Pediatric emergency care
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Pediatric emergency care · Feb 2020
Youth Victims of Violence Report Worse Quality of Life Than Youth With Chronic Diseases.
Measuring health-related quality of life (HRQOL) provides the patient's perspective of his/her well-being and offers a unique outcome measure to demonstrate the impact of violence on the victim. To date, no study has described HRQOL in youth victims of violence in the United States. The purpose of this study was to describe HRQOL in youth victims of violence as compared with healthy youth and youth with chronic disease. ⋯ Youth victims of violence suffer significant impairment in HRQOL compared with healthy populations and youth with specific disease burdens. Future studies into violence prevention effectiveness should use HRQOL as a comparative outcome measure to better tailor post injury management and interventions.
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Pediatric emergency care · Feb 2020
Case ReportsBeyond Point-of-Care Ultrasound: Bedside Ultrasound in the Diagnosis of Soft Tissue Mass.
Cancer is diagnosed in 1 in 7000 children annually. Here, we report 6 cases of a mass identified by the author, a novice sonographer in a pediatric emergency medicine fellowship, using point-of-care ultrasound, from January of 2017 to May of 2018. Identification of these cases early in presentation allowed for earlier involvement of the relevant specialist and shorter time to diagnosis and treatment, and might be expected to increase parent satisfaction as well.
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Pediatric emergency care · Feb 2020
Randomized Controlled TrialA Randomized Control Trial of Cardiopulmonary Feedback Devices and Their Impact on Infant Chest Compression Quality: A Simulation Study.
In effort to improve chest compression quality among health care providers, numerous feedback devices have been developed. Few studies, however, have focused on the use of cardiopulmonary resuscitation feedback devices for infants and children. This study evaluated the quality of chest compressions with standard team-leader coaching, a metronome (MetroTimer by ONYX Apps), and visual feedback (SkillGuide Cardiopulmonary Feedback Device) during simulated infant cardiopulmonary resuscitation. ⋯ In the adult literature, feedback devices often show an increase in quality of chest compressions. Although more studies are needed, this study did not demonstrate a clinically significant improvement in chest compressions with the addition of a metronome or visual feedback device, no clinically significant difference in Pediatric Advanced Life Support-approved compression technique, and no difference between compression quality between genders.
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Pediatric emergency care · Feb 2020
ReviewConfronting Subconscious Bias: Ethics in the Pediatric Emergency Department.
Physicians are only human. Upon graduating from medical school, physicians take an oath declaring veracity and fidelity toward our patients. We are told to lay aside negative feelings toward patients in exchange for integrity, truth, honor, and compassion. ⋯ Recognition of these reactions and emotions will help physicians understand more about themselves, and assist in interacting more favorably with challenging patients. It is common for doctors to attempt to suppress their human reactions to maintain clinical objectivity, yet these reactions facilitate a better doctor-patient relationship. Allowing ourselves to yield to our emotions help the patient realize that the physician is a human being.
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Pediatric emergency care · Feb 2020
A Prospective Study of the Causes of Bruises in Premobile Infants.
This study had 2 objectives. First, to determine the behavior of physicians evaluating premobile infants with bruises. Second, and most importantly, to learn whether infants with unexplained bruising who had been initially evaluated by primary care and emergency department (ED) physicians are as likely to have their bruises attributed to child abuse as those children evaluated by child abuse physicians. ⋯ More than half of premobile infants with initially unexplained bruises were found to be abused. Abuse was as likely for infants identified by primary care and ED providers as for those identified by CAPs. Currently, physicians often do not obtain full abuse evaluations in premobile infants with unexplained bruising. Their initial clinical judgment about abuse likelihood was inadequate. Bruised infants often have clinically occult abusive injuries or will sustain subsequent serious abuse. Bruised infants should have full abuse evaluations and referral for Protective Services and police assessments.