Pediatric emergency care
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Pediatric emergency care · Feb 2023
Pediatric Emergency Medicine Faculty Response to Point-of-Care Ultrasound Credentialing Curriculum.
As point-of-care ultrasound (POCUS) continues to evolve in pediatric emergency medicine (PEM), new protocols and curricula are being developed to help establish the standards of practice and delineate training requirements. New suggested guidelines continue to improve, but a national standard curriculum for training and credentialing PEM providers is still lacking. To understand the barriers and perception of curriculum implementation for PEM providers, we created an ultrasound program at our institution and observed attitudes and response to training. ⋯ These results show that a simplified structured curriculum can improve perception of POCUS and decrease barriers to usage while helping to understand obstacles for implementation of POCUS among PEM-fellowship-trained faculty.
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Pediatric emergency care · Feb 2023
Observational StudyRisk Factors for Pediatric Sepsis in the Emergency Department: A Machine Learning Pilot Study.
To identify underappreciated sepsis risk factors among children presenting to a pediatric emergency department (ED). ⋯ Machine learning models trained to identify pediatric sepsis using ED clinical and sociodemographic variables confirmed well-established predictors, including heart rate and mean arterial pressure, and identified underappreciated relationships between sepsis and patient age, immunization status, and demographics.
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Imaging algorithms for assessment of thoracic trauma in pediatric patients remain controversial, attempting to balance radiation dose and its associated risk with the need for thorough assessment of patients' injuries. This study reviewed the value of chest radiography in detecting traumatic injuries, and the impact that computed tomography (CT) had on clinical management. ⋯ Use of thoracic CT in pediatric trauma patients identifies a significantly greater number of injuries compared with than radiography but significantly increases radiation dose while changing management in only a very small proportion of cases. Despite the relatively small sample size, the findings reflect 2 years of experience at a level 1 trauma center, and this study suggests that it may be reasonable to decrease the frequency of cross-sectional imaging.
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Pediatric emergency care · Feb 2023
It's a Hard Knock Life: How Kids With Mild Traumatic Brain Injuries Are Treated.
The diagnosis and treatment of mild traumatic brain injuries (mTBIs) by emergency medicine providers is greatly varied. Because of the frequency and long-term consequences associated with pediatric head injuries, it is crucial that adequate counseling is provided in acute care settings. The purpose of our study is to evaluate existing practices at Loyola University Medical Center emergency department to address inconsistencies in diagnostic or discharge practices and determine future quality improvement measures. ⋯ There is a lack of consistency in the evaluation and education of mTBI in pediatric patients. There is a need for personalized discharge instructions to ensure adequate patient and parent understanding and compliance. Further studies looking at long-term outcomes in these patients would also be beneficial.
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Pediatric emergency care · Feb 2023
Machine Learning-Based Prediction of Hospital Admission Among Children in an Emergency Care Center.
Machine learning-based prediction of hospital admissions may have the potential to optimize patient disposition and improve clinical outcomes by minimizing both undertriage and overtriage in crowded emergency care. We developed and validated the predictive abilities of machine learning-based predictions of hospital admissions in a pediatric emergency care center. ⋯ Machine learning-based prediction of hospital admissions may support physicians' decision-making for hospital admissions. However, further improvements are required before implementing these models in real clinical settings.