5,914 results match your criteria Pediatric Emergency Care[Journal]


Extracranial Internal Carotid Aneurysm in a 10-Year-Old Boy Diagnosed via Ultrasound.

Pediatr Emerg Care 2019 Feb 13. Epub 2019 Feb 13.

Johns Hopkins All Children's Hospital, St Petersburg, FL.

Background: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001759DOI Listing
February 2019

Point-of-Care Ultrasound to Identify the Source of Dyspnea in a Patient With Systemic Lupus Erythematosus.

Pediatr Emerg Care 2019 Feb 8. Epub 2019 Feb 8.

From the Pediatric Emergency Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York and Elmhurst Hospital, NYC Health + Hospitals, Elmhurst, NY.

Point-of-care ultrasound can be used to help identify the source of dyspnea in patients presenting to the emergency department. We present a case of an adolescent girl with a history of systemic lupus erythematosus presenting to the emergency department with chest pain and dyspnea and found to have both pleural and pericardial effusions on point-of-care ultrasound. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001761DOI Listing
February 2019
1 Read

Is Asymmetric Dimethylarginine a Useful Biomarker in Children With Carbon Monoxide Poisoning?

Pediatr Emerg Care 2019 Feb 8. Epub 2019 Feb 8.

Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.

Objective: Carbon monoxide poisoning (COP) is the leading cause of mortality and morbidity due to poisoning worldwide. Because children are affected more quick and severely from COP, they may require a longer treatment period, even if carboxyhemoglobin (CO-Hb) and/or lactate levels return to normal. Therefore, a new marker that predicts the duration of treatment and the final outcomes of COP is needed. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001758DOI Listing
February 2019

Reduction in Head Computed Tomography Ordering in Pediatric Emergency Patients: Effect of National Publication and Local Availability of Urgent Neurology Appointments.

Pediatr Emerg Care 2019 Feb 8. Epub 2019 Feb 8.

Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS.

Objective: The objective of this study was to evaluate the effect of the Pediatric Emergency Care Applied Research Network (PECARN) blunt head trauma guidelines and implementation of urgent neurology follow-up (UNF) appointments on an observed decline in head computed tomography (CT) use for pediatric emergency department (PED) patients presenting with headache, seizure, and trauma.

Methods: Patients ages 0 to 18 years presenting to and discharged from an urban tertiary care PED with chief complaint of trauma, headache, and seizure between 2007 and 2013 were retrospectively included. The total number of head CTs obtained in the trauma, headache, and seizure groups was compared before and after the publication of the PECARN guidelines in 2009 and the implementation of urgent UNF within a week from PED discharge in 2011, respectively. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001757DOI Listing
February 2019

Computed Tomography Diagnostic Abilities for Open-Globe Injuries in Pediatric Versus Adult Patients.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

From the Departments of Ophthalmology, and.

Objectives: The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups.

Methods: Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001747DOI Listing
January 2019
1 Read

The Administration of Postintubation Sedation in the Pediatric Emergency Department.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

From the Division of Pediatric Emergency Medicine, University of Texas at Austin-Dell Medical School, Austin, TX.

Background: The administration of postintubation sedation (PIS) is an essential component of postintubation care. Recent studies in the adult emergency medicine literature have highlighted both delays in time to administration of PIS and subtherapeutic dosing of sedative agents in the emergency department. We aimed to investigate the administration of PIS in the pediatric population as this has not been adequately reviewed to date. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001744DOI Listing
January 2019

Anomalous Left Coronary Artery From the Pulmonary Artery Presenting as Dilated Cardiomyopathy With Regional Wall Motion Abnormality on Point-of-Care Ultrasound.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA.

Anomalous left coronary artery from the pulmonary artery is a rare cause of dilated cardiomyopathy. We present the first reported case of anomalous left coronary artery from the pulmonary artery diagnosed by point-of-care ultrasound, leading to expedited management, stabilization, and eventual treatment. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001741DOI Listing
January 2019
1 Read

A Multi-institutional Case Series With Review of Point-of-Care Ultrasound to Diagnose Malrotation and Midgut Volvulus in the Pediatric Emergency Department.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT.

