Pediatric emergency care
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Pediatric emergency care · Aug 2021
Observational StudyEffect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study.
The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. ⋯ After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.
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Pediatric emergency care · Aug 2021
Eliminating Lumbar Puncture for Low-Risk Febrile Infants: A Quality Improvement Initiative.
Bacterial meningitis in low-risk febrile young infants (FYIs) aged >28 days has become increasingly rare. Routine performance of lumbar puncture (LP) in these infants is associated with adverse consequences and may be unnecessary. We modified our clinical practice guideline (CPG) to reduce the number of FYIs 29 to 56 days old who receive LP. ⋯ A change in CPG reduced the number of LPs performed in febrile infants 29 to 56 days old. This change resulted in fewer LPs, hospitalizations, ED revisits, and a lower ED length of stay for FYIs 29 to 56 days old.
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Pediatric emergency care · Aug 2021
Case ReportsFlorid Scurvy in an Autistic Child on a Ketogenic Diet.
Ketogenic diets used for treating various neurological disorders can have potentially serious adverse effects. Among these is scurvy, a rarely reported, yet potentially fatal adverse effect of the ketogenic diet caused by vitamin C deficiency. ⋯ We have also reviewed the clinical indications and adverse effects of ketogenic diets with special reference to scurvy. This case emphasizes the importance of vitamin supplements in patients consuming a special diet.
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Pediatric emergency care · Aug 2021
Timing of Button Battery Removal From the Upper Gastrointestinal System in Children.
The aim of the study was to investigate the appropriate time of removal of button batteries (BB) from the esophagus and stomach in children. ⋯ Button batteries ingestion is a common problem with variable time of presentation to the emergency department. Esophageal BB presents the highest risk of injury even in as short time as 2 hours. Gastric mucosal injury can occur within 10 hours of ingestion. Button batteries of 20-mm diameter need to be urgently removed from the esophagus and be considered for removal earlier than 24 hours if in the stomach.
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Pediatric emergency care · Aug 2021
Code Team Structure and Training in the Pediatric Resuscitation Quality International Collaborative.
Code team structure and training for pediatric in-hospital cardiac arrest are variable. There are no data on the optimal structure of a resuscitation team. The objective of this study is to characterize the structure and training of pediatric code teams in sites participating in the Pediatric Resuscitation Quality Collaborative. ⋯ Code team structure, equipment, and training vary widely in a survey of international children's hospitals. The variations in team composition, role assignments, equipment, and training described in this article will be used to facilitate future studies regarding the impact of structure and training of code teams on team performance and patient outcomes.