Pediatric emergency care
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Pediatric emergency care · Nov 2023
Evaluation of Pediatric Readiness Using Simulation in General Emergency Departments in a Medically Underserved Region.
Regionalization of pediatric care in the United States was developed to improve care by directing patients to hospitals with optimal pediatric resources and experience, leading to less pediatric-trained providers in medically underserved areas. Children with emergencies, however, continue to present to local general emergency departments (GEDs), where pediatric emergencies are low-frequency, high-risk events. ⋯ This study shows a significant disparity in the performance and readiness of GEDs versus a PED in a medically underserved area. More education and better access to resources is needed in these areas to adequately care for critically ill pediatric patients.
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Pediatric emergency care · Nov 2023
National Survey on the Emergency Department Management of Febrile Infants 29 to 60 Days Old With an Abnormal Urinalysis.
Recent clinical practice guidelines recommend that decisions regarding lumbar puncture (LP) for febrile infants older than 28 days should no longer be based on urinalysis results, but rather independently determined by inflammatory markers and sometimes guided by shared decision-making (SDM). This study sought to assess management decisions for febrile infants aged 29 to 60 days with an abnormal urinalysis. ⋯ Knowledge translation initiatives reflecting current evidence should target use of inflammatory markers rather than urinalysis results to guide decisions regarding LP. Efforts emphasizing outpatient management with oral antibiotics and SDM for low-risk infants with an abnormal urinalysis could also further align management with current evidence and guidelines.
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Pediatric emergency care · Nov 2023
Predictors for Dental Intervention in Children After Dental Injury: A Retrospective Analysis and Literature Review.
This study aimed to explore risk factors for dental intervention in patients presenting to the pediatric emergency department (PED) after dental injury. ⋯ Alveolar fracture is a severe dental injury, requiring intervention, for primary and permanent teeth injuries. Tooth luxation with significant mobility or malocclusion, incomplete avulsion, a suspected root involvement, or facial bone injury in the primary teeth and tooth luxation (extrusive/lateral) and avulsion in the permanent teeth dictate urgent dental consultation and intervention. Clinical algorithms for dental injury management are suggested.
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Pediatric emergency care · Nov 2023
Athletic Trainer and Emergency Medical Technician or Paramedic Opinions of Each Other's Understanding of Essential Emergent Football Injury Situation Tasks.
Improving the role understanding between essential emergency healthcare providers may improve teamwork and efficacy. This study asked licensed athletic trainers (ATs) and emergency medical technicians (EMTs) or paramedics for their opinions of the others' understanding of essential tasks in an emergent football injury situation. The hypothesis was that groups would have differing opinions. ⋯ Opinions differed about the other profession's understanding of essential tasks. More experienced ATs partnered more strongly with EMTs/paramedics. Both professional groups would benefit from collaborative workshops or seminars to improve the teamwork needed to optimize an emergent football injury situation. The development and implementation of practices such as these may also improve teamwork and patient-center healthcare at mass participant sporting events such as marathons, triathlons, and road cycling events.
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Pediatric emergency care · Nov 2023
Tibiofemoral Dislocation Management in a Rural High School Football Scenario: Development of a Popliteal Artery Injury Suspicion Index.
This study evaluated the knowledge and preparedness of athletic trainers (ATs) for diagnosing and managing an anterior tibiofemoral knee dislocation in a rural or limited-resource high school football setting scenario. The study hypothesis was that more experienced ATs would display greater preparedness than less experienced ATs. A secondary objective was to develop evidence-based guidelines to help the AT provide better emergency triage care. ⋯ More experienced ATs perceived a more serious situation than less experienced ATs and were more likely to activate the emergency action plan. Both groups were neutral about their ability to diagnose the condition or manage the case, had poor ankle-brachial index test familiarity, and agreed that they would benefit from evidence-based guidance. Proposed guidelines provide the AT with a more measured, evidence-based index of suspicion for potential popliteal artery injury in anterior tibiofemoral dislocation cases. This will complement existing hospital emergency department-based management algorithms, decreasing the likelihood of this condition progressing to limb loss or death.