Point-of-care ultrasound can be used to screen for malrotation with and without volvulus in the newborn with bilious vomiting, as well as children with unexplained intermittent abdominal pain. We discuss cases where infants and children presenting to pediatric emergency departments with bilious vomiting and/or intermittent abdominal pain were initially screened for small bowel pathology with point-of-care ultrasound. Bedside findings suggestive of midgut volvulus were confirmed with radiology-performed ultrasound or upper gastrointestinal fluoroscopy. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001737DOI Listing
January 2019

Accuracy of Parental-Reported Tetanus Vaccination Status for Children With Lacerations.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

From the Division of Pediatric Emergency Medicine, Department of Pediatrics, and.

Objectives: The aim of this study was to determine whether emergency department (ED) providers are able to accurately assess whether a child with a laceration needs tetanus prophylaxis.

Methods: We conducted an 8-month prospective cross-sectional study of children presenting with a laceration to a pediatric ED. We asked ED providers whether tetanus prophylaxis was necessary. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001739DOI Listing
January 2019
4 Reads

Treatment of Hypothermic Cardiac Arrest in the Pediatric Drowning Victim, a Case Report, and Systematic Review.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

Department of Pediatrics, University of Minnesota.

Objectives: Drowning is the second leading cause of death in children. Extracorporeal membrane oxygenation (ECMO) has become the criterion standard therapy to resuscitate the hypothermic drowning victim in cardiac arrest. We present our own experience treating 5 children with hypothermic cardiac arrest in conjunction with a systematic review to analyze clinical features predictive of survival. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001735DOI Listing
January 2019
1 Read

Patient Experience in a Spanish Pediatric Emergency Department.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

From the Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.

Objectives: To study the experience reported by pediatric patients when visiting a pediatric emergency department (PED).

Methods: This was a prospective descriptive study, carried out in November 2014. A 12-question survey was developed, based on the Picker Patient Experience Questionnaire. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001713DOI Listing
January 2019

Burns Due to Application of Raw Garlic to the Feet as a Home Remedy for Fever.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

From the University of New Mexico Children's Hospital, Albuquerque, NM.

We present an illustrative case of unintentional burns to the feet of a 15-month-old child following the application of raw garlic as a home remedy for fever. We provide an overview of the historical medicinal uses of garlic as well as its unintended adverse effects. This case underscores the importance of clinicians' ability to recognize unusual presentations of injury due to culturally based practices that require care in emergency settings. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001714DOI Listing
January 2019

Success Rates for Reduction of Pediatric Distal Radius and Ulna Fractures by Emergency Physicians.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

Phoenix Children's Hospital, Phoenix, AZ.

Background: Emergency physicians are trained in urgent fracture reduction. Many hospitals lack readily available in-house orthopedic coverage.

Objectives: The aim of this study was to determine success rates for reduction of pediatric distal radius or ulna fractures by emergency department (ED) physicians. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001691DOI Listing
January 2019

Management of Pain After Pediatric Trauma.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

Department of Research Administration, Children's Health Dallas, Dallas, TX.

Objectives: The primary objective of this study was to evaluate the management of pain after traumatic injury in the pediatric emergency department (ED) as measured by time to analgesic administration and pain resolution, stratified by triage acuity level.

Methods: This is a retrospective descriptive study evaluating the management of children who presented with pain after injury to an urban level 1 trauma center. Consecutive enrollment of 1000 patients identified by ICD-9 codes that included all injuries or external causes for injury (700-999 and all E codes) and who had pain identified by triage pain assessment was performed. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001658DOI Listing
January 2019

A Finding of Hepatic Abscess in a Teenager Presenting With Abdominal Pain.

Pediatr Emerg Care 2019 Feb;35(2):e34-e36

From the Department of Pediatric Emergency Medicine, Cooper University Hospital, Camden, NJ.

