Pediatric emergency care
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Pediatric emergency care · Jun 2019
Multicenter StudyPelvic Inflammatory Disease in a Pediatric Emergency Department: Epidemiology and Treatment.
Most adolescent cases of pelvic inflammatory disease (PID) are diagnosed in the emergency department (ED). An important step to prevent PID-related morbidity among this high-risk population is to quantify prevalence and microbial patterns and identify testing and treatment gaps. ⋯ There is a high prevalence of PID among adolescents in the pediatric ED. Rates of STI testing and appropriate treatment reveal gaps in diagnosis and management, representing a lost opportunity for identification and treatment of PID/STIs among high-risk adolescents.
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Pediatric emergency care · Jun 2019
Effectiveness of a High-Fidelity Simulation-Based Training Program in Managing Cardiac Arrhythmias in Children: A Randomized Pilot Study.
Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias. ⋯ A simulation-based training with debriefing had positive effects on stress and satisfaction about skills of pediatric residents and nurses and on observed TSs and NTSs of the leaders during simulation sessions. A future study should assess the effectiveness of this training in a larger sample and its impact on skills during actual emergencies.
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Pediatric emergency care · Jun 2019
Case ReportsAcquired Constriction Ring: A Case of Rubber Band Syndrome.
Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovascular structures. These symptoms are difficult to relate to this rare but typical condition. ⋯ The child had excellent recovery postoperatively. The cardinal features of a linear constricting scar around the wrist in the presence of a swollen hand should always alert the clinician to the possibility of a forgotten band around the wrist, which might have burrowed into the soft tissues for a period. Early recognition may be important to prevent further damage of essential structures.
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Pediatric emergency care · Jun 2019
ReviewCurrent Approach to the Evaluation and Management of Acute Compartment Syndrome in Pediatric Patients.
Acute compartment syndrome is an emergent condition caused by increased pressure within a closed compartment. The most common etiology is fractures, but there a number of atraumatic causes cited in the literature. Acute compartment syndrome occurs most frequently in the anterior compartment of the lower leg, followed by the volar forearm. ⋯ No finding in isolation can exclude the diagnosis. Direct measurement of the intracompartmental pressure is the most important diagnostic test. Treatment involves removal of compressive dressings and surgical consultation for emergent fasciotomy.
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Pediatric emergency care · Jun 2019
Reliability of Smartphone-Based Instant Messaging Application for Diagnosis, Classification, and Decision-making in Pediatric Orthopedic Trauma.
Smartphones have the ability to capture and send images, and their use has become common in the emergency setting for transmitting radiographic images with the intent to consult an off-site specialist. Our objective was to evaluate the reliability of smartphone-based instant messaging applications for the evaluation of various pediatric limb traumas, as compared with the standard method of viewing images of a workstation-based picture archiving and communication system (PACS). ⋯ Smartphone-based instant messaging applications are reliable for evaluation of a wide range of pediatric limb fractures. This method of obtaining an expert opinion from the off-site specialist is immediately accessible and inexpensive, making smartphones a powerful tool for doctors in the emergency department, primary care clinics, or remote medical centers, enabling timely and appropriate treatment for the injured child. This method is not a substitution for evaluation of the images in the standard method over computer-based PACS, which should be performed before final decision-making.