5,991 results match your criteria Pediatric Emergency Care[Journal]


Increased Testing and Health Care Costs for Pediatric Cannabis Exposures.

Pediatr Emerg Care 2019 Apr 12. Epub 2019 Apr 12.

University of Colorado Anschutz Medical Campus, Aurora, CO.

Objectives: This study aimed to evaluate the process of identifying marijuana exposure in a children's hospital emergency department and compare the cost of diagnostic testing and procedures.

Methods: A retrospective chart review was performed on patients 31 days to 20 years old with a positive marijuana toxicology screen result between November 2009 and December 2014. Primary outcomes included time to provider recognition of marijuana exposure, number of diagnostic tests and procedures performed, and length of hospital stay. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001811DOI Listing

Trochanteric Fractures in Young Children.

Pediatr Emerg Care 2019 Apr 16. Epub 2019 Apr 16.

From the Department of Trauma and Orthopaediatrics, University Hospital of Wales, Cardiff, United Kingdom.

Background: Isolated avulsion fractures of the greater and lesser trochanter are usually seen in adolescents prior to the fusion of the apophysis. Greater trochanter fractures in adults have a high incidence of intertrochanteric extension and lesser trochanter fractures are regarded as a pathognomonic sign of metastatic disease. These fractures are very rare among children. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001825DOI Listing
April 2019
1 Read

A Paper-Based Car Seat Safety Educational Intervention in the Pediatric Emergency Department.

Pediatr Emerg Care 2019 Apr 16. Epub 2019 Apr 16.

Department of Emergency Medicine, Children's Hospital of Los Angeles, Los Angeles, CA.

Objective: Motor vehicle crashes are a leading source of pediatric morbidity and mortality in children younger than 13 years. Proper car seat safety device (CSD) markedly reduces mortality, but the majority of families misuse them. Emergency department (ED)-based educational interventions can improve knowledge patient regarding proper CSD use but historically have been resource intensive. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001808DOI Listing

Development of a Clinical Prediction Model for Central Line-Associated Bloodstream Infection in Children Presenting to the Emergency Department.

Pediatr Emerg Care 2019 Apr 11. Epub 2019 Apr 11.

†University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Objective: The majority of the children with a central line who present to the emergency department with fever or other signs of bacteremia do not have a central line-associated bloodstream infection (CLABSI). Our objective was to develop a clinical prediction model for CLABSI among this group of children in order to ultimately limit unnecessary hospital admissions and antibiotic use.

Methods: We performed a nested case-control study of children with a central line who presented to the emergency department of an urban, tertiary care children's hospital between January 2010 and March 2015 and were evaluated for CLABSI with a blood culture. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001835DOI Listing
April 2019
2 Reads

Leaving Without Being Seen From a Pediatric Emergency Department: Identifying Caregivers' Perspectives Using Q-methodology.

Pediatr Emerg Care 2019 Apr 11. Epub 2019 Apr 11.

Objective: National rates of left (or leaving) without being seen (LWBS) in pediatric emergency departments (PED) are higher than general emergency departments. We investigated coexisting perspectives on LWBS.

Methods: Q-methodology was implemented through a mixed-methods design. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001792DOI Listing

Amphetamine and Clonidine Toxicity Resulting in Posterior Reversible Encephalopathy Syndrome.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Emergency Medicine, and.

Amphetamine toxicity typically presents with hypertension and tachycardia. Conversely, clonidine acts as an agonist at central α2 and imidazoline receptors, which may cause brief initial hypertension followed by hypotension and bradycardia in overdose. We report a case of mixed ingestion resulting in posterior reversible encephalopathy syndrome (PRES) successfully treated with phentolamine. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001819DOI Listing
April 2019
3 Reads

Early Recognition and Treatment of Acute Disseminated Encephalomyelitis in Pediatrics: A Case Series.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Objective: Our aim is to emphasize the varied presentation of acute disseminated encephalomyelitis (ADEM) to help health care professionals improve recognition of the disease in a timely manner, thereby allowing for the selection of an appropriate treatment regimen. Therefore, this may avoid neurocognitive consequences and the ultimate fatality of the patient.

