Pediatric emergency care
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Pediatric emergency care · Jan 2025
Presence of Sonographic Secondary Signs Without Visualization of Appendix Is Indicative of Appendicitis in Children Younger Than 5 Years.
Diagnosis of acute appendicitis is more difficult in children aged 0-4 years due to atypical clinical presentation, leading to delay in diagnosis and higher incidence of complications. Nonvisualization of the appendix on ultrasound increases diagnostic challenge. We examined the utility of standardized reporting of sonographic secondary signs of appendicitis in children younger than 5 years with nonvisualization of the appendix. ⋯ Presence of secondary signs without visualization of the appendix was shown to be indicative of appendicitis, with high suspicion for complicated appendicitis, in patients younger than 5 years. Further validation of the presence of secondary signs on right-lower-quadrant ultrasound may lead to more expedient diagnosis, reduction in cross-sectional imaging, and earlier treatment of complicated appendicitis.
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Pediatric emergency care · Jan 2025
Prehospital Restraint Use in Pediatric Patients With Mental and Behavioral Health Emergencies.
The aims of the study are to characterize children with mental and behavioral health conditions (MBH) transported by emergency medical services (EMS) and examine differences in patient, emergency department (ED), and EMS transport characteristics based on restraint interventions during EMS transport. ⋯ Nearly 1 in 10 pediatric patients experiencing mental health crises and transported by EMS required restraint interventions in the field. Male patients, younger aged children, and those picked up from school represent a distinct and vulnerable population that could benefit from specialized prehospital care to manage agitation.
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Pediatric emergency care · Jan 2025
Preferences for Management of Pediatric Pneumonia: A Clinician Survey of Artificially Generated Patient Cases.
It is unknown which factors are associated with chest radiograph (CXR) and antibiotic use for suspected community-acquired pneumonia (CAP) in children. We evaluated factors associated with CXR and antibiotic preferences among clinicians for children with suspected CAP using case scenarios generated through artificial intelligence (AI). ⋯ Ordering preferences for CXRs demonstrated similarities and differences with evidence-based risk models for CAP. Clinicians relied heavily on CXR findings to guide antibiotic ordering. These findings can be used within decision support systems to promote evidence-based management practices for pediatric CAP.
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Pediatric emergency care · Jan 2025
Caregiver Accompaniment in Pediatric Critical Care Transport: A Systematic Scoping Review.
Family-centered care is a critical component of critical care interfacility and medical retrieval transport (MRT) services. These services provide a critical bridge for a physiologically and psychologically unique population often best served in specialized, tertiary centers. Caregivers often wish to accompany patients during MRT. However, there is currently little research on the impact of caregiver accompaniment on MRT. ⋯ Caregivers and healthcare providers largely prefer caregiver accompaniment on MRT services. There is little data on patient perspectives and transport-related adverse events affecting patient outcomes.
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Pediatric emergency care · Jan 2025
Evaluation of Antivenom Therapy for Middle East Scorpion Envenomations.
Scorpion envenomation is a leading cause of envenomation in our region. Antivenom has been used successfully to treat the systemic manifestations of envenomations inflicted by toxic scorpions. Toxic scorpions common in our area include Leiurus quinquestriatus , Androctonus australis , and Buthus occitanus . This study describes the outcomes of children envenomated by these scorpions, and treated with SCORPIFAV, a polyvalent scorpion antivenom F(ab') 2 (equine), used since 2016 at our institution. ⋯ Patients treated with antivenom exhibited rapid resolution of symptoms without severe hypersensitivity. We recommend broadened availability of antivenom at sites where it is needed.