Pediatric emergency care
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Pediatric emergency care · Jul 2022
Pediatric Softball Injuries Presenting to Emergency Departments.
This study sought to characterize the mechanisms of injury responsible for common softball-related injuries in recent years. ⋯ Being hit by the ball was the most common mechanism of injury, especially in the head/neck region, and shoulder/elbow injuries increase with athlete age. Coaches and leagues may consider mandating helmets for infielders and pitch counts for pitchers, especially among adolescent athletes.
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Pediatric emergency care · Jul 2022
The Association Between Initial Serum Bicarbonate Levels and the Management of Dehydrated Children in the Emergency Department: A Retrospective Review.
There is no consensus in the current literature on the relevance of serum bicarbonate levels, cutoff benchmarks and the management of dehydration; therefore, this study aims to explore whether an association can be established between initial serum bicarbonate levels and the subsequent management of children between the ages of 0 to 36 months presenting to the emergency department (ED) with dehydration. ⋯ Initial serum bicarbonate level of dehydrated children does not appear to be associated with the severity of dehydration, vomiting, diarrhea and the patients' management in the ED or the hospital. Initial serum bicarbonate is associated with the decision to administer fluid boluses and potential bounce back.
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Pediatric emergency care · Jul 2022
Identifying Barriers to Trainees Addressing Corporal Punishment and Effective Discipline Using Simulation and Semistructured Debriefing.
The objective of the current study was to examine (1) physician trainee interventions when confronted with a situation in which corporal punishment (CP) occurs in a simulated medical setting and (2) their knowledge, comfort, and experiences shared during a semistructured debriefing. ⋯ Trainees felt uncomfortable with intervening when CP was observed and did not know how to provide appropriate guidance to families on discipline. Moreover, performance during the simulation and discussions during the debriefings revealed knowledge gaps regarding the difference between CP and physical abuse, how to word recommendations about CP to caregivers, and what resources should be provided. These data suggest the need for education on CP and discipline to be integrated into pediatric training.
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Pediatric emergency care · Jul 2022
Emergency Department Initiated Mental Health Interventions for Young People: A Systematic Review.
Young people (10-24 years old) with mental health concerns are increasingly presenting to hospital emergency departments (EDs). The purpose of this review was to identify the core components and outcomes of mental health interventions for young people that are initiated in the ED, such that they are delivered in the ED and/or by ED health workers. ⋯ This systematic review demonstrated that ED-initiated mental health interventions result in improved service outcomes, but further innovation and robust evaluation are required. Future research should determine whether these interventions lead to better clinical outcomes for young people and staff to inform the development of best practice recommendations for ED-initiated mental health care for young people presenting to the ED.
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Pediatric emergency care · Jul 2022
Multicenter Study Observational StudyRisk Factors of Serious Bacterial Infection in Previously Healthy Children Older Than 90 Days Old With Fever and Neutropenia.
The main objective was to determine the clinical or analytical factors that independently predict risk of serious bacterial infection (RSBI) in immunocompetent patients older than 90 days given a diagnosis of fever and for whom neutropenia was an incidental finding. The secondary objective was to describe the prevalence of serious bacterial infections (SBIs). ⋯ None of the clinical or analytical variables assessed were associated with the RSBI. However, according to a post hoc analysis, in patients with greater than 5000 leukocytes/μL, a neutrophil percentage less than 20% could be an independent risk factor for SBI. A thorough physical examination and basic diagnostic tests (urinalysis and chest x-ray) may help to establish a diagnosis of SBI in the vast majority of cases.