Pediatric emergency care
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Pediatric emergency care · Sep 2022
Multicenter StudyAnatomic Characteristics of the Adolescent Cricothyroid Membrane on Computed Tomography Scans.
The cricothyroid membrane (CTM) is the most important anatomic structure when performing emergency front-of-neck access (FONA) procedures. Adolescence is a period of rapid morphologic change in laryngeal structures, including the CTM. We hypothesized that the adolescent CTM would be sufficiently different from pediatric or adult anatomy to merit special consideration in FONA. ⋯ The adolescent CTM is smaller than previously recognized. We recommend having a variety of equipment sizes readily available at any site where airway management in adolescents may occur.
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Pediatric emergency care · Sep 2022
ReviewCareer Development in Pediatric Emergency Medicine: What Do We Need?
The Women in Pediatric Emergency Medicine (PEM) subcommittee of the American Academy of Pediatrics Section on Emergency Medicine identified 2 top priorities for 2021: career development and mentorship/sponsorship. The objective of this study was to catalog and delineate the career development domains for women physicians in PEM. ⋯ This study demonstrates that the career development needs of women in PEM include a range of personal, teaching, research, administrative, clinical, and service domains. However, more than two-thirds of the career development topics were categorized into just 2 domains, administrative and personal.
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Pediatric emergency care · Sep 2022
Multicenter StudySARS-CoV-2 With Concurrent Respiratory Viral Infection as a Risk Factor for a Higher Level of Care in Hospitalized Pediatric Patients.
As of early 2021, there have been over 3.5 million pediatric cases of SARS-CoV-2, including 292 pediatric deaths in the United States. Although most pediatric patients present with mild disease, they are still at risk for developing significant morbidity requiring hospitalization and intensive care unit (ICU) level of care. This study was performed to evaluate if the presence of concurrent respiratory viral infections in pediatric patients admitted to the hospital with SARS-CoV-2 was associated with an increased rate of ICU level of care. ⋯ This study demonstrates an association between concurrent SARS-CoV-2 infection with viral respiratory coinfection and the need for ICU care. Further research is needed to identify other risk factors that can be used to derive and validate a risk-stratification tool for disease severity in pediatric patients with SARS-CoV-2.
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Pediatric emergency care · Sep 2022
Randomized Controlled Trial0.45% Versus 0.9% Saline in 5% Dextrose as Maintenance Fluids in Children Admitted With Acute Illness: A Randomized Control Trial.
The safety of giving intravenous (IV) maintenance fluids according to Holliday and Segar's recommendations of 1957 has recently been questioned after reports of complications caused by iatrogenic hyponatremia in children receiving hypotonic fluids. However, the current practice of choice of maintenance IV fluids for hospitalized children varies worldwide. This study was planned to compare 0.45% and 0.9% saline in 5% dextrose at standard maintenance rates in hospitalized children aged 3 months to 12 years. ⋯ The fall in serum sodium values was significant, and there was significant risk of hyponatremia with the use of hypotonic fluids at 12 and 24 hours. Hence, the use of isotonic fluids seems to be more appropriate among the hospitalized children.Trial Registration: CTRI/2019/10/021791.
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Pediatric emergency care · Sep 2022
Multicenter StudyAdherence to Pediatric Sepsis Treatment Recommendations at Emergency Departments: A Multicenter Study in Latin America.
Sepsis is one of the most urgent health care issues worldwide. Guidelines for early identification and treatment are essential to decrease sepsis-related mortality. Our aim was to collect data on the epidemiology of pediatric septic shock (PSS) from the emergency department (PED) and to assess adherence to recommendations for its management in the first hour. ⋯ We found poor adherence to the international recommendations for the treatment of PSS in the first hour at the PED in third-level hospitals in Latin America.