Pediatric emergency care
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Pediatric emergency care · Jun 2017
Intussusception in Children Presenting to the Emergency Department: An Asian Perspective.
This project examines the presenting complaints of children with intussusception in the emergency department in an Asian population, with a focus on older children, which has not been well described in previous studies. ⋯ Intussusception is usually diagnosed in the younger population (age <1 year) and predominantly in males. Our study has established that older Asian children can also have intussusception. The classical triad is not a very sensitive diagnostic tool, but the combination of abdominal pain, indrawing of legs, and vomiting may be a more common presenting triad in Asian children.
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Pediatric emergency care · Jun 2017
An Assessment of Newly Identified Barriers to and Enablers for Prehospital Pediatric Pain Management.
The aim of this study was to quantitatively assess the prevalence of newly identified barriers and enablers to prehospital narcotic analgesic administration in a sample of paramedics and determine whether these barriers and enablers differ between new and experienced paramedics. ⋯ Top barriers to prehospital pediatric analgesic administration are related to skills and knowledge deficits, whereas enablers include support from agency leadership and personal views on analgesics. This information can be used to guide interventions to improve the management of pain in children.
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Pediatric emergency care · Jun 2017
Impact of an Institutional Guideline on the Care of Neonates at Risk for Herpes Simplex Virus in the Emergency Department.
Herpes simplex virus (HSV) is rare in neonates but carries significant morbidity and mortality in that group. Emergency department (ED) clinicians have little guidance to decide when to test for HSV and give acyclovir. We created an institutional guideline to provide guidance in patients younger than 6 weeks. Our objective was to evaluate whether guideline implementation affected the ED's decision to test for HSV, and ED use of HSV polymerase chain reactions (PCRs) and acyclovir. ⋯ Guideline implementation reduced HSV evaluations in low-risk patients, but did not improve test utilization or acyclovir administration among those tested. Additional work is needed to improve guideline utilization.
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Pediatric emergency care · Jun 2017
Case ReportsEmergency Point-of-Care Ultrasound Diagnosis of Retained Soft Tissue Foreign Bodies in the Pediatric Emergency Department.
The presence of a foreign body (FB), its depth and size, is often indeterminate by clinical examination. Conventional imaging such as a radiograph can fail to visualize soft tissue FBs. We present 2 cases where point-of-care ultrasound was used to detect previously unidentified FBs.
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Many indications justifiably drive the pediatrician to request a urine sample in order to assess the health status of the incontinent baby or infant. Urine collection by means of an adhesive perineal bag is the most widely used in children who do not control urine emission, despite its inaccurate reflection of bacteriuria. We suggest a novel technique to immediately visualize the micturition event upon occurrence, in attempt to shorten waiting times and exhausting checking and rechecking opaque diapers in order to determine whether the desired sample has finally been delivered. ⋯ Widespread adoption of the diaper slit technique seems a promising procedure enhancing comfort and facilitating the process of obtaining a urine sample in the incontinent child. Assumptions that this procedure actually shortens waiting times and raises the success rates of sample retrieval remain to be proven by formal comparative trials.