Pediatric emergency care
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Pediatric emergency care · Oct 2021
Craniocervical Dissociation in Pediatric Patients: Pearls and Pitfalls of Diagnosis and Management.
The aims of this study were to document the injury pattern in pediatric traumatic craniocervical dissociation (CCD) and identify features of survivors. ⋯ In pediatric CCD, high-velocity mechanism, cardiac arrest, high Injury Severity Score, and low Glasgow Coma Scale score are associated with mortality. If CCD is correctly managed in the absence of cardiac arrest or traumatic brain or spinal cord injury, children may survive intact.
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Pediatric emergency care · Oct 2021
ReviewEfficacy of Apneic Oxygenation During Pediatric Endotracheal Intubation.
Because of the abundance of complications associated with peri-intubation hypoxia, maintaining adequate oxygen saturation during endotracheal intubation (ETI) is of great concern. In addition to standard preoxygenation techniques, apneic oxygenation (AO), the continuous flow of passive oxygenation, is a potential tool that can be used to eliminate hypoxia during ETI. Although scarcely studied in the pediatric population, AO has proven effective in reducing the incidence of hypoxia in adult patients with minimal side effects. The objective of this study is to evaluate the use of apneic oxygenation in pediatric patients and to determine its efficacy in preventing or delaying oxygen desaturation during the apneic period of ETI. ⋯ The findings in this study confirm that the practice of AO is not only efficacious in increasing the time until initial desaturation but also reduces the overall incidence of hypoxia during laryngoscopy in children.
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Pediatric emergency care · Oct 2021
Unintentional Opioid Ingestions Presenting to a Pediatric Emergency Department.
The purpose of this study was to describe unintentional opioid exposures in young children, including demographics, medical interventions, and clinical outcomes. ⋯ While opioid exposures in young children are a common and potentially life-threatening problem, most children remain asymptomatic. The majority of patients are able to be discharged from the ED after observation, and of those who are admitted, most have favorable outcomes and brief hospital stays. A small number of these patients require considerable medical interventions.
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Pediatric emergency care · Oct 2021
Occult Pneumothorax Identification on Extended Focused Assessment with Sonography for Trauma Examination in Children.
Occult pneumothoraces (OPTXs) are defined by air within the pleural space that is not visible on conventional chest radiographs (CXR). The aim of this study was to understand how frequently the Extended Focused Assessment with Sonography for Trauma (eFAST) examination identifies occult PTX in a pediatric blunt trauma population as compared with a criterion standard of chest computed tomography (CCT). ⋯ Although the sample size in this data set was small, our eFAST examinations identified none of 16 proven and 4 presumed OPTXs. The standard eFAST examination performed poorly in the detection of OPTXs in this single-center study of pediatric blunt trauma victims.
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Pediatric emergency care · Oct 2021
Randomized Controlled TrialComparison of Minimally Invasive Loop Drainage and Standard Incision and Drainage of Cutaneous Abscesses in Children Presenting to a Pediatric Emergency Department: A Prospective, Randomized, Noninferiority Trial.
This study aimed to determine whether the treatment of skin abscesses with vessel loop drainage is noninferior to standard incision and drainage (I&D) regarding treatment failure in pediatric patients in the emergency department (ED). ⋯ Abscess drainage with a vessel loop in the pediatric ED results in failure rates noninferior to those of the standard I&D. Satisfaction and cosmetic scores are favorable in both groups.