Pyogenic hepatic abscess is a rare infection, but it is an important diagnosis to consider because the current mortality is approximately 5%. We present a case of abdominal pain in a 16-year-old male patient whose presentation was initially concerning for appendicitis but was later diagnosed as having a pyogenic hepatic abscess. It is important to direct the patient to the proper treatment including source control with drainage and antibiotics to decrease morbidity and mortality. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001724DOI Listing
February 2019

Another Useful Application of Point-of-Care Ultrasound: Detection of Esophageal Foreign Bodies in Pediatric Patients.

Pediatr Emerg Care 2019 Feb;35(2):154-156

From the Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Foreign body ingestion is a common pediatric complaint. Esophageal foreign body (EFB) requires early diagnosis and emergency removal of the object. We report 3 cases of EFB detected by point-of-care ultrasound demonstrating characteristic sonographic findings. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001729DOI Listing
February 2019

Pulmonary Embolism in Children.

Authors:

Pediatr Emerg Care 2019 Feb;35(2):152-153

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http://dx.doi.org/10.1097/01.pec.0000553515.10166.5aDOI Listing
February 2019
1 Read

Pulmonary Embolism in Children.

Pediatr Emerg Care 2019 Feb;35(2):143-151

Assistant Professor (Stein), Department of Radiology, Children's Hospital of Colorado, University of Colorado School of Medicine, Aurora, CO.

Pulmonary embolism is an uncommon but potentially life-threatening event in children. There has been increasing awareness of pulmonary embolism in children with improved survival in children with systemic disease and advancements in diagnostic modalities. However, literature regarding pulmonary embolism in children is sparse, and thus current guidelines for management of pulmonary embolism in children are extrapolated from adult literature and remain controversial. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001730DOI Listing
February 2019
2 Reads

Shock Index as a Predictor of Morbidity and Mortality in Pediatric Trauma Patients.

Pediatr Emerg Care 2019 Feb;35(2):132-137

From the Departments of Pediatric Emergency Medicine and.

Objectives: Compared with unadjusted shock index (SI) (heart rate/systolic blood pressure), age-adjusted SI improves identification of negative outcomes after injury in pediatric patients. We aimed to further evaluate the utility of age-adjusted SI to predict negative outcomes in pediatric trauma.

Methods: We performed an analysis of patients younger than 15 years using the National Trauma Data Bank. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001733DOI Listing
February 2019
1 Read

Provider Prediction of Disposition for Children With an Acute Exacerbation of Asthma Presenting to the Pediatric Emergency Department.

Pediatr Emerg Care 2019 Feb;35(2):108-111

School of Medicine, University of Louisville, Louisville, KY.

Objective: The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation.

Methods: We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents of children presenting with asthma exacerbation. The treating provider completed a survey after finishing the examination and immediately upon exiting the patient's room. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001723DOI Listing
February 2019

Bone Fractures in Children With Cholestatic Liver Disease May Mimic Those Seen in Child Abuse.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Department of Social Work, New York Presbyterian Hospital, New York, NY.

Certain fractures in children are highly specific for child abuse. Metabolic bone disease frequently develops in patients with cholestatic liver disease (CLD); this can result in weakened bones and a predisposition to pathologic fractures. Fractures that occur in patients with rickets and osteopenia may mimic a bone response to inflicted injury, which in children raise the concern of child abuse. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001740DOI Listing
January 2019

Delayed Subaponeurotic Fluid Collections: A Benign Cause of Scalp Swelling in Infancy.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Children's Protection Program, and.

Delayed subaponeurotic fluid collections (DSFCs) are a recently described cause of idiopathic scalp swelling in young infants. Associated with traumatic birth and the use of vacuum-assisted devices or fetal scalp electrodes, DSFCs can be differentiated from similar causes of neonatal scalp swelling based on characteristic history and physical examination findings. In this article, we highlight 2 cases of young infants presenting to a pediatric emergency department with large, fluctuant scalp swellings, which were appropriately diagnosed as DSFCs; clinical data on an additional eight cases are presented in table format. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001720DOI Listing
January 2019

Clinical Features and Biomarkers Suggestive of Bloodstream Infection in Pediatric Patients With Intestinal Failure and Central Venous Lines for Parenteral Nutrition: A Retrospective Pilot Study.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Departments of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, MI.

