Pediatric emergency care
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Pediatric emergency care · Dec 2019
Comparative StudyA Qualitative Analysis of General Emergency Medicine Providers' Perceptions on Pediatric Emergency Telemedicine.
Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers. ⋯ General ED providers identified 7 specific potential uses of pediatric emergency video telemedicine. However, they also identified several limitations of telemedicine in caring for pediatric emergency patients. Further studies after implementation of telemedicine program and comparing provider perceptions with actual practice may be helpful. Furthermore, studies on telemedicine's effect on patient-related outcomes and studies on cost-effectiveness might be necessary before the widespread implementation of a telemedicine program.
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Pediatric emergency care · Dec 2019
Comparative Study Observational StudyA Time-and-Motion Study of Clinical Trial Eligibility Screening in a Pediatric Emergency Department.
Challenges with efficient patient recruitment including sociotechnical barriers for clinical trials are major barriers to the timely and efficacious conduct of translational studies. We conducted a time-and-motion study to investigate the workflow of clinical trial enrollment in a pediatric emergency department. ⋯ Screening patients for eligibility constituted the most time. Automated screening methods could help reduce this time. The findings suggest improvement areas in recruitment planning to increase the efficiency of clinical trial enrollment.
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Pediatric emergency care · Dec 2019
Review Case ReportsA Rare Pediatric Case of Posttraumatic Pseudoaneurysm: Case Report and Literature Review.
Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thrill, and an audible to-and-fro murmur" (1), which can be confirmed by various imaging techniques. ⋯ Because pseudoaneurysms, particularly posttraumatic pseudoaneurysms, are extremely rare in the pediatric population, it may be easy to miss these cases during clinical examination. Misdiagnosis of the pseudoaneurysm can cause delayed treatment, a longer recovery period, and complications such as infection, rupture, and hemorrhage. It is important for physicians to consider this entity when evaluating patients with symptoms of asymptomatic bulges to painful pulsatile masses after trauma.
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Pediatric emergency care · Dec 2019
Review Case ReportsBeware the Innocent Presentation of a Spontaneous Perforated Meckel Diverticulum: A Rare Case and Review of the Literature.
Perforation of a Meckel diverticulum in a preterm neonate is very rare. To our knowledge, only 7 cases of spontaneous Meckel perforation in a preterm neonate have previously been described in the literature. ⋯ We present the case of a 30-week preterm female twin with a spontaneous Meckel diverticulum perforation discovered on day 3 of life and review the published cases. A possible etiological explanation for this rare entity at this age group is also suggested.
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Pediatric emergency care · Dec 2019
Review Comparative StudyCurrent Approach to the Evaluation and Management of Abdominal Compartment Syndrome in Pediatric Patients.
Abdominal compartment syndrome is an emergent condition caused by increased pressure within the abdominal compartment. It can be caused by a number of etiologies, which are associated with decreased abdominal wall compliance, increased intraluminal or intraperitoneal contents, or edema from capillary leak or fluid resuscitation. The history and physical examination are of limited utility, and the criterion standard for diagnosis is intra-abdominal pressure measurement, which is typically performed via an intravesical catheter. Management includes increasing abdominal wall compliance, evacuating gastrointestinal or intraperitoneal contents, avoiding excessive fluid resuscitation, and decompressive laparotomy in select cases.