Articles: child.
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Pediatric emergency care · Jun 2022
Multicenter StudyPediatric Emergency Department Testing for Gonorrhea and Chlamydia in Children.
This study aimed to describe trends in the utilization of nucleic acid amplification (NAAT) testing for gonorrhea and chlamydia in US pediatric emergency departments. Nucleic acid amplification has been recommended over genital culture by the American Academy of Pediatrics and Centers for Disease Control and Prevention for children evaluated for sexual abuse. ⋯ Over a 14-year period, downtrend of culture use with increase in NAAT was observed, suggesting general adherence to evidence-based guidelines. Almost 10% of children diagnosed with maltreatment continued to be tested with culture. This could indicate provider concerns regarding test accuracy, legal admissibility, or lack of test availability.
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Pediatric emergency care · Jun 2022
Multicenter StudyPrediction of Pediatric Patient Admission/Discharge in the Emergency Department: Irish Pediatric Early Warning Score, Pediatric Observation Priority Score, and Irish Children's Triage System.
The aim of this study was to evaluate the ability of the Irish Paediatric Early Warning Score (PEWS), the Paediatric Observation Priority Score (POPS), and the Irish Children's Triage System (ICTS) to predict patient disposition pathways in an emergency department (ED) setting. ⋯ The POPS has greater accuracy as a predictor of admission from the ED than PEWS and ICTS. Possible future implementation of POPS into pediatric EDs as a cognitive prompt before admission decision seems to be merited. Further multicenter validation in Ireland would be helpful.
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Randomized Controlled Trial Multicenter Study
Impact of critical illness and withholding of early parenteral nutrition in the pediatric intensive care unit on long-term physical performance of children: a 4-year follow-up of the PEPaNIC randomized controlled trial.
Many critically ill children face long-term developmental impairments. The PEPaNIC trial attributed part of the problems at the level of neurocognitive and emotional/behavioral development to early use of parenteral nutrition (early-PN) in the PICU, as compared with withholding it for 1 week (late-PN). Insight in long-term daily life physical functional capacity after critical illness is limited. Also, whether timing of initiating PN affects long-term physical function of these children remained unknown. ⋯ Four years after PICU admission, former critically ill children showed worse physical performance as compared with healthy children, without impact of timing of supplemental PN in the PICU. This study provides further support for de-implementing the early use of PN in the PICU. Trial registration ClinicalTrials.gov, NCT01536275 ; registered on February 22, 2012.
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Pediatric emergency care · May 2022
Multicenter StudyPain Prevalence Among Children Visiting Pediatric Emergency Departments.
The main purpose of this study was to investigate the prevalence, characteristics, and intensity of children's pain in emergency departments. The secondary purpose was to evaluate the interobserver agreement regarding the level of pain perceived by professionals, parents, and children. ⋯ Pain is a common symptom among emergency department patients, and its evaluation should therefore be obligatory. We found low interrater agreement on pain levels between patients, professionals, and parents, which confirms how difficult it is to accurately evaluate pain intensity.
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Randomized Controlled Trial Multicenter Study Comparative Study Pragmatic Clinical Trial
Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Following Extubation on Liberation From Respiratory Support in Critically Ill Children: A Randomized Clinical Trial.
The optimal first-line mode of noninvasive respiratory support following extubation of critically ill children is not known. ⋯ Among critically ill children requiring noninvasive respiratory support following extubation, HFNC compared with CPAP following extubation failed to meet the criterion for noninferiority for time to liberation from respiratory support.