Pediatric emergency care
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Pediatric emergency care · Dec 2022
Case ReportsPoint-of-Care Ultrasound and the Discovery of Pulmonary Arterial Hypertension in a Teenager.
We present a case of a teenage patient with new-onset cardiac symptoms discovered to have primary pulmonary arterial hypertension. Point-of-care ultrasound used early in the patient's presentation identified significant right-sided heart dilatation and dysfunction despite the patient's relatively unrevealing physical examination. This article emphasizes the utility of performing focused cardiac ultrasound in pediatric patients early in their presentation. We briefly review focused cardiac ultrasound technique and highlight relevant literature.
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Pediatric emergency care · Dec 2022
Risk Factors for Ankle Fractures in Asian Adolescents Seen in a Pediatric Emergency Department.
Pediatric ankle injuries remain one of the most common presenting complaints to the pediatric emergency department (PED). In this study, we aimed to describe risk factors associated with simple ankle fractures and ankle fractures that require surgery, among adolescents presenting to the PED with ankle injuries. ⋯ We found that younger age, male sex, and clinical findings in the Ottawa Ankle Rules correlated well with predicting ankle fractures and are well suited for application in the Southeast Asian population. Weight greater than the 90th percentile for age was a significant risk factor for ankle fractures requiring surgery.
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Pediatric emergency care · Dec 2022
Overutilization of Radiographs for Pulled Elbow Among Orthopedic Surgeons Compared With Pediatricians.
Electronic medical records of the largest health provider in Israel, which provides health services to more than 50% of the population, were reviewed for pulled elbow cases between 2005 and 2020. Patients aged 4.5 months to 7 years were included. Demographic information, the discipline of the treating physician, and acquisition of elbow radiographs were gathered. ⋯ Orthopedic surgeons use elbow radiographs much more than pediatricians; effort should aim at reducing the imaging rate for this population.
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Pediatric emergency care · Dec 2022
Adequacy of Emergency Department Documentation of Child Restraint Use After a Motor Vehicle Crash.
There are limited data on how often providers collect and document adequate restraint information in children seen in the emergency department (ED) after motor vehicle crashes (MVCs). The objectives of this study are to determine (1) how often adequate child restraint information to determine age-appropriate use is documented after MVC; (2) the frequency of incorrect use of the child restraint when adequate details are documented; and (3) for those discharged from the ED with identified incorrect use, the frequency of provision of information on child passenger safety (CPS). ⋯ Adequate details to determine proper age-appropriate restraint use are documented in only half of ED visits for MVC. Very few are given CPS instructions on discharge, even when incorrect use has been identified. Identification of incorrect restraint use in the ED is an opportunity for a teachable moment that is being underused.
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Pediatric emergency care · Dec 2022
Risk Factors of Nonsurgical Management Failure in Pediatric Intussusception Patients With Delayed Presentation.
The present study aimed to investigate the time-related predicting factors of the ultrasound-guided hydrostatic reduction (USGHR) failure in pediatric patients with ileocolic intussusception and delayed presentation. ⋯ The presence of entrapped fluid between the intussuscepted loops, free peritoneal fluid, and the length of the intussuscepted segments were all associated with USGHR failure in our study. Therefore, determining these predictors may help anticipate failure of reduction.