Pediatric emergency care
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Bruising is the most common presentation of child physical abuse. Many patterns of abusive bruising result in positive or negative imprints of the implement used (eg, fingertips in "grab mark" contusions or hand in slap injury). ⋯ Four cases of children with this unique pattern of bruising due to abusive squeezing are presented. Recognition of these bruises as inflicted represents an opportunity for early identification and intervention in cases of child physical abuse.
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Pediatric emergency care · Jun 2021
Randomized Controlled TrialSedoanalgesia Versus Infraclavicular Block for Closed Reduction of Pediatric Forearm Fracture in Emergency Department: Prospective Randomized Study.
Procedural sedoanalgesia is commonly used in pediatric patients in the emergency department (ED) for interventional procedures, diagnosis, and treatment. However, this method causes serious systemic complications, such as respiratory and cardiac depression. To minimize these complications, ultrasound-guided regional anesthesia methods have been used in recent years. We aimed to compare the use of procedural sedoanalgesia (PSA) and infraclavicular block (ICB) in the pain management of pediatric patients who underwent closed reductions of forearm fractures. ⋯ Ultrasound-guided ICB is a safe and effective method in the management of pain during closed reduction of forearm fracture in pediatric patients in EDs. It can be used safely in emergency rooms and has a high level of both parental and operator satisfaction.
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Pediatric emergency care · Jun 2021
Randomized Controlled TrialA Randomized Single-Blinded Simulation-Based Trial of a Novel Method for Fluid Administration to a Septic Infant.
For children presenting in shock, American College of Critical Care Medicine guidelines recommend 3 boluses of intravenous fluids during initial resuscitation, but these are often not met. This study aims to compare a novel device LifeFlow, to established manual methods for rapid fluid delivery in a simulated environment. ⋯ LifeFlow allowed for faster fluid administration rate and thus could be the preferred technique for rapid fluid resuscitation in pediatrics patients. Further investigations should explore the reproducibility of these results using this device in real patients in multiple centers.
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Pediatric emergency care · Jun 2021
Epipericardial Fat Pad Necrosis-A Rare Cause of Chest Pain in an Adolescent.
Epipericardial fat necrosis is a rare cause of acute pleuritic chest pain reported in approximately 40 cases. This diagnosis mimics a myocardial infarction, pulmonary embolism, or pericarditis; however, the cardiac enzymes and electrocardiogram are usually normal. We present the first reported case of epipericardial fat necrosis in an adolescent.
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Pediatric emergency care · Jun 2021
Prevalence of Cyberbullying in Patients Presenting to the Pediatric Emergency Department.
Mental health (MH) complaints are increasingly responsible for visits to pediatric emergency departments (PEDs). Bullying is associated with MH problems. Most adolescents use social media and many experience problems with cyberbullying (CB). This study determines prevalence of CB in MH and non-MH adolescents in a PED, describes technology use in these groups, and measures influence of CB on presentation to the PED and on thoughts/acts of self-harm. ⋯ Prevalence of bullying in MH patients presenting to a PED is significantly greater than controls, and CB caused more MH patients to have acts or thoughts of self-harm. Bullying is a risk factor for self-harm and suicide in patients with MH problems. Future studies should evaluate CB as part of suicide screening tools for emergency MH patients.