Objectives: This study aimed to describe demographic, clinical, and laboratory values in febrile pediatric intestinal failure patients with indwelling central venous catheters presenting to the emergency department to determine if there are low-risk features predictive of negative blood cultures that could help identify a subset that do not need hospitalization and/or broad-spectrum antibiotics.

Methods: We conducted a retrospective cohort study of febrile patients younger than 18 years with diagnosis of intestinal failure requiring a central venous catheter for home parenteral nutrition to identify factors associated with normal blood cultures to identify a low-risk subset.

Results: Of 119 encounters, 46% had a bloodstream infection. Read More

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http://Insights.ovid.com/crossref?an=00006565-900000000-9825
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http://dx.doi.org/10.1097/PEC.0000000000001731DOI Listing
January 2019
2 Reads

Trends in Emergent Head Computed Tomography Utilization for Minor Head Trauma After Implementation of a Clinical Pathway.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Office of Clinical Quality Improvement, The Children's Hospital of Philadelphia, Philadelphia, PA.

Objective: The aims of this study were to evaluate trends over time in computed tomography (CT) scan utilization after implementation of a clinical pathway in a tertiary care children's hospital emergency department (ED), to determine how ED throughput differs by CT utilization, and to determine provider reasoning for obtaining head CT in low-risk patients.

Methods: This was a retrospective cohort study of patients 21 years or younger discharged from our ED with head trauma (Glasgow Coma Scale score ≥13 and a head trauma International Classification of Diseases code) over a 5-year period, starting 1 year after pathway implementation (January 2012 to December 2016). A manual chart review of 10% of patients who received a CT was performed to determine reasoning for CT utilization and guideline compliance. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001728DOI Listing
January 2019

The Reliability of Computerized Physician Order Entry Data for Research Studies.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

From the Division of Emergency Medicine and.

Objectives: In the United States, adolescents account for nearly half of the newly diagnosed sexually transmitted infections annually, and many of these infections are asymptomatic. Adolescents often seek care in pediatric emergency departments; thus, the emergency department is an important setting to implement adolescent sexually transmitted infection screening. Before implementation, baseline data reflecting current screening rates of symptomatic and asymptomatic patients were needed. Read More

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http://Insights.ovid.com/crossref?an=00006565-900000000-9825
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http://dx.doi.org/10.1097/PEC.0000000000001726DOI Listing
January 2019
4 Reads

Surgical Emphysema in a Pediatric Tertiary Referral Center.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

From the Royal Manchester Children's Hospital, Manchester, England.

Background: Laryngeal trauma in pediatrics is extremely rare; however, because of the smaller pediatric larynx, it can have catastrophic consequences. Following laryngeal trauma, surgical emphysema is a relatively common presentation. In pediatrics, it can be a life-threatening condition. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001725DOI Listing
January 2019
1 Read

Rest-Based Concussion Management of Pediatric Emergency Medicine Providers.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Loma Linda University Children's Hospital, Loma Linda, CA.

Objectives: This study aimed to survey pediatric emergency medicine (PEM) providers on their management of 2 hypothetical acute concussion scenarios. We hypothesized that most providers would recommend a management strategy based on cognitive and physical rest.

Methods: Fifty-nine percent (46/78) of PEM providers that were surveyed completed the study. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001727DOI Listing
January 2019
4 Reads

A Frosty Challenge.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Background: We report a case of geometrical skin lesions in a teenage patient.

Case: A previously healthy 14-year-old boy presented in our pediatric emergency department with unusual skin lesions on his left forearm. The patient said the lesions started 2 weeks earlier following a spider bite. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001722DOI Listing
January 2019

Pediatric Handlebar Injuries: More Than Meets the Abdomen.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Division of Pediatric Radiology, Department of Radiology, Indiana University School of Medicine.

