Pediatric emergency care
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Pediatric emergency care · May 2022
Predictors of Empiric Antibiotic Use in the Emergency Department in Children Without Urinary Tract Infections.
Urinary tract infections (UTIs) are a common diagnosis within the pediatric emergency department (ED). Because of the necessary delay in obtaining urine culture results, clinicians must decide whether to prescribe antibiotics for a suspected UTI before urine culture results. The primary objective of this study was to identify the proportion of children given empiric antibiotics who subsequently did not meet consensus definition of an UTI. The secondary objective was to identify factors associated with return visits to the ED after an index visit for UTI. We also attempted to identify predictors of prescription of empiric antibiotics for children who did not have a UTI. ⋯ A high number of patients discharged on empiric antibiotics did not meet criteria for a UTI. We did not identify clinically useful factors that predicted prescription of empiric antibiotics for children who do not have a UTI. We believe that unnecessary antibiotic prescriptions could be substantially decreased by decreasing empiric use of antibiotics coupled with reliable follow-up for positive urine cultures.
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Pediatric emergency care · May 2022
Observational StudyAssessment of Iron Status in Adolescents Presenting to the Emergency Department With Heavy Menstrual Bleeding.
Iron deficiency is extremely common in adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department; however, patients are rarely screened for this. The objective of this study was to evaluate screening for iron deficiency in adolescents presenting to the emergency department for HMB. ⋯ Adolescents presenting to the emergency department with HMB are at significant risk of iron deficiency but are not being screened or treated, which may have significant consequences.
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Pediatric emergency care · May 2022
Case ReportsA Case of Esophageal Duplication Cyst Identified on Cardiac Point-of-Care Ultrasound.
Esophageal duplication cysts are rare congenital anomalies that are often symptomatic because of compression of surrounding structures. They are commonly diagnosed during childhood, with affected patients often presenting with abdominal pain or chest pain. Point-of-care ultrasound can be used as part of the emergency department evaluation of pediatric chest pain. We present a case of a 6-year-old boy who presented to the emergency department with worsening abdominal and chest pain, where point-of-care cardiac ultrasound identified a cystic structure in the posterior mediastinum.
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Pediatric emergency care · May 2022
Adolescent Male Receptivity of and Preferences for Sexual Health Interventions in the Emergency Department.
Male adolescents frequently present to the emergency department (ED) and many participate in behaviors increasing their risk of sexually transmitted infections and unintended pregnancies. Although the ED visit may represent an intervention opportunity, how best to design and deliver a sexual health intervention matching the preferences of adolescent male users is unclear. Our objective was to explore receptivity to and preferences for sexual health interventions among adolescent male ED patients. ⋯ Adolescent male ED patients are receptive to ED-based digital sexual health interventions. These identified preferences should be considered when designing future user-informed sexual health interventions for the ED setting.
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Pediatric emergency care · May 2022
Hematemesis in Infants: The First Evidence-Based Score to Predict the Need for Timely Endoscopy.
Infantile acute upper gastrointestinal bleeding involves a decision for therapeutic intervention that most pediatricians first coming into contact with the patient are, not unreasonably, unable to objectively provide. Therefore, some objective tools of individual risk assessment would seem to be crucial. The principal aim of the present study was to investigate the anamnestic and clinical parameters of infants with hematemesis, together with laboratory and instrumental findings, to create a scoring system that may help identify those infants requiring an appropriate and timely application of upper gastrointestinal (GI) endoscopy. ⋯ We provided the first objective tool of individual risk assessment for infants with hematemesis, which could be very useful for pediatricians first coming into contact with the patient in the emergency department.