Pediatric emergency care
-
Pediatric emergency care · Mar 2024
Clinical Outcomes of Children With COVID-19 by SARS-CoV-2 Strain: A Cohort Study.
We sought to investigate the disease outcomes and predictors of severe outcomes among children infected with the Delta variant of SARS-CoV-2 compared with pre-Delta strains. ⋯ The severity of measured disease outcomes was similar in pediatric patients when comparing children infected with the pre-Delta and Delta variants of SARS-CoV-2, even among children with comorbidities once adjusting for acuity.Ongoing research is essential to determine disease severity and risk for children with comorbidities because SARS-CoV-2 continues to mutate, including with Omicron subvariants.
-
Pediatric emergency care · Mar 2024
Applying Topical Anesthetic on Pediatric Lacerations in the Emergency Department: A Quality Improvement Project.
Caring for pediatric lacerations in the emergency department (ED) is typically painful because of irrigation and suturing. To improve this painful experience, we aimed to increase the use of a topical anesthetic, Eutectic Mixture of Local Anesthetics (EMLA) on eligible pediatric lacerations with an attainable, sustainable, and measurable goal of 60%. The baseline rate of applying topical anesthetic to eligible lacerations was 23% in our ED. We aimed to increase the use of topical anesthetics on eligible pediatric lacerations to a measurable goal of 60% within 3 months of implementing our intervention. ⋯ With a few simple interventions, our aim of applying EMLA to 60% of eligible pediatric lacerations was attained and maintained.
-
Pediatric emergency care · Mar 2024
Utilization of Transport Data to Decrease Unnecessarily Repeated Laboratory Tests.
In pediatric patients being transported for management of diabetic ketoacidosis, laboratory tests will frequently be trended throughout transportation and subsequently immediately repeated upon arrival to a particular institution. These laboratory tests may not add value to a patient's care trajectory and therefore may be unnecessary. This study examines differences between pH, sodium, potassium, chloride, bicarbonate, and glucose levels drawn during transportation and those drawn at our home institution immediately upon arrival to determine if repeating those laboratory tests upon arrival to the emergency department serves any purpose in adding to patient care. ⋯ Although there were some statistically significant differences between the laboratory value sets, it is arguable whether there are any clinically significant differences between them.Based on our failure to show a clinically significant difference between laboratory values drawn during transportation and those drawn immediately upon presentation to the institution, repeating laboratory draws after transportation do not add value to a patient's care trajectory. We should therefore rely on the laboratory values that were drawn from our transportation teams as part of the continuum of patient care.
-
Pediatric emergency care · Mar 2024
Qualitative Point-of-Care Ultrasound Enema Management for Constipation.
We discuss 10 cases where the qualitative evaluation of hard stool in the rectum with point-of-care ultrasound helped guide enema administration in a pediatric emergency department. Point-of-care ultrasound findings were especially valuable in cases where the presenting symptoms were undifferentiated, a language barrier was present, or the guardian and child denied that constipation was an active problem. When sodium phosphate enema administration was done in the pediatric emergency department, evacuation of the rectal stool burden was observed in most cases before final disposition.
-
Pediatric emergency care · Mar 2024
Evaluation of the Renal Angina Index to Predict the Development of Acute Kidney Injury in Children With Sepsis Who Live in Middle-Income Countries.
The renal angina index (RAI) provides a clinically feasible and applicable tool to identify critically ill children at risk of severe acute kidney injury (AKI) in high-income countries. Our objective was to evaluate the performance of the RAI as a predictor of the development of AKI in children with sepsis in a middle-income country and its association with unfavorable outcomes. ⋯ The RAI on the day of admission is a reliable and accurate tool for predicting the risk of developing AKI on day 3, in critically ill children with sepsis in a limited resource context. A score greater than eight 72 hours after admission is associated with a higher risk of death, the need for renal support therapy, and PICU stay.