Pediatric emergency care
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Pediatric emergency care · Jul 2023
Multicenter StudyDrowning in Children and Predictive Parameters: A 15-Year Multicenter Retrospective Analysis.
Drowning is a serious and underestimated public health problem, with the highest morbidity and mortality reported among children. Data regarding pediatric outcomes of drowning are often inadequate, and data collection is poorly standardized among centers. This study aims to provide an overview of a drowning pediatric population in pediatric emergency department, focusing on its main characteristics and management and evaluating prognostic factors. ⋯ This study offers several perspectives on ED victims who drowned. One of the major finding is that no difference in outcomes was seen in patients who received cardiopulmonary resuscitation performed by bystanders or medical services, highlighting the importance of a prompt intervention.
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Pediatric emergency care · Jul 2023
Multicenter StudyWhich Trauma Severity Scores Are Useful in Predicting Pediatric Mortality?
Trauma is the leading cause of death in children. Several trauma severity scores exist: the shock index (SI), age-adjusted SI (SIPA), reverse SI (rSI), and rSI multiplied by Glasgow Coma Score (rSIG). However, it is unknown which is the best predictor of clinical outcomes in children. Our goal was to determine the association between trauma severity scores and mortality in pediatric trauma. ⋯ Several trauma scores may help predict mortality in children with trauma, the best being rSIG. Introduction of these scores in algorithms for pediatric trauma evaluations can impact clinical decision-making.
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Pediatric emergency care · May 2023
Multicenter StudyUnderstanding Bilateral Skull Fractures in Infancy: A Retrospective Multicenter Case Review.
Bilateral skull fractures in infancy often raise suspicion for abuse. Nevertheless, literature suggests that they may occur accidentally. However, empiric data are lacking. ⋯ A fall history was common in bilateral skull fractures deemed accidental by a CAP. Most accidental cases involved young infants with biparietal simple linear fractures, without skin trauma or additional fractures. A skeletal survey may aid in the determination of accidental or abusive injury for unwitnessed events resulting in bilateral skull fractures in infants.
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Pediatric emergency care · Mar 2023
Multicenter StudyOmphalitis: Clinical Presentation and Approach to Evaluation and Management.
Omphalitis is an uncommon but potentially serious infection in neonates. Findings include erythema and induration around the umbilical stump, and purulent drainage may be present. Fever and signs of systemic illness may occur, or there may only be signs of localized soft tissue infection. ⋯ Underlying urachal abnormalities should be considered in the infant with umbilical drainage. Treatment of omphalitis consists primarily of antibiotic administration, with surgical intervention rarely needed. Although antibiotics are typically administered intravenously, there may be a role for oral antibiotics in some lower risk infants with omphalitis.
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Pediatric emergency care · Feb 2023
Multicenter StudySARS-COV-2 Infection in Children in Emergency Departments in Spain: A Multicenter Study.
The first cases of infection by SARS-CoV-2 in the Spanish pediatric population were reported on early March 2020. Although most were mild or asymptomatic, new forms of clinical presentation and severity were reported with the evolution of the pandemic. We aimed to describe demographics, clinical features, and management of children with COVID-19 treated in Spanish emergency departments (EDs). ⋯ Most pediatric COVID-19 cases in EDs during the first months of the pandemic were healthy, well-appearing children, presenting with fever +/- respiratory symptoms. In a significant number of cases, there was household transmission. Most children were managed as outpatients with symptomatic treatment, being exceptional the evolution to a serious illness.