Pediatric emergency care
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Pediatric emergency care · Dec 2022
Risk Factors for Death and Severe Neurological Sequelae in Childhood Bacterial Meningitis.
Acute bacterial meningitis (ABM) continues to be a challenge from a diagnostic and therapeutic point of view. Identifying severity risk factors and predictive scores may guide interventions to reduce poor outcome. ⋯ The present score accurately discriminated the probability of death in children hospitalized with ABM, and it could be a useful tool to select candidates for admission to the intensive care unit and for adjunctive therapy in clinical trials.
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Pediatric emergency care · Dec 2022
ReviewAdolescent Confidentiality and Consent in an Emergency Setting.
The adolescent population comprises a large volume of emergency department visits each year. A recent study showed that 20% of the ambulatory care visits of adolescent patients aged 15 to 25 years were made to the emergency department. This specific population often has poor access to health care and often is a vulnerable population, causing medical care to be a challenge. The purpose of this article was to review the standard practice and the specific laws regarding confidentiality and consent when treating an adolescent patient to provide the best possible care and treatment. ⋯ Patient confidentiality and informed consent are complex and complicated topics when dealing with the pediatric patient. Although some laws may vary state to state, there are specific details regarding adolescent confidentiality and informed consent that every provider should be aware of. The adolescent population is more likely to seek emergency care if the visit is confidential and the patient feels a sense of trust. Although it is important for providers to respect patient confidentiality when treating adolescents, it is also important for providers to encourage adolescents to confide in their parents regarding health issues.
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Pediatric emergency care · Dec 2022
Case ReportsUltrasound-Guided Supraclavicular Brachial Plexus Blocks Performed by Pediatric Emergency Medicine Physicians for Painful Orthopedic Procedures in a Pediatric Emergency Department-A Case Series.
The aim of this study was to describe our experience with ultrasound-guided supraclavicular brachial plexus blocks performed by pediatric emergency physicians for the purpose of forearm fracture reductions in the emergency department. ⋯ We conclude that in select pediatric cases ultrasound-guided brachial plexus blocks can be a safe, swift, and efficient means of pain management and procedural analgesia. This approach obviates the need for sedation, thus shortening the time lag between presentation and the reduction procedure, as well as overall length of stay.
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Pediatric emergency care · Dec 2022
Case ReportsPoint-of-Care Ultrasound and the Discovery of Pulmonary Arterial Hypertension in a Teenager.
We present a case of a teenage patient with new-onset cardiac symptoms discovered to have primary pulmonary arterial hypertension. Point-of-care ultrasound used early in the patient's presentation identified significant right-sided heart dilatation and dysfunction despite the patient's relatively unrevealing physical examination. This article emphasizes the utility of performing focused cardiac ultrasound in pediatric patients early in their presentation. We briefly review focused cardiac ultrasound technique and highlight relevant literature.
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Pediatric emergency care · Dec 2022
Overutilization of Radiographs for Pulled Elbow Among Orthopedic Surgeons Compared With Pediatricians.
Electronic medical records of the largest health provider in Israel, which provides health services to more than 50% of the population, were reviewed for pulled elbow cases between 2005 and 2020. Patients aged 4.5 months to 7 years were included. Demographic information, the discipline of the treating physician, and acquisition of elbow radiographs were gathered. ⋯ Orthopedic surgeons use elbow radiographs much more than pediatricians; effort should aim at reducing the imaging rate for this population.