Articles: pediatrics.
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Semin Respir Crit Care Med · Feb 2025
Early experience on universal prophylaxis in infants against RSV: Facts and expectations.
During the 2023-2024 season, nirsevimab significantly reduced the risk of bronchiolitis and confirmed RSV infections in primary care, hospital, and pediatric intensive care unit admissions among infants aged 0 to 11 months, even in a season with a high community RSV burden, particularly for older infants. These findings are very useful for public health authorities to continue to implement immunization campaigns against RSV in the coming seasons. ⋯ However, achieving these goals will require addressing challenges related to vaccine uptake, funding, and RSV surveillance to prompt detect resistances due to mutations of the virus. These interventions need to be integrated into public health strategies because they hold the potential to make a significant impact on infant's health worldwide.
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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 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
Highlights From the 2023 Revision of Pediatric Tactical Emergency Casualty Care Guidelines.
In 2023 the Committee for Tactical Emergency Casualty Care (C-TECC) issued updated Pediatric Tactical Emergency Casualty Care (TECC) Guidelines ( Guidelines ) that focus on the delivery of stabilizing care of children who are the victims of high-threat incidents such as an active shooter event. The Guidelines provide evidence-based and best practice recommendations to those individuals and departments that specifically provide operational medical support to law enforcement agencies caring for children in this uniquely dangerous environment where traditional resources may not be available. This article highlights key takeaway points from the Guidelines , including several updates since the first version was released in 2013. ⋯ The high-threat environment is dynamic and there is competing safety, tactical/operational, and patient care priorities for responders when infants and children are injured. The Guidelines provide recommendations on the type of medical and psychological care that should be considered under each phase of threat and establishes the context for how and why to deliver (or potentially defer) certain interventions under some circumstances in order the maximize the opportunity for a good outcome for an injured pediatric patient. The Guidelines also emphasize the importance of synergizing hospital-based pediatric trauma care with those law enforcement and fire/emergency medical services that may provide field care to children under high-threat circumstances.