Pediatric emergency care
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Pediatric emergency care · Jun 2021
ReviewTop Citations of Pediatric Emergency Medicine Publications in the Emergency Medicine Literature.
The goal of this study was to identify and analyze the 100 most frequently cited journal articles pertaining to the field of pediatric emergency medicine (PEM) and published in emergency medicine (EM) peer-reviewed literature. ⋯ This analysis provides a review of citation frequency of top-cited PEM articles published in EM journals. This determines the influence of these PEM publications on the EM specialty. The importance of education on resuscitation and anesthesia topics in PEM was evident. Most of the articles were published more than 10 to 15 years ago, indicating that they could be considered landmarks in the subspecialty of PEM. This signifies their importance to other authors in this field, who chose to cite them as having created a significant impact on their own publications.
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Pediatric emergency care · Jun 2021
Case ReportsSeizures, Meds, and Vtach: A Journey to a Brugada Diagnosis.
Sudden cardiac arrest of cardiac etiology is rare in children and adolescents and most often occurs with exertion. Conversely, syncope is a common pediatric emergency department complaint but rarely is associated with a serious underlying cardiac disorder. This report describes a case of the channelopathy Brugada syndrome (BrS) as a cause of sudden cardiac arrest in a febrile preadolescent child taking medications known to affect cardiac conduction. ⋯ Confirmatory electrophysiologic testing was performed, and an implantable cardiac defibrillator was placed. Pediatric emergency specialists must recognize both the importance of ECG in the workup of syncope and be familiar with the specific ECG findings suggestive of BrS. Ventricular arrhythmias that occur at rest should raise the suspicion of this genetic cardiac channelopathy, regardless of age.
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Death is an uncommon event in the pediatric emergency department. The sudden end of a young life is always an undesirable event. Staff and family members are never prepared. ⋯ Whether the patient is old or young, previously sick or healthy, it is important to stop and consider how hard it must be for the assembled family. As frontline clinicians, we all deeply care about the outcome of our patients and their families, yet for them to feel they have been understood and well cared for, it is recognized that clinicians must attend to health care conversations on a deeper and more relational level. Consideration that these events happen and reinforcing that it is difficult for all involved ensure staff that their challenges are recognized.
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Pediatric emergency care · Jun 2021
Randomized Controlled TrialA Randomized Single-Blinded Simulation-Based Trial of a Novel Method for Fluid Administration to a Septic Infant.
For children presenting in shock, American College of Critical Care Medicine guidelines recommend 3 boluses of intravenous fluids during initial resuscitation, but these are often not met. This study aims to compare a novel device LifeFlow, to established manual methods for rapid fluid delivery in a simulated environment. ⋯ LifeFlow allowed for faster fluid administration rate and thus could be the preferred technique for rapid fluid resuscitation in pediatrics patients. Further investigations should explore the reproducibility of these results using this device in real patients in multiple centers.
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Pediatric emergency care · Jun 2021
Prevalence of Cyberbullying in Patients Presenting to the Pediatric Emergency Department.
Mental health (MH) complaints are increasingly responsible for visits to pediatric emergency departments (PEDs). Bullying is associated with MH problems. Most adolescents use social media and many experience problems with cyberbullying (CB). This study determines prevalence of CB in MH and non-MH adolescents in a PED, describes technology use in these groups, and measures influence of CB on presentation to the PED and on thoughts/acts of self-harm. ⋯ Prevalence of bullying in MH patients presenting to a PED is significantly greater than controls, and CB caused more MH patients to have acts or thoughts of self-harm. Bullying is a risk factor for self-harm and suicide in patients with MH problems. Future studies should evaluate CB as part of suicide screening tools for emergency MH patients.