Pediatric emergency care
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Pediatric emergency care · Jul 2023
Case ReportsRuptured Appendicitis Within an Intussusception on Point-of-Care Ultrasound.
This case describes a 21-month-old girl who was transferred to our pediatric emergency department with daily fevers for 9 days and concern for intussusception on an ultrasound obtained at the outside hospital. Her examination was notable for diffuse tenderness to palpation with no rebound or guarding. ⋯ To our knowledge, this is the first reported case of perforated appendicitis within an intussusception identified on POCUS in a pediatric patient. This case demonstrates the utility of POCUS in facilitating the recognition of an atypical diagnosis of a perforated appendicitis contained within an intussusception and helping to guide further evaluation and management.
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Pediatric emergency care · Jul 2023
Impact of Adjunct Corticosteroid Therapy on Quality of Life for Children With Suspected Pneumonia.
To determine the association between adjunct corticosteroid therapy and quality of life (QoL) outcomes in children with signs and symptoms of lower respiratory tract infection and clinical suspicion for community-acquired pneumonia (CAP) in the emergency department (ED). ⋯ In this cohort of children with suspected CAP, receipt of corticosteroids was associated with asthma history and was not associated with missed days of activity or work, except in a subset of children aged older than 2 years.
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Pediatric emergency care · Jul 2023
Clinical Utility and Patient Distribution of Brief Resolved Unexplained Event Classification for Apparent Life-Threatening Events.
In 2016, brief resolved unexplained events (BRUEs) were proposed as alternative concepts to apparent life-threatening event (ALTE). The clinical utility of managing ALTE cases according to the BRUE classification is controversial. To verify the clinical utility of the BRUE criteria, we evaluated the proportion of ALTE patients who met and those who did not meet the BRUE criteria and assessed the diagnoses and outcomes of each group. ⋯ Many of the patients with ALTE were classified into the ALTE-not-BRUE group, suggesting that replacing ALTE with BRUE is difficult. Although patients classified as lower-risk BRUE showed no adverse outcomes, there were only a few of them. In the pediatric emergency medicine setting, the BRUE risk classification may be beneficial for certain patients.
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Pediatric emergency care · Jul 2023
Viral Detection Is Associated With Severe Disease in Children With Suspected Community-Acquired Pneumonia.
To evaluate the role of virus detection on disease severity among children presenting to the emergency department (ED) with suspected community-acquired pneumonia (CAP). ⋯ The detection of a virus in the nasopharynx was associated with more severe disease compared with no virus; this finding persisted after adjustment for age, biomarkers, and radiographic findings. Viral testing may assist with risk stratification of patients with lower respiratory tract infections.
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Pediatric emergency care · Jul 2023
Early Intravenous Magnesium Sulfate Administration in the Emergency Department for Severe Asthma Exacerbations.
Severe asthma exacerbations in pediatric patients occur frequently and can require pediatric intensive care unit (PICU) admission. ⋯ Early administration of IVMg to pediatric patients experiencing severe asthma exacerbations does not result in fewer PICU admissions.