Pediatric emergency care
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"One Pill Can Kill" is a meme originating in the 1990s. This construct lists pharmaceuticals that have the alleged potential for fatality after the ingestion of a single pill by a toddler. ⋯ The negative outcome of the one pill can kill construct is inappropriate management manifested by over-referral of young children by poison centers to emergency departments for care, overly prolonged emergency department observation and needless hospital admissions. A more accurate construct is that one pill of anything other than opioids will not kill anybody with the caveat being that we are referring to regulated pharmaceuticals.
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Pediatric emergency care · Jul 2024
Unveiling the Dark Side of Datura in Pediatric Poisoning With Insights From Jordanian Experience: A Retrospective Clinical Study.
Datura stramonium , jimsonweed, is a toxic plant with hallucinogenic properties. Although there are many studies on Datura poisoning, none reported cases in Jordan. This study offers a comprehensive review on D. stramonium ingestion, covering its epidemiology, clinical presentation, and treatment. We aimed to provide better understanding of the factors for Datura ingestion, identify prevention and management strategies, and address research challenges. ⋯ Understanding the risks associated with D. stramonium poisoning and implementing effective prevention and management strategies are crucial. This study highlights the importance of recognizing Datura poisoning as a potential diagnosis in children presenting with unexplained anticholinergic symptoms or agitation to the emergency room.
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Pediatric emergency care · Jul 2024
Diagnostic Accuracy of the World Health Organization Pediatric Emergency Triage, Assessment and Treatment Tool Plus Among Patients Seeking Care in Nairobi, Kenya: A Cross-sectional Study.
The World Health Organization developed Emergency Triage Assessment and Treatment Plus (ETAT+) guidelines to facilitate pediatric care in resource-limited settings. ETAT+ triages patients as nonurgent, priority, or emergency cases, but there is limited research on the performance of ETAT+ regarding patient-oriented outcomes. This study assessed the diagnostic accuracy of ETAT+ in predicting the need for hospital admission in a pediatric emergency unit at Kenyatta National Hospital in Nairobi, Kenya. ⋯ ETAT+ demonstrated diagnostic accuracy for predicting patient need for hospital admission. This finding supports the utility of ETAT+ to inform emergency care practice. Further research on ETAT+ performance in larger populations and additional patient-oriented outcomes would enhance its generalizability and application in resource-limited settings.
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Pediatric emergency care · Jul 2024
Utility of Synovial Fluid Biomarkers for Culture-Positive Septic Arthritis in a Lyme Disease-Endemic Region.
To evaluate the performance of synovial fluid biomarkers to identify children with culture-positive septic arthritis. ⋯ None of the routinely available synovial fluid biomarkers had sufficient accuracy to be used in isolation in the identification of children with septic arthritis. New approaches including multivariate clinical prediction rules and novel biomarkers are needed.
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Pediatric emergency care · Jul 2024
Randomized Controlled Trial Comparative StudyComparison of Ultrasound Guided Saline Enema and X-ray-Guided Air Enema in the Treatment of Intussusception Reduction in Children.
To compare the effect of ultrasound guided saline enema (USGSE) and x-ray fluoroscopic air enema in the reduction of intussusception in children, 80 children with intussusception were randomly divided into ultrasonic-guided saline enema reduction in 40 cases (USGSE group) and x-ray air enema reduction in 40 cases (air enema group). The enema pressure, success rate, average time, and cost of the 2 methods were compared. The average operation time of the USGSE group was lower than that of the air group ([5.35 ± 1.79] min vs [6.03 ± 2.41] min, P = 0.159), the average pressure of the air group was higher than that of the air group ([10.95 ± 1.54] kPa vs [9.6 ± 1.26] kPa; P < 0.001), the success rate of resetting was higher than that of the air group (87.5% vs 85.0%; P = 0.745), and the cost of USGSE was lower than that of the air group ([339.23 ± 10.73] yuan vs [378.23 ± 18.20] yuan, P < 0.001). ⋯ The success rate and operation time of USGSE in pediatric intussusception reduction are similar to that of air enema, and the advantages of low cost and no radiation are worthy of popularization. For children with onset time ≥48 hours, enema reduction is safe and effective, but the conversion rate to open is high. It is necessary to carefully identify the symptoms of intestinal perforation and necrosis on the basis of strictly following the indications to avoid delayed treatment.