Pediatric emergency care
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Pediatric emergency care · Jan 2019
ReviewKetamine Infusion for Pain Control in Acute Pediatric Sickle Cell Painful Crises.
Sickle cell disease is the most common hemoglobin variant in the world and can present with recurrent vaso-occlusive painful crises. Pain control in these patients is often difficult and requires a multimodal approach. In patients with uncontrolled pain after traditional pain control methods, ketamine infusions have proven beneficial. Unfortunately, no source alone had described ketamine infusions for pediatric sickle cell patients. Our objective was to provide a thorough definitive reference for health care providers regarding the use of ketamine infusion for pain control in pediatric sickle cell painful crises. ⋯ Ketamine infusions have shown promise in assisting physicians in appropriately treating pediatric sickle cell painful crises.
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Pediatric emergency care · Jan 2019
Multicenter StudyProfile of Interfacility Emergency Department Transfers: Transferring Medical Providers and Reasons for Transfer.
The aim of this study was to determine the reasons for pediatric emergency department (ED) transfers and the professional characteristics of transferring providers. ⋯ Most pediatric interfacility ED transfers are referred by general emergency medicine physicians who often transfer for inpatient admission or subspecialty consultation. Understanding the needs of the community-based ED providers is an important step to forming more collaborative efforts for regionalized pediatric emergency care.
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Pediatric emergency care · Jan 2019
Case ReportsMistaken Asymptomatic Carinal Foreign Body in a Child.
Foreign body aspirations are commonly seen in emergency departments (EDs) worldwide, presenting with cough, dyspnea, wheeze, and decreased air entry. Chest radiographs are commonly utilized diagnostic tools to confirm foreign object aspiration. The following is a case report of a child who presented in the ED with a carinal push-pin aspiration and a lack of respiratory symptoms; an extremely rare ED presentation of foreign body aspirations masquerading as a foreign body ingestion. This attests to the importance of conducting a lateral chest radiograph for diagnostic purposes to accurately interpret an esophageal or tracheal foreign body placement.
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Pediatric emergency care · Jan 2019
A National Analysis of Pediatric Trauma Care Utilization and Outcomes in the United States.
More childhood deaths are attributed to trauma than all other causes combined. Our objectives were to provide the first national description of the proportion of injured children treated at pediatric trauma centers (TCs), and to provide clarity to the presumed benefit of pediatric TC verification by comparing injury mortality across hospital types. ⋯ Our results provide the first national evidence that treatment at verified pediatric TCs may improve outcomes, supporting a survival benefit with pediatric trauma verification. Given lack of similar survival advantage found for level-1 dual TCs (both general/pediatric verified), we highlight the need for further investigation to understand factors responsible for the survival advantage at pediatric-only TCs, refine pediatric accreditation guidelines, and disseminate best practices.
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Pediatric emergency care · Jan 2019
Pediatric Anaphylaxis in the Emergency Department: Clinical Presentation, Quality of Care, and Reliability of Consensus Criteria.
The objective of this study was to describe the quality of emergency department (ED) care for pediatric patients with anaphylaxis. The secondary objectives were to describe (1) the clinical presentation of pediatric patients with anaphylaxis including the proportion of patients meeting each of the National Institute of Allergy and Infectious Diseases (NIAID) consensus criteria and subcriteria and (2) the Interrater reliability (IRR) for applying the NIAID criteria. ⋯ Our findings highlight a gap between best practice and ED care. In addition, our results suggest that the NIAID criteria can reliably be used to retrospectively identify pediatric patients with anaphylaxis. Accurately identifying cases is a prerequisite for measuring gaps in management and developing interventions to improve care.