Pediatric emergency care
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Pediatric emergency care · Jul 2021
Parental Attitudes and Knowledge About Lumbar Puncture in Children.
Lumbar puncture (LP) is fundamental for diagnosis and treatment; however, some parents do not provide consent for their children to undergo the procedure, which can make diagnosis and determination of the optimal treatment difficult. The present study aimed to describe the level of knowledge and attitudes toward LP of parents whose children were scheduled to undergo the procedure. ⋯ We found that most parents had little knowledge about LP, and the most common parental concern was paralysis. Despite this, in our study, only 5% of parents did not consent to LP.
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Pediatric emergency care · Jul 2021
ReviewDelayed Subaponeurotic Fluid Collections: A Benign Cause of Scalp Swelling in Infancy.
Delayed subaponeurotic fluid collections (DSFCs) are a recently described cause of idiopathic scalp swelling in young infants. Associated with traumatic birth and the use of vacuum-assisted devices or fetal scalp electrodes, DSFCs can be differentiated from similar causes of neonatal scalp swelling based on characteristic history and physical examination findings. ⋯ In cases of isolated DSFCs in otherwise well-appearing infants, further laboratory work, imaging, subspecialty consultation, and child abuse investigation is not necessary. Recommendations for the diagnosis and management of DSFCs presented reflect the clinical experience of the authors in conjunction with a review of the available medical literature on this topic.
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Single-sided (1-tailed) and double-sided (2-tailed) probabilities are products of statistical tests that can be crucial to drawing accurate conclusions in scientific studies. In a review of articles published in issues of Pediatric Emergency Care from 2020, we identified 2 where single-sided versus double-sided probability issues potentially reversed a conclusion of study investigators. The purpose of this study is to describe single-sided versus double-sided probability issues found in Pediatric Emergency Care 2020 articles to increase awareness surrounding these issues. ⋯ These articles demonstrate how single-sided versus double-sided probability issues can cause researchers to draw inaccurate conclusions. As such, we would urge that this be more rigorously evaluated when the P values are between 0.05 and 0.10.
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Pediatric emergency care · Jul 2021
Case ReportsUncommon Presentation of Childhood Leukemia in Emergency Department: The Usefulness of an Early Multidisciplinary Approach.
Leukemia is the most common childhood malignancy, and it is often characterized by pallor, fatigue, cytopenia, and organomegaly; sometimes musculoskeletal symptoms, mainly characterized by diffuse bone pain in the lower extremities, are the onset clinical characteristics of the disease. In these cases, the disease may initially be misdiagnosed as reactive arthritis, osteomyelitis, or juvenile idiopathic arthritis delaying appropriate diagnosis and management. ⋯ However, they could be helpful to get the right diagnosis if integrated with other features; thus, it is important knowing them, and it is mandatory for the multidisciplinary comparison to talk about dubious cases even in an emergency setting. We describe 4 patients visited in the emergency department for musculoskeletal complaints and having radiological lesions and a final diagnosis of acute lymphoblastic leukemia, in whom the onset of the manifestations could mimic orthopedic/rheumatologic diseases.
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Pediatric emergency care · Jul 2021
Telemedicine Medical Screening Evaluation Expedites the Initiation of Emergency Care for Children.
Prior studies show that staffing a physician at triage expedites care in the emergency department. Our objective was to describe the novel application and effect of a telemedicine medical screening evaluation (Tele-MSE) at triage on quality metrics in the pediatric emergency department (PED). ⋯ A Tele-MSE is an innovative modality to expedite the initiation of emergency care and reduce PED LOS for children. This novel intervention offers potential opportunities to optimize provider and patient satisfaction and safety during the COVID-19 pandemic.