Pediatric emergency care
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Pediatric emergency care · Dec 2021
Performance of the BIG Score in Predicting Mortality in Normotensive Children With Trauma.
Children have a larger reserve for traumatic hemorrhagic shock, requiring a score that uses physiologic variables other than hypotension. Recently, the BIG score comprising admission base deficit, international normalized ratio, and the Glasgow Coma Scale has been reported to predict traumatic mortality. We aimed to validate the performance of the BIG score in mortality prediction of normotensive children with trauma. ⋯ The BIG score can predict mortality with excellent accuracy in normotensive children with trauma.
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Pediatric emergency care · Dec 2021
Utility of Blood Cultures and Empiric Antibiotics in Febrile Pediatric Hemophilia Patients With Central Venous Access Devices.
Children with hemophilia frequently require long-term central venous access devices (CVADs) for regular infusion of factor products. Hemophilia patients are not immunocompromised, but the presence and use of CVADs are associated with infections including bacteremia. Currently, the utility of blood cultures in evaluation of the febrile hemophilia patient with an indwelling CVAD is unknown, nor is optimal empiric antibiotic use. ⋯ Febrile immunocompetent hemophilia patients with indwelling CVADs have high rates of bacteremia. Empiric antimicrobial therapy should be targeted to anticipated pathogens and take into consideration local susceptibility patterns for Staphylococcus aureus.
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Pediatric emergency care · Dec 2021
Characteristics of Diagnosed Concussions in Children Aged 0 to 4 Years Presenting to a Large Pediatric Healthcare Network.
The aim of the study was to comprehensively describe the natural history of concussion in early childhood between 0 and 4 years. ⋯ These results provide insight into the clinical characteristics of concussion in early childhood up to 4 years of age. Because assessment in this group relies heavily on parent/caregiver symptom reporting, rather than patient self-report, these results will aid clinicians with the challenge of diagnosing concussions in this population. These findings highlight the need to develop additional tools to adequately and systematically assess common signs and symptoms of concussion in early childhood that may not be included in standard assessment scales routinely used in older adolescents and adults.
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Pediatric emergency care · Dec 2021
Factors Associated With Increased Risk of Pediatric Orbital Cellulitis-Who Should Be Scanned?
Evaluation of a child with POC/OC is complicated due difficulties in physical examination and risks of imaging by computed tomography. ⋯ Differentiation between POC/OC is cardinal. This study highlights the importance of ancillary laboratory tests especially C-reactive protein in the assessment of infections of the eye.
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Pediatric emergency care · Dec 2021
Multicenter StudyMulticenter Retrospective Review of Adult Patients Presenting to Pediatric Emergency Departments: Impact of Interfacility Distance.
This descriptive study aimed at evaluating the impact of distance between a general and pediatric emergency department (PED) on adults seeking care at PEDs. ⋯ Statistically significant differences were seen in the adult population presenting to PEDs based on the interfacility distance between a pediatric and general ED. These data can help PEDs prepare for the adult patients they are more likely to treat.