Patients And Methods: This is a retrospective case series involving 7 cases of children presenting to the Pediatric Emergency Department of Hackensack University Medical Center who were ultimately diagnosed with ADEM. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001771DOI Listing
April 2019
1 Read

Early Ultrasound Follow-Up of Extension-Type Supracondylar Fractures Treated by the Collar-and-Cuff (Blount) Technique.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Department of Pediatric Imaging, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris6, Paris, France.

Background: Extension-type supracondylar fractures can be treated with external immobilization, with the elbow flexed 100°. However, this technique requires early evaluation by true lateral x-ray of the elbow to detect secondary fracture displacement.

Questions/purpose: The purpose of this work is to evaluate whether ultrasound imaging is suitable for demonstrating initial reduction of supracondylar fractures and early secondary displacement of the fracture. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001822DOI Listing

Trends in Pediatric Poisoning-Related Emergency Department Visits: 2001-2011.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

From the Division of Emergency Medicine, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC.

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. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001817DOI Listing
April 2019
2 Reads

Coarctation of the Aorta in Adolescence: Significance of Detailed Cardiac Examination in Pediatric Hypertension.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Although coarctation of the aorta (CoAo) is a congenital anomaly, it can pose a diagnostic challenge in those presenting beyond neonatal period, as some patients can remain asymptomatic until complications of hypertension develop later in life. Careful physical examination can play an important role in timely diagnosis and prevention of complications.We present 2 cases of adolescents with undiagnosed CoAo who both presented with nonspecific headaches and hypertension. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001834DOI Listing
April 2019
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Pulmonary Alveolar Proteinosis: A Case of Profound Hypoxemia in a Previously Healthy Teenager.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Children's Hospital Colorado, Aurora, CO.

The profoundly hypoxemic child presents an interesting set of diagnostic and management challenges in the pediatric emergency department. While common pathologies including pneumonia, asthma, bronchiolitis, and pneumothoraces are managed using evidence-based algorithms, more enigmatic pathologies may present the treating physician with less diagnostic and therapeutic clarity. We present the case of a profoundly hypoxemic 16-year-old girl who presented in minimal distress, with oxyhemoglobin saturation of 63% on room air. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001820DOI Listing
April 2019
4 Reads

Screening Laboratory Testing in Asymptomatic Minor Pediatric Blunt Trauma Leads to Unnecessary Needle Sticks.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Saint Louis School of Medicine, St. Louis.

Objective: Screening blood work after minor injuries is common in pediatric trauma. The risk of missed injuries versus diagnostic necessity in an asymptomatic patient remains an ongoing debate. We evaluated the clinical utility of screening blood work in carefully selected asymptomatic children after minor trauma. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001810DOI Listing
April 2019
1 Read

Multiple Abusive Fractures in an Infant With a Concurrent Parathyroid Hormone-Related Peptide-Secreting Renal Tumor: Abusive Fractures Accompanying a Parathyroid Hormone-Related Peptide-Secreting Tumor.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Background: When evaluating an infant with unexplained fractures for child abuse, it is important to evaluate for possible causes of underlying bone fragility.

Case: A 7-month-old infant was found to have a parathyroid hormone (PTH)-related peptide-secreting mesoblastic nephroma. In spite of having an elevated serum calcium, depressed serum phosphate, and high levels of PTH-related peptide, he had no demineralization or other hyper parathyroid-related bone changes. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001796DOI Listing
April 2019
2 Reads

Chromhidrosis: An Unusual Cause of Skin Discoloration.

Pediatr Emerg Care 2019 Apr 4. Epub 2019 Apr 4.

From the Texas Children's Hospital, Department of Pediatric Emergency Medicine at Baylor College of Medicine, Houston TX.

