Pediatric emergency care
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Pediatric emergency care · Apr 2013
Assessing pediatric residents' clinical performance in procedural sedation: a simulation-based needs assessment.
Our primary objective in this study was to perform a needs assessment of clinical performance during simulated procedural sedation (PS) by pediatric residents. Our secondary objective was to describe reported experience and confidence with PS during pediatric residency. ⋯ Significant differences exist in the reported confidence and observed performance among PGY levels during simulated PS. Resident performance on this checklist demonstrates educational needs in PS training. A curriculum in PS for pediatric residents should focus on reviewing preparation steps, equipment, and potential interventions should an AE occur.
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Pediatric emergency care · Apr 2013
Clinical factors associated with invasive testing and imaging in patients with complex febrile seizures.
Complex febrile seizures (CFSs) are a common diagnosis in the pediatric emergency department (PED). Although multiple studies have shown a low likelihood of intracranial infections and abnormal neuroimaging findings among those who present with CFS, the absence of a consensus recommendation and the diversity of CFS presentations (ie, multiple seizures, prolonged seizure, focal seizure) often drive physicians to do a more extensive workup than needed. Few studies examine the factors that influence providers to pursue invasive testing and emergent neuroimaging. ⋯ Despite the low utility of associated findings, there are important clinical parameters that are associated with obtaining a lumbar puncture or a head CT as part of the diagnostic workup. National practice parameters to guide evaluation for CFSs in the acute setting are warranted to reduce the amount of invasive testing and imaging.
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Pediatric emergency care · Apr 2013
Adolescents' preference for technology-based emergency department behavioral interventions: does it depend on risky behaviors?
This study aimed to (1) determine the prevalence of technology use and interest in technology-based interventions among adolescent emergency department patients and (2) examine the association between interest in an intervention and self-reported risky behaviors. ⋯ Among this sample of adolescent emergency department patients, high rates of multiple risky behaviors are reported. Patients endorsed interest in receiving interventions for these behaviors, regardless of whether they reported the behavior. Most used multiple forms of technology, and approximately 50% preferred a technology-based intervention format.
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Pediatric emergency care · Apr 2013
Rise in emergency department visits of pediatric patients for renal colic from 1999 to 2008.
Renal colic has been considered predominantly a disease of adults with only occasional cases occurring in the pediatric population. A recent report from a single hospital showed a rise in the number of children with renal colic. Our objective was to examine this in a much larger multihospital database of emergency department (ED) visits. ⋯ We found a marked increase in ED pediatric visits for renal colic over the past decade. This may reflect a real increase in the incidence of renal colic in the pediatric population or an increased use of imaging modalities for abdominal and flank pain.
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Pediatric emergency care · Apr 2013
Case ReportsTracheal foreign bodies: are radiographs misleading?
This study aimed to highlight the pitfalls of relying on radiographs in identifying potentially life-threatening upper airway foreign bodies in children. ⋯ Tracheal foreign bodies present a diagnostic challenge, and patients may fail to manifest radiographic abnormalities. In patients with a characteristic history and biphasic stridor, an endoscopic evaluation of the airway should be performed to avoid potentially devastating consequences.