Pediatric emergency care
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Pediatric emergency care · Dec 2021
Utility of Blood Cultures and Empiric Antibiotics in Febrile Pediatric Hemophilia Patients With Central Venous Access Devices.
Children with hemophilia frequently require long-term central venous access devices (CVADs) for regular infusion of factor products. Hemophilia patients are not immunocompromised, but the presence and use of CVADs are associated with infections including bacteremia. Currently, the utility of blood cultures in evaluation of the febrile hemophilia patient with an indwelling CVAD is unknown, nor is optimal empiric antibiotic use. ⋯ Febrile immunocompetent hemophilia patients with indwelling CVADs have high rates of bacteremia. Empiric antimicrobial therapy should be targeted to anticipated pathogens and take into consideration local susceptibility patterns for Staphylococcus aureus.
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Pediatric emergency care · Dec 2021
The Association of Race, Sex, and Insurance With Transfer From Adult to Pediatric Trauma Centers.
Our objective was to investigate whether racial/ethnic-based or payer-based disparities existed in the transfer practices of pediatric trauma patients from adult trauma center (ATC) to pediatric trauma center (PTC) in Pennsylvania. ⋯ Although we assume that a desire for specialized care is the primary reason for transfer of injured children to PTCs, our analysis demonstrates that race, female sex, and lack of insurance are also associated with transfers from ATCs to PTCs for children younger than 15 years in Pennsylvania. Further research is needed to understand the basis of these health care disparities and their impact.
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Pediatric emergency care · Dec 2021
Characteristics of Diagnosed Concussions in Children Aged 0 to 4 Years Presenting to a Large Pediatric Healthcare Network.
The aim of the study was to comprehensively describe the natural history of concussion in early childhood between 0 and 4 years. ⋯ These results provide insight into the clinical characteristics of concussion in early childhood up to 4 years of age. Because assessment in this group relies heavily on parent/caregiver symptom reporting, rather than patient self-report, these results will aid clinicians with the challenge of diagnosing concussions in this population. These findings highlight the need to develop additional tools to adequately and systematically assess common signs and symptoms of concussion in early childhood that may not be included in standard assessment scales routinely used in older adolescents and adults.
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This pilot study aims to identify potential predictors of postadmission interventions of hospitalized croup patients and derive a risk model aimed at reducing hospitalizations for croup. ⋯ There appear to be promising predictors in croup patients presenting to the ED, which might help stratify risk for interventions after the ED encounter and thus reduce the number of potentially avoidable admissions.
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Pediatric emergency care · Dec 2021
Intentional Poisoning in Pediatric Patients: Examining the Risk Factors.
Poisonings in children are common reasons for presentation to the emergency department and can potentially have serious complications. Our research aims to review risk factors leading to intentional self-poisoning. ⋯ Known psychiatric history or a history of deliberate self-harm are risk factors for intentional poisoning. Appropriate risk stratification and preemptive interventions involving closer surveillance or cognitive behavioral programs are possible measures to prevent intentional self-poisoning, especially in these at-risk groups.