Pediatric emergency care
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Pediatric emergency care · Feb 2019
Shock Index as a Predictor of Morbidity and Mortality in Pediatric Trauma Patients.
Compared with unadjusted shock index (SI) (heart rate/systolic blood pressure), age-adjusted SI improves identification of negative outcomes after injury in pediatric patients. We aimed to further evaluate the utility of age-adjusted SI to predict negative outcomes in pediatric trauma. ⋯ Elevated SI is an accurate and specific predictor of morbidity and mortality in pediatric trauma patients and is superior to tachycardia or hypotension alone for predicting mortality.
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Pediatric emergency care · Feb 2019
Review Case ReportsAcute Disseminated Encephalomyelitis in an Incarcerated Adolescent Presents as Acute Psychosis: Case Report and Literature Review.
We aimed to describe a case of an incarcerated adolescent with acute disseminated encephalomyelitis (ADEM) presenting as acute psychosis. ⋯ Acute disseminated encephalomyelitis can present as acute psychosis; therefore, clinical suspicion is important when treating patients who have a history of past infectious brain diseases, especially encephalitis. Given the rapid onset of disease, physicians must be knowledgeable of the diagnosis and treatment of ADEM and be vigilant in finding organic causes of acute psychosis.
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Pediatric emergency care · Feb 2019
ReviewSee-Hear-Feel-Speak: A Protocol for Improving Outcomes in Emergency Department Interactions With Patients With Autism Spectrum Disorder.
The presentation of children and adolescents with autism in the emergency department (ED) poses a unique set of challenges to clinicians and their teams, which have not yet been met. Children and adolescents with autism spectrum disorder (ASD) are more likely than their age and ethnically matched counterparts to visit both pediatric and general EDs and are more likely to use it for primary care complaints and dental care and to present for psychiatric concerns including suicidality. ⋯ After performing a literature review of existing evidence-based recommendations via PubMed as well as resources from autism advocacy and self-advocacy groups, we compiled a 4-step system: "See-Hear-Feel-Speak" an approach conducive to learning with the goal of enabling clinicians and their teams to facilitate patient-centered encounters with pediatric patients with ASD. The protocol meets the practicality requirements defined by published research.
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Pediatric emergency care · Feb 2019
Multicenter StudyPain Assessment in Children Younger Than 8 Years in Out-of-Hospital Emergency Medicine: Reliability and Validity of EVENDOL Score.
Pain in children is underestimated and undertreated in out-of-hospital emergency medicine. In this setting, caregivers need a reliable pain scale, but none has been validated. A single observational pain scale for all children younger than 8 years, EVENDOL, has been validated in emergency pediatric units. We study the feasibility of EVENDOL score in an out-of-hospital emergency setting. ⋯ EVENDOL is a quick, easy-to-use, discriminant instrument to assess pain in young children in out-of-hospital emergency settings.
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Pediatric emergency care · Feb 2019
ReviewPrevalence of Abuse Among Young Children With Rib Fractures: A Systematic Review.
We aimed to estimate the prevalence of abuse in young children presenting with rib fractures and to identify demographic, injury, and presentation-related characteristics that affect the probability that rib fractures are secondary to abuse. ⋯ Abuse is the most common cause of rib fractures in infants younger than 12 months. Prospective studies with standardized methods are needed to improve accuracy in determining abuse prevalence among children with rib fractures and characteristics associated with abusive rib fractures.