Objectives: Injuries associated with bicycles can generally be categorized into 2 types: injuries from falling from/off bicycles and injuries from striking the bicycle. In the second mechanism category, most occur as a result of children striking their body against the bicycle handlebar. The purpose of this study was to evaluate the presentation, body location, injury severity, and need for intervention for pediatric handlebar injuries at a single level one pediatric trauma center and contrast these against other bicycle-related injuries in children. Read More

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http://Insights.ovid.com/crossref?an=00006565-900000000-9824
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http://dx.doi.org/10.1097/PEC.0000000000001690DOI Listing
January 2019
8 Reads

Sudden Diplopia at Pediatric Emergency Department: A Case of Gradenigo Syndrome in a Child.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.

Objective: Otitis media, facial pain in trigeminal region, and ipsilateral abducens nerve palsy clinically define Gradenigo syndrome, a rare but serious complication of suppurative middle ear infection. Radiological investigation is required to confirm petrous apex involvement and to exclude further consequences as sinus thrombosis, meningitis, and intracranial abscess.

Methods/results: We report the case of an 8-year-old child referred to our emergency department for recurrent headache and sudden strabismus. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001684DOI Listing
January 2019
3 Reads

A Novel Pediatric Emergency Department Intervention to Improve Adolescent Sexual Health Care.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS.

Objective: The aim of this study was to evaluate a novel educational intervention for physician trainees to improve sexual health care provision, including condom distribution, in the pediatric emergency department.

Methods: Resident physicians and medical students in an urban pediatric emergency department viewed an evidence-based educational video on sexual health care provision. It featured role-plays and a description of the condom distribution process, and targeted trainees who provide health care to patients aged 14 years or more with potential genitourinary complaints. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001670DOI Listing
January 2019
1 Read

Asthma-Related Emergency Department Visits Among Low-Income Families With Young Children by Race/Ethnicity and Primary Language.

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, MA.

Objective: The aim of this study was to examine the existence of racial/ethnic and language disparities in asthma-related emergency department (ED) initial and return visits among young children in low-income families in California.

Methods: Children younger than 6 years with at least 1 asthma-related ED visit recorded in the California Office of Statewide Health Planning and Development data set between January 1, 2009, and December 31, 2013, and on Medicaid (Medi-Cal) were assessed. Primary outcomes were hospitalization at the first asthma-related ED visit and a return asthma-related ED visit within 12 months. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001430DOI Listing
January 2019

Craniocervical Dissociation in Pediatric Patients: Pearls and Pitfalls of Diagnosis and Management.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

From the Divisions of Pediatric Surgery.

Aims: The aims of this study were to document the injury pattern in pediatric traumatic craniocervical dissociation (CCD) and identify features of survivors.

Methods: Pediatric traumatic CCDs, diagnosed between January 2004 and July 2016, were reviewed. Survivors and nonsurvivors were compared. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001721DOI Listing
January 2019
7 Reads

Randomized Controlled Trial of Acute Illness Educational Intervention in the Pediatric Emergency Department: Written Versus Application-Based Education.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, WI.

Objectives: The aim of this study was to determine the (1) feasibility, (2) demand, (3) acceptability, and (4) usefulness of a mobile health (mHealth) application (app) compared with a written intervention distributed in a pediatric emergency department (ED).

Methods: This was a randomized controlled trial with parents of children 12 years or younger presenting to the ED for nonurgent complaints. Parents were randomized to receive a (1) low literacy pediatric health book with video, (2) pediatric mHealth app, (3) both 1 and 2, or (4) car-seat safety video and handout (control). Read More

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http://dx.doi.org/10.1097/PEC.0000000000001719DOI Listing
January 2019
5 Reads

Subacute Gummy Vitamin Overdose as a Rare Manifestation of Child Neglect.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

We present a case of a 20-month-old girl who presented to the emergency department with anorexia, progressive weakness, and lethargy who was found to have severe hypercalcemia (20.7 mg/dL) and vitamin D hypervitaminosis. Further questioning revealed that this was secondary to a subacute toxic ingestion of "L'il Critters" calcium and vitamin D3 gummy vitamins that were being administered by the patient's mother multiple times a day for several weeks or even months. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001718DOI Listing
January 2019
6 Reads

Patterned Bruises From Abusive Squeezing.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT.

