Pediatric emergency care
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Pediatric emergency care · Nov 2021
Evaluation of the Efficacy and Safety of 3 Different Management Protocols in Pediatric Diabetic Ketoacidosis.
Management protocols for pediatric diabetic ketoacidosis (DKA) vary considerably among medical centers. The aim of this study was to investigate the efficacy and safety of 3 different fluid protocols in the management of DKA. ⋯ Severity of acidosis and dehydration are associated with the development of cerebral edema. It can be concluded that fluid therapy with higher Na content and a constant maintenance rate may present less risk for the patient with DKA.
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Pediatric emergency care · Nov 2021
Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department.
This study aimed to investigate the feasibility of point-of-care ultrasound (POCUS) for diagnosing hypertrophic pyloric stenosis (HPS) in the emergency department (ED). ⋯ Point-of-care ultrasound is accurate and useful for diagnosing HPS and improved the ED patient flow by reducing EDLOS and door-to-disposition time in non-HPS patients.
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Pediatric emergency care · Nov 2021
Attending-Provider Handoffs and Pediatric Emergency Department Revisits.
The objective of this study was to determine if intradepartment attending-provider transitions of care (handoffs) during a pediatric emergency department (ED) encounter were associated with return ED visits resulting in hospitalization. ⋯ Provider handoffs in a pediatric ED did not increase the risk of return ED visits or return ED visits with deficiencies in care after adjustment for demographic, clinical, and visit factors.
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A growing number of adolescents are being diagnosed with acute myocarditis following mRNA COVID-19 vaccinations. This case describes an adolescent who presented to the emergency department with chest pain and tachycardia following the Pfizer-BioNTech COVID-19 vaccination. Point-of-care ultrasound was performed prior to the return of laboratory studies and revealed depressed left ventricular systolic function. Point-of-care ultrasound may be a tool used to rapidly diagnose or risk stratify patients with potential post-COVID-19 vaccine myocarditis.
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Pediatric emergency care · Nov 2021
A Case Series of Life-Threatening Complications of Central Venous Catheter Insertion.
Central venous catheters are commonly used in emergency department and the intensive care units for the treatment of critically ill patients. Reports on the rate of mechanical complications of catheter insertion are around 1%. ⋯ Here, we report a case series of 4 patients who had life-threatening complications of central venous catheter insertion, including venous intimal injury leading to pleural effusion, kinked central venous catheter in the superior vena cava, knotted guidewire with the separation of coil and core, and a missed guidewire with their respective insertion history and imaging. Increasing the awareness of and developing strategies to prevent these rare but potentially fatal conditions may have impact on patient outcomes.