Chromhidrosis is a rare condition characterized by the secretion of colored sweat. We report a case of a preadolescent healthy girl presenting with acute, recurrent blue discoloration of her armpits. The blue discoloration can be wiped off but recurs. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001790DOI Listing

Impact of Environmental Noise Levels on Endotracheal Intubation Performance Among Pediatric Emergency Providers: A Simulation Study.

Pediatr Emerg Care 2019 Apr 4. Epub 2019 Apr 4.

Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA.

Background: The emergency department is a stressful workplace environment with environmental stimuli and distractions, including noise. This has potential effects on perceived stress for providers and critical procedure performance.

Objective: This study aimed to characterize the impact of environmental noise levels on the time to intubate, the quality of intubation, and physiologic stress response in pediatric emergency department providers. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001831DOI Listing

Bihemispheric Cerebral Oximetry Monitoring's Functionality in Suspected Cerebral Edema Diabetic Ketoacidosis With Therapeutic 3% Hyperosmolar Therapy in a Pediatric Emergency Department.

Pediatr Emerg Care 2019 Apr 4. Epub 2019 Apr 4.

Division of Biostatistics ACHRI, Department of Pediatrics, Arkansas Children's Hospital Research Institute, College of Medicine, University of Arkansas, Little Rock, AR.

Background: Suspected cerebral edema diabetic ketoacidosis (SCEDKA) is more common than perceived with symptoms including altered mentation, headache with vomiting, depressed Glasgow coma scale (GCS), abnormal motor or verbal responses, combativeness, and neurological depression. Suspected cerebral edema diabetic ketoacidosis has been associated with initial diabetic ketoacidosis (DKA) presentation and at start of DKA therapy.Cerebral oximetry (bihemispheric regional cerebral oxygen saturation [rcSO2] and cerebral blood volume index [CBVI]) can detect increased intracranial pressure (ICP)-induced altered bihemispheric cerebral physiology (rcSO2) (Crit Care Med 2006;34:2217-2223, J Pediatr 2013;163: 1111-1116, Curr Med Chem 2009;16:94-112, Diabetologia 1985;28:739-742, Pediatr Crit Care Med 2013;14:694-700). Read More

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http://dx.doi.org/10.1097/PEC.0000000000001774DOI Listing
April 2019
2 Reads

A Mixed Presentation of Serotonin Syndrome Versus Neuroleptic Malignant Syndrome in a 12-Year-Old Boy.

Pediatr Emerg Care 2019 Jan 4. Epub 2019 Jan 4.

Department of Public Health and Clinical Medicine Umeå University Umeå, Sweden Sunderby Research Unit Department of Clinical Sciences Division of Psychiatry Umeå University Umeå, Sweden.

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http://dx.doi.org/10.1097/PEC.0000000000001830DOI Listing
January 2019
1 Read

Development of a Quality Improvement Curriculum in a Pediatric Emergency Medicine Fellowship.

Pediatr Emerg Care 2019 Jan 4. Epub 2019 Jan 4.

From the Department of Pediatrics, Section of Emergency Medicine, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.

Quality improvement (QI) is a science of systematic analysis and improvement of health care delivery systems. Working knowledge of QI models is imperative to professional development of future pediatric emergency medicine practitioners. The Accreditation Council for Graduate Medical Education has established a list of QI and patient safety expectations for trainees. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001824DOI Listing
January 2019

High Risk of Bias in a Systematic Review of Rib Fractures and Abuse by Paine et al (2019).

Pediatr Emerg Care 2019 Apr 5. Epub 2019 Apr 5.

Department of Women'sand Children's HealthUppsala UniversityUppsala Forensic MedicineDepartment of Surgical SciencesUppsala UniversityUppsala, Sweden Formerly Department of Women'sand Children's HealthChild and Adolescent Psychiatric UnitKarolinska InstitutetStockholm, Sweden Forensic MedicineDepartment of Surgical SciencesUppsala UniversityUppsala, Sweden.

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http://dx.doi.org/10.1097/PEC.0000000000001832DOI Listing
April 2019
8 Reads

Ocular Point-of-Care Ultrasound in the Pediatric Emergency Department.

