Pediatric emergency care
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Pediatric emergency care · Feb 2024
A Comparison of State-Specific Pediatric Emergency Medical Facility Recognition Programs, 2020.
Prior research suggests that the presence of state-specific pediatric emergency medical facility recognition programs (PFRPs) is associated with high emergency department (ED) pediatric readiness. The PFRPs aim to improve the quality of pediatric emergency care, but individual state programs differ. We aimed to describe the variation in PFRP characteristics and verification requirements and to describe the availability of pediatric emergency care coordinators (PECCs) in states with PFRPs. ⋯ There is variation in state PFRPs, although all prioritize the presence of a PECC. We encourage further research on the effect of different aspects of PFRPs on patient outcomes.
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Pediatric emergency care · Feb 2024
Ten-Year Analysis of Complications Related to Simple Basilar Skull Fractures in Children Presenting to a Trauma Center.
Head trauma is a common presenting complaint among children requiring urgent medical attention, accounting for more than 600,000 emergency department (ED) visits annually, 4% to 30% of which identify skull fractures among the patient's injuries. Previous literature shows that children with basilar skull fractures (BSFs) are usually admitted for observation. We studied whether children with an isolated BSF have complications precluding them from safe discharge home from the ED. ⋯ Our findings suggest that patients with uncomplicated BSFs can be safely discharged from the ED if the patient has reliable follow-up, is tolerating oral fluids, has no evidence of cerebrospinal fluid leak, and has been evaluated by appropriate subspecialists before discharge.
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Pediatric emergency care · Feb 2024
Use of a Rubric for Pediatric Emergency Medicine Fellowship Application Review.
There is a need to review a large number of applications for pediatric emergency medicine fellowship in a holistic and systemic, unbiased manner. There exists a need to restructure the application process. We sought to develop and implement a rubric screening rubric for initial evaluation of pediatric emergency medicine fellowship applications that avoided traditionally used metrics that may be biased against racially underrepresented groups who are historically excluded from medicine. ⋯ Developmental and use of a rubric screening allowed our institution to reflect on our priorities, as well as avoid potential bias. The use of the tool allowed us to communicate about applications in an objective and consistent manner. As we continue to iterate on the rubric, we hope to incorporate additional criteria to better identify highly qualified applicants who may otherwise be overlooked in a traditional screening process and gain familiarity in reviewers use.
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Pediatric emergency care · Feb 2024
Regional Anesthesia as an Alternative to Procedural Sedation for Forearm Fracture Reductions in the Pediatric Emergency Department.
Pediatric forearm fractures are common injuries in the pediatric emergency department (PED). Pediatric procedural sedation (PPS) is often required for forearm fracture reductions and pain control for casting. Bier blocks and hematoma blocks are types of regional anesthesia (RA) procedures that can be performed as a potential alternative to PPS. ⋯ Bier blocks and hematoma blocks are an acceptable alternative to PPS for children requiring forearm reductions. The AE rate is low and the reduction success rate is high. Duration of treatment in the PED is shorter for patients receiving RA compared with PPS.
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Pediatric emergency care · Feb 2024
Pushing Backwards: Evaluating Effectiveness of Conservative Treatment of Intestinal Intussusception.
Intestinal intussusception (II) is a common cause for acute abdomen in children, occurring in 0.33 to 0.71 per 1000 children per year. Early diagnosis and treatment are fundamental for prevention of irreversible intestinal damage. The first line of treatment is conservative, with saline reduction enema or air reduction enema. Our goal is to evaluate results with conservative treatment of II in children. ⋯ Conservative treatment in II is a safe and effective option, preventing invasive surgical procedures. Effectiveness of such treatments may be as high as 88% after 1 attempt, with rapid diet reintroduction. Same-day discharge after oral feeding toleration is safe.