Pediatric emergency care
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Emergency departments (EDs) varied in their preparedness to provide pediatric emergency care, with mortality rates being higher when EDs were unprepared. Guidelines are available to aid EDs in their preparedness. We aimed to determine the preparedness of EDs in our healthcare cluster using the guidelines from the Royal College of Pediatrics and Child Health (RCPCH) and International Federation for Emergency Medicine (IFEM) as references for audit. ⋯ The standards of pediatric emergency care were met to different extents in the healthcare cluster. Using available references, EDs should identify lapses unique to their own settings to improve the delivery of pediatric emergency care.
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Pediatric emergency care · Dec 2020
Early Hospital Discharge After Helicopter Transport of Pediatric Trauma Patients: Analysis of Rates of Over and Undertriage.
Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. ⋯ Triage of pediatric trauma patients to HAA remains difficult. There remains potential for improvement, particularly as regards interhospital HAA overtriage, but well developed transfer protocols (such in-state protocols) may help.
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Pediatric emergency care · Dec 2020
Observational StudyEffectiveness of Emergency Department Treatment of Pediatric Headache and Relation to Rebound Headache.
This study aimed to assess the association between the degree of headache relief obtained in the pediatric emergency department (PED) with abortive treatment and unscheduled return visits to the PED for a recurrent or persistent headache within 72 hours. ⋯ Complete resolution in the PED may not be necessary, given the lack of association between the degree of pain relief and revisit rates. Perhaps, the goal should be to achieve at least 50% pain reduction before discharge.
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Pediatric emergency care · Dec 2020
Case ReportsHerpes Simplex Virus Pneumonia in an Immunocompetent Child on Corticosteroids for Acute Wheezing.
Herpes simplex virus (HSV) is rarely the cause of pneumonia in immunocompetent patients. We describe a previously healthy child, with no evidence of an immunodeficiency, who presented to the emergency department with severe pneumonia, wheezing, and pleural effusions with a history of orolabial HSV infection. ⋯ Oral lesions, blood, and pleural fluid tested positive for HSV, and improvement was achieved only after the addition of acyclovir and discontinuation of steroids. We suggest that steroids should be used with caution in patients presenting with lower respiratory tract symptoms and herpetic oral lesions.
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Pediatric emergency care · Dec 2020
Pain Intensity and Risk of Bone Fracture in Children With Minor Extremity Injuries.
Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture. ⋯ In this series, pain intensity in children with a minor extremity injury was not a good marker of fracture. Nevertheless, children with mild palpation pain or with a mild increase of pain between spontaneous and palpation pain had a low risk of fracture.