care Ultrasound Diagnosis of Perforated Appendicitis in the Pediatric Emergency Department: A Case Series
We present a series of 4 patients in whom POCUS was used to facilitate a diagnosis of perforated appendicitis. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - December 1, 2020 Category: Emergency Medicine Tags: Ultrasound Case Review Source Type: research