Pediatric emergency care
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Pediatric emergency care · Sep 2024
Code Milk: Finding the Pulse of Lactation Culture, Practices, and Preferences of Pediatric Emergency Medicine Fellows.
The aim of the study is to characterize the lactation goals and practice of pediatric emergency medicine (PEM) fellows and to identify areas of improvement related to 1) policy awareness, 2) departmental culture and accommodations, and 3) lactation space and time. ⋯ PEM fellows are likely to have lactation needs during fellowship but receive inconsistent support from their programs. Based on our findings, we advocate for the creation of more visible and PEM-specific workplace lactation policies, planning with PDs pre-return to work, and improved availability and usability of designated lactation spaces. Further optimization may help support PEM fellows' personal, clinical, and academic productivity.
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Pediatric emergency care · Sep 2024
Risk of Urinary Tract Infection and Bacteremia in Infants Infected With COVID-19.
Our objective was to evaluate the risk of urinary tract infection (UTI) and bacteremia in infants 1 year or less of age infected with COVID-19. ⋯ Infants with fever found to have COVID-19 had lower risks of UTI and bacteremia.
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Pediatric emergency care · Sep 2024
Point-of-Care Ultrasound Diagnosis of Early Pyomyositis in a Pediatric Patient: A Case Report.
Skin and soft tissue infections are common in the pediatric emergency department. Because pyomyositis occurs deep to the fascial plane, it is often difficult to appreciate on physical examination. ⋯ This case report describes a child who presented to the pediatric emergency department with leg pain and redness, initially concerning for an abscess based on clinical findings. Point-of-care ultrasound diagnosed early pyomyositis, prompting early involvement of the pediatric surgical service and urgent computed tomography imaging, which confirmed the diagnosis.
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Pediatric emergency care · Sep 2024
Observational StudyUltrasound Investigation of the Fifth Intercostal Space Landmark for Chest Tube Thoracostomy Site Selection in Pediatric Patients.
Chest tube thoracostomy site selection is typically chosen through landmark identification of the fifth intercostal space (ICS). Using point-of-care ultrasound (POCUS), studies have shown this site to be potentially unsafe in many adults; however, no study has evaluated this in children. The primary aim of this study was to evaluate the safety of the fifth ICS for pediatric chest tube placement, with the secondary aim to identify patient factors that correlate with an unsafe fifth ICS. ⋯ A significant number of pediatric patients have diaphragms that cross into or above the fifth ICS, suggesting that placement of a chest tube thoracostomy at this site would pose a significant complication risk. POCUS can quickly and accurately identify these unsafe sites, and we recommend it be used before pediatric chest tube thoracostomy.
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Pediatric emergency care · Sep 2024
Low-Acuity Pediatric Emergency Department Utilization: Caregiver Motivations.
Proper emergency department (ED) utilization is a hallmark of population health. Emergency department overcrowding due to nonurgent visits causes increased stress to healthcare staff, higher costs, and longer wait times for more urgent cases. This study sought to better understand post pandemic reasons caregivers have when bringing in their children for nonurgent visits and devise effective interventions to improve caregiver choice for non-ED care for nonurgent conditions. ⋯ This study highlights 3 key findings. An immediate desire for care plays a key role in caregiver decision making for low-acuity visits. There is potential socioeconomic and racial bias in where care is recommended that needs to be further explored in this region. Cross community interventions that target key reasons for seeking low-acuity care have the highest likelihood of impacting the use of the ED for low-acuity conditions.