Pediatric emergency care
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Pediatric emergency care · Jan 2024
Meta AnalysisMedication Errors in Pediatric Emergency Departments: A Systematic Review and Recommendations for Enhancing Medication Safety.
This systematic review aims to investigate the prevalence, preventability, and severity of medication errors in pediatric emergency departments (P-EDs). It also aims to identify common types of medication errors, implicated medications, risk factors, and evaluate the effectiveness of interventions in preventing these errors. ⋯ Overall, this systematic review provides valuable insights into the complexity of medication errors in the P-ED, emphasizes the need for targeted interventions, and offers recommendations to enhance medication safety and reduce preventable errors in this critical health care setting.
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Pediatric emergency care · Jan 2024
Smartphone App PACOM to Provide Advice Regarding Self-Triage for the Acute Primary Care Needs of Children: Accuracy of Algorithms.
We developed a phone app, PACOM (Parents Application Conseils et Orientation Médicale), to provide medical advice to caregivers based on several algorithms and a series of binary questions related to children's symptoms. We compared the recommendations of the PACOM algorithms and clinicians for children visiting the emergency department (ED). ⋯ The PACOM algorithms has high sensitivity but low specificity for reducing ED visits and calls for urgent medical support.
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Pediatric emergency care · Jan 2024
Evaluating the Proportion of Low-Value Blood Cultures Obtained in a Pediatric Emergency Department.
Existing literature suggests that for some pediatric conditions, blood cultures may be of low value in specific clinical circumstances. The goals of our study were to: 1) identify common pediatric illnesses and define criteria for low-value blood cultures in children aged from 91 days to 19 years, 2) apply these criteria retrospectively to identify the patients in our emergency department (ED) who had low-value blood cultures obtained, and 3) describe this cohort and assess the proportion of true bacteremia in low-value blood cultures. ⋯ We identified a cohort of patients in our ED with blood cultures obtained when available literature indicates they were of low value.
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Pediatric emergency care · Jan 2024
Do We Need a Strictly Lateral Radiograph for Fracture Management of Forearm Buckle Fractures in Children?
Buckle fractures of the distal forearm are a common fracture entity in children treated conservatively. Diagnostics primarily include radiographs in 2 planes. Inadequate images may occur in the mostly very young patients. Therefore, additional lateral radiographs are often obtained to assess a possible angular tilt. The aim of this study is to investigate whether a strictly lateral x-ray image has an influence on fracture management. ⋯ Based on our results, the acquisition of additional lateral radiographs seems to be unnecessary in the diagnostic procedure of buckle fractures of the distal forearm, in case a possible palmar or dorsal angulation cannot be entirely assessed on the initial set of radiographs. An additional lateral image had no influence on fracture management, which was chosen conservatively in every case and led to excellent clinical results.Level of evidence: level III.
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Pediatric emergency care · Jan 2024
Diagnostic Yield of Abdominal Radiographs in the Pediatric Emergency Department.
Abdominal radiographs (ARs) are commonly used in the pediatric emergency department (PED). Their low diagnostic accuracy leads to overuse, excess radiation exposure, and increased resource usage. This study aims to assess the diagnostic yield of ARs in the evaluation of intraabdominal pathology in the PED. ⋯ There is a low rate of intraabdominal pathologic processes that an AR can identify. A normal AR does not change patient management, nor does it reduce the need for further radiologic imaging. Despite a good NPV, the AR is not a useful diagnostic tool in the PED because of its limited ability to rule in or rule out clinically significant diagnoses.