Articles: child.
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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 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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Children with new-onset psychosis often require hospitalization for medical evaluation. ⋯ Study findings suggest that there has been a stable rate of hospitalization for children with new-onset psychosis, yet a significant variation in the medical evaluation exists. Significant increases and variations in resource utilization across all categories suggest an emerging need for robust evidence and consensus-based practice guidelines.
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Editorial Letter
NAP7: high mortality risk in neonates and very low risk in children.
Editor-We congratulate Lyne and colleagues1 on their initiative to explore and improve consent around perioperative mortality in children. Providing such data for families and clinicians is a key purpose of the Royal College of Anaesthetists' National Audit Projects (NAPs), and to this end, NAP7 studied perioperative cardiac arrest.2-4.
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Despite the high morbidity associated with glenohumeral dysplasia (GHD) in children with brachial plexus birth injuries, the progression of this condition often remains unnoticed, even after correcting for the underlying brachial plexus birth injuries. GHD, driven by a multifactorial process involving disruptions in both direct and indirect neural regulation of bony and muscular structures, can lead to intermittent or permanent shoulder mobility imbalances, significantly impacting the quality of life of those affected. Recent research efforts are increasingly directed toward identifying the root causes, managing the deformity, and determining effective treatment options for correcting GHD. ⋯ As research continues to focus on understanding the complexities of this condition, the aim of this review article is to summarize the current literature on the course of brachial plexus birth injury and the development of GHD. By doing so, we hope to provide neurosurgeons with the necessary knowledge and essential tools needed to identify and effectively treat GHD during management of brachial plexus birth injuries.