Pediatric emergency care
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Pediatric emergency care · Sep 2023
Moral Distress and Its Relating Factors Among Pediatric Emergency Department Nurses: A Cross-Sectional Study.
Emergency services are patient circulation units that require chaos, trauma, and high tension. It was aimed to determine the moral distress levels of pediatric nurses in pediatric emergency and emergency departments and relevant factors. ⋯ It was found in the study that nurses had low levels of moral distress; however, many factors relevant to working conditions were associated with moral distress. The pediatric emergency service nurses were determined to experience a higher moral distress compared with the emergency department nurses serving pediatric patients.
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Pediatric emergency care · Sep 2023
Observational StudyStroke Volume Measurements by Echocardiography and Ultrasonic Cardiac Output Monitor in Children: A Prospective Observational Cohort Study.
Stroke volume (SV) and cardiac output monitoring is a cornerstone of hemodynamic assessment. Noninvasive technologies are increasingly used in children. This study compared SV measurements obtained by transcutaneous Doppler ultrasound techniques (ultrasonic cardiac output monitor [USCOM]), transthoracic echocardiography jugular (TTE-J), and parasternal (TTE-P) views performed by pediatric intensivists (OP-As) with limited training in cardiac sonography (20 previous examinations) and pediatric cardiologists (OP-Bs) with limited training in USCOM (30 previous examinations) in spontaneously ventilating children. ⋯ Our findings show that the methods are not interchangeable because SV values by USCOM are higher in comparison with the SV values obtained by TTE. Both methods have low level of intraobserver variability. The SV measurements obtained by TTE-P were significantly lower compared with the TTE-J for the operator with limited training in echocardiography. The TTE-P requires longer practice compared with the TTE-J; therefore, we recommend to prefer TTE-J to TTE-P for inexperienced operators.
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Pediatric emergency care · Sep 2023
Risk Factors for Failure of Closed Forearm Fracture Reduction in the Pediatric Emergency Department.
This study aimed to explore risk factors for failure of forearm fracture closed reduction in the pediatric emergency department (ED) and to suggest indications for initial surgery. ⋯ Most pediatric forearm fractures can be successfully managed by closed reduction in the ED. Two-bone fractures had the strongest association with reduction failure. Refracture, open fracture, midshaft location, initial radius bone translation of 37% and higher (and not initial angulation), and patient age of 10 years and older are independent risk factors for reduction failure in two-bone fractures. We propose a risk score for reduction failure that can serve as a decision-making tool.
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Pediatric emergency care · Sep 2023
Observational StudyPediatric Croup Due to Omicron Infection Is More Severe Than Non-COVID Croup.
Croup due to infection with the omicron variant of COVID is an emerging clinical entity, but distinguishing features of omicron croup have not yet been characterized. We designed a study to compare the clinical features of croup patients presenting to the pediatric emergency department pre-COVID pandemic with COVID-positive croup patients who presented during the initial omicron surge. ⋯ Pediatric patients with omicron croup develop more severe disease than do children with classic croup. They are more likely to require additional emergency department treatments and hospital admission than patients with croup before the COVID pandemic.
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Pediatric emergency care · Sep 2023
Review Case ReportsPoint-of-Care Ultrasound for the Diagnosis of Pediatric Foreign Body Ingestion: A Narrative Review and Illustrative Case Report.
Foreign body ingestion (FBI) is a frequent concern in emergency departments. Clinical guidelines recommend performing plain x-rays as the primary modality of diagnosis. Although point-of-care ultrasound (PoCUS) has increasingly been integrated into the daily practice of emergency medicine, it has been poorly investigated in the diagnostic approach for FBI.This review aims to highlight the current state of PoCUS use for pediatric FBI.The following research question was considered in this narrative review: Is PoCUS useful for FBI management? ⋯ This review suggests that PoCUS might be a reliable modality for the initial management of FBI. PoCUS can locate, identify, and evaluate the size of the FB in a wide range of materials and gastrointestinal locations. Point-of-care ultrasound could eventually become the go-to modality in the case of radiolucent FB, thus avoiding the use of radiation. Further studies are nevertheless required to validate PoCUS use for FBI management.