Pediatric emergency care
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Pediatric emergency care · Mar 2021
Review Case ReportsOsteomyelitis in an Unusual Location With an Atypical Presentation: A Case Report and Review of the Literature of Scapular Osteomyelitis in Pediatric Patients.
Bacterial osteomyelitis of the scapula is rare in pediatric patients. When it occurs, it usually affects young infants and patients often exhibit fever and functional limitation of the extremity. We present a case of a 12-year-old boy with subacute bacterial scapular osteomyelitis and a normal physical examination. The patient was briefly treated with intravenous antibiotics and then transitioned to oral antibiotics to complete a 4-week course for methicillin-sensitive Staphylococcus aureus osteomyelitis.
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Pediatric emergency care · Mar 2021
Randomized Controlled TrialEfficacy of Veinlite PEDI in Pediatric Peripheral Intravenous Access: A Randomized Controlled Trial.
A total of 112 pediatric patients were enrolled in the study. Children who presented to the emergency department aged 1 to 10 years old were randomly assigned to the Veinlite PEDI (Veinlite) group or standard of care (SoC) group. The primary outcome measure was first attempt success. Secondary outcome measures were number of intravenous (IV) attempts and time to peripheral intravenous catheter (PIC) placement. ⋯ The use of new technology in the Veinlite PEDI (TransLite, Sugar Land, Tex), to assist with peripheral IV access in children, improves the first time success rate for IV access. Improved visualization of veins also reduced the number of attempts and the time required for PIC placement. These results suggest that the new technology of the Veinlite results in better PIC access than Veinlite transilluminaton device with white light.
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Pediatric emergency care · Mar 2021
Case ReportsModerate Gastrointestinal Complications Due to "Superglue" Ingestion in a Pediatric Patient.
Childhood cases of cyanoacrylates generally do not cause moderate or severe gastrointestinal complications. We report the case of a 3-year-old boy referred to our pediatric emergency room and admitted to the pediatric department with signs of upper gastrointestinal obstruction that required invasive intervention. Although it is rare, cyanoacrylate ingestion may injure esophageal and gastric mucosa in the pediatric population.
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Pediatric emergency care · Mar 2021
Randomized Controlled Trial Multicenter StudyChange in Cardiopulmonary Resuscitation Performance Over Time During Simulated Pediatric Cardiac Arrest and the Effect of Just-in-Time Training and Feedback.
Effective cardiopulmonary resuscitation (CPR) is critical to ensure optimal outcomes from cardiac arrest, yet trained health care providers consistently struggle to provide guideline-compliant CPR. Rescuer fatigue can impact chest compression (CC) quality during a cardiac arrest event, although it is unknown if visual feedback or just-in-time training influences change of CC quality over time. In this study, we attempt to describe the changes in CC quality over a 12-minute simulated resuscitation and examine the influence of just-in-time training and visual feedback on CC quality over time. ⋯ There was no significant drop in CC depth over a 12-minute cardiac arrest scenario with 2 team members providing compressions.
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Pediatric emergency care · Mar 2021
The Medical Resuscitation Committee: Interprofessional Program Development to Optimize Care for Critically Ill Medical Patients in an Academic Pediatric Emergency Department.
Provision of optimal care to critically ill patients in a pediatric emergency department is challenging. Specific challenges include the following: (a) patient presentations are highly variable, representing the full breadth of human disease and injury, and are often unannounced; (b) care team members have highly variable experience and skills and often few meaningful opportunities to practice care delivery as a team; (c) valid data collection, for quality assurance/improvement and clinical research, is limited when relying on traditional approaches such as medical record review or self-report; (d) specific patient presentations are relatively uncommon for individual providers, providing few opportunities to establish and refine the requisite knowledge and skill; and (e) unscientific or random variation in care delivery. ⋯ We specifically describe the grassroots development of an interprofessional medical resuscitation program. Key components of the program are as follows: (a) a database of all medical patients undergoing evaluation in the resuscitation suite, (b) peer review and education through video-based case review, (c) a program of emergency department in situ simulation, and (d) the development of cognitive aids for high-acuity, low-frequency medical emergencies.