Pediatr Emerg Care 2019 Feb 14. Epub 2019 Feb 14.

Department of Pediatric Emergency Medicine, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.

Objective: Point-of-care ultrasound has become an important adjunct for diagnostic assessment in pediatric emergency medicine. In this case series, we demonstrate how ocular point-of-care ultrasound is used to correctly diagnose ocular pathologies and to expedite care.

Methods/results: We present a series of cases in which the point-of-care ultrasound ocular examination proved valuable in the timely diagnosis of pathologies involving the lens, vitreous, retina, and retrobulbar segment of the eye. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001762DOI Listing
February 2019
1 Read

Long-Term Follow-Up of Infants After a Brief Resolved Unexplained Event-Related Hospitalization.

Pediatr Emerg Care 2019 Apr 3. Epub 2019 Apr 3.

Objective: A brief resolved unexplained event (BRUE) in infancy is a common reason for visiting the emergency department. However, little is known about the long-term outcomes of such an event. This study evaluates future mortality, morbidity, and/or developmental outcome after a BRUE. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001816DOI Listing
April 2019
4 Reads

A Response to "Pediatric Referrals to an Emergency Department From Urgent Care Centers".

Pediatr Emerg Care 2019 Apr 3. Epub 2019 Apr 3.

University of Missouri-School of Medicine University of Kansas School of Medicine Division of Urgent Care Patient and Family Engagement Children's Mercy Kansas City Kansas City, MO and Society for Pediatric Urgent University of Missouri-School of Medicine University of Kansas School of Medicine Division of Urgent Care Children's Mercy Kansas City Kansas City, MO and Society for Pediatric Urgent Care University of Missouri-School of Medicine University of Kansas School of Medicine Division of Urgent Care Department of Pediatrics Children's Mercy Kansas City Kansas City, MO Society for Pediatric Urgent Care University of Missouri-School of Medicine University of Kansas School of Medicine Children's Mercy East Urgent Care Children's Mercy Kansas City Kansas City, MO and Society for Pediatric Urgent Care.

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http://dx.doi.org/10.1097/PEC.0000000000001806DOI Listing

Utility of Neuroimaging in Children Presenting to a Pediatric Emergency Department With Ataxia.

Pediatr Emerg Care 2019 Mar 29. Epub 2019 Mar 29.

From the Children's Hospital of Michigan and.

Objectives: The aim of this study was to evaluate the utility of neuroimaging in children who present to the pediatric emergency department with acute-/subacute-onset ataxia. Neuroimaging is performed in many children with ataxia to rule out serious intracranial pathology. There is, however, limited evidence to support such practice. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001823DOI Listing
March 2019
1 Read

Croup Admissions: Can We Shrink the Elephant in the Room?

Pediatr Emerg Care 2019 Mar 28. Epub 2019 Mar 28.

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN.

Objective: This pilot study aims to identify potential predictors of postadmission interventions of hospitalized croup patients and derive a risk model aimed at reducing hospitalizations for croup.

Methods: Data were collected on all croup hospitalizations for patients aged 1 month to 17 years admitted through a community hospital's emergency department (ED) between 2012 and 2017. Potential predictors were obtained from the electronic medical records including demographics, vital signs, ED length of stay, preintervention and postintervention Westley Croup Score (WCS), number of racemic epinephrine nebulizations administered, time to dexamethasone administration, preexisting conditions, and additional interventions during hospitalization. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001829DOI Listing
March 2019
2 Reads

Retrospective Comparison of Intranasal Fentanyl and Inhaled Nitrous Oxide to Intravenous Ketamine and Midazolam for Painful Orthopedic Procedures in a Pediatric Emergency Department.

Pediatr Emerg Care 2019 Mar 28. Epub 2019 Mar 28.

From the Emergency Pediatrician, Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Objectives: To compare the efficacy and adverse events of 2 pharmacological strategies: intranasal fentanyl and nitrous oxide (FN) inhaled against intravenous ketamine and midazolam (KM) as procedural sedation and analgesia (PSA) in painful orthopedic procedures in the pediatric emergency department (ED).

