The American journal of emergency medicine
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Observational Study
Pediatric point-of-care ultrasound of optic disc elevation for increased intracranial pressure: A pilot study.
Papilledema is often difficult to detect in children. Ocular point-of-care ultrasound (POCUS) measurement of the optic nerve sheath diameter (ONSD) is a non-invasive test for increased intracranial pressure (ICP), but no consensus exists on normal pediatric ONSD values. Detection of optic disc elevation (ODE, a component of papilledema) using POCUS has recently been qualitatively described. We sought to establish the diagnostic accuracy of different ODE cutoffs to detect increased ICP in children who underwent ocular POCUS in our pediatric emergency department (PED). ⋯ ODE-B may represent the optimal ocular POCUS measurement for detecting increased ICP in children, and future prospective studies could more accurately describe the diagnostic performance of different pediatric ODE-B cutoffs.
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Emergency departments (EDs) play an essential role in the timely initiation of HIV post-exposure prophylaxis (PEP) for sexual assault victims. ⋯ While ED patient acceptance of HIV PEP after sexual assault was high, infectious disease clinic follow-up and documented completion of PEP remained low. Innovative care models bridging EDs to outpatient clinics and community support services are needed to optimize transitions of care for sexual assault victims, including those receiving HIV PEP.
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Letter Multicenter Study
Complications of serious acute conditions in children during the COVID-19 pandemic.