Articles: pediatrics.
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Pediatric laceration repairs are common in the emergency department (ED) and often associated with significant procedural anxiety. Despite the increased use of intranasal midazolam (INM) prior to pediatric ED procedures, there is limited, real-world data on the effects of INM on anxiety. This study aimed to describe the proportion of children who were nonresponsive to INM (i.e., exhibited extreme anxiety) and identify factors associated with INM nonresponse. ⋯ Nearly half of the children in our sample exhibited extreme procedural anxiety despite receiving INM. The high incidence of nonresponse to INM has important clinical practice implications and suggests that 0.2 mg/kg INM alone may not be sufficient to manage all pediatric procedural anxiety in the ED. Findings highlight a need for further research examining multimodal strategies to manage procedural anxiety in the pediatric ED, particularly for younger children with low sociability temperament or extremity lacerations.
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Pediatric emergency care · Feb 2025
Accuracy of Visual Estimation of Left Ventricular Ejection Fraction Compared With Echocardiography in Children.
This study compared visual assessments of left ventricular systolic function in children by pediatric physicians with quantitative measurements using the Simpson method. ⋯ The study suggests that visual assessment of LVEF in children is reliable when conducted by experienced pediatricians familiar with echocardiography. However, the results of this study are primarily applicable to the assessment of normal or near-normal left ventricular function.
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Pediatric emergency care · Feb 2025
POCUS the Pelvis: A Case Series of Timely Diagnoses in Pediatric Patients With Abdominal Pain.
Abdominal pain is a frequent presenting complaint in the pediatric emergency department (PED). Point-of-care ultrasound (POCUS) can expedite the diagnosis and management of patients in the PED with abdominal pain. We present a series of 6 patient cases in which a "POCUS the pelvis" approach expedited diagnosis of undifferentiated abdominal pain in the PED, and thus facilitated definitive management.
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Pediatric emergency care · Feb 2025
Assessment of Facility Readiness for Pediatric Emergency and Critical Care Utilizing a 2-Phase Survey Conducted in Six Hospitals in Uganda and Cameroon: A Quality Improvement Study.
Each year, 5.3 million children under 5 years of age die in low-resource settings, often due to delayed recognition of disease severity, inadequate treatment, or a lack of supplies. We describe the use of a comprehensive digital facility-readiness survey tool, recently developed by the Pediatric Sepsis Data CoLaboratory, which aims to identify target areas for quality improvement related to pediatric emergency and critical care. ⋯ These pilot findings indicate that facilities are partially equipped and ready to provide pediatric emergency and critical care. This facility-readiness tool can be utilized in low-resource settings to assist hospital administrators and policymakers to determine priority areas to improve quality of care for the critically ill child.