Pediatric emergency care
-
Pediatric emergency care · Oct 2023
Point-of-Care Ultrasonography for the Assessment of Dehydration in Children: A Systematic Review.
Accurate estimation of the degree of dehydration remains a diagnostic challenge. The primary objective was to systematically review the literature on the role of ultrasound in assessment of the degree of dehydration in children. ⋯ This study showed that the quantity and quality of research on the application of POCUS for the assessment of dehydration in children is limited. There is no criterion standard for assessing the degree of dehydration and no universal definition of the degree of dehydration. Thus, more methodologically rigorous studies are required. Current systematic review does not support the routine use of US to determine the severity of dehydration in children. Despite these limitations, the use of POCUS in children with dehydration demonstrates potential. Given the clear increase in IVC size with rehydration, repeated IVC US scans may be helpful in guiding fluid resuscitation in children with dehydration. From different proposed US parameters, IVC/Ao ratio has better diagnostic accuracy in detecting significant dehydration than Ao/IVC ratio and IVC collapsibility index. Despite low to moderate diagnostic performance, US still showed better assessment of dehydration than physician gestalt and World Health Organization score.
-
Children and adolescents can present to the emergency department with acute agitation and aggression due to various physical and/or mental health conditions. With acute agitation/aggression, these patients may present a risk of injury to themselves, their caregivers, or emergency department providers/staff. It is imperative for providers to understand how to safely care for these children. ⋯ Without proper training or preparation, physical restraints can lead to significant morbidity and mortality. Given these potential risks, strict guidelines have been set out by the Center for Medicare and Medicaid Services and the Joint Commission regarding the use of physical restraints in the pediatric population. This article will review approaches to the acutely agitated/aggressive patient, the appropriate use of physical restraints, and recommended assessment/documentation of restraints in the acutely agitated/aggressive pediatric patient.
-
Pediatric emergency care · Oct 2023
The Difference in Time to Discharge Between Daytime and Nighttime Administration of Ketamine in Children.
The objective of this study was to compare the time to discharge between daytime and nighttime ketamine administration to children undergoing primary facial repair in the emergency department (ED). ⋯ The findings of the study suggest that the time of ketamine injection has no relationship to duration of sedation for primary facial repair in children.