Pediatric emergency care
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Pediatric emergency care · Jul 2021
Dexamethasone Versus Prednisone for Pediatric Acute Asthma Exacerbations: Specialists' Practice Patterns.
Dexamethasone has emerged as a viable alternative to prednisone in the treatment of pediatric acute asthma exacerbations, with the potential for improved compliance secondary to decreased frequency of dosing, improved taste, and decreased cost. The objective of this study is to identify whether providers are prescribing dexamethasone for pediatric acute asthma exacerbations. Secondary objectives are to describe variation in practice between different specialties and to identify the commonly used dosing and frequency for dexamethasone. ⋯ Although most pediatric emergency medicine academic physicians have transitioned to using dexamethasone to treat acute pediatric asthma exacerbations, other specialties continue to favor prednisone.
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Pediatric emergency care · Jul 2021
Utility of Chest Radiographs in Children Presenting to a Pediatric Emergency Department With Acute Asthma Exacerbation and Chest Pain.
Previous studies have not evaluated the utility of obtaining chest radiographs (CXR) in patients with acute asthma exacerbation reporting chest pain. The aims of this study were to evaluate the symptom of chest pain as a predictor for clinicians obtaining a CXR in these patients and to evaluate chest pain as a predictor of a positive CXR finding. ⋯ Providers are more likely to obtain CXRs in asthmatic patients complaining of chest pain; however, these CXRs infrequently yield positive findings. This further supports limiting the use of chest radiography in patients with acute asthma exacerbation.
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Pediatric emergency care · Jul 2021
ReviewDelayed Subaponeurotic Fluid Collections: A Benign Cause of Scalp Swelling in Infancy.
Delayed subaponeurotic fluid collections (DSFCs) are a recently described cause of idiopathic scalp swelling in young infants. Associated with traumatic birth and the use of vacuum-assisted devices or fetal scalp electrodes, DSFCs can be differentiated from similar causes of neonatal scalp swelling based on characteristic history and physical examination findings. ⋯ In cases of isolated DSFCs in otherwise well-appearing infants, further laboratory work, imaging, subspecialty consultation, and child abuse investigation is not necessary. Recommendations for the diagnosis and management of DSFCs presented reflect the clinical experience of the authors in conjunction with a review of the available medical literature on this topic.
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Pediatric emergency care · Jul 2021
Treatment Outcomes of Pediatric Status Epilepticus in a Tertiary Pediatric Intensive Care Unit.
Status epilepticus is associated with high rates of morbidity and mortality; thus, early diagnosis and proper treatment are crucial. We aimed to study the etiology, clinical features, and treatment among pediatric patients with convulsive status epilepticus. ⋯ Phenytoin is still one of the most efficient antiepileptic drugs. If the duration of status epilepticus can be shortened by prompt treatment, neurological complications may be prevented.
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Single-sided (1-tailed) and double-sided (2-tailed) probabilities are products of statistical tests that can be crucial to drawing accurate conclusions in scientific studies. In a review of articles published in issues of Pediatric Emergency Care from 2020, we identified 2 where single-sided versus double-sided probability issues potentially reversed a conclusion of study investigators. The purpose of this study is to describe single-sided versus double-sided probability issues found in Pediatric Emergency Care 2020 articles to increase awareness surrounding these issues. ⋯ These articles demonstrate how single-sided versus double-sided probability issues can cause researchers to draw inaccurate conclusions. As such, we would urge that this be more rigorously evaluated when the P values are between 0.05 and 0.10.