Pediatric emergency care
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Pediatric emergency care · Oct 2021
Randomized Controlled TrialAn Evaluation of High Preprocedural Anxiety and Venipuncture Pain Experienced by Young Children.
The aim of this study was to determine if young children with high preprocedural anxiety experience increased pain at venipuncture. ⋯ Most young children undergoing venipuncture experienced high preprocedural anxiety. Children with high preprocedural anxiety had increased odds of moderate to severe pain at venipuncture. Anxiety-reducing interventions should be explored to reduce pain experienced during venipuncture.
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Pediatric emergency care · Oct 2021
Guideline Adherence in Diagnostic Testing and Treatment of Community-Acquired Pneumonia in Children.
The objective of this study was to determine emergency department (ED) physician adherence with the 2011 Pediatric Infectious Diseases Society (PIDS) and Infectious Diseases Society of America (IDSA) guidelines for outpatient management of children with mild-to-moderate community-acquired pneumonia (CAP). ⋯ Reported ED CXR use in the management of outpatient CAP was often nonadherent to the PIDS/IDSA guidelines. Most respondents were adherent to the guidelines in their use of antibiotics. Strategies to increase diagnostic test accuracy are needed to improve adherence and reduce variation in care.
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Pediatric emergency care · Oct 2021
Case ReportsTreatment of a Case of Toe Hair-Thread Tourniquet Syndrome With Hirasè Technique.
Hair-thread tourniquet syndrome (HTTS) is an uncommon condition that affects mostly babies, usually a few months old. It happens when a strand of hair or cloth fiber encircles an appendage causing a condition of total or subtotal ischemia (West J Med 1976;125:335-336). This condition has been described several times in the recent literature. ⋯ After 3 days, we observed a complete survival of the toe without any sign of necrosis. Later control at 6 months showed complete restitutio ad integrum of the affected digit with a normal perfusion and absence of any onychopathy. Hirasè technique represents a simple, safe, and low-cost option of treatment for HTTS.
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Pediatric emergency care · Oct 2021
Rest-Based Concussion Management of Pediatric Emergency Medicine Providers.
This study aimed to survey pediatric emergency medicine (PEM) providers on their management of 2 hypothetical acute concussion scenarios. We hypothesized that most providers would recommend a management strategy based on cognitive and physical rest. ⋯ In both of our hypothetical concussion scenarios, including a very mild head injury, most PEM providers surveyed recommended a management strategy that included a moderate degree of a delay of return to school and sports. Given recent evidence suggesting that prolonged rest does not reduce the risk of prolonged concussion symptoms, recommendations of periods of cognitive rest, particularly absences from school, should be approached cautiously. Future studies should examine why providers are recommending rest-based treatment strategies and the potential benefits of active rehabilitation.
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Vomiting in young infants is a common presentation to the pediatric emergency department with a broad differential diagnosis. We present 2 cases seen in our emergency department of infant females with symptomatic complex ovarian cysts who presented with vomiting. ⋯ The second case study describes a patient with reportedly normal prenatal ultrasounds with a subsequent diagnosis of a large complex ovarian cyst. These cases were selected to review pertinent imaging findings, discuss management decisions, and expand the differential of vomiting in the young female infants.