Bruising is the most common presentation of child physical abuse. Many patterns of abusive bruising result in positive or negative imprints of the implement used (eg, fingertips in "grab mark" contusions or hand in slap injury). However, bruising may also form along the lines of greatest anatomical stress (eg, gluteal cleft or pinna bruising). Read More

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http://dx.doi.org/10.1097/PEC.0000000000001717DOI Listing
January 2019
11 Reads

Focused Cardiac Ultrasound in Pediatric Pulmonary Hypertension.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

From the Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.

We present 2 cases of pediatric pulmonary hypertension presenting with respiratory distress. Focused cardiac ultrasound revealed findings consistent with right ventricular dilatation and elevated right ventricular pressure. These findings, in conjunction with the clinical presentation, allowed for early identification and rapid evaluation of a pathologic process that can often go unidentified. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001700DOI Listing
January 2019

Etiology, Management, and Outcome of Pediatric Epistaxis.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Munich, Munich.

Objective: Epistaxis in children is one of the most common causes for seeking professional medical help. Patients may be treated by several disciplines with various approaches to pediatric epistaxis. We reviewed cases of pediatric epistaxis from an otorhinolaryngologist's point of view. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001698DOI Listing
January 2019

Provision of Guideline-Based Pediatric Asthma Care in US Emergency Departments.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

From the Division of Emergency Medicine, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA.

Objectives: National guidelines for routine pediatric acute asthma care recommend providing corticosteroids, and discourage routinely obtaining chest radiographs (CXRs) and using antibiotics. We examined rates of adherence to all 3 of these aspects during emergency department (ED) visits and compared performance between pediatric and general EDs.

Methods: Using the National Hospital Ambulatory Medical Care Survey, we included all nontransfer ED visits for patients younger than 19 years with a diagnosis of asthma and treatment with albuterol from 2005 to 2015. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001706DOI Listing
January 2019

Foreign Body Reaction Due to a Forgotten Rubber Band on the Neck of a Toddler Girl.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

From the Departments of Pediatrics.

In the presence of an unhealed granulation tissue-like wound, a possibility of abuse and neglect along with a foreign body should come to mind. However, it may be difficult to recognize a foreign body in patients with atypical clinical presentations. We demonstrated delayed diagnosis of a rubber band embedded into subcutaneous tissue in a 2½-year-old girl who presented with a circumferential scar with 2 granulation tissue-like wounds on her neck due to a foreign body reaction developed over years. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001702DOI Listing
January 2019
2 Reads
0.923 Impact Factor

Morel-Lavallée Lesion of the Knee in the Young Athlete: About 2 Cases After Sports Trauma.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

From the Division of Surgery of the Child and the Adolescent, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.

Background: Differential diagnosis of soft tissue swelling on exposed body parts in the young athlete is large and mostly includes benign self-limiting conditions, once underlying lesion to the bone, the cartilage, and the ligaments is excluded. Morel-Lavallée lesion represents a rare soft tissue injury requiring prompt intervention to ensure favorable outcome.

Cases: A 10-year-old boy presented with 2-week-old swelling of the medial side of the knee without recent traumatic event. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001704DOI Listing
January 2019
8 Reads

Hospital-Based Emergency Department Visits With Pediatric Burns: Characteristics and Outcomes.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

Division of Critical Care, Stead Family Children's Hospital, University of Iowa, Iowa City, IA.

Objective: The objective of this study was to examine the characteristics and outcomes in children presenting to emergency departments (EDs) with burn injuries.

Methods: The Nationwide Emergency Department Sample (NEDS) for the years 2008 to 2013 was used. All patients younger than 18 years who visited a hospital-based ED with a burn injury were selected. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001699DOI Listing
January 2019
0.923 Impact Factor

Credentialing Pediatric Emergency Medicine Faculty in Point-of-Care Ultrasound: Expert Guidelines.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

Departments of Pediatrics and Emergency Medicine, University of Pittsburgh, Pittsburgh, PA.

