Pediatric emergency care
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Pediatric emergency care · Aug 2017
Case ReportsA Curiously Rare Case of Septic Shock From Clostridium difficile Colitis.
This case provides the first report of a young healthy child presenting in septic shock from Clostridium difficile colitis. This child had no identifiable risk factors for C. difficile, raising the suspicion for a hypervirulent strain. Once infection was recognized and treated appropriately, the child made a full recovery. This case presentation highlights the need to consider C. difficile colitis in the differential diagnosis of severely ill patients, even in the absence of traditional risk factors or symptoms.
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Pediatric emergency care · Aug 2017
The Effectiveness of Remote Facilitation in Simulation-Based Pediatric Resuscitation Training for Medical Students.
To assess the effectiveness of pediatric simulation by remote facilitation. We hypothesized that simulation by remote facilitation is more effective compared to simulation by an on-site facilitator. We defined remote facilitation as a facilitator remotely (1) introduces simulation-based learning and simulation environment, (2) runs scenarios, and (3) performs debriefing with an on-site facilitator. ⋯ A pediatric acute care simulation by remote facilitation significantly improved students' performance. In this pilot study, remote facilitation seems as effective as a traditional, locally facilitated simulation. The remote simulation can be a strong alternative method, especially where experienced facilitators are limited.
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Pediatric emergency care · Aug 2017
Relation of Medical History to the Pediatric Out-of-Hospital Cardiac Arrest Managed by Emergency Medical Services.
The aim of this study was to examine the medical history of the pediatric out-of-hospital cardiac arrest (OHCA) patients to determine preexisting conditions that may relate to a later OHCA. ⋯ Majority of the patients had prior medical records. Psychiatric disorders were strongly presented.
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Pediatric emergency care · Aug 2017
Symptom-Guided Emergency Department Discharge Instructions for Children With Concussion.
The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed. ⋯ Both study groups reported frequent use of the DIs. Caregivers with symptom DIs found them particularly helpful in determining when their child could return to school and physical activity. Larger-scale investigations are needed to further develop instructions that are easy to use and that may decrease the postconcussive period.
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Pediatric emergency care · Aug 2017
Case ReportsPoint-of-Care Ultrasound Identification of an Abdominal Hernia.
Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall hernia but subsequently determined to be an unusual presentation of an inguinal hernia with testicular entrapment. We review each of these diagnoses in addition to relevant POCUS findings.