Pediatric emergency care
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Pediatric emergency care · May 2021
Resuscitation With Ringer's Lactate Compared With Normal Saline for Pediatric Diabetic Ketoacidosis.
The aims of this study were to describe the use of Ringer's lactate (LR) or normal saline (NS) for resuscitation among children with diabetic ketoacidosis (DKA) and compare the effect of fluid type on cost, length of stay, and rate of cerebral edema (CE). ⋯ Ringer's lactate was infrequently used for resuscitation of pediatric DKA patients. However, resuscitation with LR compared with NS was associated with lower total cost and rates of CE. Further investigation using patient-level clinical and laboratory data is needed to evaluate factors that drive cost and risk of CE development with each fluid.
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Pediatric emergency care · May 2021
Factors Influencing Pediatric Emergency Department Visits for Low-Acuity Conditions.
Emergency department (ED) overcrowding is a growing problem, and pediatric patients are contributing. In this study, we aimed to determine which factors influence parents or guardians to choose the ED over their primary care physician (PCP). ⋯ There appears to be a common misperception that PCPs do not offer extended hours. In addition, the parent or guardian's perception of severity was oftentimes more serious than perceived by medical staff. These results suggest that improving health literacy among our patient population by educating them on PCP availability and capability, ancillary services offered by PCP, and appropriate usage of the ED could potentially reduce nonurgent ED visits.
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Pediatric emergency care · May 2021
Test Characteristics of Cerebrospinal Fluid Gram Stain to Identify Bacterial Meningitis in Infants Younger Than 60 Days.
In our cohort of 20,947 infants aged 60 days or younger, cerebrospinal fluid Gram stain had a sensitivity of 34.3% (95% confidence interval, 28.1%-41.1%) and a positive predictive value of 61.4% (95% confidence interval, 52.2%-69.8%) for positive cerebrospinal fluid culture, suggesting that Gram stain alone may lead to both underdiagnosis and overdiagnosis of bacterial meningitis.
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Pediatric emergency care · May 2021
Effects of Glucocorticoids on Hospitalized Children With Anaphylaxis.
The benefits of glucocorticoid treatment and recent trends of adjunctive treatments during episodes of anaphylaxis remain unclear. ⋯ We observed increasing trends of H1- and H2-receptor antagonist use. Length of hospital stay and total hospitalization cost were greater in the steroid group than in the nonsteroid group, whereas readmission risks were similar between the 2 groups.
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Pediatric emergency care · May 2021
Outcomes of Short Versus Long Leg Casts for Childhood Accidental Spiral Tibial CAST Fractures.
The objective of the current study was to analyze the outcomes of short versus long leg casts in the treatment of childhood accidental spiral tibial (CAST) fractures. ⋯ A short leg walking cast seems to be an effective and safe method of treatment for CAST fractures and could be considered as potentially preferable to long leg casts because of the added benefits of increased mobility and function. Follow-up to this preliminary study is warranted to better elucidate any differences in benefit between these treatment options, and clinical judgment should be used when considering immobilization options.