As point-of-care ultrasound (POCUS) becomes standard practice in pediatric emergency medicine (PEM), it is important to have benchmarks in place for credentialing PEM faculty in POCUS. Faculty must be systematically trained and assessed for competency in order to be credentialed in POCUS and granted privileges by an individual institution. Recommendations on credentialing PEM faculty are needed to ensure appropriate, consistent, and responsible use of this diagnostic and procedural tool. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001677DOI Listing
January 2019

Universal Intimate-Partner Violence Assessment in the Pediatric Emergency Department and Urgent Care Setting: A Retrospective Review.

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

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. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001635DOI Listing
January 2019
3 Reads

A Systematic Review of Hospital Trauma Team Activation Criteria for Children.

Pediatr Emerg Care 2019 Jan;35(1):8-15

Emergency Medicine and Pediatrics, Medical College of Wisconsin, Milwaukee, WI.

Objectives: Hospital trauma activation criteria are intended to identify children who are likely to require aggressive resuscitation or specific surgical interventions that are time sensitive and require the resources of a trauma team at the bedside. Evidence to support criteria is limited, and no prior publication has provided historical or current perspectives on hospital practices toward informing best practice. This study aimed to describe the published variation in (1) highest level of hospital trauma team activation criteria for pediatric patients and (2) hospital trauma team membership and (3) compare these finding to the current ACS recommendations. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001256DOI Listing
January 2019

Carotid Dissection and Cerebral Infarction From Posterior Oropharyngeal Trauma: The Diagnostic and Therapeutic Challenges.

Pediatr Emerg Care 2019 Jan;35(1):e17-e21

Loma Linda University Medical Center, Loma Linda, CA.

Posterior oropharyngeal trauma commonly occurs in children and frequently presents to the emergency department (ED). Rarely, serious infectious and neurologic sequelae result. Emergency providers are tasked with the challenge of diagnosing the minority with life-threatening complications while maintaining thoughtful stewardship regarding radiation exposure. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001708DOI Listing
January 2019
9 Reads

Mistaken Asymptomatic Carinal Foreign Body in a Child.

Pediatr Emerg Care 2019 Jan;35(1):e11-e13

From the Departments of Paediatrics and Medicine, Schulich School of Medicine, University of Western Ontario, Children's Hospital at London Health Sciences Centre, London, Ontario, Canada.

Foreign body aspirations are commonly seen in emergency departments (EDs) worldwide, presenting with cough, dyspnea, wheeze, and decreased air entry. Chest radiographs are commonly utilized diagnostic tools to confirm foreign object aspiration. The following is a case report of a child who presented in the ED with a carinal push-pin aspiration and a lack of respiratory symptoms; an extremely rare ED presentation of foreign body aspirations masquerading as a foreign body ingestion. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001707DOI Listing
January 2019
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Point-of-Care Ultrasound in Pediatric Diagnostic Dilemmas: Two Atypical Presentations of Intussusception.

Pediatr Emerg Care 2019 Jan;35(1):72-74

Department of Radiology, Faculty of Medicine, University of Toronto.

Diagnostic dilemmas are ubiquitous in pediatric emergency medicine because of the varied and often insidious presentations of many pediatric conditions. Point-of-care ultrasound (POCUS) in emergency departments is being used for some of these diagnostic challenges and can often provide rapid and valuable information to supplement a physician's clinical assessment. Intussusception is a pediatric condition that may be challenging to recognize because of its subtle and varied presenting symptoms. Read More

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http://Insights.ovid.com/crossref?an=00006565-201901000-0001
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http://dx.doi.org/10.1097/PEC.0000000000001712DOI Listing
January 2019
1 Read
0.923 Impact Factor

Point-of-Care Ultrasound to Diagnose Pyomyositis in a Child.

Pediatr Emerg Care 2019 Jan;35(1):69-71

We report a case of a patient presenting with fever, right lower leg swelling, and pain who was found to have a fluid collection between muscle planes noted on point-of-care ultrasound. Point-of-care ultrasound raised the clinician's concern for deep musculoskeletal infection, leading to prompt initiation of antibiotics and magnetic resonance imaging. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001711DOI Listing
January 2019