Pediatric emergency care
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Airway management is a fundamental component of care during resuscitation of critically ill and injured children. In addition to predicted anatomic and physiologic differences in children compared with adults, certain conditions can predict potential difficulty during pediatric airway management. ⋯ These strategies include optimization of effective bag-mask ventilation, alternative approaches to laryngoscopy, use of adjunct airway devices, modifications to rapid sequence intubation, and performance of surgical airways in children. The importance of considering systems of care in preparing for potentially difficult pediatric airways is also discussed.
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Pediatric emergency care · Mar 2023
Resource Utilization for Pediatric Patients Discharged After Interhospital Transfer.
Transfers to a pediatric emergency department (ED) with subsequent discharge home should be optimized. Transfers to a pediatric ED (PED) from community and academic general EDs are compared with a focus upon subsequent resource utilization with the PED to identify patterns of resource and education needs within general EDs. ⋯ Most children transferred to a PED from a general ED required few resources in the PED before discharge home. The pattern of care delivered in the PED differed by the designation of the transferring ED providing insight into the differential educational and resource needs of general EDs in caring for pediatric patients.
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Pediatric emergency care · Mar 2023
Examining Parental Acceptance of Confidential Contraception Initiation in a Pediatric Emergency Department.
The pediatric emergency department (PED) is a valuable site for contraceptive services among adolescents at risk for pregnancy. Studies have shown that adolescents are interested in such services; however, little is known about parental opinions on contraceptive care in the PED. We aimed to (1) assess parental acceptance of confidential provisions of contraception in the PED and (2) identify facilitators/barriers to parental acceptance of contraception in this setting. ⋯ Although most parents were accepting of the PED provider offering confidential contraception to their adolescent, more parents preferred to be involved with decisions regarding contraception, in a collaborative approach. Further research is necessary to better elucidate parental/adolescent preferences.
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Pediatric emergency care · Mar 2023
Review Case ReportsFactors Associated With Low Procedural Pain Scores Among 1- to 5-Year-Old Patients Undergoing Facial Laceration Repair.
Our objectives were to quantify pain experienced by young children undergoing facial laceration repair and identify factors associated with low procedural pain scores. ⋯ The majority of 3- to 5-year-old patients were able to undergo facial laceration repair without restraint, sedation, or anxiolytics and with low mean distress scores. Our findings suggest that children's risk of experiencing moderate and severe distress during facial and scalp laceration repair may be reduced by prioritizing wound closure by expert-level clinicians, ensuring effective lidocaine-epinephrine-tetracaine application, avoiding restraint, and concealing needles from patient view.
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Pediatric emergency care · Mar 2023
Comparative StudyComparison of Specialist and Nonspecialist Transport Teams for Emergency Neurosurgery.
Current guidance in the United Kingdom recommends that children requiring emergency neurosurgical intervention should be transported by referring hospital (RH) teams. We aimed to compare transports performed by RH teams and by specialized pediatric critical care transport (PCCTs) teams in terms of timings and patient outcomes. ⋯ Specialist critical care transport teams are involved in one third of transfers of children with acute neurosurgical emergencies. While the overriding priority is timely transfer, a tailored approach to the use of PCCTs may be appropriate particularly for children presenting to hospitals nearer to neurosurgical centers.