Pediatrics
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Comparative Study
The validity of the uriscreen test for early detection of urinary tract infection in children.
To determine the validity of the Uriscreen, a rapid diagnostic test based on the detection of urine catalase for the early detection of urinary tract infection (UTI) in children, compared with standard urinalysis and dipstick tests. STUDY DESIGN. Cross-sectional study. ⋯ The clinical use of Uriscreen for the presumptive diagnosis of UTI in children is limited and not significantly superior to urinalysis or the dipstick test. However, because of its 100% sensitivity and negative predictive value and its ease of use, rapidity, and low cost, it is recommended highly for ruling out the diagnosis of UTI. In laboratories, a negative Uriscreen result may prevent the need for performing expensive urine cultures.
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None of the 20 previously reported infants weighing <750 g at birth who received cardiopulmonary resuscitation (CPR) in the delivery room (DR) survived. To clarify whether such resuscitation is futile in our center, we evaluated our experience with DR-CPR over a 4-year period. ⋯ Our results indicate that intact survival is possible for infants weighing <750 g at birth after DR-CPR.
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Practice Guideline Guideline
Emergency preparedness for children with special health care needs. Committee on Pediatric Emergency Medicine. American Academy of Pediatrics.
Children with special health care needs are those who have, or are at risk for, chronic physical, developmental, behavioral, or emotional conditions and who also require health and related services of a type or amount not usually required by typically developing children. Formulation of an emergency care plan has been advocated by the Emergency Medical Services for Children (EMSC) program through its Children With Special Heath Care Needs Task Force. Essential components of a program of providing care plans include use of a standardized form, a method of identifying at-risk children, completion of a data set by the child's physicians and other health care professionals, education of families, other caregivers, and health care professionals in use of the emergency plan, regular updates of the information, 24-hour access to the information by authorized emergency health care professionals, and maintenance of patient confidentiality.
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Prognostication is central to developing treatment plans and relaying information to patients, family members, and other health care providers. The degree of confidence or certainty that a health care provider has in his or her mortality risk assessment is also important, because a provider may deliver care differently depending on their assuredness in the assessment. We assessed the performance of nurse and physician mortality risk estimates with and without weighting the estimates with their respective degrees of certainty. ⋯ The level of medical training correlated with the provider's ability to predict mortality risk. The higher the level of certainty associated with the mortality prediction, the more accurate the prediction; however, high levels of certainty did not guarantee accurate predictions. Measures of certainty should be considered when assessing the performance of mortality risk estimates or other subjective outcome predictions.