Current opinion in pediatrics
-
Curr. Opin. Pediatr. · Aug 2007
ReviewScreening for suicide risk in the pediatric emergency and acute care setting.
This paper reviews epidemiology, psychiatric comorbidities, risk factors, warning signs, screening measures, and issues related to screening for suicide risk in the pediatric emergency department and acute care settings. ⋯ Suicide is the third leading cause of death in adolescents. Although a prior suicide attempt is the single most important risk factor, affective, cognitive, family and peer factors also affect risk of completed suicide. Practitioners in the acute care and emergency department setting are well positioned to identify, assess, and appropriately refer these adolescents and their families. Screening instruments in this setting need to be accurate, brief, and relevant to patients, families, and providers. We propose a two-question algorithm that targets imminent risk for a suicide attempt. This type of screening also needs to be accompanied by hospital or community-based support systems for further assessment, intervention and follow-up.
-
Curr. Opin. Pediatr. · Jun 2007
ReviewTrends and challenges in international pediatric emergency medicine.
Pediatric emergency care internationally is practiced in a wide variety of local contexts, and the quality of care varies. International pediatric emergency medicine refers to the spectrum of care provided to children with serious illnesses and injuries globally. This article serves as the first of its kind to characterize current trends and challenges in this area. ⋯ While there are many recent advances in the state of pediatric emergency medicine internationally, there still exist many barriers to the improvement in its quality. Many of these obstacles are not specific to pediatric emergency medicine, but reflect overall disparities between the developing and developed worlds. One first step to overcoming pediatric emergency medicine practiced in isolation is a formal organization of the field of international pediatric emergency medicine.
-
Childhood tuberculosis has long been neglected in international tuberculosis control efforts. There are, however, many opportunities to prevent childhood tuberculosis that are not being fully employed. ⋯ True progress will require a rethinking of basic tuberculosis control with a commitment to address problems specific to childhood tuberculosis.
-
Curr. Opin. Pediatr. · Jun 2007
ReviewControversies in the evaluation and management of minor blunt head trauma in children.
We present data from recently conducted research regarding controversial aspects of the evaluation and management of children with minor blunt head trauma. ⋯ Research in the management of children with minor head trauma is actively evolving. We present a review of recent developments that can influence current clinical practice.
-
Curr. Opin. Pediatr. · Jun 2007
ReviewThe new American Heart Association cardiopulmonary resuscitation guidelines: should children and adults have to share?
The latest American Heart Association guidelines for pediatric cardiopulmonary resuscitation (CPR) were published in December 2005. Changes from the 2000 guidelines were directed toward simplifying CPR. Infants, children, and adults now share the same recommendation for the initial compression:ventilation ratio. This is a significant change for pediatricians trained in the importance of a respiratory etiology of pediatric cardiopulmonary arrest. The present review will focus on the rationale behind these guideline changes. ⋯ Although based primarily on adult, animal, and computational models, the new compression:ventilation ratio, recommended for both initial pediatric and adult CPR, is a reasonable recommendation. The simplified CPR guidelines released in 2005 will hopefully contribute to improved bystander delivery of CPR and improved outcome.