Pediatric emergency care
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Pediatric emergency care · Aug 2024
Ultrasound-Guided Hematoma Block for Distal Forearm Fracture Reduction in Adolescent With History of Difficult Airway: A Case Report.
Distal forearm fractures are frequently encountered in the pediatric emergency department and often require reduction. Procedural sedation is commonly used to facilitate reduction of these injuries, although it can be associated with potentially severe complications, particularly in patients with cardiorespiratory comorbidities. The ultrasound-guided hematoma block has been gaining popularity as an analgesic alternative in adult patients, but literature supporting its use in pediatric patients is limited. We describe a point-of-care ultrasound-guided hematoma block used to facilitate successful reduction of a distal radius fracture in an adolescent patient with a history of a difficult airway for whom procedural sedation would have posed considerable risk.
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Pediatric emergency care · Aug 2024
Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children.
Screening for blunt intra-abdominal injury in children often includes directed laboratory evaluation that guides need for computed tomography. We sought to evaluate the use of urinalysis in identifying patients with clinically important intraabdominal injury ( ci -IAI). ⋯ Microscopic hematuria was not a useful marker for ci -IAI and may lead to falsely assuming a more serious injury.
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Pediatric emergency care · Aug 2024
Multicenter StudyUsability Testing Via Simulation: Optimizing the NEAR4PEM Preintubation Checklist With a Human Factors Approach.
To inform development of a preintubation checklist for pediatric emergency departments via multicenter usability testing of a prototype checklist. ⋯ Simulation-based, human factors usability testing of the National Emergency Airway Registry for Pediatric Emergency Medicine Preintubation Checklist allowed optimization prior to clinical implementation. Next steps involve integration into real-world settings utilizing rigorous implementation science strategies, with concurrent evaluation of the impact on patient outcomes and safety.
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Pediatric emergency care · Aug 2024
Volar Distal Radius Buckle Fractures: Is Bracing and Home Management Safe?
A removable brace with home management is widely accepted treatment for distal radius buckle fractures, which most commonly involve the dorsal cortex. ⋯ When diagnosis of volar buckle fracture is made using the same strict criteria used for dorsal buckle fractures, removable brace and home management treatment is safe. Shared decision making with caregivers may alter buckle fracture treatment.