Pediatric emergency care
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Pediatric emergency care · Feb 2025
ReviewCurrent Evidence on the Care of Young Infants With Hypothermia in the Emergency Department.
The presence of hypothermia among young infants in the emergency department may be a sign of serious or invasive bacterial infections, or invasive herpes simplex viral infection. However, hypothermia may also occur due to a variety of other infectious and noninfectious conditions or environmental exposure. In some settings, hypothermia may represent a protective, energy-conserving response to illness. ⋯ Risk factors for serious bacterial infections in infants with hypothermia, as identified in single-center and multicenter retrospective studies, include lower temperatures, older age, and abnormalities in blood and urine testing. Given the absence of clear guidelines, management of infants with hypothermia relies heavily on clinician judgment and shared decision making, guided by individual patient assessments and risk factors. This review article summarizes existing evidence and identifies gaps in the management of infants (<90 days) with hypothermia in the emergency department.
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Pediatric emergency care · Jan 2025
ReviewReview of Point-of-Care Diaphragmatic Ultrasound in Emergency Medicine: Background, Techniques, Achieving Competency, Research, and Recommendations.
The diaphragm is the major muscle of inspiration accounting for approximately 70% of the inspired tidal volume. Point-of-care diaphragmatic ultrasound offers the ability to quantitatively assess diaphragmatic function, perform serial evaluations over time, and visualize structures above and below the diaphragm. ⋯ As a result, it is infrequently performed, and its potential value in research or clinical practice may not be fully appreciated. The purpose of this review is to describe the developmental aspects of the diaphragm as it pertains to POCUS, discuss the POCUS techniques for evaluating diaphragmatic function, address competency acquisition in this POCUS application, summarize relevant research in the ED, and provide a summary of recommendations for further research and clinical utilization of POCUS in diaphragm evaluation.
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Pediatric emergency care · Jan 2025
Caregiver Accompaniment in Pediatric Critical Care Transport: A Systematic Scoping Review.
Family-centered care is a critical component of critical care interfacility and medical retrieval transport (MRT) services. These services provide a critical bridge for a physiologically and psychologically unique population often best served in specialized, tertiary centers. Caregivers often wish to accompany patients during MRT. However, there is currently little research on the impact of caregiver accompaniment on MRT. ⋯ Caregivers and healthcare providers largely prefer caregiver accompaniment on MRT services. There is little data on patient perspectives and transport-related adverse events affecting patient outcomes.
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Pediatric emergency care · Jan 2025
Caregiver Accompaniment in Pediatric Critical Care Transport: A Systematic Scoping Review.
Family-centered care is a critical component of critical care interfacility and medical retrieval transport (MRT) services. These services provide a critical bridge for a physiologically and psychologically unique population often best served in specialized, tertiary centers. Caregivers often wish to accompany patients during MRT. However, there is currently little research on the impact of caregiver accompaniment on MRT. ⋯ Caregivers and healthcare providers largely prefer caregiver accompaniment on MRT services. There is little data on patient perspectives and transport-related adverse events affecting patient outcomes.
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Pediatric emergency care · Dec 2024
ReviewNeonatal Mastitis: Clinical Presentation and Approach to Evaluation and Management.
Mastitis is an uncommon but potentially serious infection in neonates. Characteristic findings include erythema, induration, and tenderness around the breast bud. Fluctuance and purulent drainage may be present with abscess formation. ⋯ Treatment of neonatal mastitis consists primarily of antibiotic administration. Surgical intervention, such as incision and drainage or intraoperative debridement, may be needed for frank abscesses. While antibiotics are typically administered intravenously, there may be a role for oral antibiotics in some lower risk infants with mastitis.