Pediatric emergency care
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Pediatric emergency care · Jan 2017
Observational StudyPoint-of-Care Ultrasound for the Detection of Traumatic Intracranial Hemorrhage in Infants: A Pilot Study.
Computed tomography is the criterion standard imaging modality to detect intracranial hemorrhage (ICH) in children and infants after closed head injury, but its use can be limited by patient instability, need for sedation, and risk of ionizing radiation exposure. Cranial ultrasound is used routinely to detect intraventricular hemorrhage in neonates. We sought to determine if point-of-care (POC) cranial ultrasound performed by emergency physicians can detect traumatic ICH in infants. ⋯ Traumatic ICH can be identified with POC cranial ultrasound by ultrasound fellowship-trained emergency physicians. Although variations between observers and wide confidence intervals preclude drawing meaningful conclusions about sensitivity and specificity from this sample, these results support the need for further investigation into the role of POC cranial ultrasound.
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Pediatric emergency care · Jan 2017
Case ReportsReturn of Viable Cardiac Function After Sonographic Cardiac Standstill in Pediatric Cardiac Arrest.
Sonographic cardiac standstill during adult cardiac arrest is associated with failure to get return to spontaneous circulation. This report documents 3 children whose cardiac function returned after standstill with extracorporeal membranous oxygenation. Sonographic cardiac standstill may not predict cardiac death in children.
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Pediatric emergency care · Jan 2017
Lung Ultrasound as First-Line Examination for the Diagnosis of Community-Acquired Pneumonia in Children.
The diagnosis of pediatric community-acquired pneumonia (CAP) is based on clinical criteria. Even though chest x-ray (CXR) is only recommended in severe cases, it is often requested from physicians in mild cases, thus increasing radiation exposure. Lung ultrasound (LUS) is not included in the diagnostic workup. The objective of this study was to evaluate the diagnostic performance of LUS against CXR. ⋯ Lung ultrasound plays a significant role in the detection of CAP, not inferior to CXR. The aim of this study was to encourage the use of ultrasound as a first-line examination for CAP in children.
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Pediatric emergency care · Jan 2017
Case ReportsRetropharyngeal Abscess and Mediastinitis in a Well-Appearing Infant With Prolonged Fever.
Fever is a common presenting chief complaint in the pediatric emergency department. We report the case of a well-appearing 11-month-old female with 2 weeks of daily fevers who was found to have an extensive retropharyngeal abscess with mediastinal and extrapleural extension. We review the literature on retropharyngeal abscesses and mediastinitis in children and note that this patient is unusual as she presented with such extensive disease with minimal symptoms. This case demonstrates the importance of a thorough history and broad differential diagnosis when evaluating children presenting prolonged fevers.
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Pediatric emergency care · Jan 2017
Mental Health Screening Among Adolescents and Young Adults in the Emergency Department.
To determine if a new, non-validated mental health screener can detect the prevalence of alcohol/drug abuse, traumatic exposure, and behavioral symptoms in adolescents and young adults seeking care in a pediatric emergency department (ED) for medical complaints. ⋯ Although patients present to the ED with medical complaints, they may be at risk for concomitant mental health problems potentially discoverable using the ED-DRS.