Pediatric emergency care
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Pediatric emergency care · Aug 2021
Randomized Controlled TrialDo Parents of Discharged Pediatric Emergency Department Patients Read Discharge Instructions?
The percentage of discharged emergency department (ED) patients who read discharge instructions (DCIs) is unknown. In this study of parents of pediatric ED patients, we attempt to quantify the DCI readership rate and identify variables associated with readership. We hypothesized that few families would read their child's DCIs. ⋯ A minority of parents of patients discharged from the pediatric ED appear to read through their child's DCIs, with Hispanic families and those without private insurance least likely to read. Future research can explore how best to reach these particularly vulnerable families.
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Pediatric emergency care · Aug 2021
Hypothermia in Young Infants: Frequency and Yield of Sepsis Workup.
Serious bacterial infections (SBIs) in young infants can present with fever or hypothermia. There are substantial data on fever as a presentation for SBI that help to inform the clinical approach. In contrast, data on hypothermia are lacking, thus leaving clinicians without guidance. We aimed to describe the workup and findings, specifically the occurrence, of SBIs in infants younger than 60 days of life with hypothermia. ⋯ Approximately a quarter of infants younger than 60 days with hypothermia were evaluated for SBI. Serious bacterial infection was identified in 9% of evaluated infants (2% of all hypothermic infants). Hypothermia can be a presenting sign of SBI.
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Pediatric emergency care · Aug 2021
Timing of Button Battery Removal From the Upper Gastrointestinal System in Children.
The aim of the study was to investigate the appropriate time of removal of button batteries (BB) from the esophagus and stomach in children. ⋯ Button batteries ingestion is a common problem with variable time of presentation to the emergency department. Esophageal BB presents the highest risk of injury even in as short time as 2 hours. Gastric mucosal injury can occur within 10 hours of ingestion. Button batteries of 20-mm diameter need to be urgently removed from the esophagus and be considered for removal earlier than 24 hours if in the stomach.
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Pediatric emergency care · Aug 2021
Point-of-Care Ultrasound-Guided Versus Conventional Bladder Catheterization for Urine Sampling in Children Aged 0 to 24 Months.
It can be difficult to obtain urine samples, especially in children aged 0 to 24 months who have not yet completed toilet training. Bladder catheterization is a common method for urine sampling in this age group. However, if the bladder is not adequately filled, this process fails and repeat catheterization is necessary. Point-of-care ultrasonography (POCUS) is often used to assist invasive procedures in the pediatric emergency department. This study aimed to compare success rates of bladder catheterization in patients with and without POCUS to guide the timing of the procedure. ⋯ The use of POCUS during bladder catheterization in children was found to be effective and successful. In addition, the detection of any amount of urine in the bladder using POCUS increases the success rate of bladder catheterization.
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Pediatric emergency care · Aug 2021
Case ReportsSubacute Gummy Vitamin Overdose as a Rare Manifestation of Child Neglect.
We present a case of a 20-month-old girl who presented to the emergency department with anorexia, progressive weakness, and lethargy who was found to have severe hypercalcemia (20.7 mg/dL) and vitamin D hypervitaminosis. Further questioning revealed that this was secondary to a subacute toxic ingestion of "L'il Critters" calcium and vitamin D3 gummy vitamins that were being administered by the patient's mother multiple times a day for several weeks or even months. This occurred in the setting of child neglect due to the mother's mental illness. ⋯ Our patient had the highest calcium level we are aware of in a toddler and is the only case we know of that occurred as a result of a prolonged, intentional exposure in the setting of child neglect and a complex social situation. This case reviews the causes and management of hypercalcemia and vitamin D intoxication. It also highlights the need for a comprehensive social history and exposes the vulnerabilities of children living in homes afflicted by parental depression and severe mental illness.