Pediatric emergency care
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Pediatric emergency care · Aug 2007
ReviewControversies in the sequelae of pediatric mild traumatic brain injury.
Traumatic brain injury is a common occurrence in the pediatric population, and the majority of injuries are considered to be mild. There are varying definitions of mild traumatic brain injury. Classification systems for injury severity may include initial Glasgow Coma Scale, duration of loss of consciousness, and duration of posttraumatic amnesia. ⋯ The symptoms can occur in the areas of cognitive, somatic, and/or affective/emotional complaints. There continues to be controversy concerning the definition of mild traumatic brain injury, the significance of postconcussion syndrome, and the development of other posttraumatic neuropsychological changes. This article will review the literature on the sequelae of pediatric mild brain injury and discuss areas of controversy.
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Pediatric emergency care · Aug 2007
Comparative StudyTest characteristics of parent's visual analog scale score in predicting ventriculoperitoneal shunt malfunction in the pediatric emergency department.
Many parents of children with ventriculoperitoneal shunts present to the emergency department for evaluation of a possible shunt malfunction. No study to date has evaluated their ability to predict a shunt malfunction. Our study objective was to evaluate parents' accuracy for predicting a shunt malfunction in their child. We hypothesize that parents more experienced with prior shunt malfunctions are better able to predict subsequent malfunctions in their child. ⋯ Experienced parents are better able to predict a shunt malfunction in their child.
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Pediatric emergency care · Aug 2007
Lack of evidence to support routine digital rectal examination in pediatric trauma patients.
Current advanced trauma life support guidelines recommend that a digital rectal examination (DRE) should be performed as part of the initial evaluation of all trauma patients. Our primary goal was to estimate the test characteristics of the DRE in pediatric patients for the following injuries: (1) spinal cord injuries, (2) bowel injuries, (3) rectal injuries, (4) pelvic fractures, and (5) urethral disruptions. ⋯ The DRE has poor sensitivity for the diagnosis of spinal cord, bowel, rectal, bony pelvis, and urethral injuries. Our findings suggest that the DRE should not be routinely used in pediatric trauma patients.
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Pediatric emergency care · Aug 2007
Review Practice GuidelineEvidence-based guidelines for family presence in the resuscitation room: a step-by-step approach.
The benefits of family presence (FP) during resuscitation have been well documented in the literature for the past 20 years. However, many hospitals lack written guidelines to direct staff members during a resuscitation event. ⋯ The purpose of this paper is to provide evidence-based practice guidelines to offering FP during resuscitation in the emergency department. The guidelines illustrate a practical step-by-step approach that staff members can follow every time a patient is being evaluated and/or treated in the resuscitation room.