Pediatric emergency care
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Pediatric emergency care · Feb 2022
Meta AnalysisManagement of Toddler's Fracture: A Systematic Review With Meta-Analysis.
In studies that included children diagnosed with toddler's fractures (TFs), we determined the fracture-related adverse outcomes in those treated with immobilization versus no immobilization. Furthermore, we compared health services utilization between these 2 immobilization strategies. ⋯ In children with TF, this study suggests that no immobilization may be a safe alternative to immobilization for this minor fracture; however, high-quality evidence is needed to optimally inform clinical decision making. Future work should include validated measures of patient recovery, pain, and caregiver perspectives when comparing treatment strategies for this injury.
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Pediatric emergency care · Feb 2022
Randomized Controlled TrialInfant Cardiopulmonary Resuscitation Quality While Walking Fast: A Simulation Study.
This study focuses on the characteristics (feasibility, resuscitation quality, and physical demands) of infant cardiopulmonary resuscitation (CPR) on the forearm during fast walking, performed by a trained lay rescuer. ⋯ In conclusion, pediatric walking CPR is feasible although it represents a slight quality decrease in a simulation infant CPR setting. The option "CPR while walking fast to a safe place" seems to be suitable in terms of safety both for the victim and the rescuer, as well as CPR quality in special circumstances.
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Pediatric emergency care · Feb 2022
Randomized Controlled TrialComparison of Different Clinical Decision Support Tools in Aiding Dental and Medical Professionals in Managing Primary Dentition Traumatic Injuries.
Many patients are taken to the emergency room for dental trauma treatment, but studies reveal that medical professionals do not feel confident in diagnosing and treating children with traumatic dental injuries. The purpose of this study was to determine if a clinical decision support tool (CDST) would improve dental trauma knowledge of primary teeth in medical students and pediatric dentists. Another purpose was assessing effectiveness of print and mobile app CDSTs. ⋯ Both print and mobile app CDSTs improved diagnosing and managing traumatic dental injuries in primary dentition significantly compared with those without aid. Medical students with CDSTs showed significant improvement in managing primary dental trauma; therefore, it is recommended for better, more accurate diagnosis and treatment in patients.
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Pediatric emergency care · Feb 2022
Characteristics and Outcomes of Pediatric Patients With a Ventricular Assist Device Presenting to the Emergency Department.
A growing number of children receive support from left ventricular assist devices (LVADs) in the outpatient setting. Unexpected complications of LVAD support occur that require emergent management, and no studies examine how pediatric LVAD patients present to the emergency department (ED). The goals of this study were (1) to describe frequency of visits, clinical characteristics, adverse events, and outcomes of LVAD-supported children treated in ED settings and (2) to evaluate for associations between specified patient outcomes and ED care location. ⋯ Among subjects in a single outpatient pediatric VAD program presenting to the ED, the most common complaints were abdominal pain/vomiting, fever, and headache. The most common adverse events were major infection and right heart failure. Subjects had a high rate of ED utilization and hospital admission.
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Pediatric emergency care · Feb 2022
Randomized Controlled TrialImproving Resuscitation Timing: Random Assignment of Interprofessional Team Leaders in Simulated Resuscitation.
The aims of the study were to assess whether preassigning a team leader influences resuscitation timing using simulation and to examine relationship between response timeliness and designated leader's profession, whether physician or nurse. ⋯ The leader-assigned teams and controls did not differ in resuscitation timeliness. Among leader-assigned teams, the differences in time to BVM between physician- and nurse-led teams were not statistically significant. However, all 6 nurse-led teams demonstrated timely resuscitation, suggesting a direction for future research on the feasibility of bedside nurses taking the lead during resuscitation, pending code team arrival.