Pediatric emergency care
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Pediatric emergency care · Mar 2023
Multicenter StudyOmphalitis: Clinical Presentation and Approach to Evaluation and Management.
Omphalitis is an uncommon but potentially serious infection in neonates. Findings include erythema and induration around the umbilical stump, and purulent drainage may be present. Fever and signs of systemic illness may occur, or there may only be signs of localized soft tissue infection. ⋯ Underlying urachal abnormalities should be considered in the infant with umbilical drainage. Treatment of omphalitis consists primarily of antibiotic administration, with surgical intervention rarely needed. Although antibiotics are typically administered intravenously, there may be a role for oral antibiotics in some lower risk infants with omphalitis.
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Pediatric emergency care · Mar 2023
Use and Cost Analysis of Comprehensive Respiratory Panel Testing in a Pediatric Emergency Department.
Fever and respiratory infections are among the leading causes of pediatric emergency department visits and hospitalizations. Although typically self-resolving, clinicians may perform diagnostic tests to determine microbial etiologies of these illnesses. Although comprehensive respiratory viral panels can quickly identify causative organisms, cost to the hospital and patient may be significant. The objective of this study was to analyze the financial impact of comprehensive respiratory viral panel use in relation to associated clinical outcomes. ⋯ This study demonstrates that the utilization of comprehensive respiratory viral panels in pediatric emergency department patients with bronchiolitis, unspecified fever, and/or acute upper respiratory infection adds significant cost to patient care without a decrease in their length of stay or antimicrobial use. Further studies are needed to determine the appropriate targeted use of comprehensive respiratory viral panels.
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Pediatric emergency care · Mar 2023
Pediatric Open Globe Injuries Caused by Firecrackers in a Tertiary Eye Care Hospital in Iran.
The aim of the study is to determine characteristic features of open globe injuries caused by firecrackers among pediatric population. ⋯ The present study showed several differences between the pediatric open globe injuries caused by firecrackers and other mechanisms of injuries, including the age, sex, living place, presence of IOFB, and length of hospital stay.
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Pediatric emergency care · Mar 2023
Comparative StudyComparison of Specialist and Nonspecialist Transport Teams for Emergency Neurosurgery.
Current guidance in the United Kingdom recommends that children requiring emergency neurosurgical intervention should be transported by referring hospital (RH) teams. We aimed to compare transports performed by RH teams and by specialized pediatric critical care transport (PCCTs) teams in terms of timings and patient outcomes. ⋯ Specialist critical care transport teams are involved in one third of transfers of children with acute neurosurgical emergencies. While the overriding priority is timely transfer, a tailored approach to the use of PCCTs may be appropriate particularly for children presenting to hospitals nearer to neurosurgical centers.
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Pediatric emergency care · Mar 2023
Documented Visio-Vestibular Examination and Anticipatory Guidance for Pediatric Concussion Patients.
Pediatric concussion patients are frequently managed in the primary care or acute care settings. Optimal care includes vision and vestibular assessments, as well as targeted anticipatory guidance for return to school and activity. We aimed to examine clinical practices related to the evaluation and management of concussion patients at children's hospital-based emergency department (ED) and primary care/urgent care settings. ⋯ Although most pediatric concussion patients receive instructions acutely about cognitive and physical rest, there is opportunity to increase the frequency of visio-vestibular testing in both the ED and the primary care settings. Future efforts should focus on strategies to consistently optimize visio-vestibular assessment given its value in concussion diagnosis.