Pediatric emergency care
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This pilot study aims to identify potential predictors of postadmission interventions of hospitalized croup patients and derive a risk model aimed at reducing hospitalizations for croup. ⋯ There appear to be promising predictors in croup patients presenting to the ED, which might help stratify risk for interventions after the ED encounter and thus reduce the number of potentially avoidable admissions.
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Pediatric emergency care · Dec 2021
Identifying Predictors of Physical Abuse Evaluation of Injured Infants: Opportunities to Improve Recognition.
To identify predictors of physical abuse evaluation in infants younger than 6 months with visible injury and to determine the prevalence of occult fracture and intracranial hemorrhage in those evaluated. ⋯ About half of preambulatory infants with visible injury were not evaluated for physical abuse. Targeted education is recommended as provider experience and training influenced the likelihood of physical abuse evaluation. Occult fractures and intracranial hemorrhage were often found in infants presenting with seemingly isolated "minor" injuries. Physical abuse should be considered when any injury is identified in an infant younger than 6 months.
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Pediatric emergency care · Dec 2021
A Paper-Based Car Seat Safety Educational Intervention in the Pediatric Emergency Department.
Motor vehicle crashes are a leading source of pediatric morbidity and mortality in children younger than 13 years. Proper car seat safety device (CSD) markedly reduces mortality, but the majority of families misuse them. Emergency department (ED)-based educational interventions can improve knowledge patient regarding proper CSD use but historically have been resource intensive. Our study evaluated the utility of a novel educational intervention in improving patient knowledge of proper CSD use and in evaluating for proper CSD installation. ⋯ A paper-based educational intervention in the pediatric ED is well received by parents, may improve patient knowledge surrounding proper CSD use, and encourages some families to get their CSDs checked for proper installation.
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Pediatric emergency care · Dec 2021
Pediatric Rib Fractures Identified by Chest Radiograph: A Comparison Between Accidental and Nonaccidental Trauma.
The objective of this study was to determine the prevalence of rib fractures (RFs) identified by chest x-ray (CXR) among children younger than 2 years who sustained accidental versus nonaccidental injuries. It is hypothesized that RFs are uncommon among all accidental pediatric trauma mechanisms (eg, falls, motor vehicle crashes) as compared with the prevalence of RFs in the setting of nonaccidental trauma (NAT). ⋯ The presence of RFs in pediatric accidental trauma is uncommon even in the setting of high-force mechanisms, and when identified, these RFs are acute. Comparatively, the overall prevalence of RFs identified on CXR among cases with a final diagnosis of NAT was much higher and almost exclusively healing RFs. These data provide support that identification of RFs is highly concerning for NAT even if an accidental mechanism is provided. When RFs are identified, a full NAT work-up should be considered.
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Pediatric emergency care · Dec 2021
Credentialing Pediatric Emergency Medicine Faculty in Point-of-Care Ultrasound: Expert Guidelines.
As point-of-care ultrasound (POCUS) becomes standard practice in pediatric emergency medicine (PEM), it is important to have benchmarks in place for credentialing PEM faculty in POCUS. Faculty must be systematically trained and assessed for competency in order to be credentialed in POCUS and granted privileges by an individual institution. Recommendations on credentialing PEM faculty are needed to ensure appropriate, consistent, and responsible use of this diagnostic and procedural tool. It is our intention that these guidelines will serve as a framework for credentialing faculty in PEM POCUS.