Methods: This is an observational retrospective cohort study. Patients were included that submitted to PSA for carrying out a painful orthopedic procedure in the ED of a tertiary hospital over a period of 2 years. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001788DOI Listing
March 2019
1 Read

Congenital Malaria in a Febrile Infant Born to an Immigrant Mother With No Travel During Pregnancy.

Pediatr Emerg Care 2019 Mar 28. Epub 2019 Mar 28.

From the Department of Pediatrics and Adolescent Medicine, Einstein Medical Center, Philadelphia, PA.

Congenital malaria is a condition that can be acquired during pregnancy or perinatally at the time of delivery by transplacental transmission of parasitized maternal erythrocytes. Because of its rare incidence in the United States, it is most frequently missed as a differential diagnosis by physicians when evaluating a febrile infant born to an immigrant mother. Timely diagnosis for physicians is also a challenge when there is no recent history of travel. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001786DOI Listing
March 2019
1 Read

Ethics in the PED: An Untimely Death.

Pediatr Emerg Care 2019 Mar 28. Epub 2019 Mar 28.

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Death is an uncommon event in the pediatric emergency department. The sudden end of a young life is always an undesirable event. Staff and family members are never prepared. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001828DOI Listing

Current Approach to the Management of Forearm and Elbow Dislocations in Children.

Pediatr Emerg Care 2019 Apr;35(4):293-298

Assistant Professor and Director of Ultrasound (Gottlieb), Department of Emergency Medicine, Rush University Medical Center, Chicago, IL; Assistant Professor (Suleiman), Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.

Pediatric orthopedic injuries are a common reason for presentation to the emergency department. This article sequentially discusses 2 important upper extremity injuries that require prompt management in the emergency department. Radial head subluxations are discussed with a focus on current evidence for imaging, reduction techniques, and follow-up. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001805DOI Listing
April 2019
1 Read

Varied Clinical Presentations of Acute Dystonic Reaction Due to Metoclopramide.

Pediatr Emerg Care 2019 Mar 21. Epub 2019 Mar 21.

Pediatric Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.

Objectives: In this article, in light of the literature, we aimed at discussing data obtained from patients in which extrapyramidal adverse effects that are misdiagnosed as varied clinical presentations developed due to metoclopramide, which is frequently prescribed in pediatric emergency services and in family practice centers for its powerful and rapid antiemetic action.

Methods: The files of patients who presented to a pediatric clinic at the research hospital of Mustafa Kemal University between January 2017 and January 2018 and who were diagnosed as having acute dystonic reaction were reviewed retrospectively.

Results: Generalized hypertonicity in 4 patients, abnormal involuntary movements in 2 patients, oculogyric crisis in 2 patients, local hypertonia in the wrist and fingers in 2 patients, spasmodic cervical hypertonicity in 2 patients, and trismus in 1 patient were found. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001800DOI Listing
March 2019
1 Read

An Interesting Presentation of Lyme Pseudothrombophlebitis.

Pediatr Emerg Care 2019 Mar 21. Epub 2019 Mar 21.

From the Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.

An 8-year-old boy presented to the emergency department with swelling and pain of his left knee and calf for approximately 1 week. His examination was significant for moderate knee effusion and swelling of the posterior calf with erythema and warmth of the affected areas. An ultrasound obtained at an outside hospital showed a large heterogeneous mass in the gastrocnemius, and a magnetic resonance imaging revealed a large, heterogeneous, rim-enhancing collection in the medial head of the left gastrocnemius muscle with surrounding myositis involving the gastrocnemius muscle. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001826DOI Listing

The Girl With the Bleeding Earlobe Mass.

Pediatr Emerg Care 2019 Mar 21. Epub 2019 Mar 21.

