Pediatric emergency care
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Pediatric emergency care · Mar 2024
ReviewStructured Callouts, the Shared Mental Model, and Teamwork: A Video-Based Study in a Pediatric Emergency Department.
The shared mental model is essential to high-quality resuscitations. A structured callout (SCO) is often performed to establish the shared mental model, but the literature on SCOs is limited. The objectives of this study are to describe performance of SCOs during pediatric medical emergencies and to determine whether a SCO is associated with better teamwork. ⋯ Performance of a SCO was associated with better teamwork, but the difference was of unclear clinical significance.
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Pediatric emergency care · Mar 2024
ReviewEvaluating Multiple Magnet Ingestion at 2 Large Canadian Pediatric Hospitals After Reintroduction to the US Marketplace.
To determine the trend in incidence of pediatric magnet ingestions at 2 large Canadian tertiary pediatric hospitals after reintroduction of magnets to the US marketplace and to evaluate morbidity and mortality related to these ingestions. ⋯ Our findings suggest that the overturning of the US ban did not lead to a significant increase in the incidence of rare earth magnet ingestion in 2 large tertiary pediatric hospitals in Canada despite noting a trend upwards.
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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.
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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.
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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.