Pediatric emergency care
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Pediatric emergency care · Oct 2024
Randomized Controlled Trial Comparative StudyA Randomized Controlled Comparison of Guardian-Perceived Cosmetic Outcome of Simple Lacerations Repaired With Either Dermabond, Steri-Strips, or Absorbable Sutures.
The aim of this study was to compare the guardian-perceived 3-month cosmetic outcome for pediatric lacerations repaired with absorbable sutures, Dermabond, or Steri-Strips. Secondarily, pain and satisfaction with the procedure from both guardian and provider perspectives were compared. ⋯ No differences were observed in guardian-perceived cosmesis of simple lacerations repaired with sutures, Dermabond, or Steri-Strips when evaluated 3 months after intervention. In addition, there were no differences in guardian or physician-perceived pain or satisfaction with the closure methods. The results of this study suggest that all 3 closure methods appear to be clinically equivalent, which is largely consistent with other evidence. Further study should be expanded to a larger demographic.
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Pediatric emergency care · Oct 2024
Comparative StudyA Comparison of Telesimulation Using the Virtual Resus Room and In Situ Simulation in Pediatric Emergency Medicine.
During the COVID-19 pandemic, there was a marked shift toward telesimulation in medical education. Limited studies exist comparing the effectiveness of online and offline simulation education. The goals of this study are to evaluate active learners' perceived effectiveness of telesimulation versus in situ simulation and to identify potential shortcomings of existing online teaching platforms. ⋯ Telesimulation using the VRR is comparable to in situ simulation in learners' perception of improvement in self-efficacy and of teaching quality for pediatric emergency medicine topics. However, participants felt less able to practice tactile and communication skills virtually. Further innovation is needed to improve learners' experience with fidelity and educational value.
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Pediatric emergency care · Oct 2024
Comparative StudySafety and Depth of Sedation With Ketamine Alone Versus Ketamine With Midazolam in Pediatric Fracture Reduction: A Retrospective Chart Review.
Pediatric patients with extremity fractures often require sedation for fracture reduction in the pediatric emergency department (PED). Although orthopedic literature suggests combination sedation regimens may be more effective for fracture reduction, some pediatric literature suggests adverse events are more frequent. The primary objective of this study is to determine the comparable depth of sedation and incidence of adverse events when intravenous ketamine is used alone versus with midazolam for pediatric procedural sedation and orthopedic fracture reduction. ⋯ This study showed a low rate of adverse events in pediatric sedation for orthopedic reduction with ketamine alone or ketamine with midazolam. There was an increased occurrence of hypoxia with coadministration of midazolam and an increase in the length of sedation. This study showed no difference in depth of sedation based on Ramsay scores when midazolam was coadministered. Information on the orthopedic reduction and provider satisfaction was not collected.
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Pediatric emergency care · Oct 2024
Using the Electronic Health Record to Implement Expedited Partner Therapy in the Pediatric Emergency Department.
Expedited partner therapy (EPT) is a partner treatment strategy for sexually transmitted infections (STIs) including gonorrhea and chlamydia as well as trichomoniasis in some states. The process allows healthcare providers to write prescriptions for STI treatment among partners of infected patients without a previous medical evaluation. The Centers for Disease Control (CDC) has recommended EPT as a useful option to facilitate partner treatment, particularly male partners of women with chlamydia or gonorrhea infections. Our institution implemented EPT in 2016 after Ohio legislation was passed to authorize its use. We aim to describe the implementation process and descriptive outcomes of EPT adoption in a pediatric emergency department. ⋯ The use of the electronic health record provides a platform for implementation of EPT. Our study highlights a potential strategy for increasing treatments of STIs through EPT prescribing in the emergency department setting.
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Pediatric emergency care · Oct 2024
ReviewUtility of Lactate Levels in the Diagnosis and Prognosis of Septic Shock.
Early recognition of septic shock and its treatment are key factors for limiting progression to multiple organ dysfunction and death. Lactate, a byproduct of metabolic pathways, is usually elevated in tissue hypoperfusion and shock and is associated with poor prognosis in sepsis. As a biomarker, it may help the clinician in risk stratification, and the identification and treatment of sepsis. In this article, we provide an update on lactate's pathophysiology and role in diagnosis, treatment, and prognosis in children with sepsis and septic shock.