Pediatric emergency care
-
Pediatric emergency care · Apr 2015
Multicenter StudyCervical Spine Imaging in Hospitalized Children With Traumatic Brain Injury.
The purposes of this study, in children with traumatic brain injury (TBI), to describe cervical spine imaging practice, to assess for recent changes in imaging practice, and to determine whether cervical spine computed tomography (CT) is being used in children at low risk for cervical spine injury. ⋯ The adoption of CT clearance of the cervical spine in adults seems to have influenced the care of children with TBI, despite concerns about radiation exposure.
-
Pediatric emergency care · Apr 2015
Case ReportsMassive spontaneous intraperitoneal hemorrhage in a young female with chronic immune thrombocytopenic purpura masquerading as ruptured ovarian cyst: successful nonsurgical management of this rare catastrophic event.
Chronic immune thrombocytopenic purpura has mild bleeding manifestations and severe bleeding requiring hospitalization is rare. We are reporting a case of a 19-year-old girl with chronic immune thrombocytopenic purpura who presented with spontaneous massive hemoperitoneum without any identifiable source of hemorrhage. ⋯ In young women presenting with massive hemoperitoneum, undiagnosed immune thrombocytopenia should be considered as an etiology. In absence of any identifiable source of hemoperitoneum, these patients may not require laparotomy and treatment with intravenous corticosteroid and platelet transfusions may be preferrable and lifesaving.
-
Pediatric emergency care · Apr 2015
Methicillin-Resistant Staphylococcus aureus: Decolonization and Prevention Prescribing Practices for Children Treated With Skin Abscesses/Boils in a Pediatric Emergency Department.
This study aimed to describe methicillin-resistant Staphylococcus aureus (MRSA) eradication/prevention practices of clinicians managing patients with skin and soft tissue infections (SSTIs), specifically, in those patients undergoing abscess incision and drainage (I&D) in a pediatric emergency department (ED). ⋯ Methicillin-resistant S aureus eradication/prevention discussions are not commonly included in discharge instructions for patients undergoing abscess I&D. Given the significant proportion with previous MRSA infection, the ED may be a setting to provide instructions to patients/families with recurrent infections.
-
Pediatric emergency care · Apr 2015
Observational StudyA Novel Briefing Checklist at Shift Handoff in an Emergency Department Improves Situational Awareness and Safety Event Identification.
Emergency department (ED) shift handoffs are sources of potential medical error, delays in care, and medicolegal liabilities. Few handoff studies exist in the ED literature. We aimed to describe the implementation of a standardized checklist for improving situational awareness during physician handoffs in a pediatric ED. ⋯ The Physician Active Shift Signout in the Emergency Department briefing checklist was used often and at a high completion rate, frequently identifying potential safety events. The users found that it improved the quality of care and team communication. Future studies on outcomes and processes are needed.
-
Pediatric emergency care · Apr 2015
Benefits of Brain Magnetic Resonance Imaging Over Computed Tomography in Children Requiring Emergency Evaluation of Ventriculoperitoneal Shunt Malfunction: Reducing Lifetime Attributable Risk of Cancer.
The rapid growth of computed tomography (CT) has resulted in increased concerns of ionizing radiation exposure and its subsequent risk of cancer development. We evaluated the impact of a new protocol using rapid sequence magnetic resonance imaging (rsMRI) instead of CT in children presenting with possible ventriculoperitoneal shunt (VPS) malfunction to promote patient safety. ⋯ Children with VPS are subject to multiple neuroimaging studies throughout their lifetime. Rapid sequence MRI is an effective alternative to CT while providing no ionizing radiation exposure or risk of developing radiation-induced cancer.