Pilomatrixomas, also known as epithelioma calcificans, are benign tumors of hair follicle matrix cells that are often mistaken for other lesions, especially cutaneous abscesses. We report an illustrative case in which a teenage girl developed a red, swollen earlobe that required multiple care visits and interventions until definitive diagnosis and treatment were provided. Although the lesion was initially treated as an abscess, it continued to progress in size and discomfort. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001809DOI Listing

Smartphone-Related Accidents in Children and Adolescents: A Novel Mechanism of Injury.

Pediatr Emerg Care 2019 Mar 22. Epub 2019 Mar 22.

From the Departments of Pediatric Surgery, and.

Objectives: Smartphones have become an integral part of daily life, often grabbing full attention of its user. We hypothesized that smartphone-associated trauma in children and adolescents has increased in the last decade. The objective of this study was to analyze smartphone-related injuries in children at two German centers for pediatric emergency care. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001781DOI Listing
March 2019
8 Reads

Evaluation of the Efficacy and Safety of 3 Different Management Protocols in Pediatric Diabetic Ketoacidosis.

Pediatr Emerg Care 2019 Mar 22. Epub 2019 Mar 22.

Endocrinology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Objective: Management protocols for pediatric diabetic ketoacidosis (DKA) vary considerably among medical centers. The aim of this study was to investigate the efficacy and safety of 3 different fluid protocols in the management of DKA.

Methods: Fluid management protocols with sodium contents of 75, 100, and 154 mEq/L NaCl were compared. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001770DOI Listing
March 2019
2 Reads

Do the Social and Environmental Factors Affect the Emergency Service Admission Characteristics of Preschool-Aged Pediatric Trauma Patients?: A Prospective Study.

Pediatr Emerg Care 2019 Mar 22. Epub 2019 Mar 22.

Department of Emergency Medicine, Bagcilar Medilife Hospital, İstanbul, Turkey.

Objective: Studies related to the epidemiology of trauma play a major role in determining the health status of the communities living in the vicinity of the centers that they are conducted. We have found no epidemiological study related to emergency service admission conducted only on preschool-aged children in the literature. Our aim was to determine characteristics of trauma in this age group, to analyze encountered trauma types, and to investigate possible associations among epidemiological factors, characteristics of the trauma victims, and trauma itself in pediatric patients admitted to our emergency service. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001768DOI Listing
March 2019
2 Reads

Pediatric Prehospital Intraosseous Access During Combat Operations in Iraq and Afghanistan.

Pediatr Emerg Care 2019 Mar 19. Epub 2019 Mar 19.

University of Colorado School of Medicine, Aurora, CO.

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. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001818DOI Listing
March 2019
3 Reads

Profiling Pediatric Potentially Avoidable Transfers Using Procedure and Diagnosis Codes.

Pediatr Emerg Care 2019 Mar 19. Epub 2019 Mar 19.

From the Department of Pediatrics.

Objectives: While hospital-hospital transfers of pediatric patients are often necessary, some pediatric transfers are potentially avoidable. Pediatric potentially avoidable transfers (PATs) represent a process with high costs and safety risks but few, if any, benefits. To better understand this issue, we described pediatric interfacility transfers with early discharges. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001777DOI Listing
March 2019
2 Reads

Adolescent Substance Abuse Risk: A Comparison of Pediatric Emergency Care Applied Research Network Emergency Department Patients and 2 Nationally Representative Samples.

Pediatr Emerg Care 2019 Mar 19. Epub 2019 Mar 19.

Lurie Children's Hospital of Chicago, Chicago, IL.

Objectives: The aim of this study was to understand the prevalence of alcohol and other substance use among teenagers in generalized samples.

Methods: This study compared the alcohol and other substance use of adolescents enrolled in a screening study across 16 Pediatric Emergency Care Applied Research Network emergency departments (EDs) (ASSESS) with those sampled in 2 nationally representative surveys, the Youth Risk Behavior Surveillance System (YRBSS) and the National Survey of Drug Use and Health (NSDUH). The analysis includes 3362 ASSESS participants and 11,142 YRBSS and 12,086 NSDUH respondents. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001763DOI Listing
March 2019
5 Reads

Venoarterial Extracorporeal Life Support Utilization in a Pediatric Trauma Patient Following a Severe Dog Mauling.

Pediatr Emerg Care 2019 Mar 19. Epub 2019 Mar 19.

From the University of North Carolina, Chapel Hill, NC.

According to the Centers for Disease Control and Prevention, approximately 4.5 million dog bites occur each year in the United States, and more than half of these cases affect children. An estimated 1 in 6 dog bites, representing more than 800,000 bite victims each year, requires some form of medical attention. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001753DOI Listing
March 2019
1 Read

The Medical Resuscitation Committee: Interprofessional Program Development to Optimize Care for Critically Ill Medical Patients in an Academic Pediatric Emergency Department.

Pediatr Emerg Care 2019 Mar 14. Epub 2019 Mar 14.

From the Division of Emergency Medicine, and.

Provision of optimal care to critically ill patients in a pediatric emergency department is challenging. Specific challenges include the following: (a) patient presentations are highly variable, representing the full breadth of human disease and injury, and are often unannounced; (b) care team members have highly variable experience and skills and often few meaningful opportunities to practice care delivery as a team; (c) valid data collection, for quality assurance/improvement and clinical research, is limited when relying on traditional approaches such as medical record review or self-report; (d) specific patient presentations are relatively uncommon for individual providers, providing few opportunities to establish and refine the requisite knowledge and skill; and (e) unscientific or random variation in care delivery. In the current report, we describe our efforts for the last decade to address these challenges and optimize care delivery to critically ill patients in a pediatric emergency department. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001742DOI Listing

Preferences for Expedited Partner Therapy Among Adolescents in an Urban Pediatric Emergency Department: A Mixed-Methods Study.

Pediatr Emerg Care 2019 Mar 14. Epub 2019 Mar 14.

Division of Child and Adolescent Health, Departments of Pediatrics and Population and Family Health, Mailman School of Public Health, New York, NY.

Objectives: Expedited partner therapy (EPT) refers to treating sexual partners of patients with sexually transmitted infections by providing prescriptions or medications to give to their partners. Expedited partner therapy is not routinely prescribed in the emergency department (ED). Our objective was to explore adolescent preferences for EPT use in the ED. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001746DOI Listing

A Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome Associated With Clobazam.

Pediatr Emerg Care 2019 Mar 11. Epub 2019 Mar 11.

Department of PediatricsDivision of Child NeurologySchool of MedicineDokuz Eylül University İzmir, Turkey

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http://dx.doi.org/10.1097/PEC.0000000000001754DOI Listing
March 2019
4 Reads

Austere Foreign Body Injuries in Children and Adolescents: A Characterization of Penile, Rectal, and Vaginal Injuries Presenting to Emergency Departments in the United States From 2008 to 2017.

Pediatr Emerg Care 2019 Mar 11. Epub 2019 Mar 11.

Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.

Background: Pediatric foreign body (FB) injuries to the nasal, aural, and/or oral cavities are well documented. Description of austere foreign body (AFB) injuries involving the rectum, vagina, or penis eludes the current pediatric literature. Austere FBs can be difficult to identify and have the potential to cause serious consequences. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001803DOI Listing

Liquid Nicotine Intoxication Due to Dangerous Packaging.

Pediatr Emerg Care 2019 Mar 11. Epub 2019 Mar 11.

Division of Pediatrics Department of Medicine University of Udine and Piazzale Santa Maria della Misericordia Udine, Italy Division of Pediatrics Department of Medicine University of Udine and Piazzale Santa Maria della Misericordia Udine, Italy.

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http://dx.doi.org/10.1097/PEC.0000000000001812DOI Listing
March 2019
2 Reads

Substance Use in a Domestic Minor Sex Trafficking Patient Population.

Pediatr Emerg Care 2019 Mar 11. Epub 2019 Mar 11.

Substance use and abuse have been documented as both a risk factor in and consequence of involvement in domestic minor sex trafficking (DMST). Domestic minor sex trafficking is defined as the commercial sexual exploitation of children in exchange for money, food, shelter, or any other valued entity. The current investigation sought to describe substance use in a cohort of DMST patients who present for medical evaluation. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001749DOI Listing

Atypical Presentation of Chiari I Malformation in a 13-Year-Old Adolescent.

Pediatr Emerg Care 2019 Apr;35(4):e72-e75

Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

In this report, we describe a 13-year-old with opisthotonos as the presenting symptom of Chiari I malformation. This presentation is rare and has previously been reported only in infants. We describe the physical and radiologic findings, literature regarding Chiari malformation, and differential diagnosis of opisthotonos in this patient. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001801DOI Listing

The Utility of the Focused Assessment With Sonography in Trauma Examination in Pediatric Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis.

Pediatr Emerg Care 2019 Mar 12. Epub 2019 Mar 12.

Objective: To evaluate the utility of the Point of Care Ultrasound (POCUS) Focused Assessment with Sonography for Trauma (FAST) examination for diagnosis of intra-abdominal injury (IAI) in children presenting with blunt abdominal trauma.

Methods: We searched medical literature from January 1966 to March 2018 in PubMed, EMBASE, and Web of Science. Prospective studies of POCUS FAST examinations in diagnosing IAI in pediatric trauma were included. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001755DOI Listing
March 2019
10 Reads

Roller Coaster-Induced Subdural Hematoma in a Previously Healthy Teenager.

Pediatr Emerg Care 2019 Apr;35(4):e76-e78

From the Department of Emergency Medicine, Los Angeles County-University of Southern California, Los Angeles, CA.

Of the multitude of neurologic injuries related to roller-coaster rides, a majority of them are reported about adults. In this case, we present a patient who presented to the pediatric emergency department with new-onset seizure and hemiplegia 2 days after a roller-coaster ride. She was ultimately diagnosed with a subdural hematoma. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001802DOI Listing
April 2019
8 Reads

Atraumatic Spinal Epidural Hematoma as Initial Presentation of Hemophilia A in an Infant.

Pediatr Emerg Care 2019 Mar 12. Epub 2019 Mar 12.

Hemophilia A is characterized by deficiency of factor VIII. We present a unique, illustrative case of an infant with a short history of neck pain and irritability without neurological deficits who was found to have a spinal epidural hematoma. The subsequent investigation for the etiology, including workup for nonaccidental trauma, led to a diagnosis of severe hemophilia A. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001793DOI Listing

Pediatric Abdominal Pain in Children Presenting to the Emergency Department.

Pediatr Emerg Care 2019 Mar 12. Epub 2019 Mar 12.

Department of Medicine, Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria.

Background: Undifferentiated abdominal pain is a common pediatric presentation to the emergency department (ED).

Objectives: The objective of this study was to describe the prevalence of clinically significant abdominal pathology (CSAP) including appendicitis, patterns of imaging and pathology tests, and management and outcomes of children with abdominal pain in ED.

Methods: A prospective multicenter observational cohort pilot study of children under the age of 16 years presenting to 4 Australian EDs with abdominal pain was performed for a 1-month period at each site. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001789DOI Listing
March 2019
6 Reads

Improving Pediatric Diabetic Ketoacidosis Management in Community Emergency Departments Using a Simulation-Based Collaborative Improvement Program.

Pediatr Emerg Care 2019 03 12. Epub 2019 Mar 12.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indiana University Health, Indianapolis, IN

Objectives: The majority of pediatric patients with diabetic ketoacidosis (DKA) present to community emergency departments (CEDs) that are less prepared to care for acutely ill children owing to low pediatric volume and limited pediatric resources and guidelines. This has impacted the quality of care provided to pediatric patients in CEDs. We hypothesized that a simulation-based collaborative program would improve the quality of the care provided to simulated pediatric DKA patients presenting to CEDs. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001751DOI Listing
March 2019
1 Read